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Quick reference guide


Issue date: July 2009 (reissued December 2009)

When to suspect child maltreatment




NICE clinical guideline 89
Developed by the National Collaborating Centre for Women's and Children's Health

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Open for definitions of CONSIDER and SUSPECT and information on using this guidance.

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When to suspect child maltreatment Definitions of consider and suspect



Definitions of consider and suspect
The alerting features in this guidance have been divided into two categories, according to the level of
concern, with recommendations to either `consider' or `suspect' maltreatment.

CONSIDER means maltreatment is one possible SUSPECT means serious…

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When to suspect child maltreatment


About this booklet
This is a quick reference guide that summarises the recommendations NICE has made to the NHS in
`When to suspect child maltreatment' (NICE clinical guideline 89).

Who should read this booklet?
This quick reference guide is for all healthcare professionals working in…

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When to suspect child maltreatment Contents




Contents
Definitions of consider and suspect 3

Using this guidance 3

Introduction 6

Sharing information about children and young people 6

Exclusions from the guideline 7

Key to terms used in this document 7

Physical features 8
Abrasions, bites (human), bruises, burns, cold injuries,…

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When to suspect child maltreatment Introduction




Introduction
G The effects of child maltreatment can be severe and last into adulthood.
G Children may present with both physical and psychological symptoms and signs that constitute
alerting features of one or more types of maltreatment.
G Maltreatment may be observed in parent­…

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When to suspect child maltreatment Exclusions from the guideline




Exclusions from the guideline
The following topics were outside the scope of this guideline and have therefore not been covered:
G risk factors for child maltreatment, which are well recognised (for example, parental or carer
drug or alcohol misuse, parental or…

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When to suspect child maltreatment Physical features




Physical features
Alerting features that should prompt you to CONSIDER child maltreatment:
G Any serious or unusual injury with an absent or unsuitable explanation.
G Cold injuries (for example, swollen, red hands or feet) in a child, with no medical explanation.
G Hypothermia…

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When to suspect child maltreatment Physical features




G One or more fractures in a child if there is no medical condition that predisposes to fragile bones
(for example, osteogenesis imperfecta or osteopenia of prematurity), or if the explanation is absent or
unsuitable, including:
­ fractures of different ages
­ X-ray…

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When to suspect child maltreatment Sexual abuse




Sexual abuse
Alerting features that should prompt you to CONSIDER sexual abuse:
G Persistent or recurrent dysuria or anogenital discomfort, or an anal or genital symptom (for example,
bleeding or discharge) in a girl or boy, without a medical explanation (for example, worms,…

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