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Abusive Head Trauma

Enrollment in this course is by invitation only
PLEASE NOTE: This course is currently undergoing testing and is not available to users.

This is a self-paced, open-enrollment course that may be started and completed at any time. Please note: This course requires an updated browser to function properly. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher). To check your current browser version, click here.

About This Course

In this course, learn about the mechanisms of injury, clinical findings and imaging patterns suggestive of abusive head injury. Learners will be taught about the underlying pathophysiology related to cerebral swelling, management of increased intracranial pressure, and optimization of cerebral perfusion pressure in patients with traumatic brain injury. Course content also covers the characteristics of retinal hemorrhages in evaluating patients with possible abusive head trauma.

This course was developed by the OPENPediatrics program at Boston Children's Hospital, and provides Continuing Medical Education credit. To access the videos from this course for free, as well as hundreds of other resources on pediatric care, sign up for a free account on the OPENPediatrics site.

Cost

USD $50.00

Contributors

Lisa DelSignore, MD, Michelle Silvera, MD, Jason Mantagos, MD

Instructional Time

2 hours, 00 minutes

Course Format, Media and Technical Requirements

Self-paced, using text and video, with post-test assessments. Requires 80% or higher score to earn CME credit. Online course assessment. Requires Safari (v6 or higher), Chrome (v38 or higher), Internet Explorer (v11 or higher), or Firefox (v23 or higher).

Release/Review/Expiration Dates

  • Released: XX/XX/XXXX
  • Reviewed: XX/XX/XXXX
  • Expires: XX/XX/XXXX
  • Learning Objectives

  • Describe the pathophysiology of traumatic brain injury and intracranial compliance
  • Describe physiologic targets for the management of the injured brain
  • Explain therapies used to manage increased intracranial pressure and target optimal cerebral perfusion pressure
  • Describe the various clinical presentations of children with abusive head trauma
  • Describe the various mechanisms of injury that may cause abusive head trauma
  • Recognize imaging patterns on CT and MRI that are suggestive of abusive head trauma
  • Understand the characteristics of retinal hemorrhages in the setting of abusive head trauma
  • Statement of Need/Target Audience

    Abusive head trauma (AHT) is one of the most common subtypes of non-accidental trauma and is a leading cause of traumatic brain injury in young children. Imaging plays a crucial role in the evaluation of children with suspected AHT and can aid in accurate diagnosis because clinical presentation may be nonspecific.1 Clinicians need to have knowledge of how to identify abusive head trauma and traumatic brain injury. Continuing education on the topic of abusive head trauma (AHT) is essential in order to ensure that healthcare providers understand the relevant pathophysiology and are able to accurately diagnose and treat these complex patients. According to the CDC National Center for Injury Prevention and Control, abusive head trauma poses a serious problem in the pediatric population with significant associated morbidity and mortality. The reported incidence is 20-30 per 100,000 children in the first year of life, although incidence has been historically difficult to accurately assess due to suspected underreporting and lack of a universal definition. The consequences of AHT are extensive, including long-term disability, death and high healthcare costs. One study found that as many of 31% of children with abusive head injuries go undiagnosed initially. Of those missed cases, 13% had imaging studies that were misinterpreted. Increased knowledge of neuroradiological findings in AHT may have led to earlier diagnosis and prevention of re-injury, medical complications and death in several of the patients. This data further indicates the need to promote ongoing education on the clinical presentation, neuroradiological findings and treatment of AHT among healthcare professionals.

  • Primary Care Physicians
  • Specialy Physicians
  • Pharmacists
  • Pharmacy Technician
  • Physician Assistants
  • Advanced Practice Nurses
  • Registered Nurses
  • Registered Nurses in Specialty Areas
  • Licensed Practical Nurses
  • 1Wright J., CNS Injuries in Abusive Head Trauma. American Journal of Roentgenology. 2017;208: 991-1001. 10.2214/AJR.16.17602

    Accreditation/Designation Statements

    Boston Children's Hospital is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Boston Children's Hospital designates this enduring material for a maximum of 2 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 2 ABP MOC Part 2 points in the American Board of Pediatrics' (ABP), American Board of Internal Medicine (ABIM) and the American Board of Anesthesiology (ABA) Maintenance of Certification program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABP, ABIM and ABA MOC credit. This activity has been approved for 2 ABP MOC Part 2 points.

    Through an agreement between the American Medical Association and the European Union of Medical Specialists, physicians may convert AMA PRA Category 1 Credit™ to an equivalent number of European CME Credits® (ECMECs®). Information on the process of converting AMA PRA Category 1 Credits™ to ECMECs® can be found at: www.eaccme.eu.

    The following Enduring Material: Abusive Head Trauma meets the requirement for 2 Risk Management Credits proscribed by the Massachusetts Board of Registration in Medicine and defined in 243 CMR 2.06(5)(d) I.

    Instructors

    Lisa Delsignore, MD

    Specialist in Pediatric Critical Care Medicine, Boston Children's Hospital
    Instructor of Anaesthesia, Harvard Medical School

    Michelle Silvera, MD

    Division of Neuroradiology, Boston Children's Hospital

    Jason Mantagos, MD

    Department of Ophthalmology, Boston Children's Hospital
    Harvard Medical School

    Disclosures

    In accordance with the disclosure policy of Boston Children's Hospital and the standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers and content reviewers list below any relevant relationships they or their spouse/partner have to companies producing, marketing, re-selling or distributing health care goods or services consumed by or used on patients.

    Instructor Disclosures

    No disclosures to report:

    Lisa DelSignore, MD, Michelle Silvera, MD, Jason Mantagos, MD

    Content Reviewers

    No disclosures to report:

    Traci Wolbrink, MD, MPH, Aleksandra Olszewski, MD, Ellen Grant, MD, Jeanne Chow, MD, Celeste Wilson, MD, Crystal Tom, PharmD, Denise Downey, RN, MSN

    Commercial and Financial Support Disclosure

    This program receives no commercial support.

    Privacy Policy

    Access the Boston Children's Hospital CME Privacy Policy here.

    1. Course Number

      BCH.AN008-OP
    2. Classes Start

      Aug 24, 2017
    3. Classes End

      Jan 01, 2031