Child Safeguarding / Consent

Question 1

What are the types of abuse

Answer 1

Physical 
Emotional
Sexual
Neglect
Financial
Identity 
Fabricated and induced illness

Question 2

What is fabrication and induced illness

Answer 2

Fabrication of S+S, PMH, hospital records, specimens

Induction of illness

Question 3

What are physical alarm bells of abuse

Answer 3

Late presentation
History changes
History inconsistent with findings

Question 4

NAI

Answer 4

Bruising
Bruising is likely on shins / knees / bony parts / forehead only if pulling to send
Concern if soft areas e.g. cheeks, abdominal, back, buttock
Concern if HEAD
Concern if petechiae, imprint, clusters
Non-ambulant
Thermal injury
Cigarette burns
Multiple fractures at different stages of healing

Question 5

What is the most common cause of death in physical abuse

Answer 5

Abusive head trauma

Question 6

What is associated with head trauma / shaken baby

Answer 6

Retinal haemorrhage
Subdural
Encephalopathy
Neck and cervical spine injury

Question 7

What is neglect

Answer 7

Emotional
Abandonment
Medical - failure to attend 
Nutritional 
Education
Physical
Lack of supervision

Question 8

What are sexual abuse indicators

Answer 8

Any sexual act in <13 
Disclosure
Pregnancy 
STI
Recurrent UTIs
Sexually precocious behaviour
Anal fissure, bruising
Bruising 
Reflex anal dilatation
Enuresis and encopresis
Behavioural problems, self-harm
Recurrent symptoms e.g. headaches, abdominal pain

Question 9

Forensic examination

Answer 9

Joint paediatrician and forensic examiner

Video colposcope

Question 10

What legislation is in place to protect children

Answer 10

United Nation Rights of the Child
Child Act 1995
Children and Young People Act 2014
Named person

Question 11

Who is the named person

Answer 11

Health visitor up to school

Head teacher

Question 12

What happens after referral to police or social work

Answer 12

Initial assessment to understand risk
Joint visit with health vision, social work and police
Child protection case conference
Child protection Order to place of safety
Children’s panel
Looked after child
Court

Question 13

Who must always be informed

Answer 13

Social services

Question 14

What is your role in safeguarding

Answer 14

Act upon concerns
Involve relevant agencies 
Discuss with seniors
Document everything
Full examination 
Respect, Listen, Honesty
Confidentiality

Question 15

What are indicators of abuse

Answer 15

Quiet / withdrawn
Afraid to go hom
Hungry, tired, untidy
Left unsupervised 
Too much respnosiblity
Sexually inapproriate
Inapporiate language
Decreased attendance
Misusing drugs

Question 16

When can children consent

Answer 16

If <16 if have capacity to understand known as Gillick competency

Question 17

Can children refuse Rx

Answer 17

No

They can consent for a RX but parental responsibility can overrule if they refuse

Question 18

When can child have OCP

Answer 18

Understands
Cant persuade to inform parent 
Likely to still have sex
Physical / mental health will suffer
In best interest

Question 19

What are RF for abuse

Answer 19

Domestic violence
Previous abused parent
Mental health problems
Social, psychological or financial stress
Disability in child
LD in parents
Alcohol or substance misuse
Non-engagement with services

Question 20

What is in place to support families with safe guarding concerns

Answer 20

Home visits
Parenting programmes
Therapy

Question 21

What is all intercourse <13

Answer 21

Safeguarding concern

Question 22

If concern physical abuse

Answer 22

Skeletal survey

CT head

Question 23

What are DDX NAI

Answer 23

Osteopenia
Osteogenesis imperfecta
Malignancy
Vit D definicency