Child protection in emergency medical services. Recognize, assess, act

Emergency medical services come into contact with child maltreatment, neglect and domestic violence on a regular basis. Such cases are particularly stressful for the professionals and also provoke uncertainty in how to act. Healthcare research shows that affected patients are urgently dependent on decisive and deliberated actions from all members of the healthcare system, including the emergency rescue services. The short and long-term consequences of missed chances to intervene are devastating and in extreme cases can even be fatal We aim to demonstrate the deficits and obstacles present in the emergency care treatment of maltreated children. After reading this paper, the reader should be in a position to carry out a preliminary risk assessment of maltreated children, know effective interventions and available counseling helplines. We present the relevant literature, personal experiences and a nationwide counseling helpline for healthcare professionals. Fractures and hematomas can have a high specificity for physical abuse, particularly in young children. They can be regarded as grave indicators for maltreatment, according to the German Federal Child Protection Act (Bundeskinderschutzgesetz), if they are present without any plausible explanation in a child. Based on these indicators, under certain circumstances a breach of professional discretion is allowed towards youth welfare services. Since 1 July 2017 healthcare professionals can seek counseling by trained physicians free of charge by calling the medical child protection hotline on 0800 19 210 00 around the clock. Every healthcare professional, particularly members of the emergency medical services can call this service with respect to all questions of child protection. To improve the care for children who have been victims of maltreatment, it is effective to provide training and counseling to every healthcare professional who works with children.