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Emergency Medical Minute


Nov 1, 2019

Contributor: Jared Scott, MD

Educational Pearls:

  • Non-accidental trauma (NAT) to children is commonly missed by medical providers
  • Try to remember TEN-4-FACES as a useful aide for concerning patterns that may reflect NAT:
    • Torso, ears, neck and any bruising in child 4 months or longer
    • Frenulum, angle of the mandible, cheek, eyes, sclera


Pierce MC, Magana JN, Kaczor K, Lorenz DJ, Meyers G, Bennett BL, Kanegaye JT. The Prevalence of Bruising Among Infants in Pediatric Emergency Departments. Ann Emerg Med. 2016 Jan;67(1):1-8. PMID: 26233923. 

Pierce MC, Kaczor K, Aldridge S, O’Flynn J, Lorenz DJ. Bruising characteristics discriminating physical child abuse from accidental trauma. Pediatrics. 2010 Jan;125(1):67-74. PMID: 19969620. 

Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD