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G97(P) Audit of safeguarding of children presenting with dog bites to the emergency department
  1. TJ van Hasselt,
  2. R Bowman,
  3. M Sajeel
  1. Emergency Department, Good Hope Hospital, Birmingham, UK

Abstract

Aims Recently there has been much media coverage of dog attacks on children. NICE guidelines for management of dog bites recommend that inadequate supervision should prompt consideration of child neglect.

We aimed to retrospectively analyse emergency department records to examine the nature of paediatric dog bite incidences, demographics, management, and child safeguarding actions.

Methods This was a retrospective case series review of routinely collected data, reviewing electronic notes of emergency departments attendances coded for animal bites, stings, or wounds, between 1st May 2013 and 31st of May 2014.

The audit was registered with the audit department, ethics committee approval was not required.

We obtained records for 193 patients between 0 and 17 years of age. 33 patients were excluded (17%), 7 due to insufficient documents, 19 due to bites from other animals, and 7 re-attendances.

Results 160 patients were analysed, the mean age was 9.4 years of age, with 66 female (41%) and 94 male (59%).

There were 105 injuries to the limbs and 50 facial injuries. Most injuries occurred within the family home (n = 43) or in a public place (n = 43). The commonest culprit was the family’s own dog (n = 47), the next commonest being a relative’s dog (n = 22).

135 patients received antibiotics, and 17 required referral to other specialities.

There were 3 safeguarding referrals to social services within the department, and 4 referrals to health visitors by clinicians. However the trust employs paediatric liaison nurses who retrospectively review notes and take further actions if there are child protection issues. The paediatric liaison team made 32 referrals to school nurses and 21 referrals to health visitors, though no social services safeguarding referrals.

Conclusion Our study suggests children attending emergency departments with dog bites are commonly attacked by the family dog within the family home. There was a low overall rate of child safeguarding actions taken though the trust paediatric liason team made more referrals than clinicians.

As a result of this audit we will update our online emergency department guidelines for clinicians. Moreover, we will distributea patient information leaflet including advice regarding supervision of children around dogs.

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