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Starship Children's Hospital (starship + children_hospital)
Selected AbstractsPaediatric lap-belt injury: A 7 year experienceEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2006Michael Shepherd Abstract Objective:, To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed. Methods:, Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data. Results:, In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained. Conclusions:, Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats. [source] Serious injuries from dishwasher powder ingestions in small childrenJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2006Amy Bertinelli Aims: To describe patterns and severity of caustic injuries sustained from dishwasher powder ingestion and highlight need for national safety standards. Methods: Retrospective chart review of admissions for caustic ingestion to Starship Children's Hospital from January 2003 to January 2005 and review of New Zealand National Poisons Centre data. Results: Between January 2003 and January 2005, the National Poisons Centre recorded 610 dishwashing powder ingestions, with 88% of children less than 2 years old. Twenty-three children were admitted to Starship Children's Hospital following caustic ingestion, of whom 11 were identified as having ingested dishwasher powder (9 boys and 2 girls) and were aged 11 to 30 months (mean 17.5). Five children (45%) were admitted to the Paediatric Intensive Care Unit over 4 months (October 2004 to January 2005), requiring intubation for airway control. Two children needed tracheostomy. Three of the 11 children (27%) required repeated oesophageal dilatation, and two underwent gastrostomy formation. One brand of dishwasher detergent and container type was implicated in over half of the cases. Conclusions: Dishwasher detergents are highly corrosive substances that cause potentially life-threatening injuries and ongoing morbidity. The recent surge of incidents may be related to change in product constituents or non-compliance with New Zealand safety standards. Efforts to limit product alkalinity, legislative requirement of Child-Resistant Packaging and public education may reduce injuries from these common household substances. [source] Retrospective review of children presenting with non cystic fibrosis bronchiectasis: HRCT features and clinical relationships,PEDIATRIC PULMONOLOGY, Issue 2 2003E.A. Edwards FRACP Abstract Non cystic fibrosis (CF) bronchiectasis in children presents with a spectrum of disease severity. Our aims were to document the extent and severity of disease in children with non-CF bronchiectasis, to review the inter- and intraobserver agreement for the high-resolution computed tomography (HRCT) features examined, and to assess correlations between HRCT features and clinical measures of severity. We performed a retrospective review of 56 children from the Starship Children's Hospital. HRCT scans were scored by a modified Bhalla system, and the chest X-rays using the Brasfield score. Scores were correlated with demographics, number of hospitalizations, disease duration, pulmonary function, clinical examination, and chronic sputum infection. The bronchiectasis seen was widespread and severe, particularly in Maori and Pacific Island children. The kappa coefficient for intraobserver agreement was better than that for interobserver agreement. Comparisons between HRCT scan and lung function parameters showed that the strongest relationships were between forced expiratory volume in 1 sec (FEV1) and forced expiratory flow between 25,75% of forced vital capacity (FEF25,75) with the extent of bronchiectasis, bronchial wall thickening, and air trapping. Children with digital clubbing and chest deformity showed significantly higher scores for extent of bronchiectasis, bronchial wall dilatation and thickness, and overall computed tomography (CT) score. No relationship was demonstrated between chronic sputum infection and CT score. The HRCT score demonstrated a stronger correlation between the extent and severity of bronchiectasis, and spirometry values, than the chest X-ray score. In conclusion, pediatric non-CF bronchiectasis in Auckland is extensive and severe. The good intraobserver ratings mean that consistency of scoring is possible on repeated scans. This study cannot comment on the relationships of CT and less severe disease. Pediatr Pulmonol. 2003; 36:87,93. © 2003 Wiley-Liss, Inc. [source] OK-432 and lymphatic malformations in children: the Starship Children's Hospital experienceANZ JOURNAL OF SURGERY, Issue 10 2004Jonathan S. Wheeler Background: Surgery has previously been the mainstay of treatment for lymphatic malformations but has attendant problems of marked scarring, high chance of recurrence and potential nerve damage. Alternative management for these lesions involves the intralesional injection of OK-432. The present paper reviews OK-432 use in lymphatic malformations in children. Methods: A retrospective chart review was carried out of children undergoing intralesional OK-432 therapy from the Departments of Paediatric Surgery, Paediatric Otolaryngology and Plastic Surgery at Starship Children's Hospital, Auckland. Results: Over the past 4 years, seven children under the age of 5 years underwent OK-432 therapy as day-case procedures requiring between one and seven procedures each. Four children had lesions involving the axilla/chest wall, two involved extra-mylohyoid tissues in the neck and one child had lymphatic malformation involving tongue, floor of mouth and an extramylohyoid component. Spontaneous haemorrhage into a cystic space may be the cause of the observed partial resolution of the lymphangiomas in two. A predictor of a successful outcome was the ability to aspirate fluid prior to injection. Ultrasound guidance was useful to localize the lesions for aspiration and injection. Macrocystic lesions respond well to OK-432 therapy but the response of microcystic or cavernous lesions to OK-432 is disappointing and surgery remains the definitive treatment for these microcystic lesions. Conclusion: OK-432 appears to be a safe and effective treatment for the macrocystic component of lymphatic malformations. [source] | ||||||||||