NON-ACCIDENTAL TRAUMA (NAT) SCREENING and …

NON-ACCIDENTAL TRAUMA (NAT) SCREENING and MANAGEMENT GUIDELINE (Inpatient and Outpatient) "Red Flag" History of Present Injury No history or inconsistent hx Changing history Unwitnessed injury Delay in seeking care Prior ED visit Domestic Violence in home Premature infant (< 37 weeks) Low birth weight/IUGR

Clinical Practice Guidelines : Straddle injuries

Therefore, even minor trauma can cause injury and bleeding which may appear extensive. Urogenital trauma frequently raises the question of non-accidental injury, however it is uncommonly associated with it. It is important to be able to correlate the history of the injury with physical findings on examination.

The medical assessment of fractures in suspected child ...

The clinician must be alert to subtle findings of additional injury, such as bruising or oral trauma, particularly in young infants. Bruises, especially on the child's trunk, ears and neck, may be a marker for inflicted trauma [19]–[21]. When children sustain minor accidental trauma, injuries are usually localized to one body region.

Non-accidental trauma: the role of radiology | Semantic ...

This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical decision-making for providers of emergency medicine and pediatrics. Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information …

Evaluation for Bleeding Disorders in Suspected Child Abuse ...

Other findings consistent with abuse, such as fractures, burns, or internal abdominal trauma. Other Bleeding Symptoms Children with conditions such as hematemesis, hematochezia, or oronasal bleeding as presenting symptoms should be evaluated on a case-by-case basis for possible abuse, particularly child abuse in a medical setting.

Child Abuse (Non-accidental Trauma)

All skin findings should be documented – traumatic and non-traumatic. This includes congenital findings such as birthmarks. This includes the oral cavity injury specifically looking for frenulum injury in infants and dental trauma Superficial abrasions in children are common and not typically suspicious for non-accidental trauma.

Neuroradiological Findings in Non- Accidental Trauma ...

Clinical and Neuroradiolgical findings of Non- Accidental Trauma (NAT) 3. Pitfalls Congenital infections Birth related injuries e.g. subdural tentorial hematomas 4. Search pattern to prevent observational errors 5. Assertive guidelines to call NAT to avoid cognitive errors 6. Recommended imaging plan for a follow up Background

What is the Abuse Assessment Screen?

The injury is not consistent with the account of its occurrence. What is non accidental head trauma? Non-accidental trauma (NAT) is an injury that is purposefully inflicted upon a child—in other words, child abuse. Often the injury is to the skin and soft tissue, but approximately a third of NATs are fractures. What assessment findings are ...

Abuse, Pediatric (Nonaccidental Trauma [nat]) | 5-Minute ...

The association of nonaccidental trauma with historical factors, examination findings, and diagnostic testing during the initial trauma evaluation. J Trauma Acute Care Surg. 2017;82:1147–1157. Estroff JM, Foglia RP, Fuchs JR. A comparison of accidental and nonaccidental trauma: It is worse than you think. J Emerg Med. 2015;48:274–279.

Skull Fracture Diagnosed by Ultrasound | Eurorad

Subsequent investigations included skull radiograph and CT brain which confirmed the ultrasound findings. Although no incident was identified the findings would be consistent with a traumatic event and the possibility of non-accidental injury had to be raised. A formal assessment and investigation of suspected non-accidental injury was carried out.

Non-Accidental Trauma (NAT) in Pediatric Patients

Non-Accidental Trauma (NAT) in Pediatric Patients Joshua Klatt, MD ... –Described constellation of physical findings of children who have been abused with discrepancy in reported history • Failure to thrive ... •Is the injury consistent with the explanation given?

ODJFS eManuals

Cases with non-accidental physical injury to an infant. Infant is defined as ages 0-12 months. Non-accidental injuries include, but are not limited to: bruises, bites, burns, and other such injuries. While these types of injuries may not require medical attention/treatment, in this case these injuries are considered very serious.

Non-accidental Trauma | Radiology Key

The terms "corner fracture" and "bucket handle fracture" describe fractures at the metaphyses of the long bones that are highly specific for non-accidental trauma, since nonambulatory children cannot inflict this type of injury on themselves (Box 18.2). The fractures result from tractional and torsional force applied to an extremity and ...

Non-accidental trauma in pediatric patients: a review of ...

General presentation of children with non-accidental trauma Bruising When evaluating children with bruises, the location, shape, and pattern of the bruising should be noted (36). Accidental bruises are typically found over bony prominences, such as the knees, elbow and forehead (37).

Non-Accidental Trauma - A Can't Miss Diagnosis — …

Non-accidental trauma (NAT) is a leading cause of pediatric traumatic injury and death. In 2014 alone, there were 1546 reported deaths from NAT and 3.6 million child abuse referrals submitted to Child Protective Services (CPS). [1] NAT is most commonly encountered in young children, but can occur at any age.

