HYMS H&S Year 4🌸

what is the school's role in managing child mental health?

tracking/preventing stigma, education on mental health + tackling/preventing bullying

what is a health visitors role in managing child mental health?

promotion of health + prevention of illnesses, advising mothers about physical/emotional development, helping overcome difficulties faced because of disabilites/illness

what is the social service's role in managing child mental health?

assess Childs needs provide services = support people in their own home, assess possibility of abuse in household

what is the educational psychologist's role in managing child mental health?

tackle learning difficulties/social/emotional problems enhances child's learning, enables teachers = aware of social factors = affecting teaching/learning

what services do patients with visual impairment/deafness receive?

regular sight tests with optometrist

define neonatal morality rate?

deaths that occur within first 28 days of life following live birth

define stillbirth

when a foetus is delivered > 24 weeks of gestation without showing signs of life

define perinatal mortality

deaths occurring within 6 days of life (including still births)

define infant mortality rate?

number of deaths occurring within first year of life per every 1000 live births

define low birth weight?

< 2.5kg at birth

what are risk factors for perinatal mortality?

premature delivery, congenital abnormalities, low birth weight, birth trauma, infection

how can perinatal mortality be reduced?

improve antenatal care, skilled care given at birth, improve care of small/sick newborn babies, don't discharge mother + baby too quickly

what are some maternal characteristics that increase the risk of preterm birth?

FHx, smoking, uterine abnormalities, low socioeconomic status, low/high BMI, stress

what are some reproductive risk factors increasing the risk of preterm birth?

prior preterm births, prior stillbirth/miscarriages > 16 weeks, induced abortion, cervical insufficiency

what are some risk factors in current pregnancy that can increase risk of preterm births?

vaginal bleeding, multiple gestation, gestational diabetes, IVF, poly/oligohydramnios

how can preterm labour be predicted?

transvaginal USS of cervix, measurement of foetal fibronectin

in predicting preterm labour, what happens if foetal fibronectin is positive?

if 22-34 weeks = increased risk of premature baby within 7 days

how can low birth weight be predicted?

inadequate weight gain from mum during pregnancy, Hx of preterm/low birth weight baby, passive smoker, anaemic mother

how are preterm infants managed at birth

1. stabilised, 2. body temperature control, 3. avoid infection = hand-washing 4. adequate nutrition and fluids

how are preterm infants body temperatures stabilised?

incubators, clothing and possibly plastic bags

what does meticulous hand washing prevent in preterm infants?

staphylococcus epidermidi infection

which vitamins do preterm infants require supplementation of?

phosphate + vit D

how are preterm infants < 28 weeks managed?

40 oxygen, temp maintenance, dextrose = avoid hypoglycaemia, empirical IV antibiotics, surfactant

what is given in suspected congenital heart defects to preterm infants?

prostaglandins

what are short term complications of preterm births??

resp/cardio/GI problems, intracranial lesions

what respiratory complications can occur in preterm infants?

surfactant deficiency + apnoeic attacks

what GI complications can occur in preterm infants?

necrotising enterocolitis, bowel perforation

what are long term complications that can occur in preterm infants?

retinopathy, chronic lung disease of prematurity, neurodevelopment disorders

what are some neurodevelopment disorders that can occur in preterm infants?

cereal palsy, hearing/visual impairment, seizures, behavioural/educational difficulties

what are the most common congenital abnormalities identified in the neonatal period?

congenital heart defects, chromosomal/genetic disorders, neural tube defects, cleft lip/palate, club foot

how may chromosomal/genetic disorders be identified before neonatal period?

antenatal screening test

how may neural tube defects be identified before neonatal period?

antenatal maternal blood test = high AFP

when is the neonatal screening physical examination performed and when?

by doctor within 72 hours of birth and again by GP at 6-8 weeks baby check

when is the neonatal heel prick/blood spot test performed?

at 5-9 days (up to 1 year if missed except in cystic fibrosis)

what are some conditions assessed in the neonatal heel prick/blood spot test?

sickle cell, cystic fibrosis, congenital hypothyroidism, phenylketonuria

what is the epidemiology of SIDS?

incidence = 1 in 2000 infants, peak incidence = 1-3 months of age

what is the leading cause of death beyond the neonatal period in the UK?

SIDS

up until what age can SIDS occur?

12 months

what are some risk factors for SIDS?

cosleeping, tobacco smoke, consuming alcohol/drugs, over-heating baby,

what are protective factors of SIDS?

dummy during sleep, immunisation, breastfeeding, room sharing

what key advice should be given to parents to reduce the risk of SIDS?

place baby on their back, baby's feet touch the cot, keep baby's head uncovered, baby sleep in the same room < 6 months

describe the epidemiology of childhood asthma?

affects 8 million people in uK, 12% of UK population diagnosed, incidence is higher in children > adults, more common in boys > girls

why is screening important in developmental dysplasia of the hip?

responds to conservative management in early stages = less complex + often doesn't require surgery

what manoeuvre is performed to screen for DDH?

Barlow + ortolini

what factors increase the risk of DDH?

breech presentation > 36 weeks, 1st degree FHx, congenital deformity of feet, limited abduction/flexion

how should babies with increased risk of DDH be screened?

USS < 4 months, pelvic x-ray > 4 months

how can HCP prevent spread of childhood infection?

chemoprophylaxis, hand washing, PPW, isolating infected patients, increased awareness of symptoms of disease

how do vaccines help prevent disease?

provide active immunity = provide immunological memory by stimulating = immune response = antibody production = recognise on later infection

what are examples of live attenuated vaccines?

MMR, BCG, varicella

what is included in the 6-in-1 vaccine?

