What is a non accidental trauma?

What is a non accidental 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 is an NAT workup?

All children suspected of non-accidental trauma will have a complete work-up including a complete history and physical exam with a focus on injuries and explanation for the injuries.

How is a non accidental trauma diagnosed?

A thorough examination of the skin, a neurologic exam, and an examination of the abdomen are important steps. Retinal hemorrhages, spiral fractures or femur fractures in a child who is not yet ambulatory, and unexplained visceral injuries all raise suspicion for non-accidental injury.

Who is responsible for non accidental head trauma?

Factors that are intrinsic to the perpetrator of abuse include relationship to the child, and whether the perpetrator had been abused as a child. Perpetrators are likely to be young parents and female, however males are more likely to be responsible for episodes of NAT resulting in death (13).

When should you suspect a non accidental injury?

Fractures, single or multiple, in children without a medical condition predisposing them to fragile bones, should be investigated for NAI. Fractures of different ages, especially where there is no documentation of caregivers seeking medical attention, are highly suspicious of NAI.

Where do non accidental injuries appear?

Spotting the Signs of a Non-Accidental Injury Common areas include the knees, elbows, shins and forehead. These locations tend to break a child’s fall when they are involved in a collision or trip, indicating that the trauma was unintentional. However, these marks can also appear in other locations.

What does non-accidental mean?

Non-accidental injury or physical abuse is any bodily injury that is deliberately inflicted on a vulnerable person that is considered unacceptable in a given culture at a given time. This may include hitting, kicking, burning, biting or choking.

Where do non-accidental injuries occur on a child?

What is the most common trigger for PAHT?

Although normal, infant crying is a common trigger that leads to PAHT (Catherine, Ko, & Barr, 2008; Barr et al., 2009). Nevertheless, injuries consistent with abusive head trauma have been found in children as old as 5 years of age (American Academy of Pediatrics, 2001).

How do you prevent SBS?

Tips to Prevent Shaken Baby Syndrome

1. Walk away. Put the baby in a safe place, like a crib.
2. Move your body. Regular exercise releases endorphins, a chemical in the brain that can improve your mood and make your feel less stressed.
3. Breathe deeply.
4. Make time for yourself.
5. Smile.
6. Keep a journal.
7. Call a friend.
8. Ask for help.

Where do non accidental injuries typically appear?

How do you approach a non accidental injury?

Advice / framework for NAI:

1. Open with what you plan to talk about.
2. Reassure the care giver that the child is being well looked after.
3. Take a detailed history of the events.
4. It is likely you will have to probe a couple of times, a new partner is often a red flag.

What do you need to know about non-accidental trauma?

Non-Accidental Trauma (NAT) Protocol All children suspected of non-accidental trauma will have a complete work-up including a complete history and physical exam with a focus on injuries and explanation for the injuries. Major Areas of Evaluation: A complete history (document from/by whom & if it contradicts prior story)

What is the Nat protocol for non-accidental trauma?

Non-Accidental Trauma (NAT) Protocol Non-Accidental Trauma (NAT) Protocol All children suspected of non-accidental trauma will have a complete work-up including a complete history and physical exam with a focus on injuries and explanation for the injuries. Major Areas of Evaluation:

How many children have a history of nonaccidental trauma?

Up to 40% of children with inflicted injuries have a history of prior NAT. 5,11,12 Often, the injuries are less clinically significant, such as a bruise or a torn frenulum in a nonmobile child, and may go unnoticed or may not be readily visualized in a fully clothed patient.

Which is a non-accidental injury in an infant?

The presence of long bone diaphyseal fractures in a nonambulatory infant should raise concern for non-accidental injury. Such fractures usually result from application of a bending or rotational force, as the extremity is grabbed [ 22 ]. However, in older children, long bone fractures usually result from accidental trauma.