Safeguarding Flashcards
What is shaken baby syndrome?
A form of severe child abuse where an adult shakes a baby out of anger or frustration, usually because of crying.
What can happen to the baby if it has been shaken - list 4 complications out of 8?
- Subdural haematoma
- Subarachnoid haemorrhage
- Direct trauma to the brain - comes into contact with the skull and damages
- Breakage of axons in the deeper cortex
- Hypoxic brain injury
- Retinal haemorrhage
- Skull fracture
- Body bone fractures
What is the most common age of a shaken-baby?
3-8 months old (can range up to 4 years but more commonly under 2 years)
List 6 signs of a shaken baby, these can occur immediately or 4-6 hours after the incident.
- Altered consciousness
- Drowsy and irritable
- Coma
- Convulsions or seizures
- Dilated pupils, unresponsive to light
- Decreased appetite
- Vomiting
- Posture; head back, back arched
- Breathing irregularities
- Low and shallow breathing
- Cardiac arrest
- Death
List 6 physical signs we might find on examination of a shaken baby
- Retinal haemorrhages
- Closed head injury bleeding
- Lacerations
- Contusions (brusing)
- Concussions
- Bruising to the face, scalp, arms, abdomen or back
- Soft tissue swellings
- Abdominal inuries
- Chest injury
- Hypotensive
- Tense fontanelle
What can the long term medical problems be for a shaken baby?
- Cerebral palsy
- Paralysis
- Vision loss/blindness
- Mental retardation
- Epilepsy
- Seizures
Which other services when a baby presents with NAI or signs of abuse?
- Social Services
- Police (in some scenarios)
What further investigations would we carry out when a baby presents with NAI, subdural bleeding?
- Skeletal survey; Look for fractures
- Ophthalmology review; retinal haemorrhages
- Metabolic testing; exclude glutaric aciduria
- Blood coagulation
What are the 5 types of child maltreatment?
- Physical
- Emotional
- Neglect
- Sexual
- Factitious or Induced injury
What a child risk factors that might increase their chance of being abused?
- Younger child
- Increased needs e.g. disabled
- Low BW
- Multiple births (twins, triplets etc)
What parental risk factors might increase the chance of them being abusive to their child?
- Younger parental age
- Mental illness
- Drug/alcohol abuse
- Domestic violence
- Lower socio-economic group
- Parents were abused
- Criminal history
- Chaotic family
- Vulnerable/lonely parent
- Known animal abusers
What is a body map and what is it used for?
A drawing of a body used to document visible findings on examination
What are the reassuring features in an accidental injury history?
- Mechanism consistent with injury
- Consistent stories
- Story corroborated by other sources
- No delay in seeking medical attention
- Appropriate concern from parent
- One-off injury
- Injury consistent with child age/development/mobility
What are the worrying features in a history of an NAI?
- No mechanism for injury or mechanism is inconsistent with injury
- Delay in seeking medical attention
- Inconsistent histories from multiple sources
- Inappropriate parent reaction (vague, unconcerned, aggressive, excessively distressed)
- Recurrent
- Injuries inconsistent with age/development/mobility
What fractures are common in paediatric patients with accidental injury?
- Linear skull fractures
- Long bone fractures in >5 years old
- Fracture types differ in their ratio of accidental vs. NAI