Paediatrics

Non-Accidental Injury (Safeguarding)

Suspected inflicted injury is a safeguarding and clinical emergency when the injury, account, timing or developmental stage do not fit; act on serious concern without waiting to prove abuse.

Definition

Non-accidental injury is a commonly used clinical term for physical injury that may have been inflicted, or for injury whose explanation is absent, implausible, inadequate or inconsistent with the child, the developmental stage or the observed pattern. It sits within the broader safeguarding response to child maltreatment, which also includes neglect, emotional abuse and sexual abuse.

First principles

Concern is based on the whole pattern

Compare the injury with the child's developmental abilities, the proposed mechanism, timing and all available accounts. An implausible, inadequate or inconsistent explanation is an alerting feature, not a diagnosis; the absence of a perfect history does not make a serious injury safe.

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