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TEN-4-FACESp

TEN-4-FACESp is a bruising clinical decision rule developed and validated by Dr. Mary Clyde Pierce and colleagues.

TEN-4-FACESp is a useful acronym to help screen children under 4 years of age with bruising to identify when a bruise is more likely to be caused by abuse than accidental injury. TEN-4-FACESp stands for bruising to the Torso, Ears, Neck, Frenulum, Angle of the jaw, Cheeks, Eyelids or Subconjunctivae, “4” represents infants 4 months and younger with any bruise, anywhere, and “p” represents the presence of patterned bruising (“TEN-4-FACESp”).

Attention to bruising is an actionable step that we can take to help identify children at risk of physical abuse and potentially improve the outcomes of these young children.

In the News

Resources

Implementation

Recognition

  • Pierce MC, Magana JM, Kaczor K, Lorenz DJ, Meyer G, Bennett, BL, Kanegaye JT. The prevalence of bruising among infants in pediatric emergency departments. Ann Emerg Med 2016;67:1-8. doi: 10.1016/j.annemergmed.2015.06.021 PMID: 26233923
    • Selected (as 1 of 5 papers) at the Pediatric Trauma Society annual meeting in November 2015 as “papers that should change your practice: a year in review of pediatric trauma.”
  • Pierce MC, Kaczor K , Lorenz DJ, Makoroff K, Berger RP, Sheehan K, Fortin K, Hymel K, Bertocci G, Jenny C, Herman B, Leventhal, JM. Bruising Clinical Decision Rule (BCDR) Discriminates Physical Child Abuse from Accidental Trauma in Young Children. Presented at the Pediatric Academic Societies’ Annual Meeting, San Francisco, May 2017.
    • Awarded “Best PAS abstract” by the American Academy of Pediatrics Section on Emergency Medicine
  • Pierce MC, Kaczor K , Lorenz DJ, Makoroff K, Berger RP, Sheehan K, Fortin K, Hymel K, Bertocci G, Jenny C, Herman B, Leventhal, JM. Bruising Clinical Decision Rule (BCDR) Discriminates Physical Child Abuse from Accidental Trauma in Young Children. Presented at the Ray E. Helfer Society Annual Meeting, Denver CO, April 2017.
    • Awarded best presentation for original research (tie with below)
  • Kaczor K , Pierce MC, Lorenz DJ, Makoroff K, Jenny C, Hymel K, Herman B. An Analysis of the Impact of Age Threshold on the Performance of a Bruising Clinical Decision Rule (BCDR) for Discriminating Physical Abuse from Accidental Trauma in Infants 0-12 Months of Age. Presented at the Ray E. Helfer Society Annual Meeting, Denver CO, April 2017.
    • Awarded best presentation for original research (tie with above)