This article focuses on several common examples of inflicted injury dealing with the skeleton (eg, fractures), skin (eg, burns, bruises), and CNS (eg, subdural hematoma [SDH], abusive head trauma [AHT], shaken baby syndrome [SBS]/shaking-impact syndrome). About 1750 children died in the US of maltreatment in 2020, about half of whom were < 1 year old. Patterned markings resembling objects, grab marks, slap marks, human bites, and loop marks. Poor quality photographs (need to see borders of injuries). CNS trauma is among the most serious forms of injury that is observed in the context of physical abuse. Finally, the environment may contain stressors that may make the caregiving less than ideal and may overextend the coping abilities of the caregiver. Treatment of injuries. 5] NIS defines physical abuse as a form of maltreatment in which an injury is inflicted on the child by a caregiver via various nonaccidental means, including hitting with a hand, stick, strap, or other object; punching; kicking; shaking; throwing; burning; stabbing; or choking to the extent that demonstrable harm results. Shaken Baby Syndrome - Frequently Asked Questions / FAQs. Other hints are multiple injuries at different stages of resolution or development; cutaneous lesions with patterns suggestive of particular sources of injury ( see Physical abuse Physical abuse); and repeated injury, which is suggestive of abuse or inadequate supervision. A physical exam of the patient may raise suspicion for abuse when noting multiple injuries at different healing stages or injuries that do not correlate with the child's developmental level. Emotional abuse is inflicting emotional harm through the use of words or actions. Sexual assault, including rape, may cause physical injury or illness or psychologic trauma. Skull bones may be fractured as a result of direct impact to the head with a solid surface or object.
In order to fully comprehend the morbidity of victims of child abuse victims, it is necessary to look beyond the immediate period of injury and recovery. Infants/young toddlers with unexplained. 11] The evaluation of the healing process on plain films permits some level of dating of injuries and allows the healthcare professional to distinguish new and relatively older fractures in the same child; providers should exercise caution in precisely dating fracture age based on x-ray findings alone.
Molestation, which is genital contact without intercourse. She guided the hiring process all the way to my offer for employment. Her recent research focuses on deaf and hard of hearing populations, especially in the areas of behavioral health, intimate partner violence, telemental health, and help-seeking. Cases of child sexual abuse have also declined substantially, with a 53% decrease in the number of substantiated cases of sexual abuse observed from 1992-2006. Commonly, the pediatric patient will present for medical care related to symptoms of their injury without a history of preceding trauma. Pediatric Abusive Head Trauma/Child Physical Abuse Flashcards. Multiple injuries/multiple types of injuries. Physical indicators that should raise suspicion for maltreatment include the following: -.
Many fracture types can be accidental or inflicted. Create a free account. Abusive head trauma Flashcards. Discipline gone awry. Some sexually abused children act in ways that are sexually inappropriate for their age. 19] Of 13, 494 adults who completed a standard medical evaluation in 1995-1996, 9, 508 completed a survey questionnaire that asked about their own childhood abuse and exposure to household dysfunction; the investigators then made correlations to risk factors and disease conditions.
The less-dense porous bone tolerates more deformity than adult bone and accounts for the childhood bending and buckling injuries observed with green stick and buckle injuries. Screening includes the following markers [3, 4]: Liver injury: Aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Because of its large head and weak neck muscles, a shaken infant or toddler can sustain a type of whiplash similar to that from an automobile accident. Prevention of maltreatment should be a part of every well-child office visit through education of parents, caregivers, and children and identification of risk factors. Abusive head trauma in children. No credible evidence in medical literature supports the continued use of corporal punishment; spanking is less effective than "time out" or removal of privileges for decreasing undesired behavior in children. Skull fractures typically occur at the site of impact to the head, but owing to the oval shape of the head, a single point of impact may result in bilateral fractures remote from the site of impact.
Jennifer's earlier degrees include a Bachelor of Science in Nursing and Bachelor of Science in Microbiology with emphasis on whole-genome bioinformatics, both from Montana State University. The bar is subjected to a steady torsional stress of 20 kpsi and an alternating bending stress of 10 kpsi. In this case, investigators confirmed the ease of turning on the faucet and the high temperature of the water from it. The abuse rate of black children is 1. Newer studies of dating of fractures, however, emphasize that the classic descriptions (eg, soft callus, hard callus) are based on histiologic specimens rather than plain film readings, and significant inconsistencies exist among radiologic interpretation of healing phases. Pediatric abusive head trauma quiz answers sheets. Anxiety may result... read more.
The following English-language resources may be useful. 9%), American Indian/Alaskan Native (1. Jennifer is a passionate activist in the field of mental health services, and is dedicated as a mother of two children, to family and to her community in Montana. Retrieved on Mar 15, 2023 from -.