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health care law > 11/21 - Child abuse > Flashcards

11/21 - Child abuse Flashcards

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1
Q

what to report

A
  1. suspected incidents of physical abuse, sexual abuse, neglect and emotional cruetly
  2. instances in which the child is deprived of adequate nurturing, health, education, and safety
  3. a few states also require reporting of newborn infants who suffer from fetal alcohol syndrome or other fetal drug syndromes
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2
Q

general - reporting requirements

A

all statutes include

  • definitions of child abuse and neglect
  • description of reporting procedures
  • grants of immunity from liability for mandatory reporters who make reports in good faith
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3
Q

basis for having these child abuse laws - mandating it

A

because death can occur

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4
Q

definition of child abuse

A

those acts or omissions of care that deprive a child of the opportunity to fully develop his or her unique potential as a person either physically, socially, or emotionally

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5
Q

neglect covers

A 
NOT having these things:
medical care
dental
safety
physical

treated differently than abuse

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6
Q

location of abuse more

A

orofacial region is commonly invlved

- craniofacial, head, face, and neck injuries occur in OVER 50% of the cases of child abuse

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7
Q

preventing abuse

A

recognize and report

dental professionals are in a good position to recognize and report

  • see the child parent interact over a perios of time
  • orofacial involvment (over 50% of cases here)
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8
Q

use what type od questions wth the kids

A

open ended

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9
Q

primary indicators recognizable during routine physical exam

A

uncleanliness

cigaretter or other burns, bute marks, grab marks, belt lashes

marks on neck from strangling

external ears traumitized

abrasions. / lacerations

unusual skin raashed which defy dermatologic diagnosis

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10
Q

patient gives evasice unsatisfactory responses

A

brief explanation of your concerns may elicit additional information

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11
Q

talk with parent?

A

one on one and express concerns in private

  • objective and avoid accusations

simply “i feel some concern about jack’s bump on his head and want to check these concerns with you.”

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12
Q

abuser profile

A

40-60% were abused children

isolate, young, single parents

substance abuse

seldom touches/ looks at child

overly critical of child

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13
Q

abused profile

A

more in handicapped, hyperactive

shy around adults

fearful of parent

inapporopriate sexual remarks (sexual)

preoccupaion with body (sexual)

poor overall care/ appearance

overreacts to parents
responses

30-50% invovle head and neck

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14
Q

“frozen watchfulness”

A

characterstic of someone being abused

- no eye contact but always scanning and no spontaneous smiles

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15
Q

involvement of staff

A

be observing the interactions and the way child carries themselves

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16
Q

signs of malnutrition

A 
small stature for age 
postural fatigue with rounded shoulder
flat chest
protruberant abdomen 
thinning hair

face - pale , muddy, lacks luster

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17
Q

injuries

A

if does not math given history

bruising of soft tissue not overlying bony prominences - armpits, inner thigh

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18
Q

injury more recent color

A

red-blue more vivid

older - brown / green - yellow more faded

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19
Q

bruised frenum suspect?

A

abuse

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20
Q

most commonly affecteed site

A

laceration or abrasion of the LIPS – 54%

then buccal mucosa, palate (soft/ hard) gingiva, alveolar mucosa, frenum, tongue

21
Q

fractured luxated avulsed non vital anteriorteeth

A

get history

- sign of potential abuse

22
Q

describe bite mark

A

bruises, abrasion, lacerations found in ELLIPTICAL OR OVOD PATTERN

CENTRAL AREA OF ECCHYMOSES caused by eithe

  • positive pressure from closing the teeth with disruption of bloos vessels
  • negative pressure from sunction and tongue thrusting
23
Q

animal or dog bites tend to

A

tear flesh
- human bites compress flesh and rarely tear tissue

an intercanine distance over 3cm is suspicious of an adult human bite!!

24
Q

T/F DNA from epithelial cells from the mouth may be deposited in bites

A

true

can document bites through aerican board of forensic odontology

25
Q

documenting bites

A

written observations and photos should be taken every day for 3 days

forensic odontologists may be able to match models of a suspected abusers teeth with impressions or photos of the bite mark

26
Q

sexual abuse

pathognomonic for sexual abuse?

A

visible oral injuries or infections are rare even though oral cavity is a frequent site

periorial gonorrhea in prepubertalchildren is PATHOGNOMNIC FOR SEXUAL ABUSE

27
Q

evidence of forced oral sex

A

petachiae of palate – particulary the junction of hard and soft palate

28
Q

how to check for injury to ribs

A

move the child up towards the headrest while he/ she is in a supine position

if the lifting motion results in pain, there may have been trauma to the child’s ribs or clavicles

29
Q

role of dental assistant

A

be present in room and aware of the suspicion of abuse

should verify and record findings as dentist examines child

30
Q

only areas that are not deemed withi the purview of the dentist

A

genetalia and buttocks

exception is “different child” being treated in OR setting

31
Q

after head and neck exam

A

body surfaces normally covered can be examines

pants, shorts, shirts, blouses, dresses should be lifted to the limit they allow

32
Q

dental neglect

A

untreated, rampant caies easily detected by lay person

untreated pain, infection, bleeding, trauma affecting the orofaial region

33
Q

when is it neglect

A

if caregiver has adequate knowledge of neds and demonstrates willful failure to seek care

34
Q

when is it not neglect

A

if caregiver does NOT have the knowlege nor the awareness of their child’s need for dental care

35
Q

obligation for neglec

A

point them in the right direction and tell them what they need to do

36
Q

when to consider a parent is neglecting

A

AFTER the parent has been properly notified about the condition, the tx needed, and how to get the treatment

if despite all these services (like helping through barriers too) then case should be reported

37
Q

if barriers exist between patient needing tx? your role

A

should assist the family in finding financial aid, transportation, or public facilities for needed services

38
Q

failure to report supsected abuse?

A

deentist can be liable for child injury

39
Q

reporters protected?

A

yes - protected from civil/ criminal liablity if the report is made in good faith

if make mistake but did report -

40
Q

abusing parents can be helped?

A

yes – estimated that 80-90% of abusing parents can be helped, bu many have no idea they need help or know where to find help

41
Q

examine the child when

A

without parent and with staff and ask anout injury in childs terms

then solicit history of injury from parents
- may contact MD to confirm

42
Q

describe ijury by __ when reporting

A 
type
color
size
stage
characteristics 
location
43
Q

what to incclude in report

A

take rx’s if needed
photographs with different views

treat injury and refer if needed

44
Q

so important to document injusries because?

A

may take several days before a rep and a pediatrician see the child

45
Q

can contact service agency and not report

A

yes! - to help council

46
Q

dentist obligated to inform parent they will report?

A
47
Q

when to notify the parent

A

AFTER you have reported to child protective agency

- ensures that any subsequent conversation with the parents will not result in the dentist changing that decision

48
Q

PANDA

A

prevent abuse and neglect through dental awareness coalition
- can reach out to this

49
Q

populations that rely on caregivers

A

children
elderly
disabled

health care law (12 decks)

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