Unusual or unexplained injuries in children

Many children experience bruises, broken bones and other injuries during their childhood when they are playing, taking part in sport or due to an accident. Sometimes, broken bones or bruising can be caused by a medical condition that may require further tests.

Injuries can also be caused by other children or adults. This could be by accident but sometimes the injuries may have been caused deliberately.

If the injuries are unusual in appearance, cannot be explained or the explanation is not clear, then the opinion of a paediatric doctor may be sought. A paediatrician is a specially trained children’s doctor who will gather information and examine your child. They have a legal requirement to investigate the cause of any injury.

You will be asked questions about your child’s health and how the injuries may have occurred. Different people may ask the same questions, and this may feel uncomfortable at times. The medical team need to make sure they have all the available information to ensure that they make the right decisions in the best interest of your child’s health and wellbeing.

The medical team may seek further information about your child by speaking with other specialist doctors, your child’s GP, health visitor, school nurse or teacher, social worker or police. Your child will be discussed with a paediatric consultant and the Trust’s Safeguarding Children team.

Your child may require further tests to help the medical team find out the reason for his or her injury and to ensure that there are not any other concerns. The paediatrician will discuss these investigations with you. These tests may include:

• blood tests
• x-rays (sometimes repeated after two weeks)
• computed tomography (CT) scan
• magnetic resonance imaging MRI scan
• photographs
• eye examination
• skin swabs or urine test

As part of the information gathering it is likely that children’s social care will be contacted. They have a legal duty to make enquiries and to decide whether a child with unusual or unexplained injuries requires action to be taken to safeguard their welfare.

While they are making these enquiries, your child may be admitted to hospital or discharged to a ‘place of safety’. Social care may put in place certain restrictions until the enquiry is completed. They may:

• say who may or not visit your child in hospital.
• arrange for visiting to be supervised.
• require a meeting before a child is discharged from hospital.

Your child may need to stay in hospital until all information has been gathered, tests are completed, and all the results are available. Some of the tests can take several days to be completed and your child may need to return to the hospital for additional investigations following their discharge.

We realise that this is a stressful time for you, your child and your family and nobody wants to make you more upset than you may already be feeling. All the staff are here to help. Please ask if you need anything explaining further to you. You and your child will be kept informed of any decisions and results during this admission.

If you have a social worker, we advise you to contact them for updates regarding their involvement and arrangements once your child is discharged.

The welfare of brothers and sisters and any other children that were involved with the child will also be considered and a safety plan made.

We all have a responsibility to make sure children and young people are safe and well cared for. If there are concerns that a child has been harmed or may suffer harm, we have a legal duty to act on the concern. As agencies we work together with you as parents/carers to ensure your child is safe and well cared for.