Abusive Head Trauma

Question 1

Preferred terminology

Answer 1

• Abusive head trauma- causes global damage due to shaking or impact
• Abusive head injury

Question 2

Incidence/prevalence

Answer 2

• most common cause of morbidity (disability) and mortality (death) in physical child abuse
• most common cause of death from brain injury in children less than 1 year of age
• usually occurs in children younger than 1
• rare that a child will die the 1st time they are abused so we have to recogniz the signs

Question 3

KY Stats

Answer 3

2007- Ky was number 1

2008- Ky 17th

• 30-40 deaths per year and 30-50 near fatalities

Question 4

TEN- 4 Bruising Rule

Answer 4

• Screening tool

Any bruising of the:

• Torso
• Ears
• Neck

in a child 4 years of age or younger

OR

Any bruising, anywhere, on a child 4 months of age or younger (Bruising is not normal in a baby)

Normal accidental bruises are on the front of the body or over bony prominences (child over 4 months)

*** See any of these signs send child to ER immediately.

Question 5

Abuse

Answer 5

• slap marks
• bite marks
• loop marks
• Mouth bleeding (huge red flag)

Question 6

Presenting scenarios

Answer 6

• infants with bruises
• vomiting with diarhea
• apparent life- threatening event (ALTE)
• Increase in head circumference
• Hidden fractures
• Developmental delay
• lethargy/difficult to arouse
• irritable
• seizures
• breathing difficulty
• bradycardia- slow heart rate

Question 7

Triggering situations

Answer 7

• crying baby (#1)
• child’s misbehavior
• argument/ family conflict
• toilet training
• parental stressors outside of the home
• discipline gone awry