Safeguarding of children

Question 1

What investigations are done to children who presents with fractures?

Answer 1

1. Full skeletal survey to look for other fractures or for signs of healed fractures.
2. Look into the eyes to check for retinal haemorrhages as this can be a sign of aggressive shaking of the baby.
3. CT scan to look for brain haemorrhages which can also indicate aggressive shaking of the child, or trauma.
4. Look into the mouth to check for frenulum tear.

Question 2

Besides doing a CT of the head, what is another method to check for intracranial bleeds?

Answer 2

Measuring of the head circumference

Question 3

What medical condition is suspected in babies or children with several signs of healed fractures in an X-ray?
What other clinical sign can be seen in this medical condition?

Answer 3

Osteogenesis Imperfecta (Brittle bone disease)

Blue sclera is a sign of Osteogenesis Imperfecta.

Question 4

What is the other term for “feacal incontinence” in children?

Answer 4

Encopresis

Question 5

List the 5 types of abuse

Answer 5

Physical
Neglect
Emotional
Sexual
Fabricated or Induced illness (FII)

Question 6

What are the “Toxic Trio”?

Answer 6

Parental mental health issues
Substance misuse: Alcohol or drug abuse
Domestic violence

Question 7

What characteristics makes up a vulnerable child?

Answer 7

• Being less than 1 year old
• Unsettled babies: Parents may become frustrated or overly exhausted
• Premature babies
• Hyperactive children
• Children with special needs (due to disabilities)
• Teenagers with risk-taking behaviour

Question 8

What types of bruises will warrant further investigations?

Answer 8

Black eyes
Bruising on cheeks, chest, abdomen or at the back of ears
Grip marks
Bruises with petechiae (usually presents after a slap)

Question 9

What investigations are done if a child presents with multiple bruises? Why is this investigation done?

Answer 9

FBC to look for leukemia or thrombocytopenia