Abusive Head Trauma and a Delay in Presentation for Care.

Abstract:

OBJECTIVES:Abusive head trauma (AHT) is the leading cause of death from trauma in children less than 2 years of age. A delay in presentation for care has been reported as a risk factor for abuse; however, there has been limited research on this topic. We compare children diagnosed with AHT to children diagnosed with accidental head trauma to determine if there is a delay in presentation. METHODS:We retrospectively studied children less than 6 years old who had acute head injury and were admitted to the pediatric intensive care unit at a pediatric hospital from 2013 to 2017. Cases were reviewed to determine the duration from symptom onset to presentation to care and the nature of the head injury (abusive vs accidental). RESULTS:A total of 59 children met inclusion criteria. Patients who had AHT were significantly more likely to present to care more than 30 minutes after symptom onset (P = 0.0015). Children who had AHT were more likely to be younger (median, 4 vs 31 months; P < 0.0001) and receive Medicaid (P < 0.0001) than those who had accidental head trauma. Patients who had AHT were more likely to have a longer length of stay (median, 11 vs 3 days; P < 0.0001) and were less likely to be discharged home than patients who had accidental head trauma (38% vs 84%; P = 0.0005). CONCLUSIONS:Children who had AHT were more likely to have a delayed presentation for care as compared with children whose head trauma was accidental. A delay in care should prompt clinicians to strongly consider a workup for abusive injury.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Kennedy JM,Ma J,Lyden ER,Haney SB

doi

10.1097/PEC.0000000000002197

subject

Has Abstract

pub_date

2020-07-15 00:00:00

eissn

0749-5161

issn

1535-1815

pub_type

杂志文章
  • Occult pneumonia in infants with high fever without source: a prospective multicenter study.

    abstract:BACKGROUND:The prevalence of pneumonia in infants with high fever without source (FWS; temperature, > or =39.0 degrees C) and a white blood cell (WBC) count greater than 20 x 10(9)/L (occult pneumonia) has been reported to be 20% before the introduction of the 7-valent pneumococcal conjugated vaccine (PCV7). This is th...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,多中心研究

    doi:10.1097/PEC.0b013e3181e582e4

    authors: Mintegi S,Benito J,Pijoan JI,Marañon R,Peñalba A,Gonzalez A,Muñoz G,Luaces C,Claret G

    更新日期:2010-07-01 00:00:00

  • Optimizing patient/caregiver satisfaction through quality of communication in the pediatric emergency department.

    abstract:BACKGROUND:Optimizing patient/family caregiver satisfaction with emergency department (ED) encounters has advantages for improving patient health outcomes, adherence with medical plans, patient rights, and shared participation in care, provider satisfaction, improved health economics, institutional market share, and li...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e318235be06

    authors: Locke R,Stefano M,Koster A,Taylor B,Greenspan J

    更新日期:2011-11-01 00:00:00

  • Procedural Training in Pediatric Emergency Medicine Fellowship: What Are We Teaching and What Do Fellows Need to Learn?

    abstract:BACKGROUND:Life-saving procedures are rarely performed on children in the emergency department, making it difficult for trainees to acquire the skills necessary to provide proficient resuscitative care for children. Studies have demonstrated that residents in general pediatrics and emergency medicine lack exposure to p...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002195

    authors: Weiss A,Myers S,Lockman JL,Posner J,Shaw K

    更新日期:2020-08-28 00:00:00

  • Adherence to Guidelines in the Treatment of Diabetic Ketoacidosis in Children: An Austrian Survey.

    abstract:BACKGROUND:The aim of this study is to assess the adherence of Austrian physicians to International Society for Pediatric and Adolescent Diabetes guidelines 2009 concerning treatment in diabetic ketoacidosis and whether there is a difference between specialty (endocrinologists or intensivists) or clinical experience. ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001551

    authors: Weinberger K,Seick Barbarini D,Simma B

    更新日期:2018-07-24 00:00:00

  • The Effects of Pediatric Advanced Life Support Guidelines on Pediatric Trauma Airway Management.

    abstract:OBJECTIVE:Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations have altered practice. We sought to determine if a temporal change exists in the number of prehospital pediatric trauma intubations since the 20...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000759

    authors: Sperka J,Hanson SJ,Hoffmann RG,Dasgupta M,Meyer MT

    更新日期:2016-08-01 00:00:00

  • Case-Control Study of Injury Intervention for Preschool Children in Henggang, Shenzhen.

