Safeguarding

Question 1

What are the 4 categories of child abuse?

Answer 1

• Physical abuse
• Emotional abuse
• Sexual abuse
• Neglect

Question 2

What are the important steps to a potential safeguarding issue?

Answer 2

1. Alerting features - look for signs/smptoms/behaviours that might indicate abuse.
2. Consder - other explanations for altering features
3. Suspect - serious level of concern with no proof, usually triggers investigation etc.
4. Exclude - maltreatment if there is an alternate explanation.

Question 3

What are the risk factors for child abuse?

Answer 3

Parental factors:

• Mental health disorders
• Domestic violence
• Prev. hx of maltreatment
• Drug/substance abuse
• Housing/financial problems
• Single parent

Child factors:

• Disability
• Long term illness
• Being in care

Question 4

What are the steps to follow if there are features that alert you to possible abuse?

Answer 4

Listen and observe
Seek an explanation
Record everything
Escalate to appropriate agency or superior

Question 5

What tools can we use for the history with suspected abuse?

Answer 5

Listen
Be non-judgemental
Ask only open questions
Pick up on queues
If an interpreter is needed, try not to use family.

Question 6

What tools can we use for the examination with suspected abuse?

Answer 6

Body map
Always use a chaperone
Assess whole pt and all injuries present

Question 7

What presentations of neglect might you see?

Answer 7

• Severe/persistent infestations
• Not giving essential medications
• Tooth decay not treated
• Failure to attend essential follow-up appointments
• Failure to engage in child health promotion
• Smelly/dirty children
• Repeated poor hygeine, inadequate provision of food

Question 8

What features might make you consider sexual abuse?

Answer 8

-Persistent dysuria or anogenital discomfort with no medical explanation
Gaping anus with no medical explanation
Pregnancy in under 15
Hep B or anogenital warts in children under 15

Question 9

What features might make you suspect sexual abuse?

Answer 9

• Persistent/recurrent genital or anal symptoms with behavioural/emotional change
• Anal fissue without constipations/IBD
• STI in child under 12
• Sexualised behaviour in child prepuberty

Question 10

What features might make you consider physical abuse?

Answer 10

• Any serious or unusual injury without good explanation
• Hypothermia in a child without explanaiton
• Oral injury without good explanation

Question 11

What features might make you suspect physical abuse?

Answer 11

• Bruises, laceration, burns etc on a child who is not independantly mobile
• Human bite mark on child
• Fractures of different ages
• Retinal haemorrhages wothout explanation