Health Care Improvement Facing Child Abuse. Mistakes to be Avoided and New Challenges to be Addressed

Background: Child abuse is an increasing reason of consultation, either in Pediatric Primary Care (PPC) or in Pediatric Emergency Departments (PED). Healthcare professionals typically have not received proper training on the subject at hand. This results in mistakes in patient care that could be avoided.

Clinical case: We herein describe a study case of a 15-year-old male patient who is brought by his mother to our PED, referred from a tertiary-level Hospital after having conducted higher risk intercourse with an adult male. The youngster had arranged a meeting using a mobile phone application. At the first PED he visited, no clinical samples were collected, although medical examination was executed. Instead, the patient was directly referred to the National Police, who took judicial samples with the collaboration of a forensic doctor.At our PED, which he was later referred to, the patient and his mother handed the medical report from the first PED, so no new interrogations or physical examinations were carried out. Following our Hospital’s Child Molestation Protocol a blood and urine sample was tested for sexually transmitted diseases and a negative urine toxicity study was carried out. After evaluating the results, the patient began taking the post-exposure prophylaxis and antibiotic prophylaxis medicines. Finally, he was given an appointment with the Pediatric Infectology Consultation so that a proper follow-up could be carried out.

Conclusion: Child abuse is a frequent reason of consultation in PPC services, for which Healthcare professionals (HP) are not completely prepared to assist. Usually, they have not received proper training to do so, and they are not aware of the procedure to be followed in terms of observation, notification and management. Accordingly, a standardized Health Care Protocol should be developed and introduced. HP should receive specific and proper training to successfully address this issue and provide the best patient care possible. The need for the abovementioned is particularly strong, considering the increasing amount of cases taking place,and the new ones arising from the use of the New Technologies.