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. You are a resident in the emergency department. An irate parent comes to you
furious because the social worker has been asking him about striking his
child. The child is a 5-year-old boy who has been in the emergency
department four times this year with several episodes of trauma that did
not seem related. Today, the child is brought in with a child complaint of
"slipping into a hot bathtub" with a burn wound on his legs. The parent
threatens to sue you and says "How dare you think that about me? I' love
my son!" What should you do?
a. Give reassurance to the parents and treat, the patient's injury
b. Ask risk management to evaluate the case.
c. Admit the child to remove him from the possibly dangerous
d. Call the police.
e. Ask the father yourself if there has been any abuse.
f. Speak to the wife privately about possible episodes of abuse.
g. Explain to the parents that the next time this happens you will have to
call child protective services.
h. Report the family to child protective services.
i. Give the parents a referral to a family therapist they can see with the
child the following weekAlthough, in general, it is better to address issues directly with patients
and their families, this is not the case when you strongly suspect child
abuse. Reporting of child abuse is mandatory even based on suspicion
alone. Although it is frightening to be confrontational with the family, the
caregiver is legally protected even if there turns out to be no abuse as
long as the report was made honestly and without malice. You do not
have the authority to remove the child from the custody of the parents.
Only child protective services or the courts can do that. The police would
be appropriate for an assault happening at that exact moment, but the
police are not appropriate to investigate child abuse. When you have a
suspicion of child abuse, it doesn't matter what the parents say. That is
why talking directly to the mother or father is incorrect. When you suspect
abuse, even if the family denies it, you must still report.

what should we do first?

should we take custody of the child or should we report first?

I am confused,,




admit the child


I would say report first. It is a sad situation to see a helpless child become a victim of abuse. Even if the parent says they love their child the abuse can still happen. I wold report on the smallest sign of abuse, you never can be too careful.

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