    abstract:AIM:To explore effective interventions for child accidental injury prevention and to reduce the incidence of injury. METHODS:Cluster random sampling method was adopted, and children in 19 kindergartens in Henggang, Shenzhen and their parents were selected as the objects of study. Nineteen kindergartens were randomly d...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000563

    authors: Wang H,Liu YX,Deng WJ,Yang WJ,Wang F

    更新日期:2015-10-01 00:00:00

  • Prenatal Maternal Occupational Exposure and Postnatal Child Exposure to Elemental Mercury.

    abstract:OBJECTIVES:Young children are highly vulnerable to elemental mercury toxicity, and elementary mercury exposure in young children in China unfortunately occurs regularly because of the wide use of fluorescent lamps, glass thermometers, and other mercury-contained items. This study aimed to summarize such recent cases in...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000305

    authors: Xu J,Yan CH,Hu H,Wu MQ,Shen XM

    更新日期:2016-03-01 00:00:00

  • A Mild Laryngeal Cleft Causes Severe Symptoms.

    abstract::Diagnosis and treatment of laryngeal clefts (LCs) particularly type I pose a challenge. Although rare, type I LCs are becoming increasingly identified in recent years, and this is perhaps due to both an increased awareness and better diagnostic modalities. We report a young infant presenting with feeding difficulty an...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/PEC.0000000000001350

    authors: Mandadi AR,Saeed W,Suneja U,Waseem M

    更新日期:2019-03-01 00:00:00

  • Randomized controlled trial of ultrasound-guided peripheral intravenous catheter placement versus traditional techniques in difficult-access pediatric patients.

    abstract:OBJECTIVES:We hypothesized that the use of ultrasound guidance would improve the success rate of peripheral intravenous catheter placement in pediatric patients with difficult access in a pediatric emergency department (ED). Our secondary hypotheses were that ultrasound guidance would reduce the number of attempts, the...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/PEC.0b013e31819a8946

    authors: Doniger SJ,Ishimine P,Fox JC,Kanegaye JT

    更新日期:2009-03-01 00:00:00

  • Telephone Out Patient Score: The Derivation and Validation of a Telephone Follow-up Assessment Tool for Use in Clinical Research in Children With Croup.

    abstract:OBJECTIVE:The objective was to derive a simple clinical scoring instrument for assessing children with croup by telephone for use in clinical research studies. METHODS:We reviewed published literature on croup scores, surveyed experienced pediatric emergency nurses and physicians, and conducted a prospective cohort st...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000796

    authors: Bjornson CL,Williamson J,Johnson DW

    更新日期:2016-05-01 00:00:00

  • Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult intravenous access.

    abstract:OBJECTIVE:To develop a clinical prediction rule that would be easy to apply and be useful for predicting success or failure of peripheral intravenous line insertion in children. METHODS:This was a prospective cohort study of children aged 0 to 21 years undergoing peripheral intravenous placement by staff nurses in a p...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181666f32

    authors: Yen K,Riegert A,Gorelick MH

    更新日期:2008-03-01 00:00:00

  • Two-Thumb Encircling Technique Over the Head of Patients in the Setting of Lone Rescuer Infant CPR Occurred During Ambulance Transfer: A Crossover Simulation Study.

    abstract:OBJECTIVE:The purpose of this study was to determine if the over-the-head 2-thumb encircling technique (OTTT) provides better overall quality of cardiopulmonary resuscitation compared with conventional 2-finger technique (TFT) for a lone rescuer in the setting of infant cardiac arrest in ambulance. METHODS:Fifty medic...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000833

    authors: Jo CH,Cho GC,Lee CH

    更新日期:2017-07-01 00:00:00

  • Honeycomb gallbladder: a very rare cause of right upper quadrant pain.

    abstract::Honeycomb gallbladder is a rare congenital malformation of the gallbladder. In some cases, it may be asymptomatic, whereas in others, it may lead to symptoms consistent with biliary colic even in the absence of cholelithiasis. We present the clinical and imaging findings of a case of a 10-year-old boy who was admitted...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000030

    authors: Aydin R,Bilgici MC,Polat AV,Aslan K,Kalayci AG

    更新日期:2013-12-01 00:00:00

  • Pediatric rapid sequence intubation: a review.

