The Child Protection Register: a tool in the accident and emergency department?

Area of Science:

• Pediatrics
• Forensic Medicine
• Public Health

Background:

• Children on the Child Protection Register (CPR) may access healthcare services, including accident and emergency (A&E) departments.
• Understanding the patterns of A&E attendance for these children is crucial for child protection.
• Assessing whether knowledge of CPR status influences the suspicion of non-accidental injury (NAI) is important for timely intervention.

Purpose of the Study:

• To quantify the number of children on the CPR attending A&E.
• To analyze referral sources, diagnostic categories, and attendance frequency.
• To evaluate if unawareness of CPR status hinders NAI suspicion when standard indicators are present.

Main Methods:

• Retrospective review of A&E records for children on the CPR.
• Data collected from June 1994 to May 2000 at the United Hospitals Trust.
• Analysis of attendance frequency, referral sources, and diagnoses.

Main Results:

• 191 children were on the CPR over six years; 79 attended A&E on 206 occasions.
• Self-referral was the most common source (81%), followed by GPs (13%).
• Trauma (limb, head injury) was common, with NAI not suspected in most cases; standard indicators were adequate for NAI detection when CPR status was unknown.

Conclusions:

• Screening for standard NAI indicators is sufficient for detecting most NAI cases in A&E, even without knowledge of CPR status.
• The majority of attendances were for non-abusive reasons.
• Further investigation into why concerns were not raised in all potential cases is warranted.