Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SCR exam > paediatric scenario > Flashcards

paediatric scenario Flashcards

1
Q

child protection

A

activity undertaken to protect specific children who are suffering or are at risk of suffering significant harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

children in need

A

those who require additional support or potential to achieve their full potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

safeguarding children

A

measures taken to minimise the risks of harm to children

  • protecting children from maltreatment
  • preventing impairment of children’s health or development
  • ensuring that children are growing up in a safe and caring env
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

child abuse and neglect

A

anything which those entrusted with the care of children do, or fail to do, which damages their prospects of safe and healthy development into adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

definition of child abuse

A

all 3 elements must be present
significant harm to child
carer has some responsibility for that harm
significant connection between carer’s responsibility for child and harm to child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

National Guidance Scotland

A

National Guidance for Child Protection in Scotland 2021 (2014) Scottish Gov
Children and Young People’s Act 2014
GIRFEC (not statutory)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The Children and Young People’s Act 2014

A 
13 parts - covers wide range of children's policy
4 major themes
 - children's rights (parts 1 and 2)
 - GIRFEC (parts 3,4,5,13)
 - early learning and childcare (part 6)
 - 'looked after' children (parts 7-11)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

issues with The Children and Young People’s Act 2014

A

aim of act “unquestionably legitimate and benign”

specific proposals about info sharing “are not within the legislative competence of the Scottish Parliament”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

GIRFEC in CYPA 2014 - staff and plans

A

named person for every child as a single point of contact to provide advice and support to families and to raise and deal with concerns about a child’s wellbeing
- now voluntary schemes only not mandatory
lead professional where particularly complex needs or where different agencies need to work together
- not legislated for, will remain a matter or policy and guidance only
single child’s plan - single planning process for individual children who have wellbeing needs
- legislated for in part 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 major themes of CYPA 2014

A
  • children’s rights (parts 1 and 2)
  • GIRFEC (parts 3,4,5,13)
  • early learning and childcare (part 6)
  • ‘looked after’ children (parts 7-11)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Glasgow city council named person

A

on website
preschool - HV
school age - teacher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GIRFEC in CYPA 2014 - national practice model

A

creates a shared language and approach to identifying and meeting concerns
- the well-being wheel’ (SHANARRI)
- ‘my world triangle’
- ‘resilience matrix’
shared approach to
- organising and recording info about a child
- discussing ways of addressing concerns about wellbeing
recommend - used by all agencies, inc when recording routine info
GIRFEC - emphasis on way that info is shared and recorded by different professions
the SHANARRI indicators and a concept of ‘wellbeing’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SHANARRI

A 
Safe
Healthy
Achieving
Nurtured
Active
Respected
Responsible
Included
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

outer cog of SHANARRI wheel

A

responsible citizens
successful learners
confident individuals
effective contributors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

my world triangle

A

how I grow and develop
what I need from people who look after me
my wider world

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when is the resilience matrix used?

A

when required for more complex situations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

resilience matrix

A 
resilience
                          ^
adversity     ---- l  -- >    protective env
                          l
                 vulnerability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

national practice model

A 
1 - wellbeing concerns
 - observing and recording 
 - events/observations/other info
 - SHANARRI model
2 - assessment - appropriate, proportionate, timely
 - gathering info and analysis
 - my world, resilience matrix
3 - well-being desired outcomes
 - planning action and review
 - SHANARRI model
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CYPA and info sharing

A

if safety is at risk
where benefits outweigh the public and individual’s interest in keeping info confidential
good practice to get consent where possible and safe to do so
share what you need to and keep a note of what and why you have shared the info
not restricted to instances where sig risk of harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

International - UNCRC

A

UN Convention on the Rights of the Child

based on the needs of children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

UNCRC - Children and Young People’s Charter

A 
right to respect
right to info about yourself
right to be protected from harm
right to have a say in your life
right to a good start in life
right to be and feel secure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

areas UNCRC criticised UK

A 
protection
 - physical abuse and violence 'reasonable chastisement'
 - teenagers penal system
 - asylum seeker children
participation
 - disabled children
 - access to info
provision
 - poverty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

child abuse aetiology - contributing factors

A

adults: drugs, alcohol, poverty, unemployment, marital stress, disabled, domestic violence, mental illness, step parents, isolation, abused as child, unrealistic expectations
child: crying, soiling, disability, unwanted pregnancy (born at wrong time). failed expectations, wrong gender, product of forced, coercive or commercial sex
community/env: dwelling place and housing conditions, neighbourhood
family violence and dysfct family: intergenerational cycle, violence towards pets, social isolation, poverty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

