Acute paediatrics

Question 1

What is child maltreatment?

Answer 1

• All forms of:
  
  • Physical
  • Emotional ill-treatment
  • Sexual abuse
  • Neglect
  • Farbicated or induced illness; exploitation
• Resulting in actual or potential harm to the child

Question 2

List four risk factors for child maltreatment

Answer 2

• Family and environmental:
  
  • Poverty; financial pressure; poor housing
  • Maltreatment of other children; intrafamilial violence
• Parental:
  
  • Substance abuse
  • Hx of domestic abuse; animal abuse
  • Emotional volatility; anger management problems
  • Mental illness impairing parenting
  • Poor educationl; lack of parenting knowledge; ID
• Child:
  
  • Intellectual or physical disability
  • Living in the care system
  • Multiple pregnancy

Question 3

Give two long-term consequences of child maltreatment

Answer 3

• Adverse effects on growth and physical development
• Impaired language development and behaviour by age 4
• Impaired ability to socialist, play, and learn
• Increased likelihood of antisocial behaviour
• Increased likelihood of suicidal thoughts and attempts
• Adult: Substance misuse; mental illness; physical illness

Question 4

Provide four presenting features of possible child maltreatment

Answer 4

• Frequent attendance or unusual patterns of presentation
• Inappropriately explained poor school attendance
• Refusal by carer to allow child to be seen on their own
• Unusual or marked changes in behaviour/emotional state, unexpected for given age and development
• Sexual activity in a child: ^eg. STI; pregnancy
• Poor carer-child interactions: ^eg. negativity; rejection
• Evidence of neglect

Question 5

Outline the management of possible child maltreatment

Answer 5

• Seek senior support or designated safeguarding lead
• Record exact observations, concerns, and actions
  
  • Report FGM to police
  • Avoid intimate exam if suspected sexual abuse
• Refer to social care if child discloses maltreatment
• Consider speaking to carer
• Manage individual injuries as appropriate
• Safeguard location with social care; police; paediatric ward

Question 6

Outline the basics of neonatal resuscitation

Answer 6

• Dry; wrap; stimulate
• Assess tone; breathing; HR
• Gasping; not breathing
  
  • Open airway; 5 inflation breaths
• Reassess HR and chest movement
• If chest not moving
  
  • Repeat inflation breaths
  • Ventilate for 30s
• Reassess HR; start chest compressions (3:1)

Question 7

Outline the basics of paediatric resuscitation

Answer 7

• ABC assessment; check for signs of life
• Shout for help
• 5 rescue breaths
• Chest compressions (15:2)