Tony Escobar
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Perineal bruising or injury was found in a small number of patients, but the majority were less than 4 years of age and there was significantly increased risk of mortality and morbidity with this finding
clinical ·
Non-accidental Trauma
In Mary Bridge's retrospective cohort, 89% of NAT cases had inconsistent or missing history, 79% had unwitnessed injuries, and almost 40% of patients had a prior ED visit
clinical ·
Non-accidental Trauma
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Tony's statements about Non-accidental Trauma 11 statements
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Pediatric Trauma Screening For Non-Accidental Trauma: Pediatric Trauma Series...
Statement
In Mary Bridge's retrospective cohort, 89% of NAT cases had inconsistent or missing history, 79% had unwitnessed injuries, and almost 40% of patients had a prior ED visit
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Perineal bruising or injury was found in a small number of patients, but the majority were less than 4 years of age and there was significantly increased risk of mortality and morbidity with this finding
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60% of NAT patients less than a year of age had fractures, with a fraction having undiagnosed healing fractures in other sites
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A third of NAT patients had rib fractures, which were significantly associated with severe injury (ISS ≥16) and other undiagnosed healing fractures
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After implementing standardized NAT screening at Mary Bridge, ED length of stay did not change
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Statement
After implementing standardized screening, the number of admissions went down, possibly because more standardized screening in the ER led to safer disposition planning and fewer medical holds
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Quotation
we're not saying that you abused your child. We're concerned that your child has been injured intentionally, and it is our job to be able to screen that and we protect, and this, we do this for every child that comes through
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Summaries Tony gave as host · 13 summaries
Recaps of other experts' statements, not Tony's own clinical position.
Summaries Tony gave as host · Non-accidental Trauma 13 summaries
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Pediatric Trauma Screening For Non-Accidental Trauma: Pediatric Trauma Series...
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Tony Escobar summarizes what Dr. Kristen Crichton said: trauma is the number one killer for children, and 48% of child fatalities each year are a result of physical abuse
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Tony Escobar summarizes what Dr. Kristen Crichton said: 48% of child fatalities each year are a result of physical abuse
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Tony Escobar summarizes what Dr. Kristen Crichton said: Approximately 12% of child abuse fatalities involve families that had CPS intervention in the last 5 years prior to the fatality, with the majority of these children less than 4 years of age
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Tony Escobar summarizes what Dr. Kristen Crichton said: NAT is not necessarily even considered when a young child is being evaluated in an ER for an injury
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Tony Escobar summarizes what Dr. Kristen Crichton said: In Carol Jenny's study, approximately 30% of children with abusive head trauma had NAT not originally considered or recognized by physicians
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Tony Escobar summarizes what Dr. Kristen Crichton said: Kate Dean's group demonstrated that patients with recurrent NAT had significantly higher mortality than during their first presentation
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Tony Escobar summarizes what Dr. Kristen Crichton said: The 10-4 clinical prediction rule (torso, ears, neck bruising in children <4 years, or any bruising in infants <4 months) is highly suspicious for NAT
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Tony Escobar summarizes what Dr. Kristen Crichton said: In the most recent systematic review of burns, up to 25% of children admitted to burn centers had been abused
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Tony Escobar summarizes what Dr. Kristen Crichton said: Greater than 95% of patients with intentional burns were aged less than 5 years
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Tony Escobar summarizes what Dr. Kristen Crichton said: Hollow viscous injuries, specifically duodenal injuries in children less than 4 years old, are highly suggestive of abuse
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Tony Escobar summarizes what Dr. Kristen Crichton said: Abusive abdominal injury can occur without external signs such as bruising
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Tony Escobar summarizes what Dr. Kristen Crichton said: Screening for elevated liver function tests is recommended, and if elevated, further axial imaging is recommended to evaluate for intraabdominal injury
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Tony Escobar summarizes what Dr. Kristen Crichton said: Frenulum tears in mobile children have equivalent incidence between accidental and non-accidental trauma, so in and of themselves there is not sufficient evidence to recommend a child abuse workup
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