Specific stuff following practice Flashcards
What is the role of schools in child mental health promotion?
- Ensure all students have equal access to learning
- Look out for signs of poor mental health or behavioural issues and alert parents
- Attempt strategies to manage behaviour and support children
What is the role of a health visitor in child mental health promotion?
- Provide support and someone to talk to
- Offer advice on lifestyle, diet, exercise, healthy eating, hygiene and day to day living
- Tell parents about other roles that may be useful
What is the role of social services in child mental health promotion?
- Provide initial assessments in areas where they have specialist skills, e.g. behavioural issues
- Provide reports to courts and child mental health services
- Provide mental health consultations and training to other services (e.g. schools)
What is the role of an educational psychologist in child mental health?
- Tackle problems with learning difficulties, social or emotional problems
- Provide reports for children for allocation to specialist education places
- Work with individual children, e.g. observing, assessing, counselling
- Advise teaching staff on special considerations and how to meet a child’s needs
- Facilitate group work in schools, e.g. social/anger management skills
What does an independent mental health advocate do?
- Allocated worker to support patient
- Allows them to express their views and concerns, and helps defend their rights
What does a second opinion appointed doctor do?
Used to give supportive second opinion on treatment or sectioning
What is an approved mental health professional?
- Usually a psychiatrist, but can be a social worker, CPN, etc
- Someone with specialist training in mental health who makes application for sectioning
What is a Section 12 approved doctor?
A doctor, usually a psychiatrist, who has been approved under the MHA to carry out sectioning
What is the nature of a mental health condition?
The history of the condition
What is the degree of a mental health condition?
The current manifestation of a condition
What does a Section 2 do and for how long does it last?
Allows detention of an individual for assessment for up to 28 days
What does a Section 3 do and how long does it last?
- Allows detention of an individual in hospital for treatment for 6 months
- Must be reviewed at 3 months
What its required for a Section 3?
Patient must have a specific diagnosis
Who can apply for a Section 2/3?
Must be applied for by AMHP & approved by 2 doctors (one must be section 12 approved) = 2 independent doctors
What does a Section 4 do, how long does it last and when is it used?
Allows detention in hospital for emergency assessment for 72 hours when a Section 12 doctor can’t be obtained quickly
When its a Section 5(2) used, what’s its duration and who would use it?
- Used by a doctor when they don’t think a patient should leave a locked ward
- Lasts 72 hours
When is a Section 5(4) used, who would use it and what’s its duration?
- Used by a nurse when they don’t think a patient should leave a locked ward
- Lasts 6 hours
What does a Section 135 do, who would use it and how long does it last?
- Used by police to detain someone and take them to a safe place when they are suffering from a MH disorder at home
- Lasts 36 hours but can be extended
What does a Section 136 do, who would use it and how long does it last?
- Used by police to detain someone and take them to a safe place when they are suffering from a mental health disorder in public
- Lasts 24 hours but can be extended by 12 hours
Roles of MDT?
- MANSG
- Management plan, audits, new diagnoses, specialist nurse, guidelines
What its the key statutory guidance for child protection?
Working together to safeguard children 2018
What relevant Sections to child protection are there in the Children’s Act 1989?
- Section 17
- Section 44
Describe section 17 of the Children’s Act 1989?
- If child in immediate danger give safeguarding referral to local authorities/police
- this is what you do
Describe Section 44 of the Children’s Act 1989?
- EPO
- Child taken to safe place/can’t be removed from safe place by local authority
- Lasts 8 days
Do you have to inform parents if you’re going to make a child protection referral?
Ideally but not if it risks child
What is the Healthy Child Programme?
- A policy introduced to ensure healthy development of children and screen for abuse
- Conception-5 (health visitor)
- 5-19 (school nurse)
What does the healthy child programme look at?
- Obvious things (e.g. smoking, alcohol, obesity)
- Oral health
- Vaccines
- Family MH
Examples of children’s health promotion?
- Healthy Child Programme
- Vaccines and screening
- Change4Life
- Free dental checkups
- Free schools meals
- Target vulnerable children
Causes of squint?
- Down’s
- Cerebral palsy
- Retinoblastoma
- Neonatal jaundice
- Family history
- Facial abnormality
Leading causes of UK blindness?
- ARMD
- Glaucoma
- Cataracts
Leading causes of global blindness?
