Child_Abuse_NICE_Guidelines_Flashcards
When did NICE publish guidelines on when to suspect child maltreatment?
NICE published guidelines on when to suspect child maltreatment in 2009.
What types of child abuse may be included in child maltreatment?
Child abuse may include physical, emotional, and sexual abuse, neglect, and fabricated or induced illness.
What are some features of neglect where you should consider abuse?
Features of neglect where you should consider abuse include severe and persistent infestations (e.g., scabies or head lice), parents who do not administer essential prescribed treatment, parents who persistently fail to obtain treatment for tooth decay, parents who repeatedly fail to attend essential follow-up appointments, parents who persistently fail to engage with child health promotion, failure to dress the child in suitable clothing, and animal bite on an inadequately supervised child.
What are some features of neglect where you should suspect abuse?
Features of neglect where you should suspect abuse include failure to seek medical advice which compromises the child’s health, a child who is persistently smelly and dirty, repeat observations of poor standards of hygiene that affects the child’s health, inadequate provision of food, and a living environment that is unsafe for the child’s development stage.
What are some features of sexual abuse where you should consider abuse?
Features of sexual abuse where you should consider abuse include persistent dysuria or anogenital discomfort without a medical explanation, gaping anus in a child during examination without a medical explanation, pregnancy in a young woman aged 13-15 years, and hepatitis B or anogenital warts in a child 13-15 years.
What are some features of sexual abuse where you should suspect abuse?
Features of sexual abuse where you should suspect abuse include persistent or recurrent genital or anal symptoms associated with a behavioural or emotional change, anal fissure when constipation and Crohn’s disease have been excluded as the cause, STI in a child younger than 12 years (where there is no evidence of vertical or blood transmission), and sexualised behaviour in a prepubertal child.
What are some features of physical abuse where you should consider abuse?
Features of physical abuse where you should consider abuse include any serious or unusual injury with an absent or unsuitable explanation, cold injuries in a child with no medical explanation, hypothermia in a child without a suitable explanation, and oral injury in a child with an absent or unsuitable explanation.
What are some features of physical abuse where you should suspect abuse?
Features of physical abuse where you should suspect abuse include bruising, lacerations, or burns in a child who is not independently mobile or where there is an absent or unsuitable explanation, human bite mark not by a young child, one or more fractures if there is an unsuitable explanation (including fractures of different ages and X-ray evidence of occult fractures), and retinal haemorrhages with no adequate explanation.
summarise child abuse guidelines
You are working in the emergency department when you assess a 6-year-old boy with a broken arm. As part of your examination, you notice some lacerations on his back. On questioning, he doesn’t want to talk about it but his mother quickly reassures you this is from him playing with his friends after all, ‘boys will be boys’. You are suspicious. What do you do?
Put the child’s arm in a cast then call the police
Put the child’s arm in a cast and discharge him then phone the GP to ask them to contact child protection
Put the child’s arm in a cast and admit them, then contact child protection
Put the child’s arm in a cast and discharge him
Put the child’s arm in a cast and discharge him, then contact child protection
Put the child’s arm in a cast and admit them, then contact child protection
The GMC good medical practice contains guidelines on protecting children and young people. Within this, they state that ‘you must be open-minded when considering the possible cause of an injury or other signs that may suggest that a child or young person is being abused or neglected. For example, as part of the differential diagnosis, you should consider whether an uncommon condition, including a genetic condition, might have caused or contributed to the child’s or young persons injury or symptoms. You must also make sure that the clinical needs of children and young people continue to be met and are not overshadowed by child protection concerns.
If having discussed the issues with the parents, you still have concerns that a child or young person is at risk of, or is suffering, abuse or neglect, whatever the cause, you must tell an appropriate agency.’
The question states you are still concerned. Therefore not acting on this immediately, while he is in your care, is wrong (such as in answer 2, 4 and 5). This leaves you with the option of contacting the police or contacting child protection. In this instance, it would be more appropriate to start with child protection.
