Clinical presentations

Alerting features that should prompt you to CONSIDER child maltreatment:

• Unusual pattern of presentation to and contact with healthcare professionals, or frequent presentations or reports of injuries.

• Poor school attendance that the child’s parents or carers know about that is not justified on health (including mental health) grounds, and home education is not being provided. (Amended December 2009)

• Bleeding from the nose or mouth in an infant who has an apparent life-threatening event and a medical explanation has not been identified.

• Hypernatraemia if a medical explanation has not been identified.

• A near-drowning incident that suggests a lack of supervision.

Alerting features that should prompt you to SUSPECT child maltreatment:

• Repeated apparent life-threatening events in a child, if the onset is witnessed only by one parent or carer and a medical explanation has not been identified.

• Poisoning in a child in any of the following circumstances:

  • deliberate administration of inappropriate substances, including prescribed and non-prescribed drugs

  • unexpected blood levels of drugs not prescribed for the child

  • reported or biochemical evidence of ingestions of one or more toxic substances

  • the child could not access the substance independently

  • repeated presentations of ingestions of substances in the child or other children in the household

  • there is an absent or unsuitable explanation.
    
    

• Child has a near-drowning incident with an absent or unsuitable explanation.