"As a new pediatric nurse, how can I differentiate between accidental injuries and signs of abuse?"

Always ask yourself does the described mechanism match the injury and always trust your intuition. If you’re concerned, report it!

As a school nurse who has had a fair share of DCF cases. My biggest differentiating factor is stories that do not match the description of the injury. Imagine a typical bruise from accidentally wacking it, now imagine a bruise that’s swollen, bursted blood vessels, painful to move, and possible dislocation. Ask your facility about mandated reporter training as this will help as well. Remember it’s not always just physical abuse.

Accidental injuries due to an accident that results in physical damage or injury. Concussion injury to the brain caused by a blow; usually leading to loss of consciousness which occurs during or after the accident; while substance abuse is excessive using psychoactive drugs, such as alcohol, pain medications or illegal drugs. It can lead to physical, social or emotional harm.

Look for the pattern of injury, the location of injury, the developmental age of patient in relation to injury, parent and child demeanor and interaction, and hx of patient. Has the been brought in before for the same injury? Does the child have normal injuries? Such as small bruises on shins and knees such as a toddler just learning to walk? Does the child make eye contact? Is the parent dismissive or appear overbearing or blaming of the child? There are many factors and clues that can paint a picture of what could possibly be going on. Circumferential burns on hands or feet are always suspicious to me. As well as circular burn patterns that could be attributed to cigarette burns. Every situation is different. Also, any bruises on babies is an immediate red flag. Babies don't do anything that could cause a bruise or injury.