Flashcards in Abuse/Neglect/Shaken Baby Deck (23):
What is the legal term for a report of child abuse or neglect? WHO, by law, is considered to be a MANDATED reporter?
-WHEN must a report be made?
-anyone with a PROFESSIONAL responsibility for children (includes any/all docs)
-where there is SUSPICION/reason to believe that a child has been abused/neglected
potential consequence if you...
-don't report suspected abuse/neglect, child is INJURED:
-don't report suspected abuse/neglect, child DIES:
injured: license loss/fine
dies: license loss/fine, JAIL
approximately how many kids DIE each year from suspected child abuse/neglect?
~1,500, give or take 100ish
Most common fatalities:
-more than 75% of deaths are under WHAT age?
white boys, usually LESS THAN 3 Y/O
~80% of fatalities involved at least one ____
-another 15% of fatalities are performed by a perpetrator (with/without) a PARENTAL RELATIONSHIP to the child
-15% WITHOUT parental relationship (but still known)
-only 5% by UNKNOWN perpetrator
About what percent of reported cases of abuse/neglect actually get "screened in"
MOST COMMON type of maltreatment?
17% physical abuse, 8% sexual abuse, 7% "other"
for YOUNGER victims: boys/girls more commonly victimized?
for OLDER: boys/girls?
-who dies more? boys/girls?
older: girls (sexual)
boys die more
Bruises (physical abuse) are concerning when they're in multiple locations, unusual locations, and/or when they have WHAT characteristics?
-different healing stages
-small, round, oval
-@ corners of mouth, wrists/ankles
-loop or linear shapes
-DON'T mistake for congenital mongolian spots, hemangiomas, accidentals, CT disorders, coining, or cupping (cultural)
1 in __-__ girls by 18Y/O
1 in __-__ boys by 18 Y/O
__% KNOW offender
__% are committed BY __, AGAINST ___
96% men against women/children
If you suspect ANY type of abuse, you have ___hrs to VERBALLY report, and ___hrs to submit a ____ report
-DCF (Massachusetts type of CPS) has __ days to investigate a 51A report that was screened in
T/F: YOUR role is not to determine guilt, innocence, or outcome, but rather, to gather basic info and interview parent/child separately
-may sure to ask both parent/child (separately) - how it happened, where/what/when/who
In most cases, you should tell the parent that you will be filing a 51a...EXCEPT in which circumstances?
DON'T tell parent you're filing if:
-guns/drugs in home
-parents w/ hx of threatening to harm child if tell, or if they abuse the child after report was made
T/F: about 40% of cases are d/t false allegations by children trying to get their parents in trouble, or by docs that don't like the parents
false. only ~1%.
Most common intracranial hemorrhage in SBS?
Most common eye finding in SBS
Other classic signs of shaken baby syndrome?
RETINAL hemorrhaging (multi-layer)
-skeletal injuries, esp fractured RIBS, LONG bones in parents w/ an inconsistent hx and/or delay in seeking medical care
One of the biggest triggers to SBS?
Mech: weak neck muscles can't support head weight, angular acceleration/deceleration lead to shearing/traction on vitreoretinal adhesion sites
-NO surface impact necessary
Symptoms of child w/ SBS are usually (delayed/immediate), and include what?
**most common misdiagnosis of SBS
IMMEDIATE - irritability, lethargy (or poor feeding), vomiting, bruising, seizures
-Viral gastroenteritis!! (general flu-like sx)
T/F: mild/moderate abuse will likely lead to SBS sx/signs/retinal hemes?
FALSE. must be severe/serious car accident or significant fall onto hard surface/concrete
Retinal hemorrhage ddx:
-accidental trauma (severe only)
-birth trauma: most hemes present d/t birth are gone by __ wks
-CPR - key differential?
birth trauma: hemes gone by 6 wks
-CPR: hemes will only be 1 or 2
Up to ___% of victims die from SBS injuries
-two common manifestations of abnormal visual fxn?
25% (1 in 4 die)
-CVI, optic atrophy
-note: amblyopia also possible if (+)vit heme lead to dense amblyo over long course
How many cases of SBS are reported annually in the U.S.?
Typically, victims are how old?
Other ddx for retinal hemorrhages:
accidental trauma, birth trauma (resolved in 6wks), CPR/Purtcher, terson, ruptured cerebral aneurysm, CNS infx, seizures, blood anomaly (anemia/leukemia)