#WILTM 🧵No. 2 and a focus on child abuse and a child's experience in hospital.
'A child has gone for a skeletal survey' Child protection is one of the most upsetting and important aspects of paediatrics. According to the @NCMD_England 60 children died of 'deliberately inflicted injury, abuse or neglect' last year.
The even worse news is that in 72% of deaths 'modifiable factors' were identified - they could have been prevented. So everyone working in paediatrics need to remain vigilant.
The @NCMD_England is an incredible source of data and identifies so many ways we could improve child health. @KarenLuyt and the team do a fantastic job as do the CDOP teams across the country.
Thankfully the vast majority of children who are abused don't die. This is harder to measure, @NSPCC estimate 1:10 children suffer from neglect and 1:14 are physically abused.
There are lots of excellent resources available to help us with child protection and rarely a week goes by without me consulting @RCPCH_CPP childprotection.rcpch.ac.uk
As clinicians we order tests to answer clinical questions (often very important). In this case are there any fractures? But what is it like for a child and their family to have a skeletal survey?
In summary a skeletal survey is :
👉15-20 x-rays of whole body
👉 takes up to an hour
👉children may get distressed as they will need to be
held still for the x-rays
👉 needs to be repeated after 11-14 days
As a doctor, I feel very comfortable in the hospital environment but try to remember what a stressful place they can be for children and their families. We can all help by communicating clearly.
And we need to make sure we involve CYP and their families in designing services.
@Damian_Roland update on the @UKHSA RSV data is really helpful.👇 There are a lot of susceptible infants who have not yet had RSV so this years outbreak still has a way to run.
Reflecting on my #WILTW 🧵. When we follow the latest NICE bronch guidance children often need ⬇️investigations and treatment than we might be used to. threadreaderapp.com/thread/1446588…
This means children spend more time at home with their families 🏠👪 and can help to reduce the pressure on our A&E departments and paediatric wards. 🏥🚑
Like hospitals across the country we’ve had lots of children with RSV bronchiolitis and been working hard to implement the new @NICEComms guidance. nice.org.uk/guidance/ng9/c…
Thankfully, most children with bronchiolitis get better on their own so we’ve been trying to ⬇️ unnecessary CXR, blood gases, NG tubes, suction, nebulisers and oxygen therapy.
Every week @ESHTNHS the paediatric dept have a grand round when the consultant of the week 🐄 hand over. It’s multidisciplinary and an opportunity to get colleagues advice on complex cases and how me manage common paediatric conditions
The paediatric consultants have got over 100 years of paediatric experience between them😬. I learn something every week - often from the nurses.
The meeting is also a rich source of ideas about how we can improve paediatric services locally and nationally.