A. Report Suspected Abuse. All 50 states have laws that require heath care providers to report suspected child abuse to child protective service (CPS) agencies or police. Generally the threshold for reporting should be when physician has a reasonable suspicion that child's condition may have been caused by abuse. Physician's job is to report suspected abuse, not to investigate abuse. Physician should not accuse the individual who brought child for medical care, but should explain why report is being made. Explanation should include statements such as child's injuries are too severe for or otherwise do not fit description of how injuries occurred and that physician is concerned that someone may be hurting child. Physician can add that he or she is required by law to report these types of injuries for further investigation. Reporting laws typically require a telephone report immediately to report suspected abuse and discuss immediate concerns about child's safety, followed by a written report.

B. Manage Acute Injuries. Most abusive injuries require only outpatient therapy. Consider hospitalization of young infants and more severely injured children for observation and management

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