Safeguarding children: why an issue for pediatric anesthetists?

Abstract

Child maltreatment and the responsibility of heath care professionals to assist in prevention and diagnosis is currently center stage in the United Kingdom. This subject has a very large literature base. Anesthetists were one of the first groups to have specific guidance on this subject, and key competencies are now part of the core curriculum for our trainees. This article seeks to briefly define maltreatment and provide statistics that outline the scale of the problem, and includes discussion of risk factors and recognition. We have focused on physical abuse and have provided a separate section on abusive head trauma, which is of particular importance to anesthetists. We also discuss the process of management, with some detail around Child Death Review procedures.

The rules of engagement

“…Lack of promoting good is usually not punishable in the general community, but may be in the medical fraternity. Standards have evolved within medical care that have become ‘duties’ or ‘standards of practice.’ Duties extend to the reporting of possible children at risk in order to protect them from potential harm (12). The ideal of ‘greatest good’ may be dangerous, when we impose on others whatever we as anesthetists think is best.…”