Safeguarding

Question 1

Give 6 risk factors for being at risk of a safeguarding issue

Answer 1

<12 months old
Socially excluded families 
TOXIC TRIO: Background of parental domestic abuse, mental illness and substance abuse 
Disabled children 
Recent family crisis
Parents with learning difficulties 
DNA appointments 
Chaotic lifestyle- frequent travel, family instability, miss school 
Children who are in care 
Young carers 
Concealed pregnancy 
Newly registered patients- may have switched GP to avoid suspicion

Question 2

Give the 4 types of abuse

Answer 2

Physical
Neglect
Emotional
Sexual

Question 3

Give 3 examples of physical abuse

Answer 3

Hitting 
Shaking 
Burning 
Drowning 
FII
Throwing

Question 4

Give an example of emotional abuse

Answer 4

Telling children they are unloved or worthless

Inappropriate expectations

Question 5

Give 3 examples of neglect

Answer 5

Unresponsive to emotional needs
Failure to provide food, shelter, clothing
Poor hygiene

Question 6

Give 3 signs in the nature of presentation that might be suggestive of abuse

Answer 6

Changing history
Unreasonable delay in seeking medical help
Unexplained injuries
Injuries that do not match developmental age eg. bruises in a neonate

Question 7

Give 4 physical signs of abuse

Answer 7

Unusual bruising –> symmetrical, away from bony prominences, multiple or clustered, imprinting, bruising to face, abdomen, buttocks, ears, hands
Cigarette burns
Bite marks
Weight loss
Mouth injuries
Fractures- <2 years, arms, legs, skull, ribs

Question 8

Give 3 signs of neglect

Answer 8

Poor physical care
Poor hygiene
Distant relationship to caregivers
Poor development

Question 9

Describe the process of reporting maltreatment/neglect

Answer 9

• Take Hx and document clearly
• Examine child and measure/draw injury on body chart
• Arrange all relevant tests- x-ray, bloods
• Inform senior doctor
• Keep child in hospital if presenting to hospital
• Refer to social services
• Inform parents that you are making the referral