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Nonaccidental trauma

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https://www.readbyqxmd.com/read/28541857/a-multidisciplinary-child-protection-team-improves-the-care-of-nonaccidental-trauma-patients
#1
John M Draus
We initiated a multidisciplinary Child Protection Team (CPT) as a subgroup of our pediatric multidisciplinary trauma peer review committee. Meetings are held monthly. Nonaccidental trauma (NAT) patients from the preceding month are reviewed. The meeting has two parts. During the open part, detectives and child protective services (CPS) workers are invited to discuss specific cases. The closed part focuses on improvement of specific processes and future outcomes. Attendance is recorded and minutes are kept. We sought to review accomplishments of this group...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28520688/the-association-of-nonaccidental-trauma-with-historical-factors-examination-findings-and-diagnostic-testing-during-the-initial-trauma-evaluation
#2
Mauricio A Escobar, Katherine T Flynn-OʼBrien, Marc Auerbach, Gunjan Tiyyagura, Matthew A Borgman, Susan J Duffy, Kelly S Falcone, Rita V Burke, John M Cox, Sabine A Maguire
No abstract text is available yet for this article.
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28325786/impact-on-hospital-resources-of-systematic-evaluation-and-management-of-suspected-nonaccidental-trauma-in-patients-less-than-4-years-of-age
#3
Bethann M Pflugeisen, Mauricio A Escobar, Dustin Haferbecker, Yolanda Duralde, Elizabeth Pohlson
OBJECTIVE: There has been an increasing movement worldwide to create systematic screening and management procedures for atypical injury patterns in children with the hope of better detecting and evaluating nonaccidental trauma (NAT). A legitimate concern for any hospital considering implementation of a systematic evaluation process is the impact on already burdened hospital resources. We hypothesized that implementation of a guideline that uses red flags related to history, physical, or radiologic findings to trigger a standardized NAT evaluation of patients <4 years would not negatively affect resource utilization at our level II pediatric trauma center...
March 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28318055/menkes-disease-mimicking-child-abuse
#4
Rebecca J Droms, Jillian F Rork, Riley McLean, Madelena Martin, Leah Belazarian, Karen Wiss
Althouygh Menkes disease has well-recognized neurologic, developmental, and cutaneous features, the initial presentation may resemble child abuse. We describe a 5-month-old boy with multiple fractures indicative of nonaccidental trauma who was ultimately diagnosed with Menkes disease. Copper deficiency leads to connective tissue abnormalities and may result in subdural hematomas, wormian bones, cervical spine defects, rib fractures, and spurring of the long bone metaphyses. Several of these findings, including fractures and subdural hematomas, may be misinterpreted as child abuse...
March 20, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28302360/consistent-screening-of-admitted-infants-with-head-injuries-reveals-high-rate-of-nonaccidental-trauma
#5
Paul T Kim, Jillian McCagg, Ashley Dundon, Zach Ziesler, Suzanne Moody, Richard A Falcone
PURPOSE: Implementation of a nonaccidental trauma (NAT) screening guideline for the evaluation of infants admitted with an unwitnessed head injury has eliminated screening disparities. This study sought to determine the overall NAT rate and key predictive factors using this guideline. METHODS: All infants screened via the guideline from 2008 to 2015 were retrospectively reviewed. The overall rate of NAT as determined by our child abuse team was determined. In addition, a logistic regression model was developed to evaluate potential predictors of increased risk of NAT...
March 11, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28245144/cns-injuries-in-abusive-head-trauma
#6
Jason N Wright
OBJECTIVE: Abusive head trauma (AHT) is one of the most common subtypes of nonaccidental trauma and is a leading cause of traumatic brain injury in young children. Imaging plays a crucial role in the evaluation of children with suspected AHT and can aid in accurate diagnosis because clinical presentation may be nonspecific. In this article, the CNS injuries that are characteristic of AHT are reviewed with an emphasis on pathophysiology and imaging appearance. CONCLUSION: AHT is a frequent cause of neurologic injury in children, particularly in infants in the first year of life...
May 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28186860/traumatic-rib-injury-patterns-imaging-pitfalls-complications-and-treatment
#7
Brett S Talbot, Christopher P Gange, Apeksha Chaturvedi, Nina Klionsky, Susan K Hobbs, Abhishek Chaturvedi
The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures...
March 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#8
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28059971/geographical-information-system-evaluation-and-trends-of-nonaccidental-trauma-at-a-level-i-trauma-center-pilot-study
#9
Michael Robert Smith, Robert Lee Davis, Patricia Anne Phillips, Tatyana Shvilkina, Kamalijit Kaur, Heather Katrina Tabolt, Matthew Krause, Vincent Galdi
PREMISE: Although trauma may be considered a random act, geographical patterns of trauma potentially emerge. Our institution is unique in that it rests at an intersection of two of the highest areas of poverty and assault in New York City and has adequate data to analyze these patterns. METHODS: We review the incident reports logged by emergency medical services (EMS) technicians arriving with intentionally injured trauma patients from January 1 to December 31, 2013 at a single institution...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28050641/children-presenting-in-delayed-fashion-after-minor-head-trauma-with-scalp-swelling-do-they-require-further-workup
#10
Jonathan N Sellin, Amee Moreno, Sheila L Ryan, Sandi K Lam, Marcella Donaruma-Kwoh, Thomas G Luerssen, Andrew Jea
PURPOSE: It is common to evaluate children who have sustained minor head trauma with computed tomography (CT) of the head. Scalp swelling, in particular, has been associated with intracranial injury. A subset of patients, however, present in delayed fashion, often days after the head trauma, as soft tissue edema progresses and their caregiver notices scalp swelling. We explore the value of further workup in this setting. METHODS: We conducted a retrospective review of a prospectively collected cohort of children ≤24 months of age presenting to the Texas Children's Hospital with scalp swelling more than 24 h following a head trauma...
