shaken baby syndrome (sbs) cinthya vidales, rn, bsn
TRANSCRIPT
Shaken Baby Syndrome(SBS)
Cinthya Vidales, RN, BSN
What is Shaken Baby Syndrome (SBS)?
Another name is Abusive Head Trauma (AHT) or Shaken Impact Syndrome (SIS).
This happens when a “frustrated caregiver violently shakes, slams, hits, or punches a child’s head, usually to stop them from crying or to get them to respond to the expectations of the caregiver” (The Shaken Baby Alliance, 2009).
What is Shaken Baby Syndrome (SBS)?
The baby’s brain rebounds inside the skull when shaken. This injury will cause bruising of the brain, swelling, pressure, and bleeding (intracerebral hemorrhage). This can easily lead to permanent brain damage or death (Kaneshiro & Zieve, 2011).
StatisticsSBS is a leading cause of child abuse deaths in
the United States.
At least one in four babies dies as a consequence of this form of abuse.
Infants up to 4 months are at greatest risk of injury from shaking
Inconsolable crying is a primary trigger for shaking a baby.
CDC, 2010
StatisticsIt is estimated that approximately 1,000 to
3,000 children suffer from SBS
80 percent of survivors suffer from permanent damage.
the United States, the costs of hospitalization and continuing care for SBS victims can total $1.2 to $16 billion dollars each year.
(New York State Dept of Health, 2010)
StatisticsIt is estimated that perpetrators in 65% to 90%
of cases are males — usually either the baby's father or the mother's boyfriend, often someone in his early twenties (KidsHealth, 2012).
Can occur in as little as 5 seconds of shaking (Kaneshiro & Zieve, 2011).
Videos on SBShttp://www.youtube.com/watch?v=6tEm2u-Epr0
http://www.youtube.com/watch?v=M3xytsg6oDo&feature=related
What happens when shaking a baby
3D Simulation of brain injury and hemorrhage
http://www.youtube.com/watch?v=l_toKPs9Jj4&feature=fvwrel
http://www.youtube.com/watch?v=DkRZ0y2vEHY
Remember:
Shaken Baby Syndrome is
a Preventable Public
Health Problem!
CDC, 2010
What are the signs?
Usually there are no outward physical signs of trauma, but there may be a change in the child's behavior such as irritability, lethargy, pale or bluish skin, vomiting, and convulsions (Kaneshiro & Zieve).
Signs
May also exhibit limpness in arms and legs or rigidity/posturing
Decreased level of consciousness
Vomiting; poor feeding
Inability to suck or swallow
Changes in feeding and napping patterns
Clinical ManifestationsRespiratory difficulty including apnea
Decreased level of consciousness
Seizure activity
Bradycardia
Bulging fontanels indicative of increased intracranial pressure
Possible complete cardiovascular collapse requiring CPR
(Miehl, 2005)
Diagnostic Exams CT scan
MRI scan
Eye examination
Clinical FindingsSubdural hemorrhage (A)
Retinal detachment/hemorrhage (B)
AB
Retinal HemorrhageRetinal hemorrhage is a cardinal display of
Shaken Baby Syndrome.
Occurs from the repeated acceleration-deceleration forces
Results in vitreo-retinal traction and perhaps damage to blood vessels and nerves behind the eye (orbit)
Essential that ophthalmologists familiar with ocular findings in SBS, evaluate suspected child victims
(Levin, 2006)
Subdural HemorrhageThe brain rotates within the skull cavity, injuring,
or destroying brain tissue
When shaking occurs, blood vessels feeding the brain can be torn, leading to bleeding around the brain.
Blood pools within the skull, sometimes creating more pressure within the skull and possibly causing additional brain damage.
The National Center on Shaken Baby Syndrome, (n.d)
Long-Term Consequences:
Learning & Physical disabilities
Visual disabilities or blindness
SBS survivors may have long term visual compromise. The main cause is brain injury to the vision centers (occipital lobes) and direct optic nerve injury.
Hearing impairment
Cognitive impairment
Speech disabilities
Cerebral Palsy
Seizures
Behavior disorders
Death
The National Center on Shaken Baby Syndrome, (n.d)
Tips for Parents It is important to educate parents and caregivers about the
dangers of SBS. Anyone caring for a child should know that if a baby is not uncomfortable or sick but will not stop crying, it is okay to put the baby down in a safe place (like a crib) and take a short break to relax.
