Download click here to download

8/6/2013
Abusive Head Trauma
Recognition, Stabilization, and Evaluation of Abusive Head Trauma
Disclosure Statement of
Financial Interest
We, (Drs. Gibson, Mills, and Tuell),
DO NOT have a financial
interest/arrangement or affiliation with
one or more organizations that could
be perceived as a real or apparent
conflict of interest in the context of the
subject of this presentation.
Disclosure Statement of
Unapproved/Investigative Use
We, ( Drs. Gibson, Mills, and Tuell),
DO NOT anticipate discussing the
unapproved/investigative use of a
commercial product/device during this
activity or presentation.
1
8/6/2013
Audience Identification
• Age
•
•
•
•
•
•
A. Younger - 25
B. 26-35
C. 36-45
D. 46-55
E. 56-65
F. 66 or older
Audience Identification
Age
A.Younger – 25
B. 26 – 35
C. 36 – 45
D.46 – 55
E. 56 – 65
F. 66 - Older
de
r
0%
66
‐ Ol
55
65
0%
56
–
45
25
0%
46
–
36
–
26
–
0%
Yo
u
ng
er
–
0%
35
0%
Audience Identification
• Number of years experience in the medical field
•
•
•
•
•
A. less than 5
B. 5- 10 years
C. 10-15 years
D. 15-20 years
E. 20 or more years
2
8/6/2013
Audience Identification
Number of years experience in the medical field
A.Less than 5
B. 5-10 years
C. 10-15 years
D.15-20 years
E. 20 or more years
0%
0%
20
o
r m
or
e ye
a
rs
ar
s
0%
15
‐2
0 ye
10
‐1
5 ye
ar
s
ar
s
0%
5‐
10
ye
Le
ss
th
a
n 5
0%
Audience Identification
• Title:
•
•
•
•
•
•
•
•
A. Physician
B. Resident Physician
C. Medical Student
D. Nurse Practitioner
E. Physician Assistant
F. Nurse
G. Law enforcement/Social Work/ CPS
H. Other
Audience Identification:
Your Title…
A.
B.
C.
D.
E.
F.
G.
0%
0%
0%
0%
0%
0%
r
0%
Re
sid
Ph
en y s i c
ia
t
M Phy n
ed
sic
i
c
ia
Nu
a
n
rs l Stu
e
Ph Pra den
ys
t
c
ici titi
La
an o n
w
e
A
e
ss r
nf
ist
or
an
ce
t
m
en
Nu
t/
So rse
cia
l..
.
0%
Ot
he
Physician
Resident Physician
Medical Student
Nurse Practitioner
Physician Assistant
Nurse
Law enforcement/Social
Work/ CPS
H. Other
3
8/6/2013
Audience Identification
• Practice/Employment Location:
• A. Rural
• B. Suburban
• C. Urban
Audience Identification
Practice / Employment Location
A.Rural
B. Suburban
C. Urban
n
0%
Ur
ba
ur
ba
n
0%
Su
b
Ru
ra
l
0%
Audience Identification
• Have you had any simulation lab experience in the
past?
• A. Yes
• B. No
4
8/6/2013
Audience Identification
Have you had any simulation lab experience in the
past?
A.Yes
B. No
0%
Ye
s
No
0%
Audience Identification
• Have you had any experience with abusive head
trauma in the past?
• A. Yes
• B. No
Audience Identification
Have you had any experience with abusive
head trauma in the past?
A.Yes
B. No
0%
No
Ye
s
0%
5
8/6/2013
Audience Survey
• Rate your knowledge of abusive head trauma:
•
•
•
•
•
1. Limited
2. Below Average
3. Average
4. Above Average
5. Expert
Audience Survey
Rate your knowledge of abusive head trauma:
A.Limited
B. Below Average
C. Average
D.Above Average
E. Expert
rt
e
Av
er
ag
0%
ve
Ab
o
Be
l
0%
Ex
pe
ra
ge
0%
ow
Lim
A
ve
ra
ite
ge
0%
Av
e
d
0%
Audience Survey
• Rate your comfort level in managing a patient with
possible abusive head trauma:
•
•
•
•
•
1. Not at all comfortable
2. Somewhat comfortable
3. Neutral
4. Comfortable
5. Very comfortable
6
8/6/2013
Audience Survey
Rate your comfort level in managing a patient
with possible abusive head trauma:
0%
ry
co
m
fo
rt
ab
l
e
0%
Ve
Ne
ut
ra
l
0%
fo
rta
bl
e
0%
Co
m
0%
No
t a
t a
ll c
om
So
fo
m
rt
ew
ab
ha
le
t c
om
fo
rt
ab
le
A.Not at all
comfortable
B. Somewhat
comfortable
C. Neutral
D.Comfortable
E. Very comfortable
Case presentation
• You are working in the Emergency Department. A
2-month-old infant presents with a chief complaint
from mother that she “cannot wake her baby up.”
