- Caregiver offers no history or specifically denies history of trauma despite severe injury
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- Implausible history for degree or type of injury*
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- Unexplained or excessive delay in seeking care
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- Injury attributed to in-home resuscitation efforts
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- Caregiver histories that change with retelling or conflict with versions from other observers
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- Severe injury explained as self-inflicted or blamed on other young children or pets
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