# Non-accidental Trauma — GCMD Library living collection

Everything in the library about non-accidental trauma — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 42 cited statements

## Episodes
### Diagnosis & Workup
- [Pediatric Trauma Screening For Non-Accidental Trauma: Pediatric Trauma Series...](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378) — video · 64:09 · [machine version](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378.md)

### Evidence & Research
- [Journal of Pediatric Surgery Article Review: June 2022, AAP Issue](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878) — video · 15:54 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878.md)
- [Journal of Pediatric Surgery Article Review: June 2022, AAP Issue](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881) — podcast · 15:54 · [machine version](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=0) Introduction and Series Context (Ep 1)
- [1:23](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=83) Mary Bridge Hospital NAT Screening Protocol Development (Ep 1)
- [25:06](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1506) Discussion: Regional Resources and Radiologist Access (Ep 1)
- [27:23](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1643) Barriers to NAT Detection and Quality Improvement Approaches (Ep 1)
- [51:47](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=3107) Panel Discussion: Implementation Strategies and Family Communication (Ep 1)
- [0:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=6) Introduction and Episode Overview (Ep 2)
- [1:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=116) Non-Accidental Trauma During COVID-19 Stay-at-Home Orders (Ep 2)
- [6:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=382) Metastatic Hepatoblastoma Cell Line Development (Ep 2)
- [9:18](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=558) Localization Techniques for Small Pulmonary Nodules (Ep 2)
- [12:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=746) Puberty and Growth in Pediatric Intestinal Failure (Ep 2)
- [15:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=908) Closing Remarks (Ep 2)
- [0:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=6) Introduction and Episode Overview (Ep 3)
- [1:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=116) Non-Accidental Trauma During COVID-19 Stay-at-Home Orders (Ep 3)
- [6:22](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=382) Metastatic Hepatoblastoma Cell Line Development (Ep 3)
- [9:18](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=558) Localization Techniques for Small Pulmonary Nodules (Ep 3)
- [12:26](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=746) Puberty and Growth in Pediatric Intestinal Failure (Ep 3)
- [15:08](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=908) Closing Remarks (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "The Midwest Pediatric Surgery Research Consortium (MWPSC) was established by departments of Pediatric Surgery from 11 children's hospitals" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 2:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=135)
- "The NAT study used historical patterns captured by trauma registries to predict what the volume should have been during the initial COVID time period and compared that to observed rates" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 3:42](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=222)
- "NAT was higher after the lockdown, not during the lockdown" — Todd Ponsky and Biran Modi (clinical) [Ep 2 · 4:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=247)
- "Initially non-accidental trauma rates dropped a little bit, but after that the rate increased above what they had expected during the stay at home orders" — Nicole Chandler (host_summary) [Ep 2 · 4:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=256)
- "Patients disproportionately affected were older kids who were older than 5 years who would most commonly be in school, minority children, and lower socioeconomic groups as determined by the social vulnerability index" — Nicole Chandler (host_summary) [Ep 2 · 4:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=271)
- "CDC Social Vulnerability Index was uniquely created to see neighborhood's vulnerability during times of crises" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 5:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=312)
- "During times of public health crises, it's important to maintain systems of protection for children" — Nicole Chandler (opinion) [Ep 2 · 5:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=337)
- "One has to be careful not to make too strong of conclusions based on any data when it's related to simply ICD 10 codes, regardless of how many institutions and how long the evaluation period was" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 6:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=367)
- "There are very few cell lines available to study hepatoblastoma, and a number of cell lines touted to be hepatoblastoma are actually hepatocellular carcinoma" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 6:47](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=407)
- "Management of metastatic hepatoblastoma continues to pose significant treatment challenges" — Nicole Chandler (clinical) [Ep 2 · 7:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=433)
- "The new hepatoblastoma cell line was created by injecting labeled cells into mouse tail vein, harvesting lung metastases, culturing surviving cells, and repeating the process until establishing a reliably metastatic cell line" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 2 · 7:24](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=444)
- "Compared to the original human cell line, the new cell line exhibited increased tumorigenicity, invasiveness, and increased resistance to chemotherapy" — Nicole Chandler (host_summary) [Ep 2 · 8:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=494)
- "PSORC (Pediatric Surgical Oncology Research Collaborative) is a multi-institutional consortium of North American pediatric surgeons focused on advancing care of children with cancer" — Marcus Malik (clinical) [Ep 2 · 9:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=586)
