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Fortnightly emergency department case-file audit for timely detection of missed cases of suspicious injury

Amanda Gwee, Benjamin Coghlan, Cate Rayner, Anne Smith and David Krieser
Med J Aust 2014; 200 (1): . || doi: 10.5694/mja13.10303
Published online: 20 January 2014

To the Editor: A key role of emergency department (ED) doctors who assess injured children is to determine if abuse or neglect could have caused or exacerbated an injury. Physically abused children have a median of one to two ED presentations before non-accidental injury is diagnosed.1 Better identification may be life-saving, as repeat injury occurs in up to 70% of cases.2 We assessed the impact of a fortnightly review of the case files of young children who presented to the ED with injury on the detection of cases of possible non-accidental injury.


  • 1 Department of Emergency Medicine, Sunshine Hospital, Melbourne, VIC.
  • 2 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC.
  • 3 Victorian Forensic Paediatric Medical Service, Melbourne, VIC.


Correspondence: amanda.gwee@rch.org.au

Acknowledgements: 

We thank the Windermere foundation for providing the funding for this study.

Competing interests:

No relevant disclosures.

  • 1. Guenther E, Knight S, Olson LM, et al. Prediction of child abuse risk from emergency department use. J Pediatr 2009; 154: 272-277.
  • 2. Maguire S, Moynihan S, Mann M, et al. A systematic review of the features that indicate intentional scalds in children. Burns 2008; 34: 1072-1081.
  • 3. Louwers EC, Affourtit MJ, Moll HA, et al. Screening for child abuse at emergency departments: a systematic review. Arch Dis Child 2010; 95: 214-218.
  • 4. Louwers EC, Korfage IJ, Affourtit MJ, et al. Detection of child abuse in emergency departments: a multi-centre study. Arch Dis Child 2011; 96: 422-425.

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