ABSTRACT
At the initiative of the Dutch Association of Otolaryngology and Head & Neck Surgery, in cooperation with the Dutch Institute for Healthcare Improvement (CBO), an evidence-based practice guideline was developed for adenoid and tonsil disorders in secondary care. (Adeno)tonsillectomy ((A)TE) is indicated in children with very frequent recurrent tonsillitis: 7 or more tonsillitises per year or 5 tonsillitises per year in the last 2 years. In children with moderately frequent recurrent tonsillitis, i.e. 4 to 6 tonsillitises per year, an (A)TE can be considered. If an (A)TE is performed under inhalation anaesthesia without intubation this must be done with the patient in the supine position. An (A)TE in children can be safely performed in day surgery. It is advisable to give preoperative information to both parents and children.
Subject(s)
Adenoidectomy , Otolaryngology/standards , Tonsillectomy , Tonsillitis/surgery , Child , Humans , Netherlands , Patient Education as Topic , Practice Patterns, Physicians' , Recurrence , Societies, Medical , Supine Position , Tonsillitis/epidemiologyABSTRACT
A multidisciplinary guideline for the intake and treatment of whiplash patients has been developed with regard to the impact of whiplash on public health and social security. This guideline is restricted to uncomplicated whiplash, which is defined as the sudden acceleration and deceleration of the skull with energy transfer to the neck without neurological sequelae or fractures. In whiplash victims who are not alert, have pain of the neck, diminished cervical mobility or pain on palpation of the cervical vertebrae, an X ray of the cervical spine should be carried out to exclude fractures. Following whiplash if complications have been excluded, active neck exercise treatment is the correct approach. The patient should start this as soon as possible. After uncomplicated whiplash, rest and immobilisation are undesirable.