A&E question

hi guys,

I have a question regarding doctors working in A&E. If you get a patient who you suspect has been involved in a crime, such as been a victim of stabbing or other form of assault or even been the offender, do you then as the A&E doctor have to call the police regarding your suspicion or does patient confidentiality come in here?

Also, in cases of suspected child abuse, does the doctor make a decision to inform the police?

Reply 1

LaRoar

As far as I know, doctors only currently have to inform the police if it's a gun shot wound, but there's currently campaigns to extend this to stab wounds. I'm sure I read about this on BBC News the other day but I may have dreamed it!

As for child abuse, I'm pretty sure that must be reported, same for neglect. Although whether it's directly to the police or to social services I'm not sure.

Reply 2

Helenia

Most of the stab wounds I have seen have come in with police; I'm not sure if we would be obliged to tell the police even if the patient didn't want us to. We don't see GSWs at my hospital (they go straight to a major trauma centre), but we are taught that the first thing to do when you do see one coming is to call the police, as it's not uncommon for people to follow the patient in to "finish the job" :s:

As for child abuse, most departments have a clear policy on who you should report suspected abuse to. In most cases you have to discuss the case with a senior doctor/paediatric nurse, then make an appropriate referral to social services. If you and the paeds team think that the child is in immediate danger then they can be admitted to the ward if it is not safe for them to go home. The police don't tend to get involved at the A&E level unless there has been serious violence. The really important thing for safeguarding children is to work as a team - don't act on your suspicions alone, make sure you discuss with someone more experienced. Thankfully I've only had to do this on a handful of occasions.

Reply 3

RetiredAccount89

Original post by Helenia

All GSWs and Stab wounds must be reported.

Including those where the patient claims the stab wound is self inflicted but you have doubts.

Reply 4

Wangers

Original post by Jamie

All GSWs and Stab wounds must be reported.

Including those where the patient claims the stab wound is self inflicted but you have doubts.

Is the stabbing discreationary? I was taught you can break confidentiality and call the blue boys, but you don't have to?I'm probably getting confused here...

GMC guidance: Clicky

Original post by Wangers

Is the stabbing discreationary? I was taught you can break confidentiality and call the blue boys, but you don't have to?I'm probably getting confused here...

Nope, its a must.

Reply 7

winter_mute

Original post by Jamie

Nope, its a must.

I'd read through that GMC report, it seems discretionary you should rather than must and in any case only reporting if you feel that others may still be at risk, or the patient is liable for a reprisal attack (this is of course in the situation where the patient refuses disclosure).

Reply 8

RetiredAccount89

Original post by winter_mute

Why are you calling the police?
Because if things go wrong you'll have coverage.

So what happens if you don't call the police and nothing goes wrong? Nothing.
What happens if you don't call the police and something does go wrong [example a member of staff gets stabbed] - you get hauled in front of the GMC/fight a personal law suit because the official guideline is that police should be called.

Should in GMC terms = JFDI.