Guideline for Emergency Departments, Minor Injury Units and Receiving Units where a child or young person presents under the influence of alcohol and/or drugs

exp date isn't null, but text field is

Objectives

This document provides clear guidance for the management of children attending with alcohol and/or drug misuse.

Scope

This guideline covers the whole of NHS Greater Glasgow and Clyde Health Board area and provides a framework to help Emergency Medicine health professionals identify concerns and risks to intoxicated children/young people. Response includes a standard assessment to ensure appropriate action, which may include an opportunistic brief intervention with the provision of health promotion/harm reduction advice and submission of a Notification of Concern from is submitted for all.

It is intended that professionals from Emergency Departments, Minor Injury Units and Receiving Units will find this document helpful when dealing with intoxicated children and young people up to 16 years old or up to 18 years if looked after or looked after by the local authority. It is also intended that this document will assist health professionals in their child protection decisions and to discharge safely with appropriate follow up.

Audience

Roles and Responsibilities: Professionals working with, or in contact with, children or young people and/or their families have a duty of care to ensure that the child’s or young person’s needs are considered with them in the context of their individual circumstances. This guideline aligns with the principles of GIRFEC and national child protection guidelines.

Appendix 1 provides a guideline in flowchart format for the management of children/young people presenting to Emergency Departments, Minor injury units and Receiving Units under the influence of alcohol and/or drugs.

Introduction

Adolescence is a period of significant physical, cognitive and social change. It is now well established that increasing numbers of young people are engaging in a range of risk behaviours including the misuse of alcohol, drugs and other substances before reaching the age of 16 years. Alcohol and/or drug use is now known to feature in significant other aspects of life for example sexual exploitation of young people.

Principles and procedures

A Notification of Concern (NoC) must be submitted to social work services for ALL children and young people presenting under the influence of alcohol and/or drugs.

Where there is a concern/risk regarding alcohol and/or drug use and/or other circumstances, Social Work Services should be contacted to establish if the young person is already known to Social Work, or any another support service. A NoC should be submitted to social work regardless of whether the young person is or is not already known to Social Work Services, for consideration of a single/multi-agency needs/risk assessment.  (See Appendix 1)

Staff should ensure a copy of the NOC is sent next working day to

The child or young person should not be discharged until:

  • The Emergency Medicine Clinician is fully satisfied that the child or young person is medically fit for discharge
  • The parents/guardian are informed
  • An immediate risk assessment has been completed and Social Work Services and/or the police contacted if indicated (follow flow chart)
  • The patient must be discharged into the care of a responsible adult

The acute addiction team office will liaise with alcohol and drug recovery services in the community for onward referral and follow up. Notification of actions and interventions undertaken by social work/alcohol and drug recovery services will be uploaded onto clinical portal and located under correspondence section/social service letter.

Child Protection Service can be contacted for advice on 0141 451 6605 Monday – Friday 9am – 5pm. Out of Hours – contact the duty Consultant via switchboard.

An online training programme for staff is available to support implementation of these guidelines and can be accessed on Staffnet through the Learnpro platform or via the link https://nhs.learnprouk.com. Module located under CPD tab, titled Intoxicated Children 2017 (number 152).

Sharing of information

If a practitioner/professional is concerned that the child/ young person may potentially be at risk of future harm, the sharing of information between agencies and between staff within agencies is crucial to help safeguard the child or young person and facilitate appropriate assessment/care management. Currently the School Nurse Team Lead forwards information to the relevant school nurses. Consent to share information is not required

As a standard of good practice to link with community services, the school nurse team lead in most areas is copied into the GP letter when the patient is discharged from the department or ward. Discharge letter to GP should include that NoC has been completed. If the patient absconds from the department the police and/or social work should be contacted as well as the parents or guardian.

Please detail exact reason for referral in section 7 of NOC and document any discussion/engagement with young person as social work do not have access to Clinical Portal.

Admission to hospital

On occasions where it is necessary to admit a child or young person to hospital as a direct consequence of alcohol and/or drug use, or through illness/injury caused as a result of alcohol or drug use, the assessing clinician at first point of contact should complete the NOC Form.

Form accessed through:
Clinical Portal/
Forms & Pathways tab
Add New Form
NOC

Children under 16 years requiring admission to hospital should be discussed with the paediatrics medical receiving team at RHC - 0141 452 4678

Wherever possible, staff should undertake opportunistic brief interventions including appropriate health promotion/harm reduction advice together with the issue of information/education leaflets, as a minimum standard of good practice.

Appendix 1: Guideline flowchart for intoxicated child/adolescent presentation

CPS email - ggc.cpadmin@nhs.scot
Acute Addiction Team email – acute.intoxicatedsharedrefs@ggc.scot.nhs.uk
Editorial Information

Last reviewed: 01 March 2021

Next review: 31 March 2024

Author(s): Lead Manager: Donna Hunter, Chief Nurse, Head of Service Public Protection

Version: 2 (replaces 2017 version)

Co-Author(s): Responsible Acute Directors: Isobel Neil, Director North Glasgow Sector; Frances McLinden, Director South Glasgow Sector; Melanie McColgan, Director Clyde Sector; Kevin Hill, Director Women and Children’s Directorate

Approved By: Child Protection Forum