- ARMD
- Cataracts
- Diabetic
What childhood hearing tests are commonly done?
- AOAR ( and ABSR)
- Pure tone audiometry
- Generalised SaL milestones
Prevention of hearing loss?
- Vaccination
- Knowledge of ototoxic drugs
- Avoid loud music
- Protect ears during loud events
- Avoid insertion of foreign bodies into ear
What are the aspects of a suicide risk assessment?
- SADPERSONS
- Sex (male)
- Age (30-40)
- Depression
- Previous attempts
- Ethanol
- Rational thinking (lack of)
- Social support (lacking)
- Organised plan
- No spouse
- Sickness (chronicity)
What are the 2 types of clinical reasoning?
1) Intuitive (quicker)
2) Rational (longer more reasoned; hypothetical deductive reasoning)
What is the ceiling of care?
The predetermined maximum level of care that is deemed appropriate for a patient by a medical team, aligning with patient and family wishes, values and beliefs
What are the levels of care?
0) 8:1
1) 4:1
2) 2:1 (HDU)
3) 1:1 (ICU)
What are 3 scoring systems used to assess fitness for surgery?
- ASA
- POSSUM
- Lee’s Revised Cardiac Index
What does the ASA predict?
The likelihood of intra- and post-op complications
What does Lee’s predict?
Likelihood of intra- and post- op cardiac complications from non-cardiac surgery
What does POSSUM predict?
30 day mortality from any surgery
Why are WHO surgical checklist used?
- Prevent never events
- Cost effectiveness
When are WHO surgical checklists used?
- Before anaesthetising
- Before cutting skin
- Before patient leaves the room
Role of surgical brief and debrief?
- Make sure everyone knows roles, make sure correct patient, make sure correct procedure
- Reflect on surgery, what went well, room for improvement and near misses
What are the risk factors for osteoporosis?
Female, age (>70/post menopausal) hyperparathyroidism, alcohol, smoking, sedentary lifestyle, steroids, thin, early menopause, low testosterone, renal failure, bone disease, drugs, diet
Examples of primary, secondary, and tertiary prevention of osteoporosis?
- Primary: vit D supplements, education on risk factors, weight training
- Secondary: bisphosphonates, reduce falls risk
- Tertiary: hip replacement
Screening of osteoporosis?
- FRAX
- DEXA
- Q-risk for fracture
What are the yellow flags for back pain?
- Belief back pain is due to serious underlying condition
- Negative attitude that back pain is severely disabling
- Fear avoidance behaviour
- Want passive treatment over active treatment
- Unsupportive family
What are some community support groups for patients with neuro conditions?
- Parkinsons UK
- Headway
- Dementia UK
- Stroke Association
Epilepsy and the DVLA?
- 1st seizure: 6 months
- 2nd seizure: 12 months
- HGV: 5 years
- Withdrawing epilepsy medication: 6 months
What is the doctrine of double effect?
- It’s ok to give a morally good treatment with a morally bad side effect, if the side effect wasn’t intended
- This is true even if you were aware the bad effect would happen
What is required for the Doctrine of Double Effect to be applied?
- Action must be proportional to cause
- Action must be appropriate
- Good outcome must be achieved independently of bad outcome
- Patient must have terminal illness
Problems with doctrine of double effect?
- We should anticipate the consequences of out actions
- Intention is irrelevant
- Death is not always a abad thing so doctrine is irrelevant
What is the definition of palliative care?
A medical approach to improve a patient’s quality of life through symptom management and assessing their emotional, spiritual and psychosocial needs without attempting to cure or prolong life
What are the aims of palliative care?
- SEPIA
- Support patient and family
- Ensure patient remains active as long as possible
- Provide pain relief/symptom management
- Integrate spiritual and psychosocial needs
- Affirm life and treat dying as normal
What are the 3 end of life tools?
- Gold standard framework
- Amber care bundle
- Supportive and Palliative Care Indicator Tool
What are the 3 triggers in the GSF that suggest a patient is nearing the end of life?
- Surprise question: would you be surprised if they died in weeks/months/days?
- General indicators of decline
- Specific clinical indicators
What are the 7C’s of the gold standard framework?
Communication, coordination of care, control of symptoms, continuing support, continued learning, carer and family support, care in final days
