Violence and Abuse Post Test (Chapters 62-68)
Fire/Smoke Exposure
Malignant Neoplasm
Motorized Vehicle Related Injuries
Homicide
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Host/Patient Characteristics
Environmental Conducitivity
Agent of Energy Transmission
Established EMS Response Systems
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Age < 30 at the time of the initial event
Alcohol use at the time of the initial event
Seat belt use at the time of the initial event
Speeding at the time of the initial event
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Intermediate Range Wounds : Soot Deposition
Contact Wounds : Sear Margins
Long Range Wounds : Tattooing/Stippling
Close Range Wounds : Stellate Lacerations
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Result when a sharp edged object (eg knife) is forcefully drawn across the skin
Isolated "tissue bridges" are common findings
Associated wound margins abrasions are rare findings
Involved tissue margins are smooth edged and well demarcated
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When broken (eg during an MVC), the tempered glass found in rear and side windows tends to produce linear/ stellate lacerations upon contact with intact skin
The front bumper of a vehicle that is actively braking will strike a patient at a higher point that would that bumper if the car was not actively decelerating
Upon a collision, the occupants of a vehicle will initially move in a direction away from the area of primary contact
When broken (eg during an MVC), laminated automotive glass tends to shatter into a multitute of razor edged shards
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Immersion burns characteristically exhibit a classic "drip-like" appearance
"Bucket handle" or "corner" fractures commonly occur along the diaphyseal shafts of long bones
Although essentially pathognomonic, retinal hemorrhages are seen in
Anogenital burns are unlikely to occur via hot liquids spilling down into a child's diaper and such wounds should prompt concern for possible child abuse
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Distal tibia
Midshaft humerus
Distal femur
Proximal fibula
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Elevated liver enzymes are a sensitive marker of clinically signifcant liver injuries
Duodenal hematomas can be seen despite only minor abdominal trauma (eg fall
Trauma is the second leading cause of acute pancreatitis in pediatric patients
Abdominal trauma represents the second most common type of fatal injury in child abuse related deaths
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Anogenital lacerations are the most commonly identified traumatic injuries
Copious lubricant (eg Surgilube) should be utilized during the vaginal speculum exam to limit any further injury to already jeopardized tissues
The anterior forchette is the most common site of injury
Powder-free examination gloves should be used to limit the potential for evidence contamination
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Post assault, there is a 5 day window in which HIV prophylaxis can be successfully initiated
Standard STD prophylaxis should only be offered after all associated cultures have been processed
The immediate use of an emergency contraceptive can drop the likelihood of becomming pregnant to < 15%
Hepatitis B vaccine should be offered to all patients who have not been previously vaccinated
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Under no circumstances should a victim of elder abuse be allowed to leave the hospital and return to a potentially abusive setting
The majority of states have enacted laws dictating the mandatory reporting of suspected elder abuse
By default, elderly patients should be assumed to lack adequate decision making capacity and therefore cannot legally refuse medical care
Unlike victims of other forms of abuse, elder abuse patients rarely develop associated psychological disorders (eg PTSD)
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The majority of IPV cases occur outside of the home
Nearly 95% of all IPV victims that seek care in US emergency departments subsequently self-report the abuse to law enforcement individuals
Girls who either witness or directly experience intra-familial violence as children have an increased risk of becoming IPV victims when they reach adulthood
All 50 states have laws that mandate the emergency physician to report all cases of suspected IPV to the appropriate law enforcement individuals
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By the age of 18, most US children will have seen over 200,000 acts of violence portrayed on television
Firearm related homicide rates are actually the highest in rural regions of the US
Assault rifles are currently the most commonly utilized firearms in gang-related homicides
Over the past 20 years, there has actually been a drop in the incidence of firearm related deaths in the 15-19 year-old age group
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Fully-jacketed rounds are the preferred munition of standard US law enforcement officers
The kinetic energy of a projectile is determined more by its given velocity rather than by its overall mass
The term "magnum", when applied to a firearm round, implies a larger caliber or diameter as compared to a standard "non-magnum" round
Handgun barrels are designed to impart a spin on the projectile as it exits the muzzle
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