Non-accidental injury

Non-accidental injury (NAI) refers to physical harm or trauma that is deliberately inflicted, rather than caused by an accident. It is most commonly used in the context of child protection, but it can apply to vulnerable adults as well.

### Key points about NAI:

- Cause: Usually results from abuse, such as hitting, shaking, burning, or other intentional acts. - Common in: Infants and young children, who may be unable to explain what happened. - Signs may include:

1. Injuries inconsistent with the explanation given.
2. Multiple injuries in different stages of healing.
3. Unusual bruising patterns (e.g. fingertip marks, belt marks).
4. Fractures, especially spiral or rib fractures in infants.
5. Retinal hemorrhages (in cases of shaken baby syndrome).

- Assessment involves:

1. Thorough history and physical exam.
2. Imaging (X-rays, CT, MRI).
3. Multidisciplinary evaluation, often including social services and safeguarding teams.

### Terminology: In some countries, terms like “non-accidental trauma (NAT)” or simply “suspected abuse” may be used interchangeably.