BackgroundPaediatricians are responsible for carrying out child protection medical examinations, which will sometimes include the use of photography to document injuries. Ideally, a trained medical photographer would take all photographs when needed. This service is not always available and the paediatrician may have to take time critical photographs.ObjectivesOur aim was to audit the child protection photographs taken in one year at our hospital and compare them to the national guidelines from the Institute of Medical Illustrators.MethodsAll children (0–18years) who had a child protection medical in 2019 were identified. Those that had photographs taken during their medical were highlighted and the photographs were compared against the standards set out by the Institute of Medical Illustrators.Results49 child protection medicals with photography were completed in 2019. Clothing was removed appropriately in 86% of cases. However, an appropriate background was used in only 18% of photographs. The three photograph principle (a location photograph, a close-up photograph, and a close- up photograph with a linear scale) was used in 0% of cases. Location photographs or close-ups with no linear scale were taken in only 14% of cases. Photographs with a linear scale were taken in 67% of cases, in which a triangle ruler was used in 83% of these.ConclusionsOverall, child protection medical photography in our centre is of inadequate quality. Ideally, support from medical or police photography should be available at all times for child protection medicals and other medical photography. This is not currently the case in all centres. With the COVID-19 pandemic, there has been an increase in domestic child abuse cases, possibly leading to more of us, as paediatricians, needing to complete child protection medicals. We recommend that training is offered to all paediatricians who may be taking medical photographs, and could be considered an important part of trainee induction. Any photographs taken can be used as evidence in court and, therefore, their quality is of paramount importance.
Should paediatricians be trained in the use of medical photography?