CLIPP 25 - NAT Flashcards
initial management of clinically unstable patient (5 steps)
- call a rapid response
- ensure CPR equipment and providers are available
- obtain IV access
- head CT
- PICU transfer
radiographic findings that raise suspicion for NAT (5)
- fractures or injuries inconsistent with reported mechanism of injury
- multiple injuries in different stages of healing
- femur or tibia fracture in a non-walking child
- posterior rib fractures
- skull fracture in an infant
key components of child abuse evaluation (4)
- neurological evaluation
- skeletal survey
- eye exam
- social work coordination
Brief Resolved Unexplained Event (BRUE) Characteristics (4)
Sudden, brief, now-resolved episode in an infant <1 year that includes at least one of:
- cyanosis or pallor
- absent, decreased, or irregular breathing
- marked change in tone
- altered level of responsiveness
Normal 2mo neurological function (4)
- fix and follow easily with eyes
- meaningful smile in response to voices
- strong suck
- beginning to coo
Causes of subdural hematoma (3)
- shaking/throwing (often associated with retinal hemorrhages)
- MVA
- vacuum extraction or forceps deliveries (resolve 4-6wks after birth)
- NOT after CPR, seizures, or fall from <4ft
CNS causes of apnea/altered consciousness (3)
seizure, breath-holding spells, increased ICP
Cardiac causes of apnea/altered consciousness (2)
bradycardia secondary to heart block or long QT, ductal dependent lesions
Pulmonary causes of apnea/altered consciousness (3)
RSV, pertussis, pneumonias
GI causes of apnea/altered consciousness (3)
Swallowing abnormalities, TE fistula, +/- GERD
Systemic causes of apnea/altered consciousness (5)
sepsis, congenital metabolic disorders, toxin ingestion, botulism, CO poisoning
