Whenever an infant presents with an injury it is essential that a detailed history regarding the mechanism of injury be documented. Whenever possible this should be from an eye witness. This should include details of the child’s development. Infants should be examined top to toe to ensure that no further injuries are present. This is all detailed in the accompanying Under 1 proforma. There is a low threshold for infants under 1 with such injuries being admitted. There may also be sufficient concern to warrant further investigation if alerting features such as:
- Lack of parental supervision
- Drug/alcohol misuse
- Parental mental health problem
- Domestic Abuse
- Previous concerning presentations to other professionals
- Signs suggestive of neglect/emotional abuse
- Care must be taken regarding assessment siblings especially twins
- Are present
This allows other investigations such as skeletal survey, head CT and ophthalmological assessment. If clinical decision is not to proceed to admission the reasons for this should be clearly documented in the notes.
If practitioners have concerns about an under 1, then a urgent referral by telephone should be made to social work services (see table below) and you should request a child protection investigation. A Notification of Concern form (previously known as Shared Referral Form) via Clinical Portal E-forms should also be completed for all cases.
If required:
Advice can always be sought on a 24/7 basis from the child protection service – See table below:
|
RHC/GRI |
RAH |
IRH |
Child Protection Service Weekdays – 9am to 5pm |
0141 451 6605 |
As RHC |
As RHC |
Child Protection Medical Paediatrician on call Weekdays 5pm to 9am/weekends/ public holidays |
0141 201 0000 (switchboard) |
As RHC |
As RHC |
Child Protection Consultant on call 24/7 Complex physical injury/sexual abuse cases |
0141 201 0000 (switchboard) |
As RHC |
As RHC |