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PRESIDENT’S
MESSAGE
• You suspect any type of neglect. • You suspect abuse or neglect and want guidance on the next
• Report to Child Protective Services by phone: 1-800-252- steps.
5400, or online report: http://www.txabushotline.org • You have a question on which diagnostic tests might need to
be done and whether a child might need to go to The Chil-
Report to law enforcement if: dren’s Hospital of San Antonio Emergency Room for forensic
• You suspect a non-family member is the abuser. photo-documentation
• You feel rapid intervention may be needed (severe abuse,
Other questions we might be able to help with:
threatening parents, fear of parent flight with child.) • “Does the history reasonably explain the injury(s) in this
• Note that a law enforcement report should be made to the
child?”
agency with jurisdiction over the location where the abuse • “Is this appropriate or abusive punishment?”
likely occurred — not necessarily where the child lives. • “Could this child’s failure to gain weight be due to neglect?”
• Report to law enforcement by phone. Call your local law en- • “What other non-abusive causes are possible?”
forcement agency.
• Make the report as quickly as possible. When you make a re- When to call ChildSafe, 210-675-9000, Monday through Fri-
port (either to CPS or law enforcement), be sure to record the day 8 a.m. to 5 p.m.
case report ID number in the medical record. • You suspect sexual abuse and want guidance on the next steps.
• Consider whether other tests are needed. • You have a question on whether a child needs a medical ex-
• Consider whether hospitalization is needed: Serious injuries,
especially in younger children and infants. amination at ChildSafe, Center for Miracles, or The Children’s
• To facilitate the abuse evaluation. Hospital of San Antonio Emergency Department.
• To keep the child in a safe location pending further evaluation • To refer a child for a sexual abuse evaluation when the last in-
by CPS or law enforcement. cident of abuse occurred more than 96 hours ago.
• Carefully and completely document any/all interactions with
the child or parent, preferably in quotations. When to call/refer to The Children’s Hospital of San Antonio
Emergency Department and/or Forensic Nurse Examiner pro-
How do you interact with the parent? gram, 210-704-2190, seven days a week, 24 hours a day;
• Stress your role to act in the child’s best interest to ensure they • Ask for the Emergency Physician or Forensic Nurse Examiner
are safe. on duty when:
• If the abuser is unknown, but may be the parent, or the parent • Sexual abuse may have occurred within the past 96 hours.
• The child is a suspected victim of sexual abuse or assault and
appears to be protecting an abuser, then you are not required
to release verbal or written information to the parent if it may has symptoms of ano-genital bleeding or pain.
place the child in danger. This is an exception to the HIPAA • The child has visible injuries and is in need of forensic photo-
rules.
documentation.
What information can you release to CPS or law enforcement?
• You can and should promptly release all information pertinent I hope that you find the information in this article helpful in
your practices/lives.
to the child’s injuries promptly to CPS or law enforcement,
when they request it. This is also an exception to the HIPAA Sincerely,
rules. Leah H. Jacobson, MD FAAP
2017 BCMS President
When to Call
When to call Center for Miracles, 210-704-3800, Monday **ChildSafe – www.childsafe-sa.org
through Friday; 210-704-2100 after hours **Center for Miracles – www.chofsa.org/centerformiracles
visit us at www.bcms.org 9
