Forensic pediatrics

on 6.2.09 with 0 comments

  • Infanticide

    • Elements that must be proven

      • Baby was born alive

        • Air in lungs (float test unreliable due to gas of decomposition)

        • Air in middle ear

        • Air in stomach

        • Food in stomach (only conclusive proof of live birth)

      • Death from violence or willful act of omission

      • Act or failure to act was done with intent to harm

    • Most commonly from suffocation

  • SIDS

    • Most common cause of death if <>

    • Def: death of an infant, < 1 YOA, in apparent good health who dies suddenly and unexpectedly, and in whose case a complete post mortem investigation does not reveal a commonly accepted cause of death (diagnosis of exclusion)

    • Must do complete investigation, which includes

      • Visit to scene of death

      • Interview of caretaker

      • Total body x-rays

      • Complete autopsy, including cultures, genetic and metabolic screen, and toxicology exam

    • SIDS more common with

      • Congested urban areas

      • Poverty

      • Illegitimacy

      • Poor maternal prenatal care

      • Male to female ratio = 3:2

    • Autopsy findings

      • May have petechiae on pleura, epicardium, and thymus

      • Organ congestion

      • Autopsy can’t tell difference between SIDS, overlay, and smothering

  • Child abuse

    • Most cases occur before 6 YOA (after that the kid’s in school)

    • When looking at bones, look for avulsion of the metastasis, multiple rib fractures, posterior rib fractures, long bone fractures, and skull fractures

    • Shaken baby syndrome: generally see subdural hemorrhage (from tearing of the bridging veins…hemorrhage over hemispheres), subarachnoid hemorrhage, and retinal hemorrhage

    • Ocular injuries will show retinal detachment, retinal hemorrhage, and/or permanent visual defects

    • It is a class B misdemeanor not to report suspected child abuse

Category: Forensic Medicine Notes , Medical Subject Notes



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