We’ve all heard stories about babies crying through the night and neighbors calling the police on the parents because they were annoyed. But what about the child crying because they need genuine help and no one calls?
Every U.S. state has minimum standards and mandatory reporting of child abuse laws; the list of mandated reporters includes EMTs, firefighters, teachers, nurses, social workers and more when they are operating within their respective roles.
New York State does not have a “Duty to Act” law if the individual is off-duty and out-of-uniform; if the off-duty EMT does report suspected child abuse, it is done as a private citizen. Private citizens are encouraged to report suspected child abuse. On duty mandatory reporters can be charged with a Class-A misdemeanor if they fail to report suspected child abuse. Knowingly and falsely reporting child abuse can also be charged with a misdemeanor.
Many incidents of child abuse have gone unreported for a variety of reasons, including: thinking that simply mentioning the suspicion to an ER nurse is sufficient; not recognizing the signs of child abuse; fear of reporting a non-existing case and getting the parents or self in trouble; a perceived lack of response from authorities; or not knowing what the procedure is (including the correct document to file) or who to forward it to. A child is considered to be anyone who is under the age of 18; child abuse warning signs can be neglect, physical trauma, emotional abuse, intentional malnourishment, and sexual abuse.
Be alert anytime you enter a scene involving a child and the scenario doesn’t match the “story”, if the information you are given is not consistent, or if the child appears to have an unnatural fear of a parent or guardian. Know that your report will only begin an investigation and so long as it is made in good faith, you will not get into trouble if your suspicions are wrong. If you suspect child abuse do NOT confront the parents/guardian and do not pass along your suspicions to the ER or police in front of the parents or child. Do make accurate notes of all findings on the PCR, but do not list your suspicions or any accusations on this legal document.
Here are some signs to watch for:
• Shaken Baby Syndrome – look for retinal hemorrhages, rib and long bone injuries, confusion or unconsciousness in a child under 3.
• Fractures — watch for uncommon fractures that are not consistent with the alleged accident or injury. An example, an infant that is not crawling or walking is unlikely to fall down a flight of stairs.
• Bruises — varying stages of multiple bruises, or in places not consistent with normal childhood play.
• Burns — children play and may be inquisitive, but multiple burns or unusual burns (such as multiple cigarette burns), or in unusual areas.
• Sexual Abuse — watch for complaints of pain or bleeding in the genital area or anus; if this abuse is suspected do not attempt to examine but do report this to the ER and document it thoroughly.
• Neglect — document it if a child appears malnourished or (long-term) unclean, if there has been a lack of needed medical care, if the supervising parent is drunk or under-the-influence, or if the child was found alone without supervision.
Make sure that you know your agency’s policies on mandatory reporting and which child services agency takes reports in your area. Be concise and thorough when filling out the reporting form (this is not the PCR) and include the child’s gender and age along with any complaints and findings. Include the names (if known) and relationships of any others found on scene with the patient along with your interpretation of their attitudes about the child and emergency. Make sure to document everything that pertains to this suspected child abuse case.
Remember that not every sign of child abuse actually IS child abuse, but on the chance that it is, you might save that child’s life if you report it through the proper channels.