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

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.