Physical abuse assessment
Paediatric

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Emergency Referrals

Useful Management Information

Physical abuse is any physical injury to a child that is not accidental. Physical abuse does not always leave visible marks or injuries.
When to suspect non-accidental injury:
- Any injury without adequate explanation are suspicious for inflicted injury.
- Some injuries are more specifically linked to potential abuse.
- Non-accidental injuries can include:
  - Bruises:
    - pattern bruising (linear, handprints, clustered oval marks, marks consistent with instruments)
    - multiple bruises
    - Note: Bruises cannot be accurately dated.
- TEN-4 FACES rule:
  - Torso
  - Ears
  - Neck
  - 4 months and younger (any bruise)
  - Frenulum
  - Angle of the jaw
  - Cheek
  - Eyelid
  - Subconjunctival Haemorrhage
- Abrasions and lacerations
- Bite marks
- Burns
  - Uniform scald depth/glove stocking distribution/symmetrical distribution
  - Central sparing buttocks
  - Patterned burns (e.g. cigarette burn)
  - Skin fold sparing (e.g. in the popliteal area)
- Fractures
  - Femoral fractures < 18 months
  - Humeral fractures
  - Rib fractures
  - Classic Metaphyseal fractures
- Head injury/Abusive Head Trauma
  - Skull fractures < 12 months
If you have a reason to suspect a child is experiencing or at risk of experiencing physical and sexual abuse without a parent able and willing to protect, it is mandatory to report your concerns to the Department of Children, Youth Justice and Multicultural Affairs .
To discuss an urgent referral or arrange an urgent assessment please call 07 5687 1375 between Monday to Friday 8am – 4.30pm. Outside of hours please call GCUH switchboard on 1300 744 284 and ask to speak to the Emergency Department/Consultant.

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?

Category 1 (appointment within 30 calendar days)	Physical abuse assessments
Category 2 (appointment within 90 calendar days)	No category 2 criteria
Category 3 (appointment within 365 calendar days)	No Category 3 criteria
If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Reason for concerns of physical abuse
Type of injury
Explanation provided for injury by parent/care giver

Additional Referral Information

No additional referral information

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Not available

Internal Referrals

Child Protection Unit qhRefer

Fax

(07) 5687 4497

Post

Child Protection Unit
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

(07) 5687 1375

Related HealthPathways

No directly related pathways found

HealthPathways home page

Service Availability

Dr Priyaneela Kamalanathan

Medical Director Child Protection Unit

Facilities

Gold Coast University Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Child Safety

If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, contact Department of Children, Youth Justice and Multicultural Services . Please consider if mandatory reporting applies.

Physical abuse assessmentPaediatric