[醫如往常] Junior Clerkship Day 37: AHT: Abusive head trauma

20151023 Morning meeting

OHCA; Out-of-Hospital Cardiac Arrest

ROSC: Return of spontaneous circulation

Doll eye sign; Oculocephalic reflex在腦幹正常的病患可觀察到眼球水平向右移動。若腦幹已經受損，則眼球不會移動，或是移動不對稱。

Brain echo→Subdural injury

Shaken baby syndrome改名→

AHT: Abusive head trauma/injury

• Usually<3y/o
• Brain 含水量較多
• Bridging vein tear
• Multiple layers Retinal hemorrhage 60-85%重要sign
• No visible Trauma 69%
• Mortality 比unintentionally高

CT: Subdural injury
軟硬相接處
Vein - sinus

Retinal hemorrhage

pattern很特殊Ophthalmologist 看比較準

Skeletal survey
Fractures

Life long injury
Coma 29%
Cerebral palsy

Vegetation

113線上通報家暴
https://ecare.mohw.gov.tw/

司法相驗才能開立死亡診斷書

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