Tag Archives: safeguarding

Social media icon quiz

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From left to right: Dubsmash (high risk of bullying), Snapchat (overall safety rating – average), Smule (official age rating 13+), We chat (high risk sexual and bullying), Twitch (“it’s hard to censor because it’s live”), YouTube (“people write mean things in the comments on videos”).  Follow the links to read about each site’s safety profile and find out what kind of thing your own children and your young patients are using the individual sites for.

Social media sites are here to stay and preventing children having access to them is not likely to be a successful parental pastime.  https://www.net-aware.org.uk/ is an O2 and NSPCC project which looks at the safety of social media sites and gives parents tips on how to protect their children while they are using them.

March 2020 – first all safeguarding edition!

Child Protection, For Emergency Departments, For General Practitioners, PDF digests: Emergency Departments, ,

March has been guest edited by Dr Jackie Driscoll, Academic GP and erstwhile paediatric registrar.  Jackie was keen to produce a newsletter which centres on the child but sees them in the context of their family, their school and neighbourhood.

Do leave comments below:

 

February 29th 2020

For Emergency Departments, For General Practitioners, PDF digests: Emergency Departments, PDF digests: for General Practitioners, , , , , , ,

Burns this month – with much discussion amongst the editorial group prior to publication.  There are lots of different children’s burns protocols it transpires.  RCEM’s is not aligned with the London and South East Burns Network’s.  The message is “use your own burns referral unit’s guideline”.  The other important message about burns is watch out for NAI but, even if the burn is accidental, refer all children to their health visitor as HVs in the UK are responsible for talking to families about safety in the home.

Also, complications of Kawasaki Disease, ADHD and the updated MAP guideline (managing cows milk allergy in primary care) which emphasises that 98% of crying babies do not have CMPA.  Do leave comments below.

Do you know your ABCDDE of burns management?

Child Protection, For Emergency Departments, ,

With thanks to Dr Cate Luce:

Here is a systematic approach to burns using an ABCDE approach.

A: Is their airway compromised?

Consider in:

  • Facial burns
  • Smoke Inhalation
  • Dyspnoea
  • Hoarseness
  • Drooling
  • Stridor, wheeze, crepitations
  • Increase work of breathing

For more information: https://dontforgetthebubbles.com/picu-qa-airway-injuries-due-burns/ 1

B: Basic first aid 

Adequate pain relief is essential in burns. You should use something fast-acting such as intranasal diamorphine or follow your local policy. This will allow for a better assessment of the extent of the burns and delivery of basic first aid. Don’t forget running cold water on the affected area for at least 20 minutes, which may be effective up to 3 hours after the burn.  First aid steps at https://cks.nice.org.uk/burns-and-scalds.

C: Calculate the percentage of total body surface area (TBSA)

There are several methods to calculate the percentage of TBSA. The palmar aspect of a child’s hand is 1% of a child’s surface area. You can use the Lund and Browder charts.

https://em3.org.uk/foamed/25/10/2015/remember-remember-burns-and-blasts 2

People often overestimate the percentage of TBSA affected; remember to only include partial and full thickness burns as defined at www.cks.nhs.uk/burns_and_scalds3.

Why not make it easy for yourself and download the Mersey Burns App4, which calculates the percentage of burns for you?

Children with more than 10% of TBSA will need intravenous fluids. The app also calculates the fluid required using the Parkland Formula (3-4ml x (%TBSA) x (weight kg)). You should give half in the first 8 hours followed by the rest within the next 16hours.

D: Discussion with burns centre

  • >1% TBSA in children, >3% in adults (London and South East Burns Network)
  • Chemical/electrical/high pressure steam
  • Face/hands/feet/perineum/flexures/circumferential
  • Inhalation
  • Serious co-morbidity
  • Non accidental

D: Disabilities– what are the complications?

E: External factors 

Burns can be a result of neglect or physical abuse therefore safeguarding should always be considered. All children should be referred to their Health Visitor who is responsible for talking to the family about safety in the home – even if you feel it was an accident.  Use the Child Protection Companion as a guide.  https://www.rcpch.ac.uk/sites/default/files/2019-09/child_protection_evidence_-_burns.pdf 6

Always check the child’s immunisation status, especially tetanus, as burns can act as a tetanus-prone wound.

References

  1. Davis, T. PICU Q+A: airway injuries due to burns, Don’t Forget the Bubbles, 2013.https://dontforgetthebubbles.com/picu-qa-airway-injuries-due-burns/
  2. Sillett, Remember, Remember Burns and Scalds, https://em3.org.uk/foamed/25/10/2015/remember-remember-burns-and-blasts
  3. NICE, Burns and Scalds 2019, cks.nhs.uk/burns_and_scalds.
  4. https://app.merseyburns.com/
  5. Toxic Shock Syndrome 2019, https://www.nhs.uk/conditions/toxic-shock-syndrome/
  6. Child Protection Evidence, Systemic review of burns, July 2019, https://www.rcpch.ac.uk/sites/default/files/2019-09/child_protection_evidence_-_burns.pdf

 

April and May became combined this year…

For Emergency Departments, For General Practitioners, PDF digests: Emergency Departments, PDF digests: for General Practitioners, , , , , , ,

April came and went a bit too fast for my Paediatric Pearls head.  So I’ve produced a joint April/May newsletter for 2019.  There’s a bit of safeguarding again this month with a link to a paper on what young people in care think of the language we use, a guide to enteral rehydration of children with D&V, acrodermatitis enteropathica and a reminder of what is normal on a paediatric ECG.  Do leave comments below:

September 2018 PDF content

Child Protection, For Emergency Departments, For General Practitioners, PDF digests: Emergency Departments, PDF digests: for General Practitioners, , , , , , , ,

September’s newsletter reminds us of the CPD requirements for child safeguarding for all of us, warns us of the dangers of missing Kawasaki Disease, talks about PHE’s #askaboutasthma campaign and describes the differences between fever and sepsis.  Do leave comments below: