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Paediatric stabbing and child protection: a pan-london perspective
  1. J R Apps1,
  2. C Williams1,
  3. A McGuinness2,
  4. S Gabbie3,
  5. A G Sutcliffe1
  1. 1General and Adolescent Paediatrics Unit, Institute of Child Health, London, UK
  2. 2Accident and Emergency Department, University College Hospitals NHS Trust, London, UK
  3. 3Department of Paediatrics, Royal Free Hampstead NHS Trust, London, UK

Abstract

Aims Youth stabbing in London is increasing and of national concern. There is little published data quantifying the number of paediatric stabbings attending Emergency Departments. A recent audit at one hospital highlighted the significant numbers within one area of London and a lack of engagement with the Police and Social Services. This study aimed to characterise attendances across all 32 Emergency Departments in London and audit existing referral rates to the Police and Social Services against new GMC guidance. This study also assessed the feasibility of a Pan-London audit of an acute paediatric presentation.

Methods Hospitals were contacted, a trainee identified and patients less than 18 who had been stabbed, between 1 March 2007 and 31 March 2009, were identified locally by the most appropriate method using local codings. Self harm and accidental injury were excluded. A proforma was provided to record basic details of the event, the nature and management of any wound and the involvement of parents, police and social services.

Results Of the 32 Hospitals, 25 hospitals have submitted results (further data accrual is continuing and will be presented). 276 cases were identified (aged 9–17 years), 109 of whom were less than 16 years. The majority were seen only by A+E staff and only a minority (29%) were admitted. Sadly three died in the departments. A knife was the commonest weapon and limbs the most common site of injury. Referral rates to Police were documented in only 26% of patients (39% if <16 years) and to social services in 16% (30% if <16 years) of those discharged. In the majority there was no documentation regarding these child protection procedures.

Conclusion A significant number of paediatric stabbings presented to and were discharged from Emergency Departments across London. Of those discharged, documentation regarding referral rates to Police and social services was poor, and documented referral rates low. This audit covered a period prior to the introduction of new GMC guidance and a repeat audit to assess subsequent referral rates is required. This audit also demonstrates it is possible (with a lot of effort!) to conduct a Pan-London audit of an acute paediatric presentation.

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