pediatric evaluation and diagnostic services (peds

Pediatric Evaluation and Diagnostic Services (PEDS) Computer Assisted Training - Module 2

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Welcome

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Abusive Head Trauma

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Background

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Syndrome

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Head Trauma in Child Abuse

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Child Characteristics

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Perpetrators

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Anatomy of the Infant Head

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Brain Parenchyma

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Infant Brain vs. Adult Brain

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Abusive Head Trauma 2

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Effects of Shaking 1

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Intracranial Injuries

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Infant Brain Injuries

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CT Scan - Epidural Hematoma

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CT Scan

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CT Scan - Subdural Hematoma

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Subdural Hematoma at Autopsy

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White and Grey Matter

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Axonal Injury 1

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Microscopic View

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Normal Axon Function

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Axonal Injury 2

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Severe Diffuse Axonal Injury

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Brain Injury Demonstrations

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Skull Fractures

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Simple Skull Fracture

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Complex Skull Fracture

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Eye Injury

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Eye Anatomy

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Retinal Hemorrhages

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Retinal Hemorrhages Illustrated

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Retinal Hemorrhages with Shaking

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Normal Eye

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Eye with Hemorrhages

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Eye with Significant Hemorrhages

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Retinal Hemorrhages 2

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Extracranial Injuries

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Rib Fractures 1

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Rib Fractures 2

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Rib Fractures 3

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Rib Fractures 4

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Rib Fractures 5

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Rib Fractures 6

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Bone Anatomy

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Bone Injuries 1

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Bone Injuries 2

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Bone Injuries 3

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What do the Alleged Perpetrators Say?

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Clinical Presentation

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Injuries

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Medical Work-up

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History 1

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History 2

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Physical Examination

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Lab and Radiographic Studies

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Why Test?

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Other Studies/Consultants

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Follow-up

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CT Scans of Shaking Victim

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Case 1 - EV 1

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Case 1 - EV 2

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Case 1 - EV 3

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Case 1 - EV 4

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Case 1 - EV 5

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Case 1 - EV 6

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Case 1 - EV 7

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Case 1 - EV 8

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Case 1 - EV Summary

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Missed Cases of AHT

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Erroneous Diagnoses

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Missed Radiographic Diagnoses

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Increased Risk of Missed Trauma

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Remaining Vigilant

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Case 2 - Twin B 1

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Case 2 - Twin B 2

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Case 2 - Twin B 3

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Case 2 - Twin B 4

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Case 2 - Twin A 1

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Case 2 - JL Twins Summary

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Evaluate Siblings

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Differential Diagnosis – Intracranial Bleeding

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Frequency of Short Fall Deaths

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Publicly Witnessed Short Falls

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Plunkett (2001)

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Limitations of Short Fall Studies

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Other Causes of IC Bleeding 1

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Other Causes of IC Bleeding 2

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Birth Trauma

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Other Theories

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In the Courtroom

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“So-called SBS”

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Duhaime

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Final Comments

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Thank You

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