ABSTRACT
BACKGROUND: The increase in potentially dangerous food allergic reactions (e.g. to peanuts and nuts) in children had lead to an increase in the prescription of adrenaline, including adrenaline for self- or parent-injection. This raises problems in the management of these children in schools. Our experience in response to this is described. OBJECTIVE: To develop a training package to ensure that each child can continue at school but receive optimum emergency treatment in a safe environment. To provide education, training and support to school staff, and to support parents. METHODS AND RESULTS: This paper describes a model of good practice in the support of children with potentially fatal anaphylactic reactions. The following points are emphasized. Children with a history of anaphylactic reactions should be expertly assessed prior to the prescription of adrenaline injection. A written treatment plan is essential. Parents need expert support in managing the child. Schools need training and support. Children should lead a normal life, and not be stigmatized or labelled by their problem. Close liaison between primary care, acute services, community services and education services are essential for the successful management of this problem. Data from a questionnaire showed the training package was of benefit, with considerable reduction in anxiety in school staff and parents. CONCLUSION: A broad training package is essential: training in administration of adrenaline is only one aspect, and emphasis is placed on education, recognition of allergic reactions and prevention. The presence of children in school needing access to adrenaline is no longer perceived as a problem in our area. We recommend other health authorities provide a similar service.
Subject(s)
Anaphylaxis/therapy , Residence Characteristics , Child , Education/standards , Emergency Medical Services , Epinephrine/administration & dosage , Epinephrine/pharmacology , Evaluation Studies as Topic , Food Hypersensitivity/immunology , Food Hypersensitivity/therapy , Humans , Injections , Parents/psychology , Practice Guidelines as Topic/standards , Schools , Surveys and Questionnaires/standardsSubject(s)
Blood Transfusion , Hemolytic-Uremic Syndrome/therapy , Blood Preservation , Cryopreservation , Female , Humans , Infant , Peritoneal DialysisSubject(s)
Amputation, Traumatic/surgery , Finger Injuries/surgery , Play and Playthings , Child , Child, Preschool , Consumer Product Safety , Female , Humans , Male , Microsurgery , Replantation , Thumb/injuries , Thumb/surgeryABSTRACT
Premature incomplete fusion of the growth plate results in shortening and progressive deformity of bone and joint. A preliminary report is presented of encouraging results following a new operation aimed at a surgical cure by direct attack on the pathological bony bridge. Growth has been reestablished in all of the cases treated in this way, and progressive spontaneous correction of deformity has been observed. Injuries involving high energy dissipation were mostly responsible. A small number of cases followed burns or were of spontaneous onset.
Subject(s)
Bone Diseases, Developmental/surgery , Adolescent , Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/etiology , Bone and Bones/injuries , Cartilage/surgery , Child , Child, Preschool , Female , Humans , Male , Osteotomy/methods , RadiographyABSTRACT
A technique for orienting cut nerve ends for suturing is presented. A mirror is used to reflect one end, making its image identical to that of the other end--so that proper orientation is greatly facilitated.
Subject(s)
Peripheral Nerves/surgery , Surgical Instruments , HumansABSTRACT
Microsurgery demands precise and rapid manipulation of needle and thread with maintenance of special respect for the fragility of the tissues. The design of the needleholder is of paramount importance in achieving these goals. The instrument described below is light, long enough to rest comfortably in the hand, and balanced in such a way that it can be manipulated into awkward corners with relative ease.
