Injuries in Immobile Children

Introduction

You have been given this leaflet because someone who provides care for you or your child has come across a possible injury on your child (for example a bruise or mark) or you may have reported your child has been bleeding from the nose or mouth.

If any health professional comes across such things in a child who is immobile (not mobile) and there is no clear explanation, they are required to refer the child to a paediatrician (children’s specialist doctor).

This may happen straight away when you attend the Children and Young People’s Emergency Department/Paediatric ward. In some cases it may be necessary to refer or discuss the child with children’s social care.

Immobile children are those not yet rolling, crawling, cruising, or walking independently (on their own) or older children who are not mobile because of a disability.

Why do immobile children with injuries or bleeding need to see a specialist child doctor?

It is rare for children who are not able to move around by themselves to have an injury or bleeding. This can be, for example, a sign of a health condition, a blood disease or an infection.

This means it is important a specialist child doctor looks at your child and discusses with you why there might be an injury or bleeding.

Why are injuries or bleeding in immobile children such a concern?

It is difficult to cause an injury or bleeding to immobile children with day-to-day activities such as feeding, nappy changing and normal handling.

Even where babies fall or get knocked it is unusual for them to be injured or bleed (unlike children who are crawling or walking who often gets bumps and bruises).

However, there are also some important causes of injuries or bleeding which may seriously affect your child’s health.

Your child may bruise easily, for example, due to a blood disorder or an infection such as meningitis.

Very occasionally injuries or bleeding may be due to deliberate injury. Even where there is an apparent simple explanation it is important to rule out these more serious conditions.

It can sometimes take an expert to tell the difference between a bruise and a certain type of birthmark.

I understand the reason for seeing a specialist child doctor but who do I need to be referred to children’s services?

Although rare, injuries or bleeding are occasionally caused by deliberate acts. It is important that where this occurs, it is picked up as soon as possible in order to support the family and protect the child.

Referral to children’s social care is not an accusation of wrongdoing, but a way of looking for causes of injuries in the same way that the doctor looks for illness.

What will happen next?

Your child will be seen by a specialist child doctor (paediatrician) who will talk to you about your child, examine your child fully and decide whether or not to do further investigations, such as blood tests or X-rays.

They will then decide whether your child needs any further treatment, and talk to children’s social care.

Your child may need to stay overnight in the ward until all the information is available.

What will children’s social care and the health specialist do?

Children’s social care and the health specialist will check whether you have received services from them in the past, ask for information from your GP and your health visitor or school nurse and will make arrangements to speak to you.

This may be during your stay or at a separate appointment and they may want to visit your home.

They will then discuss their finding with the paediatrician who examined your child to decide together whether any further action needs to be taken or any treatment given.

All of this is very upsetting. I feel as though I am being accused of hurting my child. Why do I have to be put through this?

We know this can be very upsetting but the only way of picking serious causes for injuries or bleeding is to investigate every case where is occurs.

However, you can be reassured you will be treated with courtesy and sensitivity. Your explanations will be listened to and discussed with you.

You will be kept informed at all times so you know what is going on and why. You can ask questions at any time and will be given the opportunity to discuss your concerns fully at every stage.

Contact numbers

Children and Young People’s Emergency Department

Telephone: 01642 624 533

Opening hours: 24 hours a day, 7 days a week.

Paediatric Ward

Telephone: 01642 382 815

Opening hours: 24 hours a day, 7 days a week.

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. The office is based on the ground floor at the University Hospital of North Tees if you wish to discuss concerns in person. If you would like to contact or request a copy of our PET leaflet, please contact:

Telephone: 01642 624719

Freephone: 0800 092 0084

Opening hours: Monday to Friday, 9:30am to 4:00pm

Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

Telephone: 01642 617617

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:

Email: [email protected]