Evaluation of Bite Marks in Terms of Child Abuse in Emergency Departments (original) (raw)
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Evaluation of Pediatric Trauma Cases Applied to Emergency Department
DergiPark (Istanbul University), 2013
Şehirler arası kara yolu trafiğinin kavşak konumunda olan ilimizde travma sonucu yatırılarak takip ve tedavisi yapılan çocuk hastalar incelenmiştir. Gereç ve yöntem: İki yıl içinde merkezlerimize başvuran travma olguları; yaşları, cinsiyetleri, travmaya uğrama yeri, travmanın şekli, yaralanma tipi, etkilenen organ sistemi, yaralanan organlar, cerrahi işlem gereken olgular ve mortalite oranları açısından incelendi. Bulgular: İncelenen 328 hastanın 240'ı erkekti. Olgular 2 yaş altı (infant), 2-7 yaş arası (oyun çocuğu) ve 7 yaş üstü (okul çocuğu) olmak üzere 3 grupta incelendi. Travmalar büyük oranda trafiğe açık alanlarda olurken ev ve okul diğer alanlardı. Olguların %38'i araç dışı, %11'i araç içi trafik kazası, %31'i ise yüksekten düşme ile başvurdu. Künt travma daha sıktı. Bu hastaların da %64'ü batın travması idi. Kafa travması 2. sıklıkta iken, iskelet sistemi, toraks, genitoüriner sistem ve anorektal bölge etkilenen diğer bölgelerdi. Karaciğer, dalak ve akciğer travmaya maruz kalan organlardı. 57 olguya cerrahi müdahale gerekti. Kafa travması eşlik eden 22 hasta tedavi sırasında kaybedildi. Sonuç: Travma sonucu kaybedilen çocuklar çoklu organ ve sistem yaralanması olanlardır. Bu tip olgular için travma merkezleri kurulmalı, 112 doktorları ve acil servisler teknik donanım bilgi ve tecrübe açısından güçlendirilmelidir. Böylece mortalite oranı düşürülebilir. Anahtar Kelimeler: çocuk, travma, mortalite Türkçe kısa makale başlığı: Çocuk travmaları ve mortalite ABSTRACT Objective: The trauma cases of our city which is located near to a busy road junction were hospitalized for follow-up and treatment. Materials and methods: Trauma patients treated and followed in our centers for two years; age, gender, place of being traumatized, shape the development of trauma, type of injury, the affected organ system, the most frequently injured organs, and mortality rates of the patients required surgical intervention were analyzed. Results: Of the 328 patients 240 were males. Patients were examined in the three group; under 2 yearsold, 2-7 yearsold and over 7 yearsold. Traumas were often in places open to traffic. Others; home and school. 38% of the cases, out of vehicle, 11% vehicle accident, 31% presented with a fall from height. More common was blunt trauma; 64% of these had abdominal trauma. Head trauma was the second. Skeletal system, chest, genitourinary tract and anorectal region were others. Liver, spleen and lung exposed to trauma. 57 patients required surgical intervention. Twenty-two patients with head trauma died during treatment. Conclusion: Children died as a result of trauma, injury of multiple organ and systems. Trauma centers should be established for this patients. Doctors of 112 and emergency services should be strengthened in terms of technical equipment, knowledge and experience. Thus, the mortality rate can be reduced.
Medicolegal Approach to Child Physical Abuse in an Emergency Clinic
Journal of Academic Emergency Medicine, 2015
Child abuse is a global health problem. For this reason, it is important to perform suitable medical approaches in suspected child abuse cases in the emergency room. The first consideration is performing life-saving medical approaches. Reporting the case to judicial authorities and correlation of medical examination findings with the medicolegal history are other important steps. We report a case of a 3-year old male child who died after severe physical abuse. In suspected child abuse cases, examination of the fundus is important. If death occurs, histopathological examination of eye globes must be performed to determine the cause of death. The present case was the first case in which eye globe examination was performed in Izmir, Turkey. Autopsy findings revealed subdural haemorrhage and subarachnoid haemorrhage due to blunt trauma. The cause of death was blunt head trauma and the manner of death was listed as homicide. Except for microhaemorrhages in the optic nerve sheath, no pathological finding was identified in the retina. Retinal haemorrhage can be seen in child abuse cases and it is associated with a poor prognosis if present, although the absence of retinal haemorrhage does not exclude child abuse. Crime scene investigation findings, witnesses' statements, medical records and the autopsy findings must all be taken into consideration in child abuse cases in a correlative and holistic way.
