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3. Paediatrics > Safeguarding Children > Flashcards

Safeguarding Children Flashcards

(89 cards)

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1
Q

What do we have a responsibility to raise concerns about?

A

Possible abuse or neglect of children or vulnerable adults - we must know who to contact for further advice and how to refer to appropriate authority

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2
Q

What is child protection?

A

Activity undertaken to protect specific children who are suffering or are at risk of suffering significant harm

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3
Q

Who are children in need?

A

Thos who need additional support or services to achieve full potential

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4
Q

What measures can be taken to minimise harm to children?

A

Protecting them from maltreatment

Prevent impairment of Childs health or development

Ensure children are growing up in safe and caring environment

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5
Q

What is child abuse and neglect?

A

This is anything which those who are trusted with the care of children to or fail to do which damages the prospects of a safe and healthy development into adulthood

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6
Q

What 3 elements must be present for child abuse?

A

significant harm to chid

carer has some responsibility for that harm

significant connection between carers responsibility for child and harm to child

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7
Q

What legislation is in place to protect children in Scotland?

A

National guidance for child protection in Scotland 2014

Children and young peoples act 2014

Getting it right for every child (GIRFEC)

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8
Q

What is the child and young people act?

A

Introduced in 2014

has 13 parents - covers wide range of children policy

main themes are:

  • children rights
  • girdec
  • early leaning and childcare
  • looked after children
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9
Q

What are the 4 major themes of the children and young peoples act 2014?

A

Children rights
girfec
looked after children
early learning and childcare

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10
Q

What is GIRFEC?

A

This is where there is a named person for every child as a single point of contact to provide advice and support to families and to raise and deal with concerns about a Childs wellbeing - its not mandatory

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11
Q

What is the national practice model for GIRFEC in cypa 2014?

A

the wellbeing wheel - shanarri

my world triangle

resilience matrix

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12
Q

What is GIRFEC a shared approach to?

A

Organising and recording info about a child, and discuss ways of addressing concerns about wellbeing

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13
Q

Describe GIRFEC?

A

Getting it right for every child is the Scottish Government’s approach to supporting children and young people. It is intended as a framework that will allow organisations who work on behalf of the country’s children and their families to provide a consistent, supportive approach for all

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14
Q

What makes up the girfec national practice model?

A

well being wheel

my world triangle

resilience matrix

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15
Q

What is the well being wheel?

A

The wellbeing wheel and indicators illustrate the basic requirements for all children and young people to grow and develop so that they can reach their full potential. The wellbeing indicators are: Safe; Healthy; Achieving; Nurtured; Active; Respected and Responsible; and Included. Collectively they are often referred to as SHANARRI.

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16
Q

What do SHANARRI ensure a child becomes?

A

Confident learner
responsible citizen
effective contributor
successful learner

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17
Q

What is the my world triangle?

A

Using the My World Triangle allows practitioners to consider systematically:

how the child or young person is growing and developing
what the child or young person needs from the people who look after him or her
the impact of the child or young person’s wider world of family, friends and community

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18
Q

What is the resilience matrix?

A

People using the Resilience matrix need to understand the basic principles of resilience and how they fit in the National Practice Model.

resiliance
adversity
protective envrionemnt
vulnerability

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19
Q

When can information about children be shared?

A

when SAFETY IS AT RISK

WHEN BENEFITS OF SHARING THE INFO OUTWEIGHT THE PUBLIC AND INDIVIDUALS INTERESTS IN KEEPING IT CONFIDENTIAL

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20
Q

If we want to share info about CYP what should we do?

A

Try get consent from child and young person if appropriate and parent too

we should only share what we have to - keep a note of what and why we shared the info

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21
Q

What are the UNs children rights?

A

Right to respect

right to info about yourself

right to be protected from harm - this is where child protecting and safeguarding comes in

right to have a say in your life

the right to a good start in life

right to be and feel secure

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22
Q

What causes child abuse - adults?

A 
Drugs
Alcohol
poverty 
mental illness
domestic violence
disabled 
step parents
absued as a child 
unrealistic expectations
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23
Q

What cause child abuse? - child?

A 
Cryig
soiling
disability 
unwanted pregnancy 
failed expectations
wrong gender 
produced of forced, coercive sex
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24
Q

What cause child abuse? - community?

