How should suspected child abuse be addressed in the ED?

• A. Disregard if the family seems trustworthy
• B. Delay reporting until legal proceedings begin
• C. Follow mandatory reporting laws; document objective findings; ensure child safety; coordinate with protective services
• D. Only report if there is identifiable perpetrator

Answer: (C)

When there is suspected child abuse in the ED, the priority is to protect the child and follow the appropriate reporting and safety procedures. You should promptly report to the required child protective services or law enforcement per hospital policy and state law, rather than waiting for proof or a confirmed perpetrator. At the same time, gather and document objective, non-interpretive findings: detailed descriptions of injuries, their location and age (if known), the mechanism of injury as reported, the child’s developmental level, and any inconsistencies in the history. Record exact times, who was present, and what was observed; use direct quotes from the child if possible and note any caregiver statements separately from your observations. Take photographs or preserve evidence as allowed, and maintain a clear chain of custody for any potential documentation or samples. Ensure the child’s safety by assessing home environment risk, arranging for safe placement or admission if needed, and coordinating with social work and protective services to plan next steps. Maintain confidentiality and support the child and family through the process. Delaying reporting or ignoring suspicion can leave the child at ongoing risk and may be illegal, so the response emphasizes prompt reporting, thorough documentation, and coordinated protection.