Emergency medicine journal : EMJ
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Multicenter Study
Pain assessments at triage with the Manchester triage system: a prospective observational study.
Pain is one of the six general discriminators of the Manchester triage system (MTS). The frequency of pain assessments conducted at triage