Assesment of Medical Staff Awareness About Child Abuse and Neglect
Turkish Journal of Forensic Medicine, 2012
This study is formed in order to put forward the knowledge levels of the medical staff on the signs and risks of child abuse-neglect, the influence of training and professional experience on this knowledge level; and to determine whether there is an increase or not in the knowledge levels of the medical staff on the subject of child abuse and neglect in years when compared with the results of other groups is aimed.
Retrospective Analysis of Pediatric Trauma Cases Admitted to the Emergency Medicine Department
Journal of Academic Emergency Medicine, 2013
Objective: The purpose of this study is to determine the prognosis of the demographic characteristics, etiology, morbidity and mortality rates of the pediatric trauma patients admitted to the emergency department of a training and research hospital. Material and Methods: Pediatric patients who have been brought to the emergency department of a training and research hospital between 1 st January-31 th December 2010 due to trauma have been included to this study. The demographic data of the patients, distribution by seasons and months, the etiologic factors that cause trauma, the way that patients have been admitted to the emergency department, conclusion figures of the patients in the emergency department, and data of the units where patients have been hospitalized, treatments, average hospitalization time, conclusion figures of the clinics where they have been hospitalized have been analyzed statistically. Results: Of the 18936 patients, 12096 boys and 6840 girls have been included to this study. The mean was as 8.11±5.19 in boys and 6.89±5.04 in girls. The most common age for trauma was 7-14 (36.15%) and it has been stated that the pediatric trauma cases have been mostly admitted in Spring and Summer months. Extremity injuries (42.40%) and falls (40.67%) were stated as the most etiologic causes. 815 of the patients have been hospitalized. 353 cases (43.31%) received surgical invention while 462 (56.69%) cases received only medical treatment. The causes of death in pediatric trauma patients were: 10 (47.62%) o due to traffic accidents, 5 (23.81%) due to falls, 5 (23.81%) due to burns and 1 (4.76%) due to drowning. It has been stated that 13 (61.90%) cases were male and 8 (38.10%) patients were girls of a total 21 cases resulting in death. Conclusion: Most of the pediatric traumas occur due to falls or simple extremity injuries. Traumas are mostly seen between the 7-14 age range during the primary school period. The most common etiological factors in hospital admissions are falls. The most common etiological cause of death in pediatric trauma is traffic accidents. (JAEM 2013; 12: 8-12) Özet Amaç: Bu çalışmanın amacı bir eğitim ve araştırma hastanesi acil tıp kliniğine başvuran pediatrik travma olgularının demografik özelliklerini, etiyolojisini, morbidite ve mortalite oranlarını, prognozlarını belirlemektir. Gereç ve Yöntemler: Retrospektif yapılan bu çalışmaya 1 Ocak-31 Aralık 2010 tarihleri arasında çocuk acil servisine travma nedeniyle getirilen, 0-18 yaşları arasındaki hastalar dahil edildi. Hastaların demografik verileri, mevsimlere, aylara göre dağılımı, travmaya neden olan etiyolojik faktörleri, hastaların acil servise nasıl başvurdukları, hastaların acil serviste sonuçlanma şekli, hastaneye yatan hastaların yattığı birim, aldığı tedavi, ortalama yatış süreleri, yattığı klinikte sonuçlanma şekli ile ilgili veriler istatistiksel olarak analiz edildi. Bulgular: Çalışmaya 18936 hasta (12096 erkek, 6840 kız) alındı. Erkek/kız oranı 1.7 idi. Olguların yaş ortalaması erkek çocuklarda 8.11±5.19, kız çocuklarda 6.89±5.04 olarak saptandı. Travmanın en sık görüldüğü yaş aralığı 7-14 (%36.15) yaş idi. Pediatrik travma olgularının en fazla bahar ve yaz aylarında başvurduğu saptandı. Etiyolojik nedenler arasında en sık basit ekstremite yaralanmaları (%42.40) ve düşme (%40.67) olgularının olduğu saptandı. Hastaların %95.56'sı