This was a European study examining a screening tool to be used in the ED to indicate the need for further investigation into the concern for possible abuse. Four questions were taken from other commonly used abuse screening tools that were used outside of the ED. SCAN questions are as follows:
Is the injury compatible with the history, and does it correspond to the child's developmental level?
Was there an unnecessary delay in seeking medical help?
Is the behavior/interaction of the child and caregivers appropriate?
Are there other signals that make you doubt the safety of the child or family?
Any positive answer triggered further evaluation, starting with a complete head to toe assessment and complete history with additional tests added as warranted. This is only a screening tool and positive answers do NOT mean that abuse has occurred, but should cause you to pause and think further.
These questions showed a "moderate" performance among close to 25000 patients and the questions were comparable in children < 5 years to other/longer screening tools used in Europe.
References
Hoedeman F, Puiman PJ, van den Heuvel EAL, Affourtit MJ, Bakx R, Langendam MW, van de Putte EM, Russel-Kampschoer IMB, Schouten MCM, Teeuw AH, de Koning HJ, Moll HA. A validated Screening instrument for Child Abuse and Neglect (SCAN) at the emergency department. Eur J Pediatr. 2023 Jan;182(1):79-87. doi: 10.1007/s00431-022-04635-0. Epub 2022 Oct 5. PMID: 36198865; PMCID: PMC9534589.
