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Neuromotor II COPY COPY > pediatric TBI > Flashcards

pediatric TBI Flashcards

1
Q

What are the types of trauma a child may experience?

A
  1. Child Abuse
  2. Near Drowning
  3. TBI
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2
Q

What is the most common cause of TBI in children?

A

shaken baby

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3
Q

What role does age play in prognosis?

A

Younger children may have worse prognosis than older children because of impairment of ability to learn and develop; however younger children have greater neuroplasticity

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4
Q

What are the types of child abuse?

A
  1. Child maltreatment - Emotional abuse
  2. Neglect - Most commonly reported and substantiated
  3. Physical abuse
  4. Sexual abuse
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5
Q

true or false:

not every state has laws to mandate reporting of suspected child abuse

A

false, every state does

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6
Q

Children with disabilities are ___ times more likely to be sexually abused

A

4-10

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7
Q

What are S and S of child abuse?

A
  1. Feeding Difficulty
  2. Delay in motor and/or social development
  3. Increased attention to surroundings
  4. Avoid eye contact
  5. Increased clumsiness while playing
  6. Passive compliance to expectation, even to painful procedures
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8
Q

What are signs of abuse?

A
  1. Impact Injuries - Bruises, abrasions, lacerations, scars
  2. Burns and scalding
  3. Fractures and joint injuries
  4. Head and brain injuries
  5. Internal Injuries
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9
Q

What are signs of neglect?

A
  1. Malnourishment
  2. Medical neglect: Parents refuse to seek or maintain medical intervention; needs to be life threatening
  3. Educational neglect: Parental indifference to school attendance or cognitive development
  4. Emotional neglect: Parental indifference to child’s need for physical contact and psychological nurturance
  5. Sexual abuse
  6. Emotional abuse
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10
Q

What are the characteristics of the abuser?

A
  • 80% of perpetrators are the child’s parents
  • 10% are another relative

Other characteristics:

  1. Lack of concern for the child
  2. Viewing child as bad or evil
  3. Offers illogical or no explanation for an injury to the child
  4. Attempting to conceal an injury
  5. Unreasonable discipline
  6. PARENTS WHO ABUSE THEIR CHILDREN WERE OFTEN ABUSED THEMSELVES!
  7. Substance abuse
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11
Q

What is primary prevention of child abuse? how can it be accomplished?

A

Protection before abuse occurs:

  1. Promote mother-infant bonding
  2. Education on child rearing
  3. Preventing social isolation
  4. Education of children on sexual abuse
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12
Q

What is secondary prevention of child abuse? how can it be accomplished?

A

Prevention of recurrence or progression:

  1. Counseling
  2. Behavior Modification
  3. Education on child discipline and stress management
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13
Q

What form must be filled out in ND if child abuse is suspected?

A

SFN 960

  • reports made directly to county social services
  • class B misdemeanor if provider chooses not to report
  • you can take a pic of the child/ suspected abuse w/o parental permission in case of suspected abuse
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14
Q

What are common methods of physical abuse?

A
  1. Hitting with a fist, open hand or object
  2. Burning with a cigarette
  3. Holding under water
  4. Scalding
  5. Shaking
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15
Q

What do you include in your report for abuse?

A
  1. Name and address of the child, his/her parents or caregivers with names and relationships
  2. Where suspected abuse occurred
  3. Age and gender of the subjects of the report
  4. Nature and extent of the suspected abuse
  5. Family composition
  6. Source of report
  7. Person making the report and contact infor
  8. Actions made by reporting source - Photos, keeping child, notifying physician
  9. Other information the department requires by regulation
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16
Q

What are common sigs of shaken baby syndrome?

A

vomiting or unresponsiveness

  • retinal and skeletal injuries common
  • most common cause of death or injury as a result of child abuse
17
Q

What are suspected residual effects of shaken baby?

A
  1. Changes in muscle tone
  2. Impaired coordination
  3. Impaired motor control
  4. Decreased strength
  5. Poor balance
  6. Delayed development
  7. Impaired cognition
  8. Impaired vision
    - global neuronal loss
18
Q

What is the 2nd most common form of traumatic injury under 5?

A

near drowning

  • Cardiac, CNS, or repiratory system complications
  • Panic, struggle, automatic swimming
  • Apnea occurs and water is aspirated
19
Q

How long does it take for the brain to result in hypoxic death of cells?

A

4-6 mins

  • complete ischemia >5 min. w/o permanent injury and irreversible damage increases significantly after 10 min
  • edema greatest at 72 hours; commonly drug induced coma
20
Q

What are the outcomes of a near drowning injury?

A
  1. Neurological outcomes are global rather than specific
  2. May have rigidity, spasticity, and abnormal posturing
  3. Diving Reflex - Very Cold Water; Blood is shunted from periphery to brain and heart; Outcomes can be miraculous
21
Q

What are the outcome measures for TBI in children

A
  1. Pediatric rancho scale (0-7 y/o) - more predictive than GCS!! higher score = better prognosis
    - low coma duration, high PCS score
  2. GCS - not as accurate in children, has been adapted to pediatric coma scale
    - PTA is more predictive than coma scale (mild <1 hr, moderate 1-24 hr, severe >24 hrs) 3 weeks significant impairments
    - Children <15 w/coma >1 week none returned to regular ed
22
Q

What is prognosis to achieve ambulation in children with TBI?

A

56% of children admitted to inpatient rehabilitation unit aged 2-18 years achieved independent ambulation by discharge

Predictors:

  • Lower extremity hypertonicity
  • Brain injury severity
  • Lower extremity injury

Neuromotor II COPY COPY (13 decks)

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