Practice Quiz

NREMT EMR First Responder

Category - Special Patient Populations

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Which of the following pediatric patient interactions is most concerning for child abuse?
  1. A 2-year-old male who fell from a tree. The EMR notices bruises on the child’s forehead, knees, and multiple abrasions on his arms. The mother states, “He is a very active child”
  2. An 8-year-old female who fell and struck her head. You note bruising on the back of both legs above the knee, along with a large bruise on the right side of her abdomen. When questioned, the child states, “I fall a lot.” The patient’s stepfather does not provide any information
  3. A 6-month-old who is not using their right arm despite no known injury. When questioned, the family states that the brother may have been swinging the child around. The father adds, “I may have picked him up by the arm suddenly”
  4. All of the above are concerning and should be reported
Explanation
Answer: B - An 8-year-old female is beyond the age of very frequent falls causing multiple bruises. Furthermore, bruising in soft tissue areas such as the abdomen, and back of the upper legs is atypical and should be investigated. A 2-year-old can be very active and can fall a lot. All wounds are consistent with an active young boy. Answer C describes a child with a nursemaid’s elbow. This injury is very common in children less than 2 years of age and is a result of being lifted by one or both arms while externally rotated.
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