Child abuse pediatric consults in the pediatric emergency department improve adherence to hospital guidelines

Background: Little data describes the role of child abuse pediatricians in consultation for physical abuse patients the pediatric emergency department. Objectives: To compare adherence in the emergency department to hospital physical abuse guidelines and need to return for testing between 2 groups: those receiving a child abuse consultation in the pediatric emergency department vs those who received standard emergency department care with subsequent child abuse review. Methods: We reviewed 471 records of visits to the pediatric emergency department for physical abuse. Data collected included demographics, studies performed, whether patients need to return after child abuse review, child abuse subpoenas, child abuse testimony in court. Results: Patients who received a child abuse consult in the emergency department or inpatient were more likely to be younger and to have more severe injuries. In cases where a consult was obtained, there was 100% adherence to emergency department clinical guidelines vs 66% when no consult was obtained. In addition, in cases that did not receive a child abuse consult, 8% had to return to the hospital for labs or radiographs after their emergency department visit. Conclusions: Child abuse consultation in the pediatric emergency department improves compliance with clinical guidelines and decreases the likelihood that patients will need to return for further testing.