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A call to the resus room Dr Hilary Glaisyer July 2017

A call to the resus room Dr Hilary Glaisyer July 2017. The setting. You are working in a DGH as an anaesthetist and called to resus in A and E at midnight. A 19 month old girl needs resuscitation She was found collapsed at home by her mother who dialed 999

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A call to the resus room Dr Hilary Glaisyer July 2017

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  1. A call to the resus roomDr Hilary GlaisyerJuly 2017

  2. The setting • You are working in a DGH as an anaesthetist and called to resus in A and E at midnight. • A 19 month old girl needs resuscitation • She was found collapsed at home by her mother who dialed 999 • There are widespread petechial haemorrhages which suggest meningococcal sepsis

  3. The mother: • is very young and is unaccompanied • smells of alcohol • is holding a small baby who is sparsely clothed and crying

  4. Treatment: • Together the paediatric registrar and you instigate treatment • The consultant paediatrician is called • The child is stabilised and transferred to the nearest Paediatric Critical Care (PCC)

  5. The Mother’s background • She is a single mother, only 17 years old • She admits to having postnatal depression and drinking heavily • She is under the community psychiatric team • She grew up in care and is without a stable family • She presently lives in temporary bed and breakfast accommodation

  6. Key questions and learning points • What are the safeguarding issues? • What are your responsibilities? • What will happen next?

  7. Features raising concerns • The physical condition of both children • The safety of the baby • The mother’s drinking while caring for the children • The mother is a “care leaver” and as such is at increased risk herself of safeguarding issues • The mother’s mental state • The mother’s apparent social isolation

  8. What are your safeguarding responsibilities and duties? • Document your involvement and any relevant facts/findings carefully but do not stray into “opinion” • It is likely that the family are known to social care • The paediatrician will involve the on-call team to further assess the safeguarding needs of the whole family • The mother should be kept informed (paediatricians will generally lead this discussion)

  9. What next? • The baby should not go home in these circumstances and also needs antibiotic prophylaxis • The paediatricians may well admit the baby to the ward • There is no reason why the mother should not be able to be with the child who is transferred if she wishes

  10. What next? • An urgent referral to other agencies is likely to be made by the paediatrician in the morning and a strategy meeting is likely to be called and a child protection plan put in place • You should ask to be kept informed of the outcome

  11. Key points • The safeguarding of the whole family raises concern and it is likely that they are already known to various agencies but this cannot be assumed • You should ensure that you document your involvement and that other findings are also carefully recorded by the team • You should not assume that all the correct steps are taken or that you will be kept informed

  12. See also www.rcoa.ac.uk/safeguardingplus

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