A

Dwelling place and housing conditions, neighbourhood

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25
What are the big three concerns in terms of parent capacity?
Domestic violence drug and alcohol misuse mental health problems MORE THAN ONE INCREASES LIKELIHOOD OF NEG OUTCOME
26
What are the categories of child abuse?
Physical Emotional Neglect Sexual Non-organic failure to thrive
27
Who do we class as vulnerable children?
Under 5s Irregular attenders Medical problems and disabilities
28
Why are under 5s more vulnerable?
Not as school yet - nursery in Scotland at 3/4 but less opportunity to access other adults
29
Why are irregular attenders more vulnerable?
Repeatedly DNA Return in pain exposed to risk of GA Not Brought to appt
30
Why are medical problem and disabled children more vulnerable?
More at risk of experiencing abuse Serious impairment of health or development is more likely as a result of untreated dental disease
31
What is neglect?
Neglect is the ongoing failure to meet a child's basic needs and the most common form of child abuse
32
What are some of a Childs needs?
Nutrition warmth, clothing, shelter hygiene and health care stimulation and education affection
33
What are the effects of nutrition neglect?
Failure to thrive short stature than would have been
34
What are effects of warmth, clothing, shelter neglect?
Inappropriate clothing, cold injury, sunburn
35
What are effects of hygiene and healthcare neglect?
Ingrained dirt (finger nails) head lice dental caries
36
What are the effects of education and stimulation neglect?
Developmental delay
37
What are effects of affection neglect?
Withdrawn or attention seeking behaviour
38
What is the short term damage of neglect?
Physical health emotional health social development cognitive development
39
What is the long term damage of neglect?
adults are at higher risks of arrest, suicide attempts, major depression, diabetes and heart disease
40
What is dental neglect?
This is the persistent failure to meet a Childs basic oral health needs resulting in serious impairment in Childs oral or general health or development failure to ensure adequate function and freedom from pain and infection
41
What factors contribute to dental caries?
Multifactorial inequalities in dental health - social class, regional inequalities in access to dental tx
42
What can severe dental disease cause?
Toothache disturbed sleep difficult eating absence from school
43
How is dental neglect related to general neglect?
dental neglect impacts on a Childs life - their sleep, ability to eat, which in turn affects schooling, playing - can't learn properly can't play properly
44
What does dental disease put a child at risk of?
Teasing due to appearance repeated antibiotics - antibiotic resistance repeated general anaesthetic extarctions - ga has risk severe infection
45
What is wilful neglect?
This is when we point out dental problems and tell parent/carer what to do and how to get it done and we set up appropriate appts that suit the pt but they fail to be Brought in or get cancelled or tx plan doesn't get completed ony come in when in pain or needs ga despite all preventative measures in place
46
What are signs of wilful neglect?
Failure to attend appts, cancellations, irregular attendance failure to complete tx plan returning in pain several times repeated ga for xla
47
What are indicators of dental neglect?
obvious dental disease - to non dental trained person impact on child - pain, problems eating and sleeping, lack of concentration practical care offered but not returned for tx
48
What are the 3 stages to manage dental neglect?
Preventative dental team management preventative multi agency management child protection referall
49
What is stage one of managing dental neglect?
Preventative dental team management
50
What is preventive dental tea, management?
This is when we offer support to the family and raise our concerns with the we set targets, and must record hat we have raised concerns, targets we have set and any progress we make we must offer appts in reasonable way they can attend - after school? can all kids come together?
51
What is stage two of managing dental neglect?
Preventative multi agency management
52
What is Preventative multi agency management?
This is when step 1 hast worked and pt still isn't bringing child so we lease with other profesh such as health visitors, school nurse, gps, social workers to see if concerns are shared we can check if child is subject to child protection plan we then agree a joint plan of action
53
What can we send to health visitors?
Can download a letter to send to His of children <5 who have failed to respond to our appts - the letter says if this fam is known to you we would welcome working together to promote their oral health
54
What is stage 3 of managing dental neglect?
Child protection referral
55
What is child protection referral?
This is when situation is complex or deteriorating we follow local guidelines and referral is usually to social services by telephone followed up in writing
56
What is physical abuse?
This is when there is over chastisement acute/ compassionate acute - just happens, spontaneous uncacluated reaction - often due to frustrations with child and parents feel remorse and take appropriate action and Childs needs are priority chronic/pathological - this is when its just accepted that this is the way things are, no remorse, help sought but not actively , child needs not a priority
57
Difference between acute/compassionate and chronic pathological abuse?
Acute/compassionate is often in the form of shaking and is an unplanned, sponaenus reaction often due to frustration, remorse is felt and help is sought immediately, the Childs needs are a priority chronic/pathological is a way of life, its just accepted, help may be sought but not actively and there is no remorse, children's needs are not a priority
