W08 - PAEDS: Injured Child; Acute Paediatrics; Child Protection Flashcards

1
Q

Issue of trauma injury in children

A

blunt&raquo_space;> penetrating. dt multiorgan effect

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2
Q

Fractures Children Sustain

A

Buckle # of distal. radius
- common
- falls and catch themselves

Clavicle fracture

Tibial # - Toddlers

Greenstick #
- Greenstick fractures are treated with closed reduction or surgery, depending on the angle of the fracture.

GrowthPlate Injuries

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3
Q

Salter Harris Classification

A

normal
type 1 = physeal #
type 2 = physeal # + metaphysis involvement
type 3 = epiphysiseal involvement
type 4 = “” “” +
Type 5 = COMPRESSION #

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4
Q

Injury Patterns in children

A

SCIWORA: nil SC radiological abn but injury present

Lap belt syndrome

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5
Q

RR for age groups

A

<1 = 30-40

2-5 = 25-30

5-12. = 20-25

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6
Q

Systolics andHR for age groups

A

<1 = 70-90mmHg / 110-160

2-5 = 80-100mmHg / 95-140

5-12 = 90-110mmHg / 80-120

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7
Q

Life Threatening Trauma

A

Resp Failure dt obstruction: FOREIGN BODY; PNEUMOTHORAX

Resp depression raised ICP, headinjury

CIRCULATORY FAILURE dt fluid loss, burns,
fluid maldistribution

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8
Q

Predicting weight in childrn

A

birth weight ~3.5 kg
< 1 year (0.5 x Age in months) + 4
1-5 year (2 x Age) + 8
6-10 years (3 x Age) + 7

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9
Q

Recognise signs/ markers of deterioration

A

Bradycardia (<60) indicates life threatening pathology (but may be seen in anorexia)

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10
Q

Initiate appropriate interventions

A

ABCDE Assessment if deterioration
- rule out cause

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11
Q

Wheeze no creps, 1+yo, and mgmt?

A

unlikely to be bronchiolitis

more likely to be viral induced wheeze

> multi dose salbutamol

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12
Q

Definitions of abuse and neglect

A

a

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13
Q

Legal frameworks in child protection

A

Children (Scotland ) Act 1995
*The Children (Scotland) Act 1995 sets out a statutory statement of parental responsibilities and rights and clarifies the law on guardianship. It requires parents and other persons who have parental responsibilities and rights to consider, as far as practical, their children’s views when making decisions which affect them.

Children and Young People (Scotland) Act 2014; GIRFEC
*Named Person was to be a point of contact for all agencies to refer to when there is concern about a child
- From birth to school attendance - Health Visitor
- School age- Head Teacher

Equal Protection from Assault (Scotland) 2019
*bring to an end the physical punishment of children by parents and others caring for or in charge of children by abolishing the common law defence of “reasonable chastisement”.

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14
Q

Your responsibilities, as a member of the public, a student, a health professional.

A

a

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15
Q

Factors that impact on the protection of children.

A

a

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16
Q

What to do and who can help you.

A

RACH: Child Protection Tea
- on-call specialist team
- general paediatric consultant

  • social service involvement

referral = initial assessment to understand risk to child
- joint visit
- case conference
- immediate place of safety - child protection order
-

17
Q

Alarm Bells @ Presentation

A

Late presentation
History changes on repeating
History inconsistent with findings

+ Bruising in NON-MOBILE infant
+ Injuries w/ nil explanation

18
Q

Impetigo Vs Cigarette Burns

A
  • similar appearance
  • DISTRIBUTION OF IMPETIGO
  • BURNT HAIR; HEALING of BURNS
19
Q

Commonest cause of death in physical abuse in paediatrics

A
  • abusive head trauma, <2yo

+ commonly presents with retinal haemorrhage
+ neck and cervical spine injury

20
Q

Neglect - signs

A

Neglect is the ongoing failure to meet a child’s basic needs

LT physical and mental impact

Emotional
Abandonment
Medical
Nutritional/FTT
Educational
Physical
Failure to provide supervision

*faltering growth

21
Q

Child Sexual Abuse

A

indicators:
- disclosure
- sexualised behaviour
- STI
- pregnancy

22
Q

Fabricated or Induced Illness

A

Fabrication: making up the symptoms of an illness

Induction: causing a child to become unwell

  • rare, 90% mother
  • GP involvement