Nonaccidental trauma - Revision history

Rossdonaldson1: /* Differential Diagnosis */

2025-01-16T00:29:36Z

Differential Diagnosis

2022-10-16T20:20:05Z

← Older revision		Revision as of 20:20, 16 October 2022
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	===Fractures===		===Fractures===
			[[File:Child Protection - Child Abuse and Neglect - Bucket Handle Fracture (XRAY).jpg\|thumb\|Bucket Handle Fracture (Courtesy of Michael Mojica<ref>Mojica, Michael. 2015. PEM Guides. NYU Langone Health.</ref>)]]
			[[File:Child Protection - Child Abuse and Neglect - Metaphyseal Chip Fracture (XRAY).jpg\|thumb\|Metaphyseal Chip Fracture (Courtesy of Michael Mojica)]]
	*[[Fractures]] highly suspicious of abuse:		*[[Fractures]] highly suspicious of abuse:
	**[[Rib fracture]], especially posterior		**[[Rib fracture]], especially posterior
	~~[[File:Child Protection - Child Abuse and Neglect - Bucket Handle Fracture (XRAY).jpg\|thumb\|Bucket Handle Fracture (Courtesy of Michael Mojica)]]~~
	**Metaphyseal or [[Corner Fracture (Bucket Handle)]]		**Metaphyseal or [[Corner Fracture (Bucket Handle)]]
	**[[Scapula fracture]]		**[[Scapula fracture]]

2022-10-16T20:13:36Z

← Older revision		Revision as of 20:13, 16 October 2022
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	*[[Fractures]] highly suspicious of abuse:		*[[Fractures]] highly suspicious of abuse:
	**[[Rib fracture]], especially posterior		**[[Rib fracture]], especially posterior
			[[File:Child Protection - Child Abuse and Neglect - Bucket Handle Fracture (XRAY).jpg\|thumb\|Bucket Handle Fracture (Courtesy of Michael Mojica)]]
	**Metaphyseal or [[Corner Fracture (Bucket Handle)]]		**Metaphyseal or [[Corner Fracture (Bucket Handle)]]
	**[[Scapula fracture]]		**[[Scapula fracture]]

2022-05-14T13:48:42Z

Evaluation

← Older revision		Revision as of 13:48, 14 May 2022
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	==Evaluation==		==Evaluation==
			[[File:Fractured ribs.jpg\|thumb\|Multiple rib fractures in an infant secondary to child abuse.]]
	*Skeletal survey for all children < 2 years of age, non-verbal, or severe developmental delay. Note: Follow-up skeletal survey should be performed within 10 to 14 days		*Skeletal survey for all children < 2 years of age, non-verbal, or severe developmental delay. Note: Follow-up skeletal survey should be performed within 10 to 14 days
	**Skull AP and lateral view (left and right)		**Skull AP and lateral view (left and right)

2022-04-25T05:31:47Z

Evaluation

← Older revision		Revision as of 05:31, 25 April 2022
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	*Trauma labs: CBC, CMP, PT, PTT, lipase, and urinalysis (looking for blood; use bag specimen). Consider urine tox screen		*Trauma labs: CBC, CMP, PT, PTT, lipase, and urinalysis (looking for blood; use bag specimen). Consider urine tox screen
	**Consider CPK and platelet function studies if extensive bruising is present		**Consider CPK and platelet function studies if extensive bruising is present
	**If trauma labs are abnormal (AST or ALT >80, lipase > 100), obtain a CT of abdomen/pelvis with IV contrast		**If trauma labs are abnormal (AST or ALT > 80, lipase > 100), obtain a CT of abdomen/pelvis with IV contrast
	*Consider a dilated [[fundoscopic exam]] if under 2 years		*Consider a dilated [[fundoscopic exam]] if under 2 years
	*Photograph injuries		*Photograph injuries

2022-04-25T05:31:18Z

Evaluation

← Older revision		Revision as of 05:31, 25 April 2022
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	*Trauma labs: CBC, CMP, PT, PTT, lipase, and urinalysis (looking for blood; use bag specimen). Consider urine tox screen		*Trauma labs: CBC, CMP, PT, PTT, lipase, and urinalysis (looking for blood; use bag specimen). Consider urine tox screen
	**Consider CPK and platelet function studies if extensive bruising is present		**Consider CPK and platelet function studies if extensive bruising is present
	**If trauma labs are abnormal, obtain a CT of abdomen/pelvis with IV contrast		**If trauma labs are abnormal (AST or ALT >80, lipase > 100), obtain a CT of abdomen/pelvis with IV contrast
	*Consider a dilated [[fundoscopic exam]] if under 2 years		*Consider a dilated [[fundoscopic exam]] if under 2 years
	*Photograph injuries		*Photograph injuries

2021-02-24T04:29:24Z

Sexual Trauma

← Older revision		Revision as of 04:29, 24 February 2021
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	===[[sexual assault\|Sexual Trauma]]===		===[[sexual assault\|Sexual Trauma]]===
	*Even among children who report vaginal or anal penetration, the rate of abnormal physical examination findings is only 5 to 15 ~~percent.~~		*Even among children who report vaginal or anal penetration, the rate of abnormal physical examination findings is only 5 to 15%
	*Consult your local sexual assault response team or transfer to an appropriate facility as indicated.		*Consult your local sexual assault response team or transfer to an appropriate facility as indicated.
	*Females		*Females

2021-02-04T16:38:22Z

External Links

← Older revision		Revision as of 16:38, 4 February 2021
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	*[http://pemplaybook.org/podcast/vomiting-in-the-young-child-nothing-or-nightmare/ Pediatric Emergency Playbook -- Vomiting in the Young Child: Nothing or Nightmare]		*[http://pemplaybook.org/podcast/vomiting-in-the-young-child-nothing-or-nightmare/ Pediatric Emergency Playbook -- Vomiting in the Young Child: Nothing or Nightmare]
	*https://www.childhelp.org/wp-content/uploads/2019/02/CPS-Phone-Numbers-2.1.19.pdf		*https://www.childhelp.org/wp-content/uploads/2019/02/CPS-Phone-Numbers-2.1.19.pdf
			*[https://pedemmorsels.com/tag/abuse/ Pediatric EM Morsels: Abuse]

	==References==		==References==

2021-02-04T16:37:35Z

2019-10-06T19:18:33Z

References