Child Protectionin the Emergency Department

xxxxxxx [consultant paediatrician]March 2010

Of the 12 million children in the UK

• 7% suffer serious physical abuse at the hands of carers and family

• 25% experience violence or abuse in the home

• Each week at least 2 children die following abuse and neglect

NSPCC 2000

All those who come in to contact with children and families …

……Have a duty to safeguard and promote the welfare of children

Department of Health 2003

What will be covered in this session

• Advice on essential knowledge & learning

• Update on events of past year

• Summary of the key documents– Competences for Health Care Staff– Working Together to Safeguard Children– Laming Progress Report– NICE guidance ‘When to Suspect Child

Maltreatment’– What to do if you are concerned ….

What will not be covered in this talk

• Policies and Procedures

• Referral process

• CYPS management

• An update – but not a full Level 2 training

• Sets out Statutory Guidance on roles and responsibilities:

• Details how doctors should:– Identify possibly abuse (in all its forms) and include in

the differential diagnosis– Contribute to a growing picture of concern– Identify children with a Child Protection Plan – or if

concerns are held by other professionals– Recognise when an adult’s problems may impact on a

child– Know when to refer– Maintain skills & regular training– Communication is key

When to suspectchild maltreatment

Physical Abuse

Physical Abuse

Typical sites for Accidental Injuries

Sites suspicious for Non-Accidental Injury

Sexual Abuse

• What would lead you to– Consider?– Suspect?

Sexual Abuse

Neglect

• What would lead you to– Consider?– Suspect?

Neglect

Emotional, Behavioural, Interpersonal & Social Functioning

• What other factors might prompt you to consider child maltreatment?

Emotional, Behavioural, Interpersonal & Social Functioning

Parent Child Interactions

Clinical Presentations

• Are there types of presentation that may lead you to consider maltreatment

• For example that suggest Fabricated or Induced Illness?

Clinical Presentations

• 18 Cards

• Free to access and distribute(Google: BMA child protection)

• Useful to have readily accessible in the department.

Further Training options

• RD&E Level 2 training

• ALSG Response and Recognition

• LSCB Level 3 Multi-Agency Training