(what the hell has Donald posted), whooping cough, tetanus, hep B, haemophilia influenza, diphtheria, polio

what is included in the 4-in-1 vaccine (preschool booster)?

(remove the h ones) whooping cough, tetanus, diphtheria polio,

what is included in the 3-in-1 vaccine (teenage booster)?

(remove whooping cough) tetanus, diphtheria, polio

at what stages are children vaccinated?

8 weeks, 12 weeks 16 weeks, 1 year, 2-10 years, 3 years + 4 months, 12-13 years, 14 years

what are children given in vaccines at 8 weeks?

6 in 1, rotavirus, menB

what are children given in vaccines at 12 weeks?

6 in 1, pneumococcal, rotavirus

what are children given in vaccines at 16 weeks?

6 in 1, men B

what are children given in vaccines at 1 year?

MenC, MMR, pneumococcal, MenB

what are children given in vaccines at 3 years and 4 months?

MMR, 4 in 1

what are children given in vaccines at 2-10 years?

flu yearly

what are children given in vaccines at 12-13 years?

HPV

what types of HPV does the HPV vaccine protect against?

16, 18 and 11

what are children given in vaccines at 14 years?

3 in 1, meningococcal ACWY

what are common concerns about vaccinations in children?

wear out immune system, don't work, bad side effects, causes autism/developmental disorders

how would a child be supported in childhood to adulthood transition for care of chronic conditions?

involve young people and carers, co-produce strategies/goals/outecomes, start discussion about transition young as possible

what is the impact of a chronic condition in a child?

time off school, needing to plan around medications, psychological, impact on future employment, life expectancy potentially lower

what is over-acceptance of a chronic illness?

letting illness take over = level of impairment above what expected to be

what does a child's reaction to chronic illness depend on?

nature/stage of illness + symptoms, age of chid, intellectual capacity, temperament, family factors

what behavioural effects can a chronic illness cause on a child?

maturing early or age regression (school performance, nocturnal enuresis)

what family effects can a chronic illness in a child cause?

tension + long term issues = supress feeling to support child

what social effects can a chronic illness cause on a child?

rebellion in children/adolescents, strained peer relationships - dont want to seem different, poor self image - side effects of medication

define safeguarding

action taken to promote welfare of children and prevent harm

what is the key statutory guidance for anyone working with children in England?

working together to safeguard children (2018)

what is the role of 'working together to safeguard children (2018)'?

sets how individual/organisations should work together, states practitioners should conduct assessment of children = share info early to identify risks/concerns about child safety

who might attend a child case conference?

social worker, GP, teacher health visitor, police, parent, child if old enough

what is the role of a HCP in safeguarding of babies, children and young people?

if abuse is disclosed, they have statutory obligation to tell an appropriate agency + discuss with senior/child protection doctor

which agencies can a HCP tell if a child has disclosed abuse to them?

social services, police, NSPCC, school, relevant doctors, MDT

what happens when a HCP has disclosed a child suffering abuse to the relevant parties?

child case conference + MDT meeting to create child protection plan

what does the children act 1989 do?

allocates duties to local authorities, courts, parents and other agencies in UK = ensure children are safe + welfare is promoted

what does the children's act 2004 do?

amended 1989 act = stating obligation to share info + co-operate to safeguard + promote child welfare

as per the children's act 2004, what is done if there is concerns on sharing information on chikld abuse disclosed to a HCP?

get advice from desginated child protection officers quickly as possible to ensure little delay to child safety

why are children of concern in potential abuse?

dependent on others making decisions in best interest, under-developed decision-making capacity, difficulty in them accessing services

can under 16 year olds make healthcare decisions for themselves?

can consent for treatment in gillick competent but not refuse

what is gillick competence?

Children <16 may consent to treatment if they show sufficient understanding and intelligence to understand fully what is proposed = parental right yeilded

can under 18s consent to their own treatments?

16-17 = presumed competent so can accept but cant refuse

what does the harm principle state?

only purpose for which power can be rightfully exercised over any member of a civilisaed community against their will is to prevent harm to others

what is the healthy child programme (2009)?

details an evidence based frame work for the delivery of public health services -> families with 5-19 yr old children

what does the healthy child programme (2009) contain?

advice on screening test (antenatal, neonatal + beyond), immunisations, developmental reviews, info to support healthy choices

what are 5 aims of the healthy child programme (2009)?

help parents/carers/guardians develop strong bond with children, support parents/carers/guardians in keeping children healthy/safe, promote oral health, protect children from serious disease through screening immunisation

what is start4life?

public health england's national programme = delivers NHS advice to parents to be and families with children < 5

what is in the primary prevention of ophthalmological conditions?

optimal glycaemic control, BP control, lipid control, healthy diet, smoking cessation

what is in the secondary prevention of ophthalmological conditions?

diabetic eye screening programme

who is offered the diabetic eye screening programme?

>12 with DM + annually

what are criteria for emergency review by an ophthalmologist in diabetic eye screening?

sudden loss of vision, pre-retinal or vitreous haemorrhage, retinal detachment

what is a squint?

one eye misaligned in relation to the other

in who does a squint occur?

downs syndrome, hydrocephalus, SDL, children with treated retinopathy

what are risk factors for a squint?

family history, prematurity, cerebral palsy, meningitis, foetal alcohol syndrome

when should a neonate be referred for a squint?

constant squint worsening from 2 months of age, or any older child with suspected squint

where are the highest rates of blindness in the world?

south asia, subsaharan africa

what are the main causes of blindness worldwide?

cataracts, glaucoma, age related macular degeneration, diabetic retinopathy, retinitis pigmentosa

why are only 1/3 of people who are blind registered blind?

many dont appreciate how bad eyesight is, unaware of benefits that come with being registered, emotional impact of diagnosis