Thoughtlessly polluted: behavior and behavior - Pediatric Switzerland

The term "non-medical trauma (NAT)" here prefers physical violence. On the basis of the study of the clinical case

The term "irregular trauma (Nat)" which is better here refers to physical abuse.Based on the clinical study studio, this article illuminates the challenges regarding the detection and assessment of injuries educated probably by external influence.The supply protocol is based on current scientific recommendations for improvement of NATs.

Gabriel (first facing name) is the immune system with a 4-or-baby birth, born in birth who do not care for children from the second born.Non -lenified.They know the family well because they were interested in the three -month -old siblings of the family discovery (Figure 1).They did not take it and then they assumed that this was due to Gabriel's place in the child's truck.

When Gabriel approves the symptoms of the "watchmen injuries",

Children's specialists - No time for medical care yet.Especially with doctors and parents.

The world is one of the main causes of childhood diseases and deaths.In the first year of life, children are at risk.Finding Nat is a challenge, especially for infants, which can lead to disagreements for different causes (2) .non-acd blood injuries ().Subdivision bleeding in the context of non-ISATOR skal bease trauma (Nash or dispute with head trauma, AHT), Bak NaV 1. Normal NAV is harmful (6).

Therefore, the obligation of NAT in a suspected injury is required for an additional explanation, which is suitable for the age and level of child's development to exclude the disease underlying in order to examine secret injuries on the one hand and on the other.

A diagnosis that was sometimes known

Although there is a significant progress in this regard

The corresponding lesions or symptoms may not be specific or not noticed in the case of a thing, it is a misuse of abuse, not the victim of abuse, or the knowledge assessment reflects the evaluation of the Wat Emotional stress task, especially if the bone maturity is convincing, convincing, aware of their own basics.

Given these difficulties, careful evaluation in connection with approaches based on evidence necessary for identifying endangered infants and preventing incorrect diagnosis (2).

Boat, reappear with an interesting job of violence

Finding side wounds: Not a very low warning signal

Gabriel rarely prevents it that adds unmarried child.

Cuts often go to childbirth, such as successful sports, such as a normal group. Why it should be a good memory to remember: It was not less than two (15).

In addition, such injuries cannot be used for public infants without progress, such as.DoHerand, clothing, clothing, clothing, clothing, clothing (15).

The proposed goods or known goods may be harmful to the theological members with Ingoaral (16).Abstract (16) (<24 hours) No. (15).

There are some cartoon research mentioned in the addicts, which the killers have suffered the worst injuries, found in murder, indicated about Babe's mistake.In general type. 6% of cases, the injury is known about the sitatiff for the doctor (20).

It was shown to many nuts children in many deaths and a large number of children have many colors.At that time the baby and two classmakers increased.

Sentinel injury is not only an additional effort to violence and unfairly, 23%) (3%) (2 22).34% of children under 11, 34% of children under the age of 24 months of thinking that (SS) (SS).

This data line has regained the importance of NAT's treatment and the importance of NAT's treatment, specialty, the most important view of X-X-X-EXIFys (25).In addition to infected children for explanation, 25% of patients have a break or high blood in 25% of cases (25).

These results show the importance of scratching and early detection of supernatural injuries, and they emphasize the need for systematic assessment of babies with smaller traumas and the addition of medical care and social care can be avoided and intensified in severe ways, in certain circumstances with death.

MOLOLOAR TO CRIBO NAR GARZAS to stand the protocol

Risk - Welfare - Development

According to the issue of large-scale issues, as suspects do not separate their proposals, such as in the risk of children in dangerous risk.

Sometimes a lift argument to limit this investigations is the burden in radiation in the skeletings.The Inver Accense of Screttal Divering (Initional and Formition and Asking 0.26 MSV (26). Except for children's hardness center, with Minime Risks.

Another threat is stigma and negative, which are often condemned by these interpretations.It can declare significant development to produce protocols and then implement on a regular basis (16).