Stabilization
• Do you agree or disagree with the stabilization
management?
1. Strongly Disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
7
8/6/2013
Stabilization
Do you agree or disagree with the stabilization
management?
gr
ee
0%
St
ro
ng
ly A
l
0%
Ag
re
e
ut
ra
gr
e
0%
St
r
on
g
ly
D
Di
isa
0%
sa
gr
ee
e
0%
Ne
A.Strongly Disagree
B. Disagree
C. Neutral
D.Agree
E. Strongly Agree
Evaluation
• Do you agree or disagree with the evaluation the
team has completed?
1. Strongly Disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
Evaluation
Do you agree or disagree with the evaluation
the team has completed?
0%
ly A
gr
ee
0%
Ag
re
e
ut
ra
l
0%
St
ro
ng
Di
sa
gr
ee
0%
St
r
on
g
ly
D
isa
gr
e
e
0%
Ne
A.Strongly Disagree
B. Disagree
C. Neutral
D.Agree
E. Strongly Agree
8
8/6/2013
Communication
• Do you agree or disagree with the communication
process the team has conducted?
1. Strongly Disagree
2. Disagree
3. Neutral
4. Agree
5. Strongly Agree
Communication
Do you agree or disagree with the communication
process the team has conducted?
gr
ee
Ag
re
e
0%
ly
A
ut
ra
l
e
gr
e
0%
St
ro
ng
Di
isa
ly
D
0%
St
r
on
g
0%
sa
gr
ee
0%
Ne
A.Strongly Disagree
B. Disagree
C. Neutral
D.Agree
E. Strongly Agree
Critical Points in Stabilization
• ABCDE
• A- Airway
• secure
• B- Breathing
• apnea
• C- Circulation
• shock
• D- Disability
• glucose
• E- Exposure
• bruising
9
8/6/2013
Critical Points in Evaluation
• Labs
• Head Imaging
• Skeletal Survey
• Ophthalmology
Critical Points in
Communication
• Safety for patient, provider, staff, and caregivers
• SAMPLE history
• S- Signs/Symptoms
• A- Allergies
• M- Medications
• P- Past Medical History
• L- Last Meal/liquids
• E- Events leading up to incident
• CPS/911/hospital security
• Documentation
Audience Survey
• Rate your knowledge of abusive head trauma:
•
•
•
•
•
1. Limited
2. Below Average
3. Average
4. Above Average
5. Expert
10
8/6/2013
Audience Survey
Rate your knowledge of abusive head trauma:
A.Limited
B. Below Average
C. Average
D.Above Average
E. Expert
rt
0%
Ex
pe
Av
er
ag
e
0%
ve
Av
e
ite
Be
l
Ab
o
ow
Lim
A
ve
ra
0%
ra
ge
0%
ge
d
0%
Audience Survey
• Rate your comfort level in managing a patient with
possible abusive head trauma:
•
•
•
•
•
1. Not at all comfortable
2. Somewhat comfortable
3. Neutral
4. Comfortable
5. Very comfortable
Audience Survey
Rate your comfort level in managing a patient with
possible abusive head trauma:
0%
Ve
Ne
ut
0%
fo
rta
bl
e
ry
co
m
fo
rt
ab
le
0%
ra
l
0%
Co
m
0%
No
t a
t a
ll c
om
So
fo
m
rt
ew
ab
ha
le
t c
om
fo
rt
ab
le
A.Not at all
comfortable
B. Somewhat
comfortable
C. Neutral
D.Comfortable
E. Very comfortable
11