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Biomedical subjects

Kent P Hymel

Publications and source records attributed to Kent P Hymel.

6 recordsLinked to original sources

Distinguishing sudden infant death syndrome from child abuse fatalities.

Fatal child abuse has been mistaken for sudden infant death syndrome. When a healthy infant younger than 1 year dies suddenly and unexpectedly, the cause of death may be certified as sudden infant death syndrome. Sudden infant death syndrome is more common than infanticide. Parents of sudden infant death syndrome victims typically are anxious to provide unlimited information to professionals involved in death investigation or research. They also want and deserve to be approached in a nonaccusatory manner. This clinical report provides professionals with information and suggestions for procedures to help avoid stigmatizing families of sudden infant death syndrome victims while allowing accumulation of appropriate evidence in potential cases of infanticide. This clinical report addresses deficiencies and updates recommendations in the 2001 American Academy of Pediatrics policy statement of the same name.

Asphyxia↗

When is lack of supervision neglect?

Occasionally, pediatricians become aware of children who are inadequately supervised. More frequently, pediatricians treat children for traumatic injuries or ingestions that they suspect could have been prevented with better supervision. This clinical report contains guidance for pediatricians considering a referral to a child protective services agency on the basis of suspicion of supervisory neglect.

Adolescent↗

Diagnosing pediatric head trauma.

The accurate diagnosis and successful management of pediatric abusive head trauma present pediatricians with many unique challenges. To overcome these challenges requires a high index of clinical suspicion; a willingness to report any suspicion of abuse; knowledge of the relevant medical literature; a direct, nonaccusatory, and supportive approach with parents; thorough history taking; meticulous physical examination; and most important, professional objectivity and integrity. Your patients deserve no less.

Child↗

Intracranial hemorrhage and rebleeding in suspected victims of abusive head trauma: addressing the forensic controversies.

Does an expanded subarachnoid space predispose to subdural bleeding? What does heterogeneity in the appearance of a subdural collection on CT or MRI imaging indicate? Spontaneous rebleeding? Minor re-injury? Major re-injury? In some specific cases, answers to these questions have important forensic implications. To conclude objectively that an infant's intracranial hemorrhage or rebleeding resulted from inflicted injury or re-injury requires an in-depth understanding of the pathogenesis of posttraumatic subdural and subarachnoid collections. The authors present two cases of indoor, accidental, pediatric, closed-head trauma that resulted in intracranial rebleeding. Both accidental cranial impacts occurred in medical settings and were independently witnessed by medical personnel. In addition, the authors summarize the relevant medical literature regarding pediatric intracranial bleeding and rebleeding.

Child↗