Bruises in Children: Normal or Child Abuse?

Tomika S. Harris, DNP, MSN, CPNP


J Pediatr Health Care. 2010;24(4):216-221. 

In This Article

Communicating with the Family

When performing an assessment to determine the cause of a bruise, it is important to be sensitive to the needs of the child and family. The family should be approached in an objective, non-judgmental manner regardless of the cause of the injury. Additionally, the extent and purpose of the examination should be explained. If abuse is suspected, caregivers should be informed and told that information obtained will be reported to child protective services. This information often provokes strong feelings in the family and child. Providing information regarding mandated state child abuse reporting laws may help caregivers understand why reporting is necessary. Health care providers should be knowledgeable about local child protective services agencies and their role in cases of suspected child abuse, and this information should be explained to the family in detail. If abuse is not suspected, the family should be informed of possible causes of the bruising based on the history, physical examination, and any additional medical work-up.


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