Non-accidental Injury Flashcards
What does NAI stand for?
Non-accidental injury
NAI refers to physical harm or injury intentionally inflicted, typically associated with child abuse.
List four types of injuries encompassed by NAI.
- fractures
- burns
- contusions
- internal injuries
What is the most severe form of NAI?
Non-accidental head injury (NAHI)
NAHI was previously termed ‘shaken baby syndrome’.
What are the characteristics of NAHI?
- subdural haemorrhages
- retinal haemorrhages
- encephalopathy
What types of investigations are performed for suspected NAI?
- comprehensive medical evaluation
- skeletal surveys (younger children)
- CT/MRI scans (suspected NAHI)
Who is involved in the management of NAI cases?
- social services
- paediatrics
- radiology
- forensic specialists
What are some clinical features of bruises associated with NAI?
- shape - hands, linear, ligatures
- pattern - non-bony areas, multiple, clustered
- age of child - non-mobilising
Why are human bites always considered suspicious in NAI cases?
They appear human
Animal bites may indicate signs of poor supervision.
In which children is there a high index of suspicion for lacerations/abrasions?
- non-mobile children
- symmetrical
- around the face
- around the ankles or wrists (ligature locations)
What should be suspected with thermal injuries in unusual areas?
NAI
Areas include soles of feet, buttocks/back, and backs of hands.
What are some signs of fractures indicative of NAI?
- fractures without medical condition predisposing to fragile bones
- fractures of different ages
- evidence of occult rib fractures
- metaphyseal corner fractures and spiral fractures
What are the indicators that intracranial injuries may be due to NAI?
- without adequate explanation
- <3 years old
- associated with retinal haemorrhage, rib or long bone fractures
- multiple subdural haemorrhages
What condition may present with excessive bruising and a family history?
Coagulopathy
Symptoms include excessive bruising and haemarthrosis.
What is osteogenesis imperfecta characterized by?
- brittle and fragile bones
- family history may be present
- x-ray shows decreased bone density