parenting capacity - the 3 big concerns

A

domestic violence
drug and alcohol misuse
mental health problems
= cumulative problems increase likelihood of a negative outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
categories of child abuse
``` physical emotional neglect sexual (non-organic failure to thrive) ```
26
vulnerable children groups
U5s (not at school, less interaction w other adults) irregular attenders - repeatedly not brought, return in pain, exposed to risks of GA medical problems and disabilities - more at risk of experiencing abuse of all kinds - serious impairment of health or development is more likely as a result of untreated dental disease - 'looked after' children
27
UK child abuse deaths
1-2 per week
28
Scotland child deaths by parent/sub
10 pa
29
child's needs
``` nutrition warmth, clothing, shelter hygiene and healthcare stimulation and education affection ```
30
effects of neglect - S+S
FTT/short stature inappropriate clothing, cold injury, sunburn ingrained dirt (finger nails), head lice, caries developmental delay withdrawn/attention seeking behaviour
31
neglect of neglect
possible as neglect is less incident focused/less shared understanding of what is meant by neglect and how it should be responded to
32
typical cases where neglect can kill
child <1yr deprived of food and drink | older independently mobile, inadequately supervised
33
short-term damage caused by neglect
physical health emotional health social development cognitive development
34
long-term damage caused by neglect
adults neglected as children - higher incidence of: | - arrest, suicide attempts, major depression, diabetes, heart disease
35
BSPD dental neglect
the persistent failure to meet a child's basic oral health needs, likely to result in the serious impairment of a child's oral or general health or development
36
how does dental neglect link to general neglect?
``` severe dental neglect can cause: - toothache - disturbed sleep - diff eating/change in food preferences - absence from school dental disease may put child at risk of - teasing due to poor dental appearance - repeated ABs - repeated GA exts - severe infection ```
37
when is neglect wilful?
after dental problems have been pointed out: - irregular attendance, repeated failed appts, repeated late cancellations - failure to complete tx - returning in pain at repeated intervals - repeated GA for dental exts
38
indicators of dental neglect
obvious dental disease (lay person can see) impact on child practical care has been offered, yet the child has not returned for tx
39
where is guidance for managing dental neglect from?
child protection and the dental team
40
stages of managing dental neglect
preventive dental team management preventive multi-agency management child protection referral
41
preventive dental team management
``` raise concerns with parents offer support set targets keep records monitor progress send reminder of tx ```
42
preventive multi-agency management
liase with other professionals (e.g. HV, School nurse, GP, social worker) to see if concerns are shared a child may be the subject of a CAF at this level check if child subject to a child protection plan (which replaced the child protection register) agree joint plan of action, review at agreed intervals
43
dental neglect - child protection referral
in complex or deteriorating situations follow local guidelines referral is to SS - usually by phone followed up in writing
44
Common Assessment Framework
lower level early intervention to provide support - not at a child protection/safeguarding report level child's developmental needs family and env factors parenting capacity
45
types of physical abuse
``` over chastisement (cultural) acute/compassionate (shaking) - spontaneous uncalculated reaction - remorse, takes appropriate action - child's needs are priority chronic/pathological (way of life) - help sought but not actively - no remorse - child's needs not a priority ```
46
Scotland and physical abuse
already illegal to hit a child with an object or to hit them anywhere on the head 2019 - Children (Equal Protection From Assault) (Scotland) Bill was passed - removes "reasonable chastisement" excuse from law - from 7th Nov 2020 it is illegal to physically punish a child
47
what law in Scotland removes "reasonable chastisement" from law?
2019 Children (Equal Protection From Assault) (Scotland) Bill
48
physical abuse types of injuries and %s
head - 95% of serious head injuries in first year of life body - 10% of 5yr olds attending A and E 10-12% of childhood burns non-accidental approx 60% of injuries in abuse cases are on H+N
49
typical accidental injuries
``` head injuries tend to involve parietal bone, occipuit, or forehead forehead nose chin palm of hand elbows knees shins typically - involve bony prominences - match the hx - are in keeping with the development of child ```
50
non-accidental injuries locations
``` ears - esp pinch marks involving both sides of ear "triangle of safety" - ears, side of face and neck, top of shoulders inner aspects of arms back and side of trunk, except directly over bony spine black eyes (esp if bilateral) STs of cheeks IO injuries forearms when raised to protect self chest and abdomen any groin/genital injury inner thighs soles of feet ```
51
types of injury that raise concerns
injuries to both sides of body injuries to STs (without bony prominences also) injuries with particular patterns any injury that doesn't fit the explanation delays in presentation untxed injuries
52
orofacial EO signs of abuse
``` bruising of face - punch, slap, pinch bruising of ears - pinch, pull abrasions and lacerations burns and bites neck - choke and cord marks eye injuries hair pulling fractures - nose > mandible > zygoma ```
53
when can bruising be suspicious?
different vintages tattoo bruising - matches instrument shape of slap, grip etc
54
orofacial IO signs of abuse
``` contusions bruises abrasions and lacerations burns tooth trauma frenal injuries - in a non-mobile child v suspicious ```
55
approx prevalence of IO injuries in physical abuse
33%
56
medical equivalents of physical abuse
impetigo - similar to cigarette burns birthmarks - mistaken for bruises facial infection - mistaken for trauma coagulation problems - bruise easily
57
Index of Suspicion
