Management of croup in children in A&E – are we doing it the right way?
Introduction – Croup (laryngotracheobronchitis) is triggered by viral infection in most cases.Diagnosis is mainly clinical and management is based on Westley croup score, where dexamethasone is administered and the child admitted or discharged.
Methodology – Retrospective study . 50 casualty cards with the diagnosis of croup was picked up randomly between the months of October and November 2005 and the management of each case was recorded.
Results - Croup score was assessed in only 24% cases.However, dexamethasone was given in 86% cases.Pulmicort nebulisations was given in 24% cases and information leaflet given in 50% cases.
Conclusion – Though dexamethasone was given in majority of the cases, Croup score was assessed in only 24%. A&E staff should be trained more effectively in the management of common pediatric problems and more emphasis is to be made on documentation.
Assessment and management of pain in children in A&E – are we doing it the right way?
Pain management is one of the most important components in patient care. The severity of the pain should be assessed effectively and weight based analgesia should be given. The BAEM Clinical Effectiveness Committee standard of analgesia for moderate & severe pain within 20 minutes of arrival in A&E should be applied to children in all A&E Departments
Methodology – Retrospective study. 5 casualty cards with soft tissue injury and fractures in children under 16 were picked randomly everyday from Jan 2005.The assessment and management of pain was recorded in each case. A validated pain score tool – Alder Hey triage pain score was introduced April 2005. 5 casualty cards were picked randomly everyday from May 2005. The assessment and management of pain in each case was recorded.
Results – There were 155 patients in each month. In January , none of the patients were assessed for the severity of their pain, 34 patients...
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