Pediatric injury resulting from family violence.

OBJECTIVE Children who live in violent households are at risk for emotional and physical injury. Although recent research has addressed the emotional impact of witnessing family violence, no study has addressed the inadvertent physical injuries that result to children who witness family violence. The objective of this study was to describe the causes, types, and patterns of pediatric injuries resulting from family violence. METHODS We reviewed the medical records of 139 children who presented to the emergency department with injuries resulting from domestic violence for demographic information, mechanism of injury, type, location, and severity of injury, treatment, and disposition. RESULTS Children who were injured during domestic violence ranged in age from 2 weeks to 17 years. Although the mean age of the children identified was 5 years, 48% of the children were younger than 2 years. Although the most common dyad involved in the fight was the mother and father (57% of cases), extended family members and nonrelated adults were involved in almost one third of the cases. The most common mechanism of injury was a direct hit (36%). Of the injured children who were younger than 2 years, 59% were injured while being held by parents. Thirty-nine percent of the children were injured during attempts to intervene in fights. The majority of injuries were to the head (25%), face (19%), and eyes (18%). Young children sustained more head and facial injuries than older children, who had disproportionately more extremity trauma. Medical intervention was indicated in 43% of patients, of which 9% required hospital admission and 2% required surgical or intensive care intervention. Of the 91% of children discharged from the emergency department, 73% returned home, and 27% went to alternative homes. CONCLUSIONS Children sustain a wide range of physical injuries from family violence. Because the majority of injuries are minor, specific inquiry into the causes of all pediatric injuries may help further identify children living among family violence.