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Patient management > Child protection > Flashcards

Child protection Flashcards

1
Q

What is child protection?

A

Activity undertaken to protect specific children who are suffering or at risk of suffering significant harm

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2
Q

What are the aims of measures taken to safe guarding children? - trying to minimise the risk of harm to children

A

Protect children from maltreatment
Preventing impairment of children’s health or development
Ensuring that children are growing up in a safe and caring environment

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3
Q

What does the law say about children’s rights?

A

Article 19:
Children should be protected from all forms of physical or mental violence, injury or abuse, neglect or negligent treatment, maltreatment or exploitation
Article 24:
Children have a right to enjoyment of the highest attainable standard of health and to facilities for treatment of illness and rehabilitation of health

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4
Q

Why are dentists well placed to recognise signs?

A

Skilled at examining the head and neck and recording findings
Head and neck are frequent site of injury in physical abuse
untreated dental decay may be a sign of neglect
Children often attend regularly
Often treat more than one family member

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5
Q

what are the different forms of physical abuse?

A

May involve hitting, shaking, throwing, poisoning burning or scalding, drowning, suffocating
Includes fabricated and induced illness

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6
Q

How do you recognise child physical abuse?

A

Bruising, abrasions, lacerations, burns bite marks, eye injuries, bone fractures, intra-oral injuries
Site, size, patterns
Delay in presentation - delayed care for a bit
Does not fit the explanation given

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7
Q

Which bruises are suggestive of abuse?

A

In non-mobile infants
Over soft-tissue areas
Carry an imprint of an implement
Large, multiple in clusters

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8
Q

What are the different patterns of accidental, intentional burns?

A

Accidental scalds - spill injuries - irregullar edge
or child reaching to grab - palm of hand
Intentional scalds - immersion - glove or stocking pattern

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9
Q

Are fractures a sign of abuse?

A

Fractures frequently seen in abused children

May present at different stages of healing

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10
Q

what medical conditions may be misdiagnosed as a child being at risk?

A 
Birth marks 
Infections - scabies impetigo
unintentional injury
Bleeding disorders 
Leukaemia 
Osteogenesis imperfecta
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11
Q

Which oral injuries do you need to look out for?

A

Accidental are common
Lips most common site of oral injury in abuse
Any oral injury in a non-mobile baby is a concern
Torn labial frenum can occur as a result of blow to face - abusive or accidental

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12
Q

What are the different types of abuse?

A

Physical
Sexual
emotional
Neglect

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13
Q

What is sexual abuse?

A

Forcing or enticing a child or young person to take part in sexual activites; including prostitution, whether or not the child is aware of what is happening

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14
Q

How do you recognise sexual abuse?

A

Direct allegation
STI
Pregnancy
Emotional and behavioural signs e.g. anxiety and depression, self-harm, drug, solvent, alcohol abuse

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15
Q

What is emotional abuse?

A

Persistent emotional maltreatment of a child such as to cause severe and persistent adverse effects on the child’s emotional development

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16
Q

How do you recognise emotional abuse?

A 
Poor growth 
Developmental delay
Educational failure
Social immaturity 
Aggression or indiscriminate friendliness
Challenging behaviour 
Attention difficulties 
Concerning parent-child interaction
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17
Q

What is neglect?

A

the persistent failure to meet a childs basic physical and/or psychological needs, likely to result in serious impairment of the child’s health or development
Includes failing to ensure access to appropriate medical care or treatment

18
Q

how do you recognise neglect?

A 
Failure to thrive
Short stature
inappropriate clothing
Frequent injuries 
Ingrained dirt
Developmental delay
Withdrawn or attention seeking behaviour 
An underdeveloped child that starts to grow when placed in care
19
Q

What is the short-term impact of neglect?

A

Emotional health
Social development
Cognitive development
Physical health

20
Q

What is the long-term impact of neglect?

A 
Arrest 
Suicide attempts
Depression 
Diabetes 
Heart disease
21
Q

How can neglect kill?

