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Paediatrics RIA > Safeguarding > Flashcards

Safeguarding Flashcards

1
Q

categories of abuse (5)

A
  • physical
  • emotional
  • sexual
  • neglect
  • inducing injury
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2
Q

signs of abuse

A
  • behavioural changes
  • clothes ill fitting/dirty
  • poor hygiene
  • not wanting to change clothes in public
  • frequent unexplained injuries
  • lack concentration @ school
  • reaching developmental milestones late
  • use of sexual language
  • sexual health problems
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3
Q

what is SENCO

A

Special Educational Needs Coordinator

  • support and identify children with special educational needs
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4
Q

differentials for a 5 month old presenting with a full fontanelle, irritability, refusing feeds, vomiting, tachycardic, cool peripheries

A
  • meningitis
  • sepsis
  • viral encephalitis
  • shaken baby syndrome
  • metabolic syndrome: disruption of urea cycle
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5
Q

management of a 5 month old presenting with irritability, no fever, full fontanelle, tachycardia

A
  • iv access
  • fluid bolus
  • blood tests
  • CT head
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6
Q

CT head in shaken baby syndrome shows:

A

subdural haematoma

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7
Q

who requests a Child protection Medical assessment

A

social services

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8
Q

Glutaric acidaemia

A
  • an inherited disorder whereby the body lacks an enzyme and is unable to break down amino acids into energy
  • risk of subdural haematoma
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9
Q

symptoms and testing for

Ehlers Danlos syndrome

A
  • joint hypermobility
  • stretchy skin
  • fragile skin: bruises/bleeds easily
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10
Q

Osteogenesis imperfecta

A
  • fragile bones: fracture easily
  • blue sclera
  • dental fragility
  • hearing loss
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11
Q

management by social services when contacted regarding a safeguarding issue

A
  • interview parents
  • social care home visit
  • investigate for hx of domestic violence
  • involve police
  • request child protection medical assessment for siblings
  • seek to place children with extended family if assessed and found to require safeguarding from impending harm
  • multi disciplinary child protection strategy meeting
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12
Q

who decides where a child goes once the child is deemed to be medically fit for discharge

A

social services

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13
Q

Triad of symptoms for shaken baby syndrome

A
  • retinal haemorrhages
  • subdural haematoma
  • encephalopathy
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14
Q

symptoms of shaken baby syndrome

A
  • irritability
  • poor feeding
  • increased head circumference
  • seizures
  • reduced GCS
  • full fontanelle
  • anaemia
  • retinal haemorrhages
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15
Q

questions when raising a safeguarding issue

A

Are there any known safeguarding issues?
Is the child on a child protection plan?
Does the child need a Place of Safety?

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16
Q

differentials for multiple bruises

A
  • Leukaemia
  • Aplastic anaemia
  • Post viral aplastic anaemia
17
Q

examination findings of respiratory distress

A
  • widespread expiratory wheeze
  • intercostal recession
  • harrisons sulcus
18
Q

horizontal groove along the lower border of the thorax corresponding to the costal insertion of the diaphragm

A

Harrisons sulcus

19
Q

when should the Child Protection Team be involved when there is poor care for a child from a patient?

A

When the poor care is putting the child’s health at serious risk and there have been repeated attempts by the team to engage with parent that have not resulted in adequate improvement

20
Q

Management for a mother that is unintentionally neglecting her child’s health?

A
  • Calling a “child in need” meeting to help train mother
  • Core group of professionals: identified to monitor how well the implantation of the plan goes

Last resort = fostering of child

21
Q

household risk factors for abuse: relating to child

A
  • being the younger child
  • increased needs e.g. disability
  • low birth weight
  • multiple births
22
Q

household risk factors for abuse: relating to parents

A
  • younger parental age
  • mental illness
  • drug/alcohol abuse
  • parental crime
  • parents: vulnerable, unsupported
  • known mistreatment of animals
  • domestic violence
  • lower socio economic class
  • parents themselves were abused
23
Q

History of an accidental injury

A
  • mechanism consistent with injury
  • consistent stories
  • no delay in seeking medical attention
  • appropriately concerned parents
  • one off injury
  • injury consistent with childs age/development/mobility
24
Q

History of a non accidental injury

A
  • no mechanism offered or is inconsistent with injury
  • delay in reporting the injury
  • inconsistent history from parents
  • inappropriate reaction from parents e.g. unconcerned/aggressive
  • recent injuries
  • injuries inconsistent with childs age
25
Q

accidental fractures

A
  • linear skull fractures

- long bone fractures (in children > 5 years)

26
Q

type of fracture that is more commonly due to abuse

A

non-supracondylar fractures

27
Q

non accidental fractures (5)

A
  • metaphyseal fractures
  • posterior rib fractures
  • fractures of different ages
  • complex skull fractures
  • long bone shaft fractures (in a non mobile child)
28
Q

non accidental bruises

A
  • face
  • buttock
  • back
  • bruise outlines a particular object
  • pattern e.g. fingertips
29
Q

features of accidental burns

A
  • asymmetrical
  • flexures are spared
  • geographical splash marks
30
Q

features of non accidental burns

A
  • uniform shape (cigarette burn)

- glove + stocking distribution

31
Q

what doe a Child Protection Medical Assessment consist of?

A
  • child must be questioned away from carers
  • growth chart: body map
  • Observations: photography

e. g. for ?shaken baby syndrome
- skeletal survey
- ophthalmology review
- metabolic testing: glutaric acidaemia
- detailed clotting screen
- genetic test for Ehlers Danlos

32
Q

who carries out a Child Protection Medical Assessment

A

at least registrar level Paediatrician and there must be a named consultant

33
Q

differentials for a child presenting with fractures

A
  • accidental injury
  • osteogenesis imperfecta
  • copper deficiency
  • Vit D/C deficiency
  • Ehlers Danlos syndrome
  • JOBs syndrome
34
Q

differentials for a child presenting with Burns/scolds

A
  • Accidental
  • Bullous impetigo
  • Staphylococcal Scalded Skin Syndrome
35
Q

differentials for a child presenting with bruising

A
  • accidental injury
  • ITP
  • meningococcal septicaemia
  • HSP
  • Mongolian blue spot
  • vWD
  • leukaemia
  • Haemophilia A + B
  • Ehlers Danlos
  • Vasculitis
  • Petechiae
  • Coagulopathy
36
Q

presentation of a child from neglect

A
  • failure to thrive
  • inadequate hygiene
  • poor emotional development
  • delay in speech/language development
  • poor school attendance

Paediatrics RIA (12 decks)

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