Rectal examination in paediatric trauma care

When providing trauma care, there is a danger that staff might forget what a frightening and confusing experience it can be for the patient, particularly if that patient is a child. As part of an academic exercise in reflection, I recently examined a critical incident involving the trauma care of a 9-year-old boy. In Accident and Emergency (A&E) the doctor inappropriately performed a rectal examination, which I witnessed in horror. The doctor failed to consider the effect of his actions on the child, the legal necessity for consent and the importance of a full explanation. Deeply disturbed by this incident and determined to avoid any repetition, I set out to find documented evidence to support my assertion that no child should be subjected to such intimate examinations, unless absolutely unavoidable. It is hoped that discussion of this incident will serve to raise the awareness of A&E staff working throughout the country with regard to paediatric rectal examination, as has been the case in my own workplace.