Recognizing the disturbing factors of social risk or abnormal family interactions is still vital to be able to start an adequate accompanying (primary prevention), but now we know that these criteria are not very sensitive and also subjective and can also lead to the 16s.Having an injury to bilge should follow this injury regardless of the existence or lack of protective or risk factors (16).

The introduction of distribution protocols in the child's primary maintenance has led to better detection of NAT-saspfical injuries and promoted compliance recommendations (2, 27).Therefore, we assume that it is necessary to withdraw a clear detection approach in addition to the discovery of the campus, to ensure that the child's immediate safety is strictly evaluated, to consider a different diagnosis, and to arrange for radiation and laboratory tests appropriate for age and medical condition.

By clarifying such, whether there is a normal harmful disease in the media and examined by the media.Certified work at the hospital, cooperation, to ensure fast accessories and professionals properly at the right time for the necessary time (28) .Radelon Radelon should work and oversee it in 72 times to ask for the other treatments based on the description, and you can consider the child to consider.

For all the surveys associated with nurse remarks, a doctor must take a clinical tower unless the study must be an informal.As a test is because of the order of children, because the child's health and security should be important.

The principles of demonstrations of industrial countries will continue during the suspects in the world's claims.

The appendix 2 also contains injury to the various diagnostications must be considered a nat.

A conversation between parents and medical experts

The decision of Sentinel injury is a sensitive moment that requires transparent communication.Some families have the impression that the information has been stopped from them or the diagnosis of Na has been determined from the beginning.It follows a diagnostic approach that contains both trauma and basic medical disease.Alphabetical clarity follows a standard protocol used to exclude more traumatic injury and exclude the medical cause without making personal decisions based on the impression that parents can be abused.

We "clarify the word" the word "explanation of a painful injury", "we have already done" Pennice and Tired "Evaluation".

Instructions that are to be used by parents in the continued parents (some of the people in NAF) management guidelines (31)

- "Explain violations of your baby unusual at this age and require additional clarification."

- "Detectable injuries can be trauma compatible, but we should also exclude all underlying diseases that can explain such injuries before we can say anything more specifically." "

- «I'm worried that someone can hurt your child.We must explain whether to continue to follow / to introduce an exam, etc.]. The

- In the context of your child's violation, there are high risk factors that may be possible, so we must perform additional investigations to confirm that the issue is not affected. „

- "My task is not to determine the responsibility or debt, but only to evaluate your child's violation; and that happens in the hospital."

In case of news, the exam of the NAT exam or nat diagnosis

- "I am legally forced to report [a type of violation to refer to the age of the child."

Seeing this injury and your children are required to make the general assessment.The wife of the doctor, as well as taking kandher pesseity, so secure should report us.

- "I don't have the right to decide whether your child can go home;This is the task of Child Protection Services.They is to provide you with the correct medical information and take care of your children. "»

Continuous clinical case studies

Gabriel's pediatrician explains to parents that Gabriel has an age bruising.This explains that normal daily activities, including entering the baby career, do not cause bruising., Which usually takes a few days and includes blood samples, two -time x difficulty skeleton, brain photography and spinal cord, but also eye mirrors.

In summary, it was shown that the Clinical Protocol had rejected the differences of abuse (2).The non -disconnected source is suspicious.

- Since at the beginning of getting tube, violence can prevent, or serious violence.

- If you suspect a non-shipping trauma, it is very important to act according to a rigid diagnostic procedure that includes a suitable integrated study.

- Systematic evaluation makes it possible to improve screening and prevent distortion.

- Contact with parents should be transparent, clarity, and convenient.

- Skip Help: Create a fast classification and contact the students that prevent people who prevent the people.