• New parents should know that it is common for babies to cry for up to three hours a day – some cry even more than this.
•Some states such as New York have legislation requiring that hospital maternity wards offer to show new parents a video on shaken baby syndrome before they leave the hospital.
• If you suspect a baby has been shaken, you should call 911 or take the baby to the closest hospital emergency room.
(New York State Dept of Health, 2010)
Tips for Parents NEVER shake a baby or child in play or in anger. Even gentle shaking
can become violent shaking when you are angry.
Do not hold your baby during an argument.
If you find yourself becoming annoyed or angry with your baby, put him in the crib and leave the room. Try to calm down. Call someone for support.
Call a friend or relative to come and stay with the child if you feel out of control.
Contact a local crisis hotline or child abuse hotline for help and guidance.
Seek the help of a counselor and attend parenting classes.
Do not ignore the signs if you suspect child abuse in your home or in the home of someone you know.
Kaneshiro & Zieve, 2011
NEVER NEVER NEVER
SHAKE A BABY!!!
Further StudyClick on the following link to read more on SBS
http://www.dontshake.org/sbs.php?topNavID=3&subNavID=23
QuizPlease follow the link on the website to take the
quiz on Shaken Baby Syndrome.
At the end of the quiz you will be able to see the correct answers.
ReferencesCenters for Disease Control and Prevention, National Center for Injury Prevention and
Control. (2010). Heads Up: Preventing Shaken Baby Syndrome- Guide for Health
Departments and Community Based Organization. Retrieved January 31, 2012
from http://www.cdc.gov/Concussion/pdf/Preventing_SBS_508-a.pdf
Kaneshiro, N. K & Zieve, D. (2011). Shaken Baby Symptoms. Retrieved January 30,
2012 from http://www.nlm.nih.gov/medlineplus/ency/imagepages/9013.htm
KidsHealth (2012). Abusive Head Trauma (Shaken Baby Syndrome). Retrieved February 6, 2012
from http://kidshealth.org/parent/medical/brain/shaken.htm
Levin, A. (2006). Eye Findings in Shaken Baby Syndrome. Retrieved January 31, 2012
from http://www.dontshake.org/sbs.php? topNavID=3&subNavID=25&navID=279
References:Miehl, N. (2005). Shaken Baby Syndrome: Clinical Presentation of SBS. Medscape. Retrieved
January 31, 2012 from http://www.medscape.com/viewarticle/515880_4
New York State Department of Health (2010, October). Shaken Baby Syndrome: Facts and
Figures. Retrieved February 3, 2012 from http
://www.health.ny.gov/prevention/injury_prevention/shaken_baby_syndrome/
sbs_fact_sheet.pdf
The National Center on Shaken Baby Syndrome (n.d). “Long-Term Consequences”. Retrieved
January 31, 2012 from http://www.dontshake.org/sbs.php? topNavID=3&subNavID=23
The Shaken Baby Alliance. (2009). What is Shaken Baby Syndrome/Abusive Head Trauma?
Retrieved January 30, 2012 from http://www.shakenbaby.com/WhatisSBSAHT/tabid/68/
Default.aspx
Videos Missouri Department of Health and Senior Services. (2011 Oct 10). Never Shake: Preventing
Shaken Baby Syndrome. [Video file]. Retreived February 9, 2012
from http://www.youtube.com/watch? v=M3xytsg6oDo&feature=related
New Mexico Aging and Long-Term Services Department. (2010 Nov 10). TBI in Young Children 4:
Shaken Baby Syndrome and Normal Infant Crying. [Video file]. Retrieved February 3,
2012 from http://www.youtube.com/watch?v=6tEm2u-Epr0
Oopshansoo. (2010 Mar 17). Shaken Baby Syndrome 3D. [Video file]. Retrieved February 3, 2012
from http://www.youtube.com/watch?v=l_toKPs9Jj4&feature=fvwrel
Tavares, S. (2008). The Rupture of Bridging Veins in Shaken Baby Syndrome. [Video file].
Retrieved February 3, 2012 from http://www.youtube.com/watch?v=DkRZ0y2vEHY