58
What was passed in 2019 in Scotland?
Children (equal protection form assault) (Scotland) bill was passed removing reasonable chastisement excuse from law
59
What can you not do form 7th November?
Physically punish a child - illegal to hit a child
60
What percentage of serious head injuries occur in first year of life?
95%
61
What percent of childhood burns are non accidental?
10-12%
62
Why is it unusual for bad burns to happen on hands?
Reflex - will pull away from hot object - think about non accidental
63
Approx how much of injuries in abuse cases are on head and neck area and why?
60% easy to get to where child makes noise from
64
Where are accidentally injuries likely to occur?
Bony prominences - areas that stick out such as palm of hands, knee, shins forehead, nose, chin elbows head injuries tend to involve parietal, occiput or forehead
65
What is important to remember in accidental injuries?
accidental injuries In bony prominence areas match the history match with development of child
66
What is important to remember about non accidental injuries?
Injuries to both sides of body injuries to soft tissues injuries with particular patterns any injury that does fit explanation delays in presentation without reasonable explanation untreated injuries
67
What injuries are common in non accidentally injuries?
black eyes - bilateral soft tissues of cheeks intra oral injuries ears - pinch marks, bruises triangle of safety - ears, side of face and neck inner aspects of arms back and side of trunks chest and abdo inner aspect of thighs soles of feet
68
What are some oro-facial signs of physical abuse?
Bursing of face - punches, slapping, nips brusing - pinch, pull abrasions and lacerations burns and bites neck - choke or cord marks eye injuries hair pulling fractures of nose mandible or zygoma
69
What are some major clinical features of abuse?
Skin lesions - bruises, burns, bites, lacs bone lesions - fractures intracranial lesions form shaking visceral lesions - from blunt trauma
70
What is important about brusing?
everyone heals different but on each individual they should heal similarly
71
What is tattoo bruising?
this is when bruise matches the thing that has caused it
72
What must we look at on the ears?
All 3 sides, look for pinches and bruises - will bruise easily as skin --> cartilage
73
What abuse signs can we see intramurally?
Contusions bruises abrasions and lacs burns tooth trauma frenal injuries
74
when might we be suspicious about frenal injuries?
iN NON MOBILE CHILD
75
what can impetigo also look like?
Cig burns
76
What can birthmarks look like?
Bruises - good that we know child and will know what's a birthmark or not
77
What raises out suspicions of Childs and parents?
Delay in getting help vague story, lacks details, different story form person to person story doesn't match injury parents mood is abnormal - they are preoccupied when all attention should be on child parents behaviour raises concerns Childs appearance and interaction with parents is abnormal child may say something that contradicts parents history of preventative injury history of violence in family
78
What is our final abuse check list questions?
Could these have been caused accidentally and if so how? does the explanation for injury fit age and clinical findings? if age is consistent with injury is this within normally acceptable limits of behaviour? if delay in seeking help, why?
79
If parent says child got dental trauma from falling into wall due to alcohol at 13/14 would this raise concerns?
yes, referral needed
80
Wha are the final checklist observations in physical abuse?
How is the child acting how is child and parents relationship? how does child react to other people? how does child react to dental or med exam? have any comments been made by child or parent that raise concerns to us?
81
Why is it important we refer if we have suspicions?
we could prevent death of a child and can be first link in chain to offer support to a family in crisis
82
What is expected of us in terms of suspected abuse? (4)
OBSERVE RECORD COMMUNICATE REFER FOR ASSESSMENT
83
What are we not expect to do as a dentist?
Diagnose abuse - this is made as part of a multi disciplinary team decision - we just observe record communicate and refer
84
How can we help children at risk?
Share concerns with a named person contact local paeds dept to ask for advice and where to go ask experienced colleague for help ask child protection advisor for help contact social work contact child services department we cn phone and ask for advice
85
How do we refer?
Initially by phone followed up in writing
86
What form do we use for referrals?
Notification of concern form/ shared referral form
87
What does the notification of concern form have?
It has our details designated contact person different to us details - this is incase we are out of office then a dental nurse or practice manager can be contacted whoever we referred to on the phone - name of them, there role subject of referral - is parent aware? if not why? will it put someone in danger by informing parent of this referral? or can we not get a hold of them? name of child referred and their detals family details - who's in the house siblings summary of concerns reason for referral agreed actions agency involvement
88
What happens if we make a referral?
If a child is in immediate danger there is a child protection order, exclusion order, child assessment order and the child may be removed by police if not immediate danger then investigation begins and an assessment is made and discussion is had - is child at risk of significant harm?
89
If no further cp action is required what may happen in Scotland and England?
England - may get additional support scotland - join investigation

3. Paediatrics (10 decks)

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