- "PSORC was founded because there was a need to amalgamate data from multiple institutions to better study surgical questions in pediatric cancer" — Marcus Malik (clinical) [Ep 2 · 10:05](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=605)
- "The most common localization techniques for small pulmonary nodules were wire and methylene blue dye, followed by methylene blue dye only" — Nicole Chandler (host_summary) [Ep 2 · 10:49](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=649)
- "There was no difference in successful IR localization or successful resection of pulmonary nodules when comparing different localization techniques" — Nicole Chandler (host_summary) [Ep 2 · 10:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=656)
- "Image-guided localization techniques varied significantly among institutions but all were wildly successful, showing that experience is probably more important than the actual technique itself" — Nicole Chandler (opinion) [Ep 2 · 12:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=726)
- "Pediatric intestinal failure was defined as requirement of parenteral nutrition for 60 days or more at any time, with diagnosis before 8 years of age" — Todd Ponsky and Biran Modi (clinical) [Ep 2 · 12:57](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=777)
- "The hypothesis was that chronic pediatric intestinal failure would delay puberty and potentially dull the sharp spike of puberty in terms of peak height velocity" — Todd Ponsky and Biran Modi (clinical) [Ep 2 · 13:44](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=824)
- "Peak height velocity occurred at significantly younger ages for both males and females with intestinal failure" — Nicole Chandler (host_summary) [Ep 2 · 14:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=840)
- "Puberty onset occurred significantly earlier compared to established norms for males, meaning they reached pubertal onset earlier than the CDC 50th percentile" — Nicole Chandler (host_summary) [Ep 2 · 14:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=840)
- "There is a high incidence of short stature in chronic intestinal failure" — Todd Ponsky and Biran Modi (clinical) [Ep 2 · 14:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=877)
- "The finding that short stature is not because kids are missing out on pubertal timing and peak height velocity suggests we need to do a better job at setting them up to go into puberty with working on their height and linear growth" — Todd Ponsky and Biran Modi (opinion) [Ep 2 · 14:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5878?t=877)
- "The Midwest Pediatric Surgery Research Consortium (MWPSC) was established by departments of Pediatric Surgery from 11 children's hospitals" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 2:15](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=135)
- "The NAT study used historical patterns captured by trauma registries to predict what the volume should have been during the initial COVID time period and compared that to observed rates" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 3:42](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=222)
- "NAT was higher after the lockdown, not during the lockdown" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 4:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=247)
- "Initially non-accidental trauma rates dropped a little bit, but after that the rate increased above what they had expected during the stay at home orders" — Nicole Chandler (host_summary) [Ep 3 · 4:16](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=256)
- "Patients disproportionately affected were older kids who were older than 5 years who would most commonly be in school, minority children, and lower socioeconomic groups as determined by the social vulnerability index" — Nicole Chandler (host_summary) [Ep 3 · 4:31](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=271)
- "CDC's Social Vulnerability Index was uniquely created to see neighborhood's vulnerability during times of crises" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 5:12](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=312)
- "During times of public health crises, it's important to maintain systems of protection for children" — Nicole Chandler (opinion) [Ep 3 · 5:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=337)
- "One has to be careful not to make too strong of conclusions based on ICD 10 codes, no matter how many institutions and how long the evaluation period was" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 6:07](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=367)
- "There are very few cell lines available to study hepatoblastoma, and a number of cell lines touted to be hepatoblastoma are actually hepatocellular carcinoma" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 6:47](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=407)
- "Management of metastatic hepatoblastoma continues to pose significant treatment challenges" — Nicole Chandler (clinical) [Ep 3 · 7:13](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=433)
- "The researchers labeled hepatoblastoma cells with luciferase, injected them into mouse tail veins where they preferentially went to lungs, harvested and cultured surviving cells, and repeated this process until establishing a reliable metastatic cell line" — Ellen Incisco and M. Tom Bash (host_summary) [Ep 3 · 7:24](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=444)
- "The new metastatic hepatoblastoma cell line exhibited increased tumorigenicity, invasiveness, and increased resistance to chemotherapy compared to the original human cell line" — Nicole Chandler (host_summary) [Ep 3 · 8:14](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=494)
- "We never had a hepatoblastoma cell line mouse model before" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 8:29](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=509)
- "PSORC (Pediatric Surgical Oncology Research Collaborative) is a multi-institutional consortium of North American pediatric surgeons focused on advancing care of children with cancer" — Marcus Malik (clinical) [Ep 3 · 9:46](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=586)
- "There has not been consistency in localization techniques for small pulmonary nodules across North America, with surgeons doing their own thing" — Marcus Malik (clinical) [Ep 3 · 10:19](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=619)
- "The most common localization techniques were wire and methylene blue dye, followed by methylene blue dye only" — Nicole Chandler (host_summary) [Ep 3 · 10:49](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=649)
- "There was no difference in successful IR localization or successful resection of pulmonary nodules among the different localization techniques" — Nicole Chandler (host_summary) [Ep 3 · 10:56](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=656)
- "Time under anesthesia can be long and quite variable depending on whether institutions use hybrid ORs or have IR on different floors" — Marcus Malik (clinical) [Ep 3 · 11:10](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=670)
- "ICG will become much more popular and more effective for nodule localization in 5 years" — Todd Ponsky and Biran Modi (opinion) [Ep 3 · 11:54](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=714)
- "Image guided localization techniques varied significantly among institutions but all were wildly successful, showing that experience is probably more important than the actual technique itself" — Nicole Chandler (opinion) [Ep 3 · 12:06](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=726)
- "The study focused on patients with pediatric intestinal failure, defined as requirement of parenteral nutrition for 60 days or more at any time, who had the diagnosis before age 8 and were older than 8 at time of study" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 12:52](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=772)
- "Puberty is at least partially dependent on having good nutritional stores based on hormonal drivers of puberty" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 13:38](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=818)
- "The hypothesis was that chronic pediatric intestinal failure would delay puberty and potentially dull the sharp spike of peak height velocity" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 13:45](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=825)
- "Peak height velocity occurred at significantly younger ages for both males and females with intestinal failure" — Nicole Chandler (host_summary) [Ep 3 · 14:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=840)
- "Puberty onset occurred significantly earlier compared to established norms for males, meaning they reached pubertal onset earlier than the CDC 50th percentile" — Nicole Chandler (host_summary) [Ep 3 · 14:00](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=840)
- "Children with intestinal failure might be slightly short statured but are not severely undersized compared to the general population" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 14:20](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=860)
- "There is a high incidence of short stature in chronic intestinal failure" — Todd Ponsky and Biran Modi (clinical) [Ep 3 · 14:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=877)
- "The finding that kids with intestinal failure are not missing out on pubertal timing and peak height velocity suggests we need to do a better job at setting them up to go into puberty by working on their height and linear growth" — Todd Ponsky and Biran Modi (opinion) [Ep 3 · 14:37](https://library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-june-2022-aap-issue-5881?t=877)
- "48% of child fatalities each year are a result of physical abuse" — Tony Escobar (host_summary) [Ep 1 · 3:06](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=186)
- "Approximately 12% of child abuse fatalities involve families that had CPS intervention in the last 5 years prior to the fatality, with the majority of these children less than 4 years of age" — Tony Escobar (host_summary) [Ep 1 · 3:15](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=195)
- "In Carol Jenny's study, approximately 30% of children with abusive head trauma had NAT not originally considered or recognized by physicians" — Tony Escobar (host_summary) [Ep 1 · 5:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=330)
- "Kate Dean's group demonstrated that patients with recurrent NAT had significantly higher mortality than during their first presentation" — Tony Escobar (host_summary) [Ep 1 · 5:50](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=350)
- "In Mary Bridge's retrospective cohort, 89% of NAT cases had inconsistent or missing history, 79% had unwitnessed injuries, and almost 40% of patients had a prior ED visit" — Tony Escobar (clinical) [Ep 1 · 11:20](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=680)
- "60% of NAT patients with prior ED visits were less than a year of age" — Tony Escobar (clinical) [Ep 1 · 11:50](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=710)
- "41% to 73% of NAT patients were missing social history data in the chart" — Tony Escobar (clinical) [Ep 1 · 12:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=730)
- "Perineal bruising or injury was found in a small number of patients, but the majority were less than 4 years of age and there was significantly increased risk of mortality and morbidity with this finding" — Tony Escobar (clinical) [Ep 1 · 12:50](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=770)
- "60% of NAT patients less than a year of age had fractures, with a fraction having undiagnosed healing fractures in other sites" — Tony Escobar (clinical) [Ep 1 · 13:20](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=800)
- "A third of NAT patients had rib fractures, which were significantly associated with severe injury (ISS ≥16) and other undiagnosed healing fractures" — Tony Escobar (clinical) [Ep 1 · 14:00](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=840)
- "In the retrospective cohort, 9 patients died, and 2/3 of those had a prior ED visit" — Tony Escobar (clinical) [Ep 1 · 14:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=870)
- "After implementing standardized NAT screening at Mary Bridge, ED length of stay did not change" — Tony Escobar (clinical) [Ep 1 · 19:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1180)
- "After implementing standardized screening, the number of admissions went down, possibly because more standardized screening in the ER led to safer disposition planning and fewer medical holds" — Tony Escobar (clinical) [Ep 1 · 19:55](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1195)
- "The use of head CT did not change after implementing the NAT screening protocol" — Tony Escobar (clinical) [Ep 1 · 19:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1150)
- "The 10-4 clinical prediction rule (torso, ears, neck bruising in children <4 years, or any bruising in infants <4 months) is highly suspicious for NAT" — Tony Escobar (host_summary) [Ep 1 · 22:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1350)
- "In the most recent systematic review of burns, up to 25% of children admitted to burn centers had been abused" — Tony Escobar (host_summary) [Ep 1 · 23:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1420)
- "Greater than 95% of patients with intentional burns were aged less than 5 years" — Tony Escobar (host_summary) [Ep 1 · 24:05](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1445)
- "Hollow viscous injuries, specifically duodenal injuries in children less than 4 years old, are highly suggestive of abuse" — Tony Escobar (host_summary) [Ep 1 · 25:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1540)
- "Abusive abdominal injury can occur without external signs such as bruising" — Tony Escobar (host_summary) [Ep 1 · 26:15](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1575)
- "Screening for elevated liver function tests is recommended, and if elevated, further axial imaging is recommended to evaluate for intraabdominal injury" — Tony Escobar (host_summary) [Ep 1 · 26:25](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1585)
- "Frenulum tears in mobile children have equivalent incidence between accidental and non-accidental trauma, so in and of themselves there is not sufficient evidence to recommend a child abuse workup" — Tony Escobar (host_summary) [Ep 1 · 27:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1630)
- "In a national study of primary care providers, PCPs often fail to report injuries concerning for child abuse to CPS due to familiarity with the family, perceived lack of value from CPS involvement, or use of their own alternative management plan" — Kristen Crichton (host_summary) [Ep 1 · 29:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1750)
- "In a study of pediatric nurses, barriers to reporting included difficulty with cases that aren't clear cut, especially in small infants where injuries can be non-severe or non-specific" — Kristen Crichton (host_summary) [Ep 1 · 30:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1810)
- "In a Dutch study of ED physicians, barriers included lack of time, fear of inaccurate suspicion, insufficient communication skill, and turnover of ED staff" — Kristen Crichton (host_summary) [Ep 1 · 30:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=1840)
- "In Carol Jenny's 1999 study of missed abusive head trauma, children where abuse was missed were significantly more likely to be white and in dual parent homes" — Kristen Crichton (host_summary) [Ep 1 · 34:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2080)
- "Wendy Lane and colleagues found minority children had higher rates of evaluation for abuse and higher reports of suspected abuse, separate from any racial disparity in actual abuse" — Kristen Crichton (host_summary) [Ep 1 · 35:00](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2100)
- "Physical abuse is considered more often in children with low socioeconomic status" — Kristen Crichton (host_summary) [Ep 1 · 35:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2130)
- "In a 2018 study of 746 child abuse pediatrician consult notes, CAP perception of a child's socioeconomic status was strongly linked to perception of risk, even when other social cues were accounted for" — Kristen Crichton (host_summary) [Ep 1 · 36:40](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2200)
- "In a 2015 study by Dan Lindberg, only 20% of infants under 6 months old who had a bruise had a skeletal survey done, though by AAP guidelines most should have" — Kristen Crichton (host_summary) [Ep 1 · 38:00](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2280)
- "Joanne Wood found that 68% of children less than a year old with traumatic brain injury had a skeletal survey done" — Kristen Crichton (host_summary) [Ep 1 · 38:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2310)
- "In Ohio's TRAIN collaborative baseline data, around 40% of kids less than 6 months with a bruise were getting skeletal surveys" — Kristen Crichton (epidemiological) [Ep 1 · 40:20](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2420)
- "In a TRAIN collaborative study of 367 infants <6 months with bruising, significantly more infants with public insurance had skeletal surveys than those with private insurance, with no racial difference seen" — Kristen Crichton (epidemiological) [Ep 1 · 41:20](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2480)
- "Posterior rib fractures, classic metaphyseal fractures, and pattern bruises will all get better without medical intervention, but identifying them provides information to protect children" — Kristen Crichton (clinical) [Ep 1 · 43:00](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2580)
- "Child abuse is more common than every bleeding disorder" — Kristen Crichton (epidemiological) [Ep 1 · 45:50](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2750)
- "A skeletal survey following American College of Radiologists and AAP guidelines requires about 24 separate X-rays, not a single babygram" — Kristen Crichton (guideline) [Ep 1 · 49:10](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=2950)
- "At Nationwide Children's, an automatic consult to the child abuse team is triggered for any child under age 5 admitted to the hospital, which has increased team visibility and access without increasing length of stay or imaging studies" — Kristen Crichton (clinical) [Ep 1 · 56:20](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=3380)
- "At Mary Bridge, standardized NAT screening eliminated racial and socioeconomic disparities in screening" — Rich (host_summary) [Ep 1 · 62:30](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=3750)
- "The risk of dying from repeated abuse is far higher than the risk of brain cancer from a head CT" — Kristen Crichton (opinion) [Ep 1 · 61:15](https://library.globalcastmd.com/watch/pediatric-trauma-screening-for-non-accidental-trauma-pediatric-trauma-series-378?t=3675)

## Changelog
- Sep 15: 3 items added automatically

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