Citation

Biss T, Sibson K, Baker P, Macartney C, Grayson C, Grainger J, Chalmers E, Dixon S. Br. J. Haematol. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1111/bjh.18361

PMID

35881677

Abstract

The aim of this Good Practice Paper is to advise on haematological evaluation of bruising and bleeding in children undergoing child protection investigation for possible physical maltreatment; to consider which children should undergo investigations, which tests are indicated, the interpretation and reporting of abnormal results, multi-disciplinary working, and the contribution of healthcare professionals to statutory child protection proceedings and to court proceedings.

The guidance has been written to assist haematologists, paediatric haematologists, paediatricians, and laboratory scientists to achieve an informed and consistent approach that supports accurate diagnosis and exclusion of bleeding disorders, reduces unnecessary testing and supports safety planning for this group of children and young people. Inadequate evaluation has the potential to miss a significant bleeding disorder diagnosis or overlook a diagnosis of physical abuse, whilst extensive testing, sometimes on the advice of court appointed medical experts and not always clinically indicated, can result in unnecessary venepuncture, false positive results, and potentially erroneous diagnoses. Pre-analytical problems and physiological variation is frequent, particularly in younger children, and can lead to difficulties in the accurate interpretation of test results. Inaccurate diagnosis and inconsistent clinical management can pose difficulties for safe decision-making in court proceedings...

Language: en