delay in seeking help story vague, lacking in detail, vary with each telling and person to person account not compatible with injury parent's mood abnormal, preoccupied parent's behaviour gives cause for concern child's appearance and interaction with parents is abnormal child may say something contradictory history of prev injury history of violence within the family
58
final checklist
could injury have been caused accidentally and if so how? does explanation for injury fit age and clinical findings? if explanation is consistent with the injury, is this itself within normally acceptable limits of behaviour? if there has been a delay in seeking help/advice, are there good reasons for this?
59
what is expected of the dental team?
``` observe record communicate refer for assessment = not expected to diagnose ```
60
who can you share concerns with?
named person
61
where to go for help and advice
``` experienced colleague named safeguarding nurse child protection advisor named doctor for safeguarding social services children's services department (e.g. First Contact) NSPCC helpline Paeds department ```
62
reasons for not telling parent about a referral
would put child in danger | unable to contact them
63
how to complete a child protection referral
telephone initially, follow up in writing - facts, statement of concerns notification of concern form/shared referral form
64
components of shared referral form
``` referrer details designated contact person (if not you) referral to (who you spoke to on phone) subject of referral family details (leave blank if don't know) - inc other adults in household and siblings not subject to referral summary of concerns reason for referral/request for services - reason for concern - alleged abuser (if applicable) - any actions you have taken agreed actions (during phone call) agency involvement e.g HV/GP/school sign and date ```
65
what should you get after referral?
a form back
66
in GGC what should be done with the referral forms?
keep one in pt records one to child protection unit one to SS
67
what happens after referral if child is in immediate danger?
child protection order exclusion order child assessment order removal by police or authority of a justice of the peace - emergency police powers
68
child protection order
can be issued to immediately remove a child from circumstances that put them at risk, or to keep a child in a place of safety.
69
exclusion order
can be issued to remove a suspected abuser from the family home. Only the local authority can apply for an exclusion order.
70
child assessment order
requires parents to allow their child’s needs to be assessed by a social worker. A CAO can only be applied for by the local authority.
71
when can emergency police powers be used?
If a sheriff isn’t available, the police or someone authorised by a justice of the peace can remove a child to a place of safety for up to 24 hours, allowing time for a CPO.
72
what happens routinely after a child protection referral?
investigation, initial assessment, discussion - begin to decide if child is at risk of significant harm outcome 1 - no further CP action, may get additional support 2 - joint investigation - child protection planning meeting - decide if put on CP Register - draw up child protection plan - may need to be referred to Children's Reporter and any court proceedings - get review meetings every 6m
73
Glasgow City Council CP contacts
``` emergency - 999 office hours - Social Care Direct out of office hours - Glasgow and Partners Emergency Social Work Services Police 101 health professionals ``` mygovscot - choose council to get numbers
74
GDC standards
must raise any concerns know who to contact for advice and how to refer concerns find out about local procedures follow these procedures if you make a professional judgement and decide not to share your concern with the appropriate authority, you must be able to justify how you came to this decision - contact your defence organisation for advice
75
NHS GGC raising a notification of concern
can cover until 18 inform local SWS snd/or Police Scotland by phone initially, clearly stating they are raising a possible child protection concern immediate danger 999 a NOC must be completed and submitted within 48hrs following initial telephone call - support from line manager and/or child protection service share relevant and proportional info - if not known don't delay NOC document concerns and actions at earliest opportunity within child's health record and within chronology of significant events
76
NOC form NHS GGC
``` electronic via clinical portal, EMIS, Corporate Services tab once completed NOC form - 1 - child's record - 2 - SWS - 3 - notify CPS ```
77
when wouldn't you notify family of NOC?
in exceptional circumstances e.g. staff felt at personal risk, or by doing so puts the child at extra risk
78
whose responsibility?
everyone's responsibility shared responsibility responsibility of every member of the dental team
79
when not to inform parents
where discussion might put the child at increased risk where discussion would impede a police investigation or social work enquiry where sexual abuse by a family member, or organised or multiple abuse is suspected where fabricated or induced illness is suspected where parents or carers are being violent or abusive, and discussion would place you or others at risk where it is not possible to contact parents/carers without causing undue delay in referral
80
6 tips for GDPs
``` identify staff member to take lead on CP adopt a CP policy work out a step-by-step guide of what to do if you have concerns follow best practice in record keeping undertake regular team training practice safe staff recruitment ```
81
how often should you do CP training?
Royal College of Paediatrics and Child Health - recommend CP training minimum every 3 years on GDC recommended CPD topics
82
GIRFEC approach
child-focused based on an understanding of the wellbeing of a child in their current situation based on tackling needs early requires joined up working
83
Named Person Service - now optional for LAs
every <18 in Scotland will have a 'named person' under school age - duty HB school age and over - duty LA exceptions - child in secure accommodation - manager of secure unit - attend independent schools - manager of school ? who within LA for those leaving school at 16

SCR exam (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions