Safeguarding Scenario (ECA)

What questions would you like to ask the parents to gain a better history of the event and the patient? 

The parents seem evasive and avoid giving full answers to your questions. They repeatedly state that their child is “clumsy” and always falling or running into things. Your colleague suspects the child is slightly post-ictal after a potential febrile seizure, but after removing the child’s t-shirt they discover bruising to the back and right upper arm in the shape of finger marks, and they draw your attention to this. What is your primary safeguarding responsibility on scene? 

Which of the following is a clear safeguarding concern in this case? 

As the child’s GCS improves and they recover from the post-ictal phase, they appear anxious around other people in the house and seem withdrawn. Their clothing is ill-fitting, they appear thin for a 3-year-old, and there is a rash on the left thigh which the parents dismiss with a shrug. What initial categories of abuse do you suspect based on the evidence so far? 

You are concerned the child may be experiencing multiple forms of abuse. As this is their first seizure, you and your colleague agree they should attend the local A&E. The parents are reluctant but agree when you explain the seizure could recur and may require emergency services again. Since you are taking the child to hospital, you can leave safeguarding referrals to the A&E team. 

You recognise you must also complete a referral as you may provide additional information in the overall safeguarding process. When documenting potential safeguarding concerns, what is the most appropriate approach? 

As you leave, you notice the house is extremely dirty and there are multiple areas of exposed electrical wiring. What should you do? 

What legislation underpins safeguarding responsibilities for children in the UK? 

What definition best describes child abuse? 

If you or your colleague identify safeguarding concerns, you have a duty of care to report your findings to the appropriate service. Failure to do so could be considered negligent. 

Children of toddler age commonly fall when learning to crawl and walk. Bruises on the elbows, shins, and forehead can be normal and may not raise safeguarding concerns. 

Which statement about confidentiality and safeguarding is true? 

In safeguarding, what is meant by “fabricated or induced illness”? 

You are unsure whether a concern meets the threshold for a safeguarding referral. What is the most appropriate action? 

If a child is recognised to be at immediate risk of harm, you should…