Child Abuse & Poisoning

what is physical abuse

purposely inflicting physical harm on a child

what is emotional abuse

behaviors that could harm a child’s self-worth/self esteem

what is neglect

failure to meet a child’s basic physical needs - housing, food, education, access to medical care

who’s most at risk for potential abuse

• children younger than 4

• a child with special needs/disabilities

• family hx of substance abuse/mental issues

• inconsistent, non-biological caregivers

• parents with low-income, education levels

• teenage parents

• single parents

• parents with multiple children

IT CAN HAPPEN TO ANYONE THOUGH

what are general signs of abuse

1. inconsistent story and injury

2. injuries that are unlikely compared to their developmental age

3. injuries that could’ve been avoided with basic parental supervision

what is our job as nurses to report abuse/neglect

nurses are mandated reporters and have to report the suspicion of abuse

what are signs of physical abuse

1. multiple injuries in various stages of healing

2. bruises on the cheek, neck, genitals, buttocks, back

3. bruises in the shape of a causative object - belt, burns

4. spiral fractures that occur because it was twisted

what are signs of shaken baby syndrome

1. lethargic, hard to rouse

2. irritability

3. poor feedings

4. retinol hemmorging

5. vomiting

6. seizures

7. periods of apnea

what are signs of emotional abuse

1. child with compliant behavior or very demanding

2. delayed emotional/physical development

signs of sexual abuse

1. difficulty walking

2. advanced understanding or behaving sexually for their age

3. child having STD

4. frequent urinary tract infection, especially for girls

5. new onset of nocturnal enuresis (bed wetting)

signs of neglect

1. frequently absent from school

2. begging/stealing food/money

3. unclean clothes

4. excessive body odor

5. poor dental health

6. child dressing inappropriately   for the weather

emergency care of poisoning

1. assess the victim

2. terminate exposure

3. identify the poison

4. prevent poison absorption

care of caustic ingestion

• call 911 immediately

• ER should have intubation readily available

acetaminophen (tylenol) poisoning

1. antidote: N-acetylcysteine (mucomyst) given IV or orally

2. overdose can lead to liver failure or death

3. most common accidental drug poisoning in children

4 steps of acetaminophen poisoning

1. 0-24 hours: nausea/vomiting, seating, pallor

2. 24-72 hours: patient improves, may have right upper quadrant abdominal pain,

3. 72-96 hours: URQ pain, jaundice, confusion, stupor, coagulation abnormalities, sometimes renal failure/pancreatitis

4. 5 days+: hepatoxicity, multiple organ failure, may be fatal

lead poisoning

1. lead chelation therapy needed for severe cases: IM infections (use numbing cream with injection)

2. children routinely have BLL checked during early childhood