NON-ACCIDENTAL TRAUMA

About 1 in 7 children experienced child abuse and neglect in the last year.

Source: CDC reports

Child maltreatment is a leading cause of death and disability in the nation and New York State and a serious public health concern.

The very young are most at risk, with the victimization rate highest for children younger than 1 year of age, with younger children being the most vulnerable to death as a result of their injuries.

Diagnosing and treating child abuse is a complex process with additional education and training needed among providers who care for children. Child Abuse Pediatricians (CAPs), certified by the American Board of Pediatrics, have additional specialized training and experience in child abuse. Upstate is fortunate to have the Child Abuse Referral and Evaluation (CARE) Program and the Inpatient Child Abuse Pediatrician services available.

Founded in 1990, the CARE Program, through its offices at the McMahon Ryan Child Advocacy Center (CAC), provides medical evaluations for children who are suspected of being maltreated or abused.

The CARE team consists of two American Board of Pediatrics certified Child Abuse Pediatricians, specially trained nurse practitioners, a nurse, and social workers who work together in managing suspected child and adolescent victims of maltreatment

In the Fall of 2020, the CARE program expanded to include its Child Abuse

Pediatrics (CAP) consult service to better serve inpatient needs. This has been a highly successful service to ensure that all appropriate medical evaluations, communications with investigative agencies and safety plans are taking place.

Over the past few years, the child abuse team, together with the trauma team and other Non-Accidental Trauma (NAT) subcommittee members (PED providers, inpatient providers, SW, radiology, nursing quality and administration, and IMT) devoted time and resources to updating our Non-Accidental Trauma Protocols and guidelines. These guidelines are important in assisting the standardization of care as it relates to the identification of and treatment of NAT.

In 2021 and 2022, 169 patients (excluding burn) were entered into the trauma registry with a mechanism of injury of suspected physical NAT. The most common injury noted in these patients was that of bruises/contusions, with other common injuries including extremity fractures, skull fractures, and brain hemorrhages.

The child abuse team played a crucial role in the evaluation and treatment of these patients to ensure that all aspects of the protocols were in place, to aid the primary team in medical treatment and follow-up care as well to assist in the coordination of a safe discharge plan.

What are Children’s Advocacy Centers?

Children’s Advocacy Centers are child-friendly facilities that offer safety, security and a wide range of victim services for children and families that have been exposed to violence and abuse. These communitybased centers and their staff serve as first responders in allegations of all types of child abuse, and they provide direct services to children in need and in crisis. The CAC response works to reduce the impact of child abuse by bringing together law enforcement, criminal justice, child protection, forensic interviewers, prosecution, mental health, medical and victim advocacy professionals in a child-friendly setting to investigage abuse, hold offenders accountable, and most importantly help chilcren heal from the trauma of abuse.