Appendix 1: Review and support for non-quality trauma: Can recommend to the team

The first diagnosis of the child with an injury that tells all parts of special steps (Fig. 1, tablet 1).Reviews of compliance of child's development skills are very important with reported devices or harmful harm.In a typical representation: In the icons-icons-icons and that either a sensitive state of cause.In agreement with parents with, exchanged with the patterns that are kept to resolve and consider further instructions and to plan further instructions and to consider further instructions and to consider further instructions and toPlan further instructions and to consider further instructions and to consider further instructions and to plan further instructions and to consider further instructions and to consider further instructions and to consider further instructions

References to Radio References College of Radio (28), which are created by the European Society (33.34) and a Skyptic Expert (SS) and a Skyptic Expert (SS) and a Skyptic Expert (SS) and a sclateral expert (SS) and a scatrate expert in children under the age of 24.Within 24-72 hours and without the basic indications of the channel brain in our institutions, headache headquarters with headache headquarters with headache headquarters, with headache headquarters, with headache headquarters.Increase with 28 % (23).This is due to the fact that the Parista reaction occurs in the phase of medicinal, good lines (0).

The ophthalmologist is performed by an ophthalmologist in an emergency in cases where there is a visualization of the brain where certain endometrial bleeding can be observed within 24 hours (5).Inexplicable bruises or bleeding in the skull are a hemostasological explanation indicating in infants and infants (7.36), in the case of unexplained fractures, calcium and phosphate metabolism (12).

Investigation of siblings is subject to an international consensus (37).The children, defined as asymptomatic siblings and children who share the same household or the same care environment with the victim of the wet (index case), must be subjected to a thorough clinical examination (37).months.In children in 24 months who have no symptoms, no systematic painting investigations (37) are needed.In the case of impressive or vague finding, additional skeletal examinations (37) are needed.Each child with contact with suspected injuries should be subjected to the same explanations as an index.

Further support, inspection of social terms and secure measures

If the existence of Naa was confirmed due to the examination and maldispinary suspicion, in the child protection and the Loi Sur La in accordance with the Natsc., Such as our birth, such as our birth, such as our birth.The steps were declared by their parents when they announce the results of various examinations.In case of criminal charges, coordination with police is made in advance so that the inspection may occur immediately after advertisements (38).

Annex 2: General Presentation of Ing Endi Lesan Suspisons Saka Nat

The general species of alert: great damage without unknown trauma.Unexpected developments.The wounds;For wounds;Atmen indications.

Bruce (1, 39-42): Worse is unsuccessful in the form of mobile and mobile, portable, portable, portable, portable, portable, portable, portable, mobile, mobile age.The age of doubts is not used for the purpose of assessment, such as except in children, unless the injury is clearly due to (40).

Fracture (6, 6, 6, 12, 12, 4, 4, 43): Back fracture for the child <18 months.Nat-diagnosed fracture is very relevant to NAT;However, including cracks in any form and all clothes (2)The predicted bones are rarely related to non-mobile infantry, usually related to the non-mobile infantry - only for appropriate orders (44).

The non-academic mutilation (Nas): In some studies, the event is more than two (102-2007).

Belly trauma: Trauma of the abdomen is rare (2 to 3 % of NAT cases), but may remain unnoticed and forms the second most common cause of death due to physical abuse (35).In the case of NAT, systematic screening for infants and young children is recommended (45).

Break: The cold is not appropriate by release of many feet, especially, often because of the bath.They may be available from one or both sides, causing complaint on the back of the backs, arose. The-look-shaped.

However, equally, this may be able to have at the same time with the disease and naturally should be considered, so a diverse insults are basically.

Abbbreat: NAT = NAT-old truma (I.e. Physical Edequate / Conseting Strategy Warming / Cut = Discess Tomentolhocopolography,

Thanks: Those who have a set will thank Dr.S. DEPALLENCE OF READING, Dr.R. Idan, M Koob and Dr.J. Villaslada for their comments, Dr.M. Rizzi and Dr.R. Renella for her hematological clarification recommendations, Dr.L. Coulon, Dr.C. Salomon and Dr.A. Rybak for his reviews in Figure 1 and Dr.D. Check the German version.

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Dr.Med.Francesca Hoagger Del Niño Protection Unit - Tin equipment, Child Service, Mother Enfant Women's Department, Chuv, Lausana

Diz Medicated Pidosa Paolaa Paola and the boy Migration, Mother Pediath service, children of women, Chuv, Lausanne

PL Steuula Bonozunity of Li