d 1 Flashcards
duty to report
- Physical harm or risk of physical harm
- sexual abuse or exploitation or risk of sexual abuse or exploitation
- The child requires treatment to cure, prevent or alleviate physical harm or suffering which is not provided
- The child has or is likely to suffer emotional harm, demonstrated by serious,
– anxiety, depression, withdrawal, self-destructive or aggressive behaviour, or delayed development
Coercive Control: What is it?
- coercive control is the subordination and domination of one human being to another.
A sense of “entrapment” that:
– removes a person from full participation in social life – restricts their access to resources
- The primary harm is political, not physical, including a deprivation of rights, resources and power that are critical to personhood and citizenship
how does CC work : Patterns
Pattern
- Establish love/trust
- Isolate
- Monopolize perception
- Induce debility or exhaustion
- Enforce trivial demands
- Demonstrations of omnipotence
- Alternates punishment and reward
- Threats (pets, children, family, friends)
How does CC work: technique
Techniques
- Isolation
- Surveillance
- Gaslighting
- Manipulation
- Degradation
- Sexual violations
- Threats
sexual exploitation of children
what is it?, common types? age of consent? mandatory reporting
What is Sexual Exploitation
- A form of sexual abuse
- Manipulated or deceived into sexual activity for profit
Common Types:
- Sex Trafficking
- Sextortion (Blackmailing with images)
- CSAM (prev. Pornography)
Consent
- Age of sexual consent in Canada is 16
- Close-in-age-exemptions 12/13 <2 years older 14/15 <5 years older
- Under 12 legally cannot consent
Mandatory Reporting
- Health Care Professionals have a mandate to report to the appropriate child protection agency for protection concerns
- Mandatory reporting to police: ONLY for gunshot wounds
- Duty to report any protection concerns to CAS o Ontario: < 16, Quebec: < 18
vunerlabilities in sexual crimes for children
- Being a child
- Unstable living situation
- LGBTQ+
- History of abuse
- Persons living with disabilities
- Economically disadvantaged
- System involved youth
human trafficking stats
drugs, health consequences, presenting ED encounters
Weaponization of Drugs
- Drugs are used to coerce, create dependency, criminalize and incapacitate sex trafficked individuals.
- Drug facilitated sexual assault (DFSA)
Health Consequences
- STIs
- Reproductive issues Injuries
- Malnutrition
- Substance use issues
- Mental Health Concerns
Presenting ED Encounters
- Overdose/Ingestion
- Depression/Suicidal
- Violent/Homicidal
- Physical Injuries/Infections
potential indicators of HT involvment
- Person with them speaking for them, holding ID, overprotective
- Avoiding eye contact, unusually fearful or anxious
- Inconsistencies in stories, evasive/lying when questions asked
- Second cell phone or expensive accessories, inappropriate attire
- Withdrawing from friends/family
- Missing school
- More sexualized photos on social media
- Having new older friends/boyfriend
Kidney function
- to balance body water and electrolytes, in response to diet, hydration, water loss and solutes
- remove metabolic wastes from the blood and excrete in urine
- regulate the production of RBCs
- calcium absorption
- regulates blood pressure
- maintaining blood volume, composition, and pH
- Glomerular filtration and tubular reabsorption together manage urine production and equilibrium
renal assesment on child
- Hydration assessment
- Vital signs
- Weight/ edema
- Intake/Output
- Blood pressure
- Urine appearance, smell & urinalysis Blood tests – BUN, creatinine
- Pain – Degree, location, with urination?
- Previous UTIs
- Toilet trained/bed- wetting?
- Enuresis (>4-5 years of age)
- Hygiene
- Known GU abnormalities
- History of constipation
- Sexual activity Pregnancy STDs
- Previous catheters, other urologic instrumentation.
- Antibiotics / other medications
UTI etiology
- Escherichia coli most common pathogen (80%)
- Klebsiella
- Group B Streptococci
- Staphylococcus epidermidis & saprophyticus
- H. influenza
- Enterococcus
- Proteus
- Pseudomonas
- Occasionally fungal and parasitic pathogens
risk factors for UTI in children
- Delaying urination
- Inadequate fluid intake
- Constipation
- Previous UTI
- Urethral instrumentation – catheters, investigations
- Congenital defects of the of the urinary tract structure
- Vesicoureteral reflux - allows urine to flow back up into the ureters and kidneys.
- Brain or nervous system illnesses that affect bladder emptying (hydrocephalus, myelomeningocele)
UTI clinical presentation for neonate
- Non specific
- Frequent or crying with urination
- poor urine stream
- Tachypnea
- Hypothermic or fever
- Jaundice, seizures
- dehydration
- Respiratory distress (Mild to severe)
UTI clinical presentation for infant
- Mainly nonspecific
- Excessive thirst/ dehydration
- Frequent urination, straining or screaming on urination
- Foul-smelling urine
- Pallor / Fever
- Persistent diaper rash
- Dehydration
- Seizures – with or without fever
UTI clinical presentation of children
- Poor appetite, vomiting
- Fever
- Excessive thirst
- Enuresis, incontinence, painful urination
- Swelling of face, pallor
- Fatigue, abdominal or back pain
- Blood in urine
- Growth failure
- Edema, hypertension
