Child/Elderly Abuse




  • Child abuse is the physical and mental injury, sexual abuse, negligent treatment, and/or maltreatment of a child under the age of 18 by a person who is responsible for the child’s welfare.
  • Elderly abuse includes physical, emotional, sexual, and financial abuse, negligent treatment, and/or maltreatment
  • A Vulnerable adult is anyone aged 18 and over with a condition that significantly limits their ability to perform their own activities of daily living. This condition may be mental, physical, or cognitive. It also includes adults who cannot provide their own protection.
  • The recognition of abuse and the proper reporting by EMS is a critical step to improving the safety of children and preventing child/elderly abuse. EMS providers have the ability to assess the home environment, the interaction of the patient with all those living in the home. They serve as a critical bridge of information to in-hospital providers.




  • Assessment of a child/elderly abuse is based upon the following principles:
    • Protect the life of the child from harm, and the EMS team from liability.
    • Suspect that the child/elderly patient may be a victim of abuse, if the injury/illness is not consistent with the reported history.
    • Respect the privacy of the child and family.
    • Collect as much evidence as possible, especially information.




  • Documentation is critical. Reports should be detailed and objective. Include quotations and any conflicting stores. Include a complete physical exam, description of the home environment.
  • Assess for and extensively document physical signs of abuse, particularly, any injuries that are inconsistent with the reported mechanism of injury.
  • Assess for and document signs and symptoms of neglect, including inappropriate level of clothing for the weather, inadequate hygiene, absence of attentive caregiver(s), or physical signs of malnutrition.
  • EMS providers are considered mandatory reporters of suspected child, vulnerable adult, and elderly abuse. South Carolina law requires the EMS provider to immediately report any suspicious findings to both the receiving hospital and to the South Carolina DSS reporting hotline phone number at 1-888-CARE-4-US 1-888-227-3487. The report should be completed on a recorded line and documented on the patient care report (PCR). There are legal protections for reporters, but potential legal ramifications for those who do not.
  • While law enforcement may also be notified, EMS should not accuse or challenge the suspected abuser. In the event of a child fatality, law enforcement must also be notified. Consider the involvement of a supervisor or law enforcement early if caregivers refuse hospital transport.