A

child under 1 deprived of food and drink

Older child inadequately supervised

22
Q

What is the impact of dental disease

A 
Toothache
crying and not playing 
Disturbed sleep 
difficulty eating or change in food preferences 
absence from school 
Repeated antibiotics 
Dental GA
Lower body-weight, growth and quality of life
Poor dental appearance 
Severe infection
23
Q

What are features of particular concern when doing a dental assessment?

A

Obvious dental disease
impact on child
Acceptable care has been offered, yet child recieving no treatment

24
Q

What is dental neglect?

A

The persistent failure to meet a childs basic oral health needs, likely to result in the serious impairment of a child’s oral or general health or development

25
Q

What are the parental risk factors for the vulnerable group/

A 
Young parents
Single parents
Mental health problems 
Parents with learning difficulties 
Alcohol and drug abuse
26
Q

What are the social risk factors for the vulnerable group?

A 
Poverty 
Social isolation
poor housing 
family violence 
Asylum seekers and refugees
Homeless families
27
Q

What are the children risk factors for the vulnerable group?

A

Babies and toddlers- physical abuse/neglect
Older children - sexual abuse
Children with disabilities
Children with behavioural problems
Children looked after in residential or foster care
children missing from education

28
Q

What is the toxic trio?

A

Domestic violence
Mental health problems
Alcohol and substance abuse

29
Q

What are the key ways to regocnise abuse?

A 
Direct allegations
Physical signs
Pointers in history 
parent-child interaction 
the wider picture
30
Q

Barriers to dentist referral to get help?

A 
Lack of certainty about diagnosis
Fear of consequences to the child from intervention 
Fear of violence to the child 
Fear of violence to the professional 
Lack of knowledge of referral procedures
Fear of litigation
31
Q

Where do you go for help if think patient being abused?

A 
LSCB/ACPC procedures
Experienced dental colleague
Consultant paediatrics
Child proteciton nurse
Social services 
Childs heakth visitor, GP
32
Q

After got help and still have concerns, what do now?

A

Provide the urgent dental care to the chils
Talk to child and parents and explain concerns
Inform your intention to refer, need to seek consent to sharing information unless puts child at immediate risk
Refer for medical examination
Keep clinical records

33
Q

What do you do after immediate action if have concerns?

A

Refer to children’s services
By telephone
Follow up in writing within 48 hours
Children’s services acknowledge receipt of referral, decide on next course of action withing one working day and feedback to you

34
Q

What further action can be done later on ?

A

Confirm that referral has been received and acted upon
arrange dental follow up as indicated
Be prepared to write case report for case conference if requested
Talk your experiences through with a trusted colleague or seek counselling if needed

35
Q

What do you do if no longer have concerns

A

No further child protection action
Other action needed:
Provide necessary dental care keep full clinical records
Provide information/referral to local support services for children
Arrange dental follow up

36
Q

What are the agencies involved?

A

Children’s social care/children’s services (social services)
Criminal justice (police and probation)
Health
Education (early years, schools, further education)
Voluntary sector organisations

37
Q

What do you do if have a new patient DNA and and on child protection plan

A

Contact social worker and document agreed action

38
Q

What do you do if have a new patient DNA and has history of child protection plan?

A

Clinician to judge whether to contact through safeguarding net or discharge to referrer with copy to GP

39
Q

What do you do if have a new patient DNA and no record of child protection plan?

A

Discharge to referrer with copy to GMP

40
Q

If patient DNA follow-up appointment and under child protection plan or history of child protection plan what needs to happen?

A

CPP - contact social worker by copying appointment letter and document action
if HCPP - refer to paediatric liasion nurse - for support in contacting patients

41
Q

What are 6 tips for good practice?

A
  1. Identify a member of staff to take the lead on child protection
  2. Adopt a child protection policy
  3. Work out a step-by-step guide of what to do if have concerns
  4. Follow best practice in record keeping
  5. Undertake regular team training
  6. Practice safe staff recruitment

Patient management (12 decks)

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