acil servisten taburcu edilmiş, 815'i (%4.30) hastaneye yatırılmıştı. Hastaneye yatış verilen hastalar içinde 353 (%43.31) olguya cerrahi müdahale yapılırken, 462 (%56.69) olguya sadece tıbbi tedavi uygulanmıştı. Yatan hastaların %95.95'inin salah ile evine taburcu edilmişti. Travma sonucu ölüm daha çok erkek cinsiyette (%61.90) en fazla 3-6 yaş aralığında (%38) ve en sık trafik kazası sonucunda (%47.62) olmuştu. Tüm travma hastalarının %0.11'inin (21 olgu) eksitus olduğu belirlendi. Sonuç: Pediatrik travmaların çoğunluğu düşme veya basit ekstremite yaralanması sonucu olmaktadır. Travmalar çoğunlukla erkek çocuklarda ve 7-14 yaş aralığında ilköğretim çağında görülmektedir. Okullarda travma oluşumunu engelleyecek önlemlerin alınması olgu sayısını azaltacaktır. Ayrıca pediatrik travmalarda ölümün en sık etiyolojik nedeni trafik kazalarıdır. (JAEM 2013; 12: 8-12) Anahtar kelimeler: Pediatrik travma, acil, demografi
Akdeniz Medical Journal
ÖZ Amaç: Günümüzde sıkça görülen çocuğa yönelik istismar olgularının bildirilmesinde önemli bir rol üstlenen sağlık profesyonellerinin çocuk istismarına yaklaşımları ve çocuk izlem merkezleri hakkındaki farkındalıklarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Tanımlayıcı tipteki bu araştırma 1-30 Ocak 2019 tarihleri arasında yapılmıştır. Araştırma evreni bir üniversite hastanesinin; acil servis, aile hekimliği, çocuk ve ergen ruh sağlığı ve hastalıkları, çocuk sağlığı ve hastalıkları, çocuk cerrahisi, kadın hastalıkları ve doğum ile ortopedi bölümlerinde çalışmakta olan hemşire, ebe ve doktorlardan oluşan 587 kişidir. Araştırmacılar tarafından oluşturulan 24 soruluk anket katılımcılara gözlem altında uygulanmıştır. Bulgular: Araştırmaya katılım %76,3 (n=448)’tür. Sağlık profesyonellerinin %23,4’ü (n=105) çocuk istismarından şüphelendikten sonraki süreçte karşılaşacağı yasal düzenlemeler hakkında bilgi sahibi olmadığını belirtirken, yalnızca %35,0’ı (n=157) daha önce ‘Çoc...
Evaluation of Pediatric Patients with Animal Bites and Rabies Suspected Exposures
Kafkas Journal of Medical Sciences, 2018
Aim: Animal bites are important public health problem worldwide, affecting especially children. It was aimed to retrospectively assess the children who admitted to Erzurum Regional Training and Research Hospital with mammalian animal bites or other rabies suspected exposures regarding their clinical and epidemiological properties in this study. Material and Method: Children aged between 0-16 years old with rabies suspected exposures by a mammalian animal (bite, scratch, licking, etc.) were included. The recorded data were; patients' age, gender, and risk category for rabies, time duration since bite, bitten body sites, type of animal, whether the animal had an owner, was provoked before bite, and was observed after bite, whether bite wound was sutured, whether the patient was given antibiotic, hospitalized, and experienced any side-effects after rabies vaccine and immunoglobulin. Results: Mean age of 121 cases was 9.3±4.1 years and 80.2% was male. Children aged between 11-16 years were mostly affected. Patients admitted after median 1 day (range, 0-30 days) after bite. Lower extremity was the mostly affected body part (n=67, % 55.3). Eighty nine (% 73.5) of patients had risk category 3. The most frequent animals were dogs (n=82, % 67.8). Among all animals , fifty five (45.4%) had owners, 102 (84.2%) were unprovoked, and 20 (17.2%) had rabies vaccines, and 70 (63.6%) were observed for ten days. None of them developed rabies. Two patients had contact with rabid animal. No patient suffered from rabies. Seventy six (62.8%) patients were given antibiotic prophylaxis and 8 (6.6%) had sutures. Only one (0.8%) patient with multiple bites was hospitalized. No patients had complication and mortality. Conclusion: It was revealed in this study that rabies suspected exposures effect mostly boys during primary education and the cases apply medical attention in such a short duration as median one day. Morbidity and mortality rates in the study were quite low.