    abstract::Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including cur...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章,评审

    doi:10.1097/01.pec.0000125667.58561.62

    authors: Bledsoe GH,Schexnayder SM

    更新日期:2004-05-01 00:00:00

  • Pediatric zolpidem ingestion demonstrating zero-order kinetics treated with flumazenil.

    abstract::Zolpidem is a widely prescribed anti-insomnia agent. Although most pediatric zolpidem ingestions are benign, large ingestions can cause significant central nervous system (CNS) depression. Flumazenil has been reported to reverse the CNS effects of zolpidem. We describe a case of a large pediatric zolpidem ingestion re...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182aa139c

    authors: Thornton SL,Negus E,Carstairs SD

    更新日期:2013-11-01 00:00:00

  • Discitis and epidural abscess after dental extraction in a pediatric patient: a case report.

    abstract::Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction. This potentially dangerous complication was diagnosed before neurological complications developed a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3181c8c60b

    authors: Henton JM,Dabis HS

    更新日期:2009-12-01 00:00:00

  • Current variability of clinical practice management of pediatric diabetic ketoacidosis in Illinois pediatric emergency departments.

    abstract:OBJECTIVE:This study aimed to investigate the management of pediatric patients with diabetic ketoacidosis (DKA) presenting to emergency departments (EDs) participating in the Illinois Emergency Medical Services for Children (EMSC) Facility Recognition program. METHODS:In 2010, Illinois EMSC conducted a survey (includi...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182768bfc

    authors: Barrios EK,Hageman J,Lyons E,Janies K,Leonard D,Duck S,Fuchs S

    更新日期:2012-12-01 00:00:00

  • Hereditary angioedema presenting as epiglottitis.

    abstract::Hereditary angioedema is a disorder characterized by decreased levels or function of complement C1 esterase inhibitor. Symptoms in children generally consist of recurrent episodes of soft tissue swelling. On rare occasion, it can cause airway edema which may lead to airway obstruction. A case is presented of a child p...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/01.pec.0000150985.81109.0d

    authors: O'Bier A,Muñiz AE,Foster RL

    更新日期:2005-01-01 00:00:00

  • Multiple seizures after bupropion overdose in a small child.

    abstract::Unintentional ingestion of bupropion in young children has generally resulted in limited toxicity. We report a case of pediatric bupropion ingestion resulting in multiple seizures. The patient experienced hallucinations, agitation, vomiting, tachycardia and seizures after ingestion of 1050 (48 mg/kg) of extended-relea...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e31817de2e6

    authors: Spiller HA,Schaeffer SE

    更新日期:2008-07-01 00:00:00

  • Amatoxin-containing mushroom (Lepiota brunneoincarnata) familial poisoning.

    abstract::Serious to fatal toxicity may occur with amanitin-containing mushrooms ingestions. A Lepiota brunneoincarnata familial poisoning with hepatic toxicity is reported. In such poisonings, acute gastroenteritis may be firstly misdiagnosed leading to delay in preventing liver dysfunction by silibinin or penicillin G. Mushro...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000399

    authors: Varvenne D,Retornaz K,Metge P,De Haro L,Minodier P

    更新日期:2015-04-01 00:00:00

  • HIV-infected children in the pediatric emergency department.

    abstract::Forty-three nonhemophiliac, confirmed HIV-positive children followed by the Children's Hospital AIDS Program made 184 visits to the children's Emergency Department (ED) during 1988 and 1989. The mean age was 30 +/- 28 months with a median of 25 months, a mode of 10 months, and a range from two days to 19 years. CD4 co...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-199310000-00002

    authors: Pinkert H,Harper MB,Cooper T,Fleisher GR

    更新日期:1993-10-01 00:00:00

  • Crural amputation of a newborn as a consequence of intraosseous needle insertion and calcium infusion.

    abstract::Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn girl, where intraoss...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000150

    authors: Oesterlie GE,Petersen KK,Knudsen L,Henriksen TB

    更新日期:2014-06-01 00:00:00

  • Acute headache in childhood: a case of sphenoid sinusitis.

    abstract::A case of sphenoid sinusitis is presented. This case exemplifies the need to consider sinusitis in the differential diagnosis of severe headache, even without the accompanying signs and symptoms of sinusitis. The clinical, presentation, diagnostic work-up, potential complications, and treatment of sphenoid sinusitis a...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/00006565-198709000-00005

    authors: Turkewitz D,Keller R

    更新日期:1987-09-01 00:00:00

  • Cranium-Penetrating Mass Detected by Ultrasound Expedited Management of Langerhans Cell Histiocytosis.

