Safeguarding Flashcards
What is child abuse?
Child abuse is a term which describes all the ways in which a child’s development and health are damaged by the actions, or inactions of others, either by commission OR omission.
What is:
- Commission
- Omission
Commissions ie: physical harm
Omission: not providing food/clothing
Define safeguarding…
- Promoting good physical and mental health
- Identifying risks and potential for harms to occur
- Recognising when harms have occurred
Define safeguarding in children…
- Protecting children from abuse and maltreatment
- Preventing harm to children’s health or development
- Ensuring children grow up with the provision of safe and effective care
- Taking action to enable all children and young people to have the best outcomes.
What are the key principles of safeguarding?
- Children have a right to be safe and should be protected
- Safeguarding children is everyone’s responsibility
- Intervene as early as possible
- Help should be interdisciplinary and well coordinated
What are the risk factors for safeguarding?
- <1 year
- Chronic illness
- Looked after kids
- Insecure
- In transition
- Lack of belonging/Identity
- Mental health issues
- Poverty
- Financial strain
Toxic Trio
- Substance abuse
- Mental health issue
- Domestic abuse
Describe a child with increased needs?
- Under 1 year
- Developmental stage of the child/ child’s presentation
- Must consider children whose language of choice is not English or require help to communicate
- Disabled Childre
- Children who self harm, including overdose
- Looked after children and young people
- Teenagers displaying risk taking behaviours
- Unplanned/Unwanted baby
- Child reluctant to go home/keen to be admitted to hospital
Describe a parent with decreased capacity for parenting?
Describe environmental factors that would increase risk?
- Housing Conditions
- Community Issues
- Professional
- Thresholds
- Culture/Religious beliefs
- Nomadic Lifestyles
What are the 3 types of adverse childhood experiences?
Longterm: can affect future adult health
What is the longterm effect of ACE (adverse childhood experiences)?
What are the categories of abuse?
- Physical Abuse
- Neglect
- Emotional abuse
- Sexual abuse
- Radicalisation
What to look for in physical abuse?
-
Bruising
- Non-mobile
- Patterns/shapes
- Head
- Injuries
- Unexplained injuries
- Untreated injuries
- Improbable explanations
- Excessive punishment
- Shrinking from physical contact
- Fear of home and parents
- Unexplained absences
- Frequent admissions
- Missed appointments
What to look for in emotional abuse?
- Developmental delay
- Self deprecation
- Fear of new situations
- Inappropriate responses
- Self harm, mutilation
- Misbehaviour
- Stealing
- Drug/solvent misuse
- Failure to thrive
- Sudden speech disorders
- Wetting/Soiling (day or night)
- Aggression
What to look for in neglect?
- Frequent infections
- Constant tiredness
- Missed school
- Constant hunger, stealing food
- Unkempt, Poor hygiene, dirty, smelly
- Especially in baby
- Inappropriate clothing
- Developmental delay
- Failure to thrive
- Untreated medical conditions
- Avoidance of health appointments
- Tooth decay
What to look for in sexual abuse?
- Inappropriate sexual awareness
- Pregnancy/STI’s
- Aggressive, angry, anxious, tearful
- Withdrawn, isolated
- Psychosomatic Illness
-
Sexual exploitation
- Unexplained amounts of money
- Controlling partner
- Multiple phones
Important To Know:
- Legal age of consent- 16 yrs
- <13 yrs– cannot consent to any sexual activity
What to look for in sexual abuse?
- Inappropriate sexual awareness
- Pregnancy/STI’s
- Aggressive, angry, anxious, tearful
- Withdrawn, isolated
- Psychosomatic Illness
-
Sexual exploitation
- Unexplained amounts of money
- Controlling partner
- Multiple phones
Important To Know:
- Legal age of consent- 16 yrs
- <13 yrs– cannot consent to any sexual activity
What to look for radicalisation?
- Isolating self
- Scripted speech
- Disrespectful attitude
- Increased levels of anger
- Secretiveness
What are the RED FLAGS in the the history in paediatrics?
- Delayed presentation
- Unexplained injuries
- Improbable explanations
- Frequent admissions
- Missed appointments
What are the RED FLAGS in the the examination in paediatrics?
- Petechial bruising
- Bruising on immobile children
- Weight faltering
- No signs of stranger anxiety
- Unexplained developmental delay
- Bulging fontanelles
- Oral injuries
- Spiral fractures
What to look for in bruising for safeguarding? (& discipline or abuse)
- Patterns
- Colour
- Location
- Head
- Soft areas vs bony
Extra Info
- Red/Blue/Purple more likely in bruises <48 hours
- Brown/Green more likely beyond 48 hours
Discipline or Abuse?
- It is not against the law for a parent to hit a child if it is considered ‘reasonable punishment’
- Considered unreasonable if child is hit with implement or a mark is left
- Illegal in Scotland as of 2017
How can you tell that bruising is accidental?
- Shins and Knees are commonest
- ‘T’ of the forehead, back of head and upper lip
- Less commonly around cheeks or eyes
- Bony prominences
How can you tell that bruising is non-accidental?
- Non-mobile child
- Abdomen, back, buttocks
- Head, neck, ears
- Cluster bruises
- Petechiae
- Imprints/Patterns
What are the differential diagnosis of bruising?
- Mongolian blue spots
- Newborn exam
- Purpura/ Petechiae??
- Meningococcal septicaemia
- Leukaemia
- Idiopathic Thrombocytopenia Purpura
- Henoch Schonlien Purpura
How to tell the difference in accidental and non-accidental scalds and burns?
What are the differential diagnosis of scalds & burns?
- Friction blisters
- Impetigo (shown on diagram)
- Dermatitis
- Photodermatitis
- Hypersensitivity
What to look for in oral injuries?
- Lip injuries
- Torn frenulum
- Tongue – erythema, lacerations and bites
- Tooth decay
- Brown or grey teeth
What to look for in fractures in safeguarding?
- Rib - anterior or posterior
- Spiral fractures - Femoral - <12 months
- Skull
What are the differential diagnosis of fractures in safeguarding?
- Osteopenia of prematurity
- Rickets
- Osteogenesis imperfecta (brittle bones)
- Osteomyelitis
- Systemic disease
What are the differential diagnosis of abusive head trauma in safeguarding?
- Extreme irritability
- Lethargy
- Poor feeding
- Apnoea
- Retinal haemorrhage
- Bulging fontanel
- High pitched cry
- Seizure
- Vomiting
What neurological injuries could a child have with abuse (safeguarding)?
How to escalate a concern with safeguarding?
