Systemic Inflammatory Response Syndrome (SYRS)
Swelling, heat, discomfort, tumor, heat, and pain indicate that the youngster may have SYRS. Bacterial translocations, particularly bacterial peritonitis, might be regarded as one of the major reasons influencing the child’s present status, given that the patient is exhibiting significant abdominal distension (Caserta et al., 2016). Due to the disorder’s association with having double chromosomes (trisomies), which foretell the appearance of the Ventricular Septal Defect (VSD) and, therefore, the emergence of systolic murmurs, the existence of Down syndrome may have aided in the progression of the systolic murmur (Breslin et al., 2014).
Child Abuse: Acts of Commission
The youngster did not sustain the epigastric bruise from the fall, as shown by its unusual posture. The boy must have been tied up since there are circumferential markings on his wrists and ankles that may be the result of rope burns. The available data is adequate to establish the existence of child abuse (Huffhines et al., 2016).
Final Diagnosis: Blunt Abdominal Trauma
The abdominal protrusion, vomiting, lassitude, and lack of appetite are all telltale indicators of traumatic abdominal trauma (Arul, Sonka, Lundy, Rickard, & Jeffery, 2015). Rapid breathing may be linked to POCHF since the youngster had post-Atrial-Septal Defect (ARD) correction and now has postoperative congestive heart failure (CHF). The existence of blunt abdominal trauma is indicated by the presence of abdominal discomfort, a protrusion in the abdominal region, epigastric bruises, a 10-cm hernia, vomiting, lassitude, and lack of appetite (Virmani, George, MacDonald, & Sheikh, 2013).
Laboratory and Ancillary Tests
The two main examinations that need to be done are computer tomography and targeted evaluation using sonography. The results of the CAT test will enable the diagnostic to rule out concurrent trauma (Polat et al., 2014). The kind of abdominal injury and its effects will thus be assessed.
Additionally, CBC and urinalysis must be considered essential. The patient’s blood cell count will be determined by CBC, which will also aid in the examination of the patient’s abdominal cavity. Every twelve hours, the evaluation is required to be performed. Urinalysis will, in turn, aid in determining whether or not urinary tract damage may be present (Olthof, Joosse, Van der Vlies, De Reijke, & Goslings, 2015).
The ancillary test required in the given situation is nasogastric tube insertion. It will make it possible to check for diaphragm ruptures. If blockages are present, an oral contrast study (1-2% ionic iodinated solution) can assist in identifying them (Kozin, Remenschneider, Cunnane, & Deschler, 2014).
One must take into account five main phases for early resuscitation and stabilization in order to meet the patient’s demands. Among these are the assessment of the patient’s respiratory system, the use of two-bore intravenous lines, the supply of oxygen supplementation to avoid hypoxia, and the installation of a device for tracking changes in the patient’s cardiac state (). After that, a SAMPLE history-based evaluation must be undertaken, and active multidisciplinary cooperation between healthcare staff members must be encouraged. When probable child abuse is suspected, child protection services need to be alerted.
The mother has to be made aware of the significance of treating children well. The mother must be informed about the legal ramifications of child maltreatment and the standards for caring for children with Down syndrome. The mother must also get thorough instructions on how to utilize the devices used to track the patient’s condition. Finally, the mother has to be informed about the child’s vaccine.
Tests that assist in identifying the existence of pain in the kid must be included in the self-assessment process. It is necessary to assess the mother’s capacity to control the suffering of the kid. In order to address the requirements of a child with Down syndrome, the mother must know how to apply the right tactics.
Arul, G. S., Sonka, B. J., Lundy, J. B., Rickard, R. F., & Jeffery, S. L. A. (2015). Management of complex abdominal wall defects associated with penetrating abdominal trauma. Journal of the Royal Army Medical Corps, 161(1), 46-52. Web.
Breslin, J., Spanò, G., Bootzin, R., Anand, P., Nadel, L., & Edgin, J. (2014). Obstructive sleep apnea syndrome and cognition in Down syndrome. Developmental Medicine & Child Neurology, 56(7), 657-664. Web.
Caserta, S., Kern, F., Cohen, J., Drage, S., Newbury, S. F., & Llewelyn, M. J. (2016). Circulating plasma microRNAs can differentiate human sepsis and systemic inflammatory response syndrome (SIRS). Scientific Reports, 6, 28006. Web.Get a custom-written paperFor only
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Huffhines, L., Tunno, A. M., Cho, B., Hambrick, E. P., Campos, I., Lichty, B., & Jackson, Y. (2016). Case file coding of child maltreatment: Methods, challenges, and innovations in a longitudinal project of youth in foster care. Children and Youth Services Review, 67, 254-262. Web.
Kozin, E. D., Remenschneider, A. K., Cunnane, M. E., & Deschler, D. G. (2014). Otolaryngologist‐assisted fluoroscopic‐guided nasogastric tube placement in the postoperative laryngectomy patient. The Laryngoscope, 124(4), 916-920. Web.
Olthof, D. C., Joosse, P., Van der Vlies, C. H., De Reijke, T. M., & Goslings, J. C. (2015). Routine urinalysis in patients with a blunt abdominal trauma mechanism is not valuable to detect urogenital injury. Emergency Medical Journal, 32(2), 119-123. Web.
Polat, A. V., Aydın, R., Nural, M. S., Gul, S. B., Polat, A. K., & Aslan, K. (2014). Bowel and mesenteric injury in blunt trauma: Diagnostic efficiency and importance of experience in using multidetector computed tomography. Ulus Travma Acil Cerrahi Derg, 20(6), 417-422. Web.
Virmani, V., George, U., MacDonald, B., & Sheikh, A. (2013). Small-bowel and mesenteric injuries in blunt trauma of the abdomen. Canadian Association of Radiologists Journal, 64(2), 140-147. Web.