Non Accidental Injury: Abuse and Neglect Flashcards
What is child maltreatment?
Any non accidental behaviour that is outside the norms of conducts and entails a substantial risk of causing physical or emotional harm to a child or young persons. May be international or unintentional and can include acts of commission (i.e. neglect) and commission (i.e. abuse)
What are the 4 types of abuse?
- Physical
- Emotional
- Neglect
- Sexual abuse
What is physical abuse?
Non accidental use of physical force against a child that results in harm to the child +/- intent. Some physical forces are considered abusive even if no injury results Includes fabricated / induced illness by a parent / carer.
What is emotional maltreatment / psych abuse?
Inappropriate verbal or symbolic acts toward a child and or a pattern of failure over time to provide a child with adequate non physical nurture and emotional availability. Can damage a child’s self esteem or social competence.
What are the 5 main forms of emotional maltreatment?
- rejecting
- isolating
- terrorising
- ignoring
- corrupting
What are the forms of neglect?
- physical (includes medical neglect)
- emotional
- educational
- environmental
What is family violence
Children being exposed to a parent or sibling being subjected to physical, emotional or sexual maltreatment
What is the most common type of abuse?
Emotional
Child factors predisposing to abuse?
- Age (older- PA)
- Sex (girls - SA)
- Race
- Difficult behaviour
- Disabilities
- MH problems
Where are concerning locations to identify bruising?
- Ear bruising
- Buttock bruising
- Back bruising
What may be inferred by the colour of a bruise?
When yellow more than likely to have occurred more than 18h ago
What are the priorities in dealing with child abuse?
- Diagnose, treat and document injuries
- Interpret pattern of injury or behaviour leading to suspicion of abuse
- Notify VFPMS
- Provide (with consent) verbal or written report to CP and police
Ix for fracture suspected of resulting from NAI?
- XR directly
- Bone scan
- Skeletal survey
(useful for detecting clinically unsuspected recent and older fractures). Use both if less than 3y and suspicion NAI.
Mx Sexual Abuse?
Recent (under 72h) needs rapid evaluation
- Contact VFPMS asap
- Treat urgent medical problems (i.e. bleeding)
- Ensure child comfortable
- Emotional support
- If possible, avoid food and drink toiling until VFPMS advises collection of samples
What child characteristics place them at greater risk of NAI?
- Speech and language disorders, learning disabilities, conduct disorders
- FTT
- Congenital anomalies, ID, chronic illness
- ADD / ADHD
- Unplanned pregnancy
- Unwanted child
