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Nur415 - Shaken Baby Syndrome
- 1. Shaken Baby Syndrome Kristen Vital Nur415: Selected Health Problems of Women & Children
- 2. What is Shaken Baby Syndrome (SBS)? Also known as: Abusive head trauma (AHT) Shaken impact syndrome Inflicted head injury Whiplash shake syndrome SBS used to describe the injuries that can result if an infant or small child is violently shaken. Child abuse Most common cause of non-accidental head injury
- 3. Victims Majority are < 1 yrs of age Can occur up to 5 y/o Highest rate is 6-8 wks old In U.S., annual incidence: 20- 30/100,000 babies Higher risk: Males More prevalent: Whites, Blacks 1/3 no long-term effects 1/3 significant injuries 1/3 die
- 4. Risk Factors Special needs Developmental delays Prematurity/LBW Multiple siblings Colic/GERD Inconsolable, frequent crying Young or single parents Unstable family situations Stress Domestic violence Alcohol or substance abuse Hx of parent being mistreated as a child Low education level Low socioeconomic status
- 6. Perpetrators 70% Male Father/Stepfather Mother’s boyfriend Babysitters Daycare workers Mothers Anyone: Easily frustrated/poor impulse control Unable to handle stressful situations With aggressive behavior
- 8. Signs & Symptoms Lethargy/Irritability Hx poor feeding Vomiting Lack of smiling/Vocalization Inability to lift head Pale/Bluish skin Retinal hemorrhage Unequal pupils Tremors/Seizures Apnea/Dyspnea Bulging/Full fontanel Bruises around head, neck, chest Fractures (skull, rib, long bone) Change in mental status
- 10. Testing & Diagnosing CT – urgent MRI – usu. 2-3 day post-injury Skeletal Survey – X-Rays Ophthalmological Exam – bleeding/injuries in eye Blood Tests – R/O metabolic, genetic, bleeding/clotting disorders
- 11. My Stance SBS/AHT significant problem in U.S. Child abuse issue Economic issue Need more awareness & prevention Educate parents and caregivers Must be reported! Never shake a baby!
- 12. Class Discussion Why do you think there is a lack of awareness of SBS? What do you think we can do to raise awareness & prevention of SBS? Can you think of any cases where SBS is not intentional?
- 13. References Goulet, C., Frappier, J., Fortin, S., Déziel, L., Lampron, A., & Boulanger, M. (2009). Development and evaluation of a shaken baby syndrome prevention program. JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing, 38(1), 7-21. doi:10.1111/j.1552- 6909.2008.00301.x. March, P., & Cabrera, G. (2015). Shaken Baby Syndrome. Reynolds, A. (2008). Shaken baby syndrome: diagnosis and treatment. Radiologic Technology, 80(2), 151. Stoll, B., & Anderson, J. K. (2013). Prevention of Abusive Head Trauma: A Literature Review. Pediatric Nursing, 39(6), 300-308.
Editor's Notes
- SBS med term used to describe… Violent shaking is one of the most devastating forms of child abuse.
- Facts &Figures Highest rate r/t when babies cry most Side note: …Infants < 6 mo. of age can cry an average of 2-3 hrs/day Males: 70% of time Death: at least 1 in 4
- Risk factors for perpetrating SBS LBW: low birth weight Colic: intestinal stress/discomfort (manifests as: inconsolable cry)
- Top 10 states with highest # of SBS cases: Ohio California New York Florida Texas Pennsylvania Virginia Wisconsin Illinois North Carolina
- Who would want to shake a baby?... Perpetrators Anyone has potential to shake a baby, but especially…
- Caused by vigorously shaking/striking the head (damage greater if against surface: wall/crib) Shake baby from torso, extremities, or shoulders Head rotates uncontrollably due to neck muscles not fully developed Baby’s brain moves back and forth inside the skull (countrecoup injury) Bleeding and bruising inside the skull Forces of ACCELERATION & DECELERATION are very strong After shaking, swelling in brain can cause pressure in skull Which increases overall irreversible brain damage Initially, baby cries more but as brain is damaged, cry less/stop
- More… Hypothermia/hyperthermia Bradycardia Complete CV collapse Subdural Spinal cord/neck injuries
- Complications: Partial/total blindness Failure to thrive Hearing loss Seizures Developmental delays Speech & learning disorders Problems with memory and attention Mentally challenged Cerebral palsy Paralysis Coma Death
- Agree with National Center on Shaken Baby Syndrome (NCSBS) 1 out of every 4 children who is shaken dies from their injuries 80% of survivors suffer permanent damage An estimated 1,000-3,000 children in the U.S. suffer from SBS each year Good thing: PREVENTABLE Economic issue: In the U.S., costs of hospitalizations &continuing care for SBS victims can total betw. $1.2 &$16 billion each yr Contributions: Lost wages & productivity of victims who can’t work Costs of prosecuting the abuser & putting him or her in jail According to National Center on Shaken Baby Syndrome, 50-75% of teenagers and adults surveyed did not know that shaking a baby is dangerous B/c of this, detection may be delayed May not be detected as a baby May not be detected until school age when health, learning and/or behavior problems start to arise ***Spread understanding that crying is natural part of development, not a problem that is resolved through violence.*** Rules: Any child abuse/ suspected child abuse must be reported (timely manner) You CANNOT be held liable for reporting You CAN be held liable if you did not report & something wrong happens HELP: National Child Abuse Hotline 1-800-4-A-CHILD Call 911 right away! Emergency medical care could prevent permanent brain damage, or even save the baby’s life.
- Given the absence of national and state registries, no firm statistical data exists, which results in little publicity and funding. Estimates are rough b/c children with SBS often do not show outward signs of abuse (makes dx difficult) HCP often miss indicators of SBS Lack of funding: ultimate barrier to educate the public Resources limited Underreported More programs PURPLE Crying program Peak pattern Unpredictable Resistant to soothing Pain-like face Long bouts Evening cry Yes: Car seat/Car travel Strollers BLS/CPR Some perpetrators of SBS didn’t mean to hurt the child, and did not realize that their actions could have this effect BE CAREFUL! When in doubt, REPORT!
- Kristen Vital Nur415 – Selected Health Problems of Women & Children Shaken Baby Syndrome