April 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#11
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894429/nonaccidental-trauma-in-pediatric-surgery
#12
REVIEW
Paul T Kim, Richard A Falcone
This article presents an overview of nonaccidental trauma in children, including common clinical presentation, evaluation, and diagnosis.
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27851666/factors-associated-with-nonaccidental-trauma-evaluation-among-patients-below-36-months-old-presenting-with-femur-fractures-at-a-level-1-pediatric-trauma-center
#13
Allison M Blatz, Catherine W Gillespie, Arielle Katcher, Allison Matthews, Matthew E Oetgen
BACKGROUND: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. METHODS: A retrospective review was performed of all patients presenting to a single pediatric tertiary care hospital with a diaphyseal femur fracture from January 2007 to June 2013 who were below 36 months old...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27851304/1669-bathtub-cold-water-immersion-secondary-to-nonaccidental-trauma-causing-near-drowning
#14
Rujul Desai, Leslie Strickler, Hemant Agarwal
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27821497/pediatric-abusive-head-trauma-prevention-initiatives-a-literature-review
#15
Nahara Rodrigues Laterza Lopes, Lúcia Cavalcanti de Albuquerque Williams
Abusive head trauma (AHT) is a serious form of child maltreatment that needs to be prevented. The aim of this study was to summarize the main AHT prevention strategies described in literature, aiming to identify evidence of their efficiency, as well as strengths and limitations. International databases were reviewed from 2005 to 2015 using the key words Shaken Baby Syndrome or abusive head trauma or nonaccidental head trauma or abusive head injury or nonaccidental head injury and prevention A total of 1,215 articles were found and 34 complete articles were selected for this study...
November 6, 2016: Trauma, Violence & Abuse
https://www.readbyqxmd.com/read/27798981/hydrocephalus-associated-with-childhood-nonaccidental-head-trauma
#16
Sudhakar Vadivelu, Harold L Rekate, Debra Esernio-Jenssen, Mark A Mittler, Steven J Schneider
OBJECTIVE The incidence of posttraumatic ventriculomegaly (PTV) and shunt-dependent hydrocephalus after nonaccidental head trauma (NAHT) is unknown. In the present study, the authors assessed the timing of PTV development, the relationship between PTV and decompressive craniectomy (DC), and whether PTV necessitated placement of a permanent shunt. Also, NAHT/PTV cases were categorized into a temporal profile of delay in admission and evaluated for association with outcomes at discharge. METHODS The authors retrospectively reviewed the cases of patients diagnosed with NAHT throughout a 10-year period...
November 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27749800/a-case-of-child-physical-abuse-with-a-rolling-pin-insertion-resulting-in-bladder-and-rectal-perforation
#17
Meda Kondolot, Selim Doganay, Cüneyt Turan, Hasim Asil, Didem B Oztop, Caglar Ozdemir
Visceral injuries are not uncommon in nonaccidental trauma and often require emergent operative intervention. However, sometimes it can be difficult to assess the extent of injury. In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography. An exploratory laparotomy revealed the perforations and surgical repair was performed. The patient was evaluated by the Hospital Child Protective team and it was revealed that bladder and rectum perforations were due to insertion of rolling pin into the rectum by the stepmother...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741078/the-utility-of-head-computed-tomography-in-the-evaluation-of-apparent-life-threatening-event
#18
Wayne Stark, Annie Rominger, Fred Warkentine, Kerry Caperell
OBJECTIVE: This study aimed to evaluate the diagnostic utility of empiric head computed tomography (CT) in apparent life threatening event (ALTE). METHODS: This was a retrospective chart review of children younger than 12 months presenting to an urban pediatric hospital and its suburban satellite for an ALTE from October 2009 to December 2012. The ALTE cases were identified as having had a diagnosis of ALTE (International Classification of Diseases, 9th Revision 799...
October 6, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27712897/a-rare-but-important-entity-epistaxis-in-infants
#19
Amy M DeLaroche, Helene Tigchelaar, Nirupama Kannikeswaran
BACKGROUND: Epistaxis is a common emergency department (ED) complaint; however, this entity is rare among children younger than 2 years of age. In this age group, epistaxis may be a presenting sign of a bleeding disorder or nonaccidental trauma. CASE REPORT: We present a case of a 2-month-old infant who was evaluated in the pediatric ED for epistaxis and discharged home. The infant returned 2 days later with facial swelling and irritability, and was found to have significant head trauma...
January 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27709874/transphyseal-distal-humerus-fracture
#20
Joshua M Abzug, Christine Ann Ho, Todd F Ritzman, Brian Brighton
Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed...
February 15, 2016: Instructional Course Lectures
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