Approach to the Critical Patient

Immediate stabilization

Life-threatening injury recognition

Monitoring and targets

Monitoring bundle

Immediate mandatory actions

Mandatory reporting and protection

Key decision points

Severity stratification

History

Presenting complaint

Chief complaint context

Red flag history features

High-specificity NAT history red flags

Symptom review

Neurological symptoms

Musculoskeletal symptoms

Skin findings reported by caregiver

Gastrointestinal and genitourinary

Past medical history

Prior medical history relevant to NAT

Family and social history

Family history

Social risk factors

Risk factors

Child-level risk factors

Caregiver risk factors

Environmental risk factors

Physical Exam

General and growth

Overall appearance and growth assessment

Skin examination

Complete skin survey (child fully undressed in gown)

Head and neck exam

Head exam

Oral cavity

Eyes

Neurological exam

Neurologic assessment

Musculoskeletal exam

Bone and joint assessment

Abdominal exam

Abdominal assessment

Genitourinary exam

GU and perineal assessment

Differential Diagnosis

Must-not-miss alternatives

Conditions that can mimic NAT

Common mimics

Dermatological and congenital conditions

Birth and perinatal findings

Laboratory Tests

Hematology and coagulation

Complete blood count

Coagulation panel

Metabolic and bone disease workup

Bone disease evaluation

Occult abdominal injury screening

Hepatic and pancreatic injury markers

Infection and metabolic

Additional labs in selected cases

Diagnostic Tests

Scoring Systems

TEN-4-FACESp clinical decision rule

Red Flag Scorecard

PECARN applicability

Pediatric HITS screening tool

Skeletal Survey

Skeletal survey indications and protocol

Scoring Systems Additional

Fracture dating and specificity

MRI

Brain MRI indications

CT

Head CT — first-line neuroimaging

Abdominal and pelvic CT with contrast

Ultrasound

Ultrasound applications in NAT

Disposition

Admission criteria

Indications for hospital admission

Safety-based admission

Protective custody admission

Transfer criteria

Transfer indications

Discharge criteria

Requirements for safe discharge

Treatment

Resuscitation and stabilization

Initial resuscitation priorities

Seizure management

Seizure treatment in abusive head trauma

Elevated intracranial pressure management

ICP reduction strategies

Fracture and orthopedic management

Fracture care

Abdominal injury management

Abdominal organ injury treatment

Burns management

Burn care in NAT

Mandatory non-medical interventions

Protective and medicolegal actions

Special Populations

Pregnancy

Pregnancy considerations in child abuse context

Geriatric

Geriatric considerations

Pediatrics

Age-specific considerations

Background

Epidemiology

Incidence and burden of disease

Pathophysiology

Mechanisms of injury in NAT

Therapeutic Considerations

Evidence base for NAT management

Patient Discharge Instructions

copy discharge instructions

Discharge instructions for Child Abuse (Non-accidental Trauma) — guardian copy

References

Guidelines and key sources

Primary evidence sources

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.