Trauma Clinical Guideline: Evaluation and Management Blunt ...

with liver injury. Pediatric non-accidental trauma (NAT) patients with elevated liver enzymes are at increased risk for intraabdominal injury. Lastly, …

0070-529.10, Assessing Allegations of Physical Abuse

Physical abuse, which refers to non-accidental bodily injury inflicted on a child, can include a single incident ranging from "over-discipline" (e.g. the caregiver loses control and inflicts a mark or bruise on a child) to the extreme case of child death. The longer the physical abuse continues, the more serious the consequences.

Haematological assessment in non-accidental injury ...

A thorough focussed bleeding history for the child and family members is central to the haematological assessment of suspected non-accidental injury. •. First line blood tests should include a FBC and film, coagulation screen (PT, APTT, TT or fibrinogen), von Willebrand factor and blood group, Factor VIII and IX. •.

Evaluation of Long Bone Fractures in Infants for Non ...

Background: Fractures are the second most common infant and toddler injury resulting from child abuse. Yet fractures are not always evaluated for possible non-accidental trauma often due to the lack of recognition and incomplete work-up by the evaluating physician. When non-accidental injuries are missed it can result in more serious or fatal injury. In this …

Nonaccidental Trauma | | Relias Media ...

Skeletal surveys have positive findings in roughly 10% of suspected abuse cases, with higher rates in children younger than 12 months of age. Nonaccidental trauma may be devastating. Early recognition, appropriate referrals, and timely management optimize a child's chance for a good outcome. — Ann M. Dietrich, MD, Editor.

The Eye Examination in the Evaluation of Child Abuse ...

Child abuse can cause injury to any part of the eye. The most common manifestations are retinal hemorrhages (RHs) in infants and young children with abusive head trauma (AHT). Although RHs are an important indicator of possible AHT, they are also found in other conditions. Distinguishing the number, type, location, and pattern of RHs is important in …

Evaluation of Physical Abuse in Children - American Family ...

Nonaccidental trauma may affect any organ system and mimic signs of accidental trauma or other disease processes. Table 3 presents patterns of physical findings that strongly suggest a diagnosis ...

INDIANA DEPARTMENT OF CHILD SERVICES

the medical reports obtained during the assessment. The child's left arm had a spiral fracture consistent with non-accidental trauma. John Boyfriend was the sole caregiver for the child during the time period in which the injury could have occurred and was unable to provide an explanation consistent with the injuries. The child was seriously

Pediatric Central Nervous System Imaging of Nonaccidental ...

Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and …

Nonaccidental Trauma and Child Abuse | American College of ...

More child abuse deaths occur from head injuries than other types of injuries, and those that survive go on to have serious neurological sequela..3 Non-accidental head trauma is defined as an injury to the skull or intracranial contents of an infant or young child (< 5 years old) due to inflicted blunt impact and/or violent shaking.1.

Non-accidental trauma: the role of radiology — University ...

Non-accidental trauma is a significant source of morbidity and mortality in the pediatric population. Given the vulnerable state of the child, the radiologist can often provide valuable diagnostic information in the setting of suspected abuse. This review focuses on common findings of abusive trauma and serves as a guide to aid in clinical ...

Physical Abuse (Non-Accidental Trauma) – PM&R KnowledgeNow

Non-accidental trauma most commonly presents as injuries to skin and soft tissue, but approximately one-third of non-accidental trauma results in fractures. Abusive head trauma is typically the most serious concern in children suffering from abuse, usually occurring during the first year of life with an estimated 25% to 30% mortality rate. 1

Diagnosing physical child abuse: the way forward ...

Physical injury occurs in some cases of the Munchausen syndrome by proxy.59 There are also cases of two related conditions, non-accidental suffocation and non-accidental poisoning. Non-accidental suffocation can be fatal; some cases of sudden infant deaths are caused by deliberate suffocation, though it is difficult to know how many.

Diagnosis and Management of Physical Abuse in Children ...

Possible abnormal findings or cause; General assessment of alertness, eye opening, and responsiveness ... .16 Consistent with previous studies, ... Hattingh L. Non-accidental injury. Curr Orthop ...

More than just a bruise: Recognizing child physical abuse ...

Bruising in children poses a diagnostic challenge to health care providers. Bruising can be caused by an underlying medical condition, accidental injury, or physical abuse. It is estimated that over 50% of children older than 1 year will have bruising from minor accidental injury.[1-4] However, bruising is also the most common injury in children who have been physically abused.

Non-accidental injury - PMM

Non-accidental injury. Non-accidental injury (NAI) is common, potentially life-threatening and often presents with musculoskeletal problems, such as pain, swelling, limping, or non-weight bearing.All healthcare professionals who have contact with children should be alert to the possibility of abuse.