طفل عمره سنتان جاء بكسر في عظم الفخذ، والأهل يقولون إنه سقط من الكنبة. عنده كدمات بأعمار مختلفة على الظهر والأذنين، والأهل تأخروا يومين في الإحضار، والأشعة تظهر كسوراً قديمة ملتئمة في الأضلاع. ما الإجراء الصحيح؟

A 2-year-old has a femoral fracture; parents say he fell off the sofa. He has bruises of different ages on the back and ears, there was a two-day delay in presentation, and X-rays show old healed rib fractures. What is the correct action?

1. Document carefully and report to child protection as required
2. Confront the parents with an accusation in front of the child
3. Accept the story and discharge after splinting
4. Avoid documentation to protect the family

Answer: A) Document carefully and report to child protection as required. Bruises of different ages in unusual sites, old fractures, delayed presentation and an inconsistent story are red flags for abuse. Nurses must document and report to child protection, keeping the child safe.