The ten 4 bruising rule is a validated screening tool that is used for identifying potential physical child abuse in children that are under 4 years of age.
The ten 4 bruising rule highlights that any bruises on the Torso, Ears, Or Neck or any bruise that is on an infant under the age of 4 months or younger are concerning.
It's normal for kids to get bruises, even kids under 4, but some bruises can be indicators of child abuse.
The main components of the ten 4 bruising rule is T-E-N, which refers to bruising on the child's Torso, Ears, or Neck in children aged 4 years or younger in age.
4, refers to any bruise that is on an infant 4 months of age or younger.
FACESp refers to Patterned Bruising, which an also indicate physical child abuse.
F is "Frenulum" which is tissue between lip and gum.
A is for Angle of Jaw.
C is for Cheeks or fleshy part.
E is for Eyelids.
S is for Subconjunctivae "white part of eye".
And p for patterned bruising like marks from a slap, grab or loop or burn.
Bruising in these areas or at these ages without any reasonable accidental explanation are strong indicators of abuse.
These bruises in children and infants are often "sentinel injuries," which also means that they are smaller, earlier injuries that also precede more severe abuse.
And the ten 4 bruising rule also helps medical professionals or doctor distinguish from accidental trauma from physical abuse.
If any of these signs of abuse are noted, the doctor or medical professional should document them, medically evaluate the child and report if abuse is suspected.