A nurse is creating a plan of care for an infant who has an epidural hematoma with a skull fracture. The child was brought to the emergency room because they were found unresponsive in their crib. The nurses perform an assessment, and notice that the child’s head is swollen and there are visible bruises on their forehead.
They also see that one side of their mouth droops when they open it. This is typical after trauma to the brain, so they know this can be caused by injury from falling or shaken baby syndrome (SBS).
SBS happens when someone shakes or violently throws a baby against something hard such as furniture or flooring, which causes bruising in different patterns on the brain and spine. The nurse checks the child’s pupils and notes that they are unequal in size. They also check their reflexes, which show abnormal deep tendon reflexes and decreased sensory responses to pain on one side of the body.
The infant then becomes unresponsive again so the nurses perform a head-to-toe assessment before moving them for CT scan imaging. A CT scan shows an epidural hematoma with skull fracture because there is bleeding around both sides of the brain – this is dangerous because it can lead to blood clotting or swelling inside their skull, resulting in increased pressure on their brain stem and death if not addressed quickly enough. To prevent things from getting worse, they need emergency surgery as soon as possible. To minimize damage to