PaediatricsEmergency Medicine
Suspected Non-Accidental Injury / Safeguarding
RCPCH safeguarding pathway — recognise patterns, document, full skeletal survey, multidisciplinary referral, never accept inconsistent history.
Source: RCPCH Safeguarding Children Toolkit 2023; HM Government 'Working Together' 2018
Step 1 of ~5
info
Recognise Concerning Features
Red flags: injury inconsistent with developmental stage / mechanism described; delayed presentation; multiple stories; bruising in a non-mobile child; pattern injuries (slap, bite, ligature, burns of buttocks/feet/hands); multiple injuries of differing ages; torn frenulum in non-mobile child; retinal haemorrhages; unexplained fractures; failure to thrive; neglect (poor hygiene, inappropriate clothing); witnessed harm. ALWAYS take a thorough history with each parent separately. NEVER discharge until safeguarding addressed. Verify all paediatric drug doses against BNFc.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Methylene Blue · Guanylate Cyclase / Nitric Oxide Pathway Inhibitor
- Dantrolene sodium · Skeletal muscle relaxant (RyR1 inhibitor)
- Dimeticone · Topical pediculicide (silicone-based)
- Sodium phenylbutyrate · Ammonia scavenger (alternative pathway)
- Marstacimab · Anti-tissue factor pathway inhibitor (TFPI) monoclonal antibody
- Methocarbamol · Centrally Acting Skeletal Muscle Relaxant
Decision support only. Always apply local guidelines and clinical judgement.