NAI TEN 4 FACES

TEN-4 FACES Bruising Rule (Pierce 2010)

Any bruise found in any of the following locations should trigger the possibility of pediatric physical abuse:

Torso

Ears

Neck

Any bruise in a child younger than 4 months old

FACES

Frenulum

Angle of Jaw

Cheek

Eyelid

Subconjunctival Hemorrhage

Pearl: Think of a subconjunctival hemorrhage in an infant as a bruise on the eyeball and frenulum injury as a bruise to the frenulum. These injuries are highly suggestive of abuse in the infant.