    abstract::A 6-year-old boy presented to the pediatric emergency department with a unilateral 5 × 3-cm superficial mass on the postauricular region growing for 1 month. Point-of-care ultrasound was used to evaluate the mass, which revealed a complex cystic mass penetrating the temporal bone. After confirmatory magnetic resonance...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001092

    authors: Morgan B,Lau HL,Yellin S

    更新日期:2017-04-01 00:00:00

  • Planning Emergency Medical Services for Children in Bolivia: part 2-results of a Rapid Assessment Procedure.

    abstract:OBJECTIVE:To obtain social and cultural data about factors affecting the development of Emergency Medical Services for Children (EMS-C) in La Paz, Bolivia. The points-of-view of potential consumers and providers were sought. METHODS:A Rapid Assessment Procedure (RAP) was conducted. RAP is a qualitative ethnographic te...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/01.pec.0000142950.58265.15

    authors: Goepp J,Chin NP,Malia T,Poordabbagh A

    更新日期:2004-10-01 00:00:00

  • Inability to walk, disequilibrium, incoherent speech, disorientation following the instillation of 1% cyclopentolate eyedrops: case report.

    abstract::A 4-year-old boy, who had no prior history of convulsions, presented with inability to walk, disequilibrium, dysarthria (incoherent speech), and impaired cognition (disorientation) following the instillation of 1% cyclopentolate, a commonly used mydriatic in pediatric practice. This case demonstrates the uncommon, alt...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0b013e3182417a63

    authors: Derinoz O,Er A

    更新日期:2012-01-01 00:00:00

  • Early Ultrasound Follow-Up of Extension-Type Supracondylar Fractures Treated by the Collar-and-Cuff (Blount) Technique.

    abstract:BACKGROUND:Extension-type supracondylar fractures can be treated with external immobilization, with the elbow flexed 100°. However, this technique requires early evaluation by true lateral x-ray of the elbow to detect secondary fracture displacement. QUESTIONS/PURPOSE:The purpose of this work is to evaluate whether ul...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001822

    authors: Choufani C,Blondiaux E,Pietton R,Bachy M,Leroy A,Vialle R

    更新日期:2020-04-01 00:00:00

  • Management of Pediatric Isolated Skull Fractures: A Decision Tree and Cost Analysis on Emergency Department Disposition Strategies.

    abstract:OBJECTIVE:Pediatric isolated skull fractures (ISFs) are common injuries that represent challenging disposition decisions for clinicians. The purpose of this study is to use a decision analysis to compare the clinical and cost-effectiveness of 3 emergency department (ED)-based disposition scenarios for a pediatric patie...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000001324

    authors: Williams DC,Russell WS,Andrews AL,Simpson KN,Basco WT Jr,Teufel RJ 2nd

    更新日期:2018-06-01 00:00:00

  • Which Clinical Features of Children on Initial Presentation to the Emergency Department With Head Injury Are Associated With Clinically Important Traumatic Brain Injury, Classification as Abuse, and Poor Prognosis?

    abstract:BACKGROUND:Pediatric traumatic brain injury (TBI) and abusive head trauma (AHT) are leading causes of morbidity and mortality. Clinicians may not be aware of AHT at presentation to the emergency department (ED). OBJECTIVE:The objective of this study was to determine which clinical features associated with head injury ...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000002239

    authors: Burns J,Rohl S,Marth D,Proctor D,Amin R,Sekhon C

    更新日期:2020-09-10 00:00:00

  • An unusual presentation of hydrochloric acid ingestion: a mystery unraveled.

    abstract:BACKGROUND:Unintentional acid ingestion is less commonly encountered than alkali ingestion. The injury develops for hours to days after ingestion and often results in progressively increasing difficulty in airway management. However, gastric perforation is rare. CASE:A 3-year-old boy presented to us with an orotonsill...

    journal_title:Pediatric emergency care

    pub_type: 杂志文章

    doi:10.1097/PEC.0000000000000382

    authors: Ganapathy VP,Das RR,Chinnakkannan S,Panda SS

    更新日期:2015-03-01 00:00:00