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Published on: February 23, 2024
A Systematic Review of Pediatric Nonaccidental Burns: Protecting the Children Through Knowledge, Vigilance, and
Konstantinos Gasteratos1, Michelle McCarthy2, Danai Chatziathanasiou3
1From the Feinstein Institutes for Medical Research, Manhasset, New York.
Insights
Pediatric nonaccidental burns (PNABs) are often caused by forced immersion scalds. Healthcare professionals must recognize abuse signs, report suspected cases, and implement prevention strategies to protect children from harm.
Area of Science:
- Pediatric medicine
- Child abuse
- Burn injuries
Background:
- Pediatric nonaccidental burns (PNABs) present significant medical and psychosocial challenges.
- PNABs are a relatively common form of child abuse requiring increased awareness.
- Early recognition and accurate diagnosis are crucial for intervention and prevention.
Approach:
- A systematic literature search was performed using PubMed, Google Scholar, and Cochrane databases up to November 2020.
- The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol guided the review process.
- Three independent reviewers screened articles using the Covidence tool, adhering to predefined inclusion/exclusion criteria.
Key Points:
- Forced immersion scalds affecting hands and feet were the predominant mechanism in reported PNABs.
- Complications included infections, sepsis, and the need for intensive care.
- Parental factors associated with abuse included mental illness, substance abuse, unemployment, and low income.
Conclusions:
- Forced immersion scalds remain the most frequent cause of PNABs.
- Healthcare providers must be vigilant in identifying subtle abuse indicators and reporting concerns.
- Prevention and education are essential to combat this societal issue and protect children.
Background:
Inflicted burns on children are a particularly difficult medical and psychosocial issue. Pediatric nonaccidental burns (PNABs) are unfortunately relatively common. In our study, we aim to present the key findings on PNABs with the intention of raising awareness, improving early, and recognizing accurately by identifying red flags, developing triage tools, and establishing prevention strategies for this sensitive issue.
Methods:
A computerized literature search was conducted on PubMed, Google Scholar, and Cochrane for articles published until November 2020. The online screening process was performed by 3 independent reviewers with the Covidence tool against set inclusion/exclusion criteria. The protocol was reported using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO).
Results:
A total of 12 studies were included for analysis. Scald burns via forced immersion accounted for the majority of reported PNABs affecting both feet and hands. Complications included wound infection, sepsis, requiring systemic antibiotics, or intensive care. Abused children's parents had a history of mental illness, unemployment, substance abuse, incarceration, and/or low annual income.
Conclusions:
Scalds via forced immersion remain the most common mechanism of PNABs. All health care professionals must remain vigilant, be able to recognize subtle signs of abuse, triage patients appropriately, report to police and/or social services, and ensure no further harm is made to the child or children. Repeated abuse with burns can lead to death. Prevention and education are the cornerstones for addressing this social phenomenon.
