Child abuse + protection + child health surveillance Flashcards
What is the threshold for local authority intervention in child abuse cases?
Significant harm
What are the four main types of child abuse?
Physical abuse
Neglect
Sexual abuse
Emotional abuse
What is the ‘Toxic Trio’ and why is it important?
(1) Domestic abuse
(2) Mental ill health
(3) Substance misuse – these are key risk factors for child abuse
What is the purpose of a child protection case conference?
To assess all relevant information about a child’s safety and welfare and determine how best to safeguard them
What is an Inter-Agency Referral Discussion (IRD)?
A meeting between agencies (social work, health, police, education) to assess a child at risk and decide next steps
When can the police use emergency powers in child protection?
When immediate safeguarding is needed and a Child Protection Order isn’t practical
(eg) out of hours
What tool helps differentiate normal vs concerning sexual behaviours in children?
The Brook traffic light tool
What behaviours in a child might suggest emotional abuse?
- Lack of confidence
- Trouble managing emotions
- Overly friendly with strangers
- Poor attachment with caregivers
- Anger outbursts
What is the purpose of a serious case review?
To understand what went wrong after a child dies or is seriously harmed due to abuse, and to improve multi-agency working
What is checked during pregnancy to ensure the baby’s health?
- Intrauterine growth
- Maternal infections (eg, HIV)
- Fetal abnormalities (ultrasound scan)
- Neural tube defects (blood tests)
What is included in the newborn clinical examination?
A full physical check of the baby, including assessment for congenital abnormalities
What screening test is done for newborn hearing?
The Newborn Hearing Screening Programme, often using an oto-acoustic emissions test
What happens at the 6-8 week check-up with a GP?
A full examination to assess growth, development, and general health
What test is done between days 5-9 of life?
- The heel-prick test
- Screening for conditions like ;
(1) hypothyroidism
(2) PKU
(3) metabolic diseases
(4) cystic fibrosis
(5) MCADD
What aspects of child health are monitored on an ongoing basis?
Growth, vision, hearing, and advice on immunisations, diet, and accident prevention
Which one of the following is not part of the core Child Health Promotion Program as outlined in the Children’s National Service Framework?
A. GP examination at 6-8 weeks
B. Newborn clinical examination
C. Heel-prick test at 5-9 days
D. 8-9 month surveillance review
E. Newborn hearing check
D
What is the normal respiratory rate for a healthy infant?
30-60 breaths per minute
What is the normal pulse range for a newborn?
100-160 beats per minute
What is the normal body temperature for an infant?
Around 37°C
What are signs of normal elimination in a healthy infant?
Regular urine and stool output
What are the most common fractures associated with child abuse?
Radial
Humeral
Femoral
A 4-week-old boy is brought to the GP by his mother, who is worried about him regurgitating a small amount of milk after each feed. Although the GP feels that this is typical posseting, she weighs the infant for further reassurance.
During the examination, the GP notes two small bruises on the child’s left calf. The mother has not seen these before but states that her son was with a childminder that day, along with several active toddlers. The mother is very concerned by the bruising and willing to engage in any further investigation.
What is the most appropriate next step? and why?
Refer to hospital for same-day paediatric assessment
= Bruising in a non-mobile infant should be referred for same-day paediatric assessment
A 2-year-old boy is brought to the emergency department by his mother with bruising after a fall. On assessment, there is a global developmental delay. He crawls and walks with difficulty, can pincer grip, and is playing with toys during the consultation. There are some bruises on his abdomen, left elbow, and left forearm, at different stages of healing.
His mother says these are from him falling due to clumsiness for the past few months and she once had bruising which required oral steroids and thinks he has developed the same condition.
What is the next most appropriate step in his management and why?
Immediately contact the safeguarding lead
= Delayed presentation is sometimes suggestive of non-accidental injury
You are asked to organise a tutorial on child protection for medical students attached to the surgery. When discussing patterns of behaviour which may point towards child abuse, which one of the following is least likely to be relevant?
A. Frequent attendance to see the GP
B.Late presentation following an injury
C. History of child abuse in the family
D. Torn frenulum
E. Poor weight gain
A
= Frequent attendance to the A&E department, rather than GP, may point towards child abuse as parents presume they will see a different doctor each time
