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Reporting of child abuse by prehospital personnel
B R King1, M D Baker, S Ludwig
1Department of General Pediatrics, University of Pennsylvania School of Medicine, USA.
Insights
Many prehospital care providers lack knowledge on child abuse identification and reporting laws. Enhanced training in emergency medical services (EMS) education is recommended to improve recognition and reporting of suspected child abuse cases.
Area of Science:
- Emergency Medicine
- Pediatrics
- Public Health
Background:
- Prehospital (EMS) personnel are crucial in identifying child abuse (CA) as they often are the first trained responders in pediatric emergencies.
- Recognizing CA and understanding reporting procedures are vital for EMS providers due to their frequent home access.
Purpose of the Study:
- To assess the knowledge and attitudes of prehospital care providers regarding child abuse (CA).
- To evaluate understanding of CA identification and legal reporting mandates among EMS personnel.
Main Methods:
- A questionnaire was administered to prehospital care providers attending a pediatric emergencies seminar.
- The survey assessed factual knowledge of CA, reporting procedures, and provider attitudes toward CA.
Main Results:
- 58% of participants reported no prior CA training, and 69% misunderstood mandatory reporter legislation.
- While 56% claimed to have reported CA, only 33% had actually filed a report.
- A significant number of those who never reported believed they hadn't encountered CA, or were uncertain about reporting protocols.
Conclusions:
- Many emergency medical technicians (EMTs) and paramedics demonstrate gaps in understanding their role in CA identification and reporting.
- Further emphasis on CA in EMT and paramedic education, along with continuing education, is necessary to address these knowledge deficits.
Introduction:
Prehospital (EMS) personnel routinely enter patient's homes and often are the first trained persons to evaluate an ill or injured child. Therefore, it is vital for these individuals to recognize child abuse (CA), and to understand the proper procedures for reporting suspected cases.
Methods:
A questionnaire was administered to prehospital care-givers participating in a seminar on pediatric emergencies. Questions were designed to test factual knowledge of CA and the correct reporting procedures, as well as to evaluate attitudes toward CA.
Results:
There were 48 responses to the questionnaire; 34 (71%) were paramedics, the remainder were emergency medical technicians (EMTs) and/or registered nurses (RNs). Thirty-three (69%) practiced either in a rural or suburban setting. Subjects had an average of 10.8 years of prehospital emergency-care experience. Twenty-eight (58%) reported no previous training in CA. All participants understood the nature of CA, were able to identify the various forms of CA, and believed CA to be a significant problem. However, 33 (69%) did not understand the legislation that mandates reporter status, and while 27 (56%) claimed to have reported CA, only 16 (33%) had made a report either to police or to children's services workers. Of the 21 who never had reported a case of CA, 14 (67%) believed that they never had encountered an abused child. The remainder were not certain, and therefore, did not report, or thought that the hospital staff would report.
Conclusions:
While this subject deserves further study, it seems that many EMTs and paramedics lack a complete understanding of their role in the identification and reporting of CA. This information should be emphasized further in EMT and paramedic education, and should be reinforced through continuing education.