Child abuse in the pediatric intensive care unit

The changing face of abuse cases in a pediatric intensive care unit: A single-center experience

BACKGROUND

Due to the increase in abuse and neglect cases in recent years, the purpose of this study was to assess child abuse and neglect of patients who were hospitalized and followed up in our pediatric intensive care unit (PICU).

METHODS

A total of 34 abuse and neglect patients who were admitted to the PICU from August 2020 to March 2021 were included retrospectively in the study. Patients' clinical and demographic characteristics were obtained from our hospital's patient record system (HIS). Comorbidities and the mental status of the patients, affected systems, treatments, and outcomes were extracted.

RESULTS

In this study, 44.1% (n: 15) of the patients were male and 55.9% (n: 19) were female. Physical neglect such as foreign body aspiration, malnutrition, electrocution, drowning, traffic accident, and body collision was detected in 14 (41.2%) patients. Emotional neglect (taking drugs, alcohol, or suicide) was found in 19 (55.9%) of our patients. Only 1 (2.9%) patient presented with physical abuse.

CONCLUSIONS

Perception of neglect varies among different cultures. Any infant or child who is admitted to the PICU with a history that is not consistent, a history of delay in seeking medical attention, a previous history of abuse or suspected abuse, or the absence of the primary caretaker at the appearance of illness should signal possible abuse. Health-care professionals should give more attention to these patients to prevent the overlooking and recurrence of neglect and abuse cases due to the intense work tempo in the PICU.

Nonaccidental trauma: guidance for nurses in the pediatric intensive care unit

Each year thousands of children are hospitalized for traumatic injuries associated with physical abuse. Nurses in the pediatric intensive care unit must be knowledgeable and skilled in caring for the physical, psychological, emotional, social, and developmental needs of such children and their families. This article provides direction for pediatric nurses working in the critical care setting. Specifically, it describes the nursing care of children in a pediatric intensive care unit where the mechanism of nonaccidental injury is blunt force to the head, abdomen, or musculoskeletal system, based on standards put forth by the American Association of Critical-Care Nurses.

The physical manifestations of shaken baby syndrome

Shaken baby syndrome (SBS) is a great concern for forensic nurses. Accurate diagnosis and treatment is essential. The purpose of this report is to review the history of SBS, as well as the physical symptoms of a patient suspected of suffering from this form of abuse. Implications of SBS for the forensic nurse will be presented; this will include the education of families and caregivers and methods of prevention.

Temporal factors and the incidence of physical abuse in young children: decreased nonaccidental trauma during Child Abuse Prevention Month

BACKGROUND/PURPOSE

Educational efforts have been shown to decrease the incidence of abusive injuries. Information related to factors that associate with child abuse would further these educational efforts. We undertook this study to determine the influence of temporal factors and a national preventative program on the incidence of abusive injuries in young children.

METHODS

The Pennsylvania Trauma Outcome Study database was queried for all children 36 months old or younger admitted with abusive injuries. Data collected included day, month, and season. Data were analyzed by Poisson regression.

RESULTS

Six hundred seventy-two cases of child abuse were reported, with a linear increase in the number of cases per year (P < .001). Sunday had fewer abuse cases admitted than any other day of the week (risk ratio, 0.70; P = .008). Younger children were less likely to be injured during April, which is National Child Abuse Prevention Month, and more likely to be injured during August and October (all P < .05).

CONCLUSIONS

We observed fewer inflicted injuries in young children on Sundays, and during April. The causes for these significant variations deserve further study.

Shaken Baby Syndrome

Unfortunately, head trauma caused by shaken baby syndrome is a common occurrence in infants and young children. The proper treatment and safety of these children can be enhanced by the nurse's ability to recognize features characteristic of this syndrome. If abuse is suspected, appropriate physicians, child-protective, and law-enforcement agencies should be notified immediately. Further research must be done to improve the understanding of the mechanisms associated with this disorder in the ultimate hope of improving the lives and outcome of infants and children.

Shaken baby syndrome

Shaken baby syndrome (SBS) is a violent act of abuse that can cause myriad neurologic, cognitive, and other functional deficits. In the most serious cases, death can result. Health care practitioners, child care providers, and parents must be educated on the signs of SBS. Cases should be thoroughly reviewed and prevention strategies developed to prevent future incidents.