Behavioral and Psychological State
Patient exhibits extreme fear response:
Continuous, high-pitched screaming without pause
No response to verbal reassurance
Attempts to physically withdraw from all staff
Flinching and shielding head/body during approach
Clinging reflex to stretcher, resisting touch
Episodes of gasping between cries
Patient appears severely traumatized, with behavior consistent with prolonged exposure to violence.
Physical Examination
Skin and Soft Tissue:
Multiple contusions and hematomas across torso, upper and lower extremities
Injuries present in various stages of healing (fresh, subacute, and older discolorations)
Patterned bruising noted on back and thighs
Numerous circular burn lesions (approx. 0.5–1 cm diameter), consistent with cigarette burns: At least 12 visible lesions, including both healed scars and recent wounds
Several open abrasions and superficial lacerations, some with dried blood
No signs of appropriate prior wound care
Head and Face:
Periorbital swelling (left side)
Small lacerations
Dried blood around nasal area
Extremities:
No obvious deformities suggesting acute fracture (further imaging required)
Guarding noted during palpation
Clinical Impression
Findings are highly indicative of prolonged, repeated physical abuse and severe neglect.
Combination of:
Multi-stage injuries
Burn patterns
Malnutrition
