Child Abuse

Question 1

ABCs

Answer 1

Airway
Breathing
Circulation
*irritate infant, check to see if breathing

Question 2

Infant colic

Answer 2

Crying for several hours a day, more than 5 nights a week

• difficult to console
• etiology unknown
• 2-6 weeks is most common time
• normal intake and growth

Question 3

ALTE

Answer 3

Apparent Life Threatening Event - “near-miss SIDS”

- not a diagnosis, but describing an event

Question 4

CNS causes of ALTE

Answer 4

seizure, CNS bleeding, meningitis, structural or metabolic abnormalities

Question 5

Cardiac causes of ALTE

Answer 5

bradycardia from congenital defect or arrhythmia

- Tet spells from tetrology of fallot

Question 6

Pulmonary causes of ALTE

Answer 6

most common = RSV

also –> pertussis or PNA

Question 7

GI causes of ALTE

Answer 7

GERD –> never been proven
swallowing abnormalities
tracheoesophageal fistula

Question 8

Systemic causes of ALTE

Answer 8

sepsis –> apnea, pallor, tachycardia, tachypnea, fever, hypothermia, poor feeding

Question 9

Rapid response team

Answer 9

Physicians
Nurses
RTs
Pharmacists

Question 10

Role of rapid response team

Answer 10

when infants deteriorate neurologically –> they stop breathing rapidly
CPR EQUIPMENT
IV ACCESS

Question 11

Mongolian Spots

Answer 11

congenital dermal melanocytoses

- flat birhtmarks –> fade over time

Question 12

Normal Neurologic function in 2-month old

Answer 12

Fix and follow with eyes
Exhibit meaningful smile and respond to voice
Have strong suck
Beginning to coo
Lie flexed and have good tone

Question 13

Subdural hematoma in infant

Answer 13

Violent shaking (shaking baby syndrome) –> associated with retinal hemorrhages
Accidental trauma
NOT FROM SEIZURES OR MINIMAL FALLS

Question 14

Abusive head trauma

Answer 14

10-12% of deaths in child abuse
Mortality 25%
Morbidity 20-40%

Question 15

Discussing non-accidental trauma with parents

Answer 15

• Gather more info
• Being honest is appropriate too
• Ask what their thoughts are

Question 16

Suspected child abuse?

Answer 16

MANDATED suspected child abuse reporting

- human services and law enforcement get involved

Question 17

Team Members in suspected child abuse

Answer 17

Attending Doctor
Neurologist
Child Advocacy Doctor
Opthalmologist
Social Worker

Question 18

Skeletal Survey in child abuse

Answer 18

fractures inconsistent with natural injuries for age
multiple fractures in different stages of healing
posterior rib fractures
femur fractures in non-walking kids
skull fractures

Question 19

Prognosis for subdural bleeds

Answer 19

Many child have developmental delays, seizures, and troubles with vision