Shaken Baby Syndrome

Kristen VitalNur415: Selected Health Problems

of Women & Children

What is Shaken Baby Syndrome (SBS)?

Also known as:Abusive head trauma (AHT)Shaken impact syndrome Inflicted head injuryWhiplash 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

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

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

Perpetrators70% Male

Father/Stepfather Mother’s boyfriend

Babysitters

Daycare workers

Mothers

Anyone: Easily frustrated/poor impulse control Unable to handle stressful situations With aggressive behavior

Mechanism of Injury

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

Complications

Testing & DiagnosingCT – 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

My StanceSBS/AHT significant problem in U.S.

Child abuse issueEconomic issue

Need more awareness & preventionEducate parents and caregivers

Must be reported!

Never shake a baby!

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?

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.