What are the most common types of bruises in abused children?
What is considered when protecting a bite mark for analysis?
Dont wash area
Dont medicate area
Dont cover or bandage area
Dont use site for IV access
Dont place monitor leads on or near site
Swabs for DNA may be helpful
Describe some examples of Pattern Marks?
Hand marks, switches/paddles, mini-blind rods, fly-swatter, belts, belt buckles, ropes, cords, shoes, kitchen tools (look marks, flip-flop imprints
What are the most common burns in small children?
Scald burns (immersions)
What are the characteristics of an abusive burn?
Distinct lines of demarcation
"Stocking or glove" pattern
What are the characteristics of an Accidental Burn?
What is the extent of a burn depended on?
Water temperature (117 F)
Duration of exposure
Presence/absence of clothing or material
Area of body exposed
What type of fracture is diagnostic of abuse unless proven otherwise?
Rib Fractures (result of direct trauma to the chest)
What are the most common types of blunt force traumas to the chest?
Pulmonary contusion (rare)
Cardiac contusion (rare)
What are the most common blunt force traumas to the abdomen?
Splenic or liver lacerations/contusions
At what age are abusive fractures most common?
18 months and younger
What fractures should you be extremely concerned about in relation to abuse?
Posterior rib fracture
Multiple fractures of different stages
Name fractures that are highly specific of abuse
Classic metaphyseal "chip" fractures/lesions
Rib fractures, especially posterior
Spinous process fractures
Name fractures that are moderately specific of abuse?
Multiple fractures, especially bilateral
Fractures of different ages
Vertebral body fractures and subluxations
Complex skull fractures
Name fractures that are common but are low in specificity for abuse?
Subperiosteal new bone formation
Long bone shaft fractures
Linear skull fractures
A disorder that causes fragile bones?
Causes fragile bones
Genetic defect in collagen production
Dominant (classical) IO has too little type I collagen or poor quality
Recessive OI interference in collagen production
what type of falls are not fatal or life-threatening?
Simple short falls (off couches, chairs, or down stairs)
When are falls fatal/life-threatening?
When a child falls more than 40 feet to have serious/life-threatening brain injuries!
What is the leading cause of death in children under 5 years old?
head injuries (They may NOT be evident externally)
when are most head injuries of abusive nature?
when in babies under 1 years old
Shaken Baby Syndrome
A form of abusive head trauma that occurs when a frustrated caregiver violently "shakes" or "shakes" and "slams" a child's head against an object. Usually to stop them from crying or to get a child to respond to the expectations of the caregiver. There are often no outward signs of abuse. usually injury to eyes and brain
What are the most common triggers for SBS?
Who is at highest risk for being a victim of SBS?
<5 years of age
Special Needs babies
Babies that are difficult to soothe
because of the extra care they require and tendency to cry more often
What are the mild S&S that can occur with SBS?
What are Severe S&S of SBS?
About what time do the S&S of SBS occur?
Moderate - Immediate onset
Severe/Fatal- immediate onset; No "lucid interval" following AHT incident
* the child will not be acting "normally" and doing "normal" activities
When are the chances of inflicted head injury highest?
When a young child sustains a serious head injury without an apparent major trauma history, such as MVC, fall from heights greater than 10 feet, etc.
What are the "big 3" diagnostic criteria of SBS/AHT?
What are the characteristics of a Subdural Hematoma?