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3A Paediatrics > Child protection and safeguarding > Flashcards

Child protection and safeguarding Flashcards

1
Q

What is the difference between safeguarding and child protection?

A

Safeguarding includes prevention, whilst child protection means that a child is at risk of harm or has been harmed

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2
Q

What is a section 47 investigation?

A

there is a full child protection investigation going on

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3
Q

What is a section 17?

A

If they say s17 they mean a child in need, hence the family are receiving support to help to ensure that the children’s needs are met.

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4
Q

What are some examples of safeguarding issues?

A

Peer on peer abuse
FGM
Cyberbullying & Sexting
Hidden Harm
Domestic Abuse
Slavery
Child sexual exploitation
Harmful sexual behaviour
Forced marriage
Honour killing
Etc

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5
Q

4 Types of Child abuse

A

Physical Abuse

Sexual Abuse

Emotional Abuse

Neglect

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6
Q

How common is child abuse?

A

Much abuse is never disclosed or reported to professionals

Around 10% adults report abuse during their childhood

More than 500 Sheffield children have a child protection plan

Approximately 650 children “looked after” by the local authority

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7
Q

What is a child protection plan

A

Much abuse is never disclosed or reported to professionals

Around 10% adults report abuse during their childhood

More than 500 Sheffield children have a child protection plan

Approximately 650 children “looked after” by the local authority

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8
Q

RFs for child abuse

A

Parental
Lack of support
Generational effect
Deprivation
Mental health problems
Learning difficulty
Alcohol and substance misuse
Domestic violence
ACEs- adverse childhood experiences

Child
Difficult to care for
Preterm
Disabled

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9
Q

How can a child undergoing child abuse present?

A

Disclosure

Injury observed e.g. At school

Found incidentally when attending for other reason

Injury presented with or without explanation.

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10
Q

How does the Child Protection Medical assessment work?

A

History

Examination - Child protection medical assessment

Investigation

Provision of opinion to support further assessment by social care. Contribution to the ‘jigsaw.’

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11
Q

How should history be taken for child abuse?

A

Part of “Whole Child” assessment

Separate histories taken from social worker, parent/carer and child.

Document who is present ,who said what and when

Identify discrepancies

Your approach should be similar to how you handle any type of medical problem. You start wit h the history of presentation, direct questioning and make your way down to the family and social history.

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12
Q

When should concerns be raised

A

A history that does not fit with observed injuries

Too many injuries
Wrong site
Unusual shape or pattern
Wrong type of incident
Not consistent with child’s development
Delay in presentation

No history

A history that changes

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13
Q

In the examination what should be observed?

A

Use body chart to document injuries

Record any explanations offered

Photographs

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14
Q

What are the types of injuries that could happen with child abuse?

A

Superficial
Bruises
Scratches
Marks from implements (Patterned injuries)

Burns and scalds

Fractures
Multiple
long bones, ribs, metaphyseal

Internal Organ Damage
Abdominal
Intracranial

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15
Q

What can happen if you Shake your baby?

A

Shaking and impact effects

Cerebral Hypoxia*

Subdural haematoma*

Rib fractures

Retinal haemorrhages*

May have other fractures ,torn frenulum, bruises etc.

hypoxia, intracranial haemorrhage like subdural haemorrhage, rib fractures and retinal haemorrhages

  • Known as Shaken Baby Syndrome
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16
Q

Where would you expect to see bruising?

A

Head injuries - involve parietal bone, occiput or forehead
Nose
Chin
Elbows
Knees
Skins

17
Q

What do you need to remember about accidental injuries

A

Involve bony prominences
Match the history
in keeping with development of the child

18
Q

What are bruises that we should worry about?

A

Ears - pinch marks
Triangle of safety - ears, side of face, neck, top of shoulders
Inner arms
Back and trunk
Black eyes
Forearms
Groin
Inner aspects of thighs
Soles of feet

19
Q

What do you need to remember about suspect injuries?

A

Injury to both sides of the body
Injuries to soft tissue
Injuries with particular patterns
Injury that doesnt fit the explanation
Delays in presentation
Untreated injuries

20
Q

DDs apart from abuse

A

Birthmarks

Congenital dermal melanocytosis

Paint

Bleeding tendency

“Brittle” bones

Normal accidents

21
Q

What is congenital Dermal melanocytosis?

A

Birth mark. Need to note that it is not always evident at birth, may appear later and it is not only confined to the buttock region. Around the ankles also common. We often get HV refer babies in because when they saw them 10 days before it was not there and they are worried about bruising.

22
Q

What is needed from a parent to a child?

A

Food and drink
Warmth
Shelter
Clothing
Grooming
Health and dental care
Education
Appropriate social opportunities
Emotional support
Protection from harm
Boundaries and behaviour

23
Q

What are the types of neglect?

A

Emotional neglect
Abandonment
Medical neglect
Educational neglect
Physical neglect
Failure to provide supervision and guidance.

24
Q

What are some diseases which could show neglect

A

Repeated head lice
Frost bite
Dental abscesses
Frozen watchfulness - anxious looking baby

25
Q

What can emotional harm do to a child?

A

Common

Often unrecognised

Damaging

Relationship high in criticism ,low in warmth

Coexists with other abuse types

Includes children exposed to domestic abuse

26
Q

What is sexual abuse?

A

Boys and girls

Any age

Family vs. stranger abuse

Wide spectrum of activities ,including on-line grooming, pornography

Linked to other abuse types

27
Q

What is the presentation of sexual abuse?

A

Disclosure or allegation

Behaviour change
Sexualised
Indicative of distress

Physical symptoms
Bleeding
Discharge
Soreness
Wetting or soiling
STI
Pregnancy

28
Q

What are the child protection medical investigations?

A

Laboratory tests e.g. FBC, clotting if bruising/bleeding

Swabs for possible infection

Bone profile ,vitamin D ,PTH

Radiology e.g. Skeletal survey ,CT,MRI

Developmental assessment

29
Q

What kind of imaging is used to monitor child abuse?

A

Skeletal survey for all children with bruises/fractures who are less than 2 years of age.
Children aged 2-3 years skeletal survey is discretional

CT head scan for babies less than 12 months

Repeat skeletal survey after 2 weeks

30
Q

Who are safeguarding concerns investigated by?

A

Safeguarding concerns are investigated by Social Care with the help of information from Health and police

All safeguarding referrals go to social care

31
Q

What do Social Care do?

A

Social Care will organise and lead on
Strategy Meetings
Case Conferences
Police will address any criminal aspects

32
Q

Roles and responsibilities of other agencies can also be?

A

Strategy Meetings Outcome
NFA
s17 investigation
s47 investigation

33
Q

What else can occur in a case conference?

A

Multiagency
Parents invited
Purpose is to agree that the child has suffered significant harm or is at risk
If agreed, the child is placed on a CP plan.
Plan addresses what needs to change to make things better for the child
Regular core group meetings to review and make sure plan is progressing
Review conferences 3-6monthly

34
Q

What is an emergency Protection order (EPO)

A

Lasts for 8 days. Can be extended
Put in place to give social Care time to get an interim care order (ICO)
Most often not needed as parents voluntarily agree for child to go into care under s20

35
Q

What happens if you see a child under an ICO with a social worker?

A

the SW can give consent if however the child is on the ward under a police protection order, you have to get consent from the police to do your medical.

36
Q

What is a Police Protection Order (PPO)

A

Lasts for 3 days

37
Q

What is a Full Care Order, Special Guardinship order, Residency Order

A

Provides more permanent placement for the child

3A Paediatrics (19 decks)

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