Community child health Flashcards
Outline the key points of the rotavirus vaccine
- Oral, live attenuated.
- 2 doses required: 2 months then 3 months.
- Risk of intussusception if given after 2 and 3 months.
Outline the factors which point towards child abuse
- Children disclosing abuse themselves.
- Story inconsistent with injuries.
- Repeated attendances to A&E.
- Delayed presentation.
- Child with a frightened, withdrawn appearance - ‘frozen watchfulness’.
Outline the possible physical presentations of child abuse
- Bruising (e.g. in a non-mobile baby).
- Fractures: particularly metaphyseal, posterior rib fractures or multiple fractures at different stages of healing.
- Torn frenulum: forcing a bottle into child’s mouth.
- Burns or scalds.
- FTT.
- STIs.
When a child lacks capacity, consent from who is sufficient to administer treatment as long as it is in the best interests of the child?
One parent
Should premature babies received their first set of vaccinations at 8 weeks as per normal timetable for term babies?
Yes - however the exception is for premature babies <28 weeks gestation, who should have some or all of their vaccines administered in the hospital environment due to an increased risk of apnoea.
Outline the features of childhood sexual abuse
- Pregnancy
- Sexually transmitted infections, recurrent UTIs
- Sexually precocious behaviour
- Anal fissure, bruising
- Reflex anal dilatation
- Enuresis and encopresis
- Behavioural problems, self-harm
- Recurrent symptoms e.g. headaches, abdominal pain
List the types of abuse
- Physical - non accidental injury e.g. unexplained bruising or fractures.
- Emotional - not providing care/love expected from a parent/care giver e.g. shouting, threatening, manipulating, scape-boating, blaming, bullying, grooming, exploitation.
- Sexual - penetrative, watching sexual videos.
- Neglect - malnourished, dirty clothes, poor dental hygiene, no access to medical care/prescriptions.
Outline the professionals involved in child abuse
- Paediatrics
- Safeguarding team
- Social care
- Health visitor
- GP
- Police
What is involved in the child protection medical?
- Blood tests.
- Skeletal surgery - X ray of all long bones.
- CT head.
- Fundoscopy - retinal haemorrhages from shearing forces via shaking injures.
Define county lines
A form of child exploitation where children are manipulated into drug dealing.
Section 17 or section 47 of the Children’s Act 1989
Immediate risk of harm - child needs to be removed from household or immediate protection required.
Early help/intervention/prevent for child protection
- Taking action to support the child or young person and their families.
- Improve issues.
- Can be escalated to section 17 (child in need) or 47 (child has suffered or is at risk of significant harm).
Outline red flag for bruising
- Linear bruises
- No pattern
- Peculiar position
Are rib fractures usually seen after cardiac compressions at birth?
No - infant ribs are more cartilaginous and flexible compared to children/adults. Uncommon for rib fractures to occur after CRP.
Differentials for unexplained bruising
- ITP
- Leukaemia
- Non-accidental injury
