A case of shaken baby syndrome after discharge from the newborn intensive care unit.
Preterm infants may be at higher risk of physical abuse after hospital discharge. Nonaccidental or inflicted head neurotrauma is the most common cause of mortality and morbidity in physical-abuse cases, and shaken baby syndrome (SBS) is the most common form of abuse. In the majority of the cases, parents who shake their infant do not intend to harm the infant. This article presents a report of a former preterm infant who presented to the pediatrician's office with a maternal report of an accidental fall. Shaken baby syndrome was suspected based on bilateral subdural hemorrhages of varying ages, which were inconsistent with the history provided. The differential diagnosis and systematic clinical evaluation for SBS are provided, and medical and nursing management is discussed. Patient care, advocacy, and mandatory reporting are reviewed. The newborn intensive care unit caregivers' role in preventing SBS in this high-risk population, including specific parent teaching and anticipatory guidance, is reviewed with an emphasis on teaching all caregivers about the dangers of shaking an infant.
Hoffman
Jacqueline M
JM
baby.nurse@verizon.net
D001034:Apgar Score; D005260:Female; D005500:Follow-Up Studies; D006408:Hematoma, Subdural / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008279:Magnetic Resonance Imaging; D008297:Male; D019221:Mandatory Reporting; D008991:Monitoring, Physiologic; D017283:Neonatal Nursing / Q000379:methods; D010351:Patient Discharge; D010359:Patient Readmission; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000451:nursing / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D038642:Shaken Baby Syndrome / Q000175:diagnosis* / Q000628:therapy