Faculty

Needs Statement

Each year in the United States nearly one million children are victims of neglect and/or non-accidental trauma (NAT). Approximately three-quarters of all NAT fatalities occur in children under age three, and an estimated 12% of these fatalities involve families that had received CPS family preservation services in the 5 years preceding the fatal incident [1]. The annual societal cost of child abuse and neglect is estimated to be over $103 billion [2], but these estimates are likely conservative as identification of child victims of NAT is difficult and inconsistent, requiring that clinicians first suspect NAT as the mechanism of injury at presentation, and then correctly evaluate and manage the trauma as non-accidental [3].

1. US Department of Health and Human Services (2013). Child Maltreatment Children's Bureau Administration for Children, Youth, and Families.
2. Wang, C.-T., J. Holton and P. C. A. America (2007). Total estimated cost of child abuse and neglect in the United States, Citeseer.
3. Roach, J. P., S. N. Acker, D. D. Bensard, A. P. Sirotnak, F. M. Karrer and D. A. Partrick (2014). "Head injury pattern in children can help differentiate accidental from non-accidental trauma." Pediatric Surgery International 30(11): 1103-1106.

Target Audience

ED physicians and trauma physicians, to educate them on the prevalence and associated morbidity and mortality with NAT.

Objectives

After the completion of this activity, participants will be able to:

1. Recognize that 48% child fatalities each year are a result of physical abuse
2. Recognize that the majority of these children are < 4 years old
3. Discuss the fact that only 56% of cases are evaluated by a pediatric surgeon
4. Identify the risk factors and systematic screening programs that may help avoid escalation injuries which contribute to worse outcomes 

Accreditation

CME
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Kentucky College of Medicine, and Eastern Association for the Surgery of Trauma. The University of Kentucky College of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Kentucky College of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The University of Kentucky College of Medicine presents this activity for educational purposes only. Participants are expected to utilize their own expertise and judgment while engaged in the practice of medicine. The content of the presentations is provided solely by presenters who have been selected for presentations because of recognized expertise in their field.

ACGME Competencies

• Patient care
• Medical knowledge
• Systems-based practice

Faculty Disclosure

No speakers, authors, planners or content reviewers have any relevant financial relationships to disclose. 

The material presented in this course represents information obtained from the scientific literature as well as the clinical experiences of the speakers. In some cases, the presentations might include discussion of investigational agents and/or off-label indications for various agents used in clinical practice. Speakers will inform the audience when they are discussing investigational and/or off-label uses.

Content review confirmed that the content was developed in a fair, balanced manner free from commercial bias. Disclosure of a relationship is not intended to suggest or condone commercial bias in any presentation, but it is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Acknowledgement

This activity is jointly provided by the University of Kentucky and Eastern Association for the Surgery of Trauma.

The activity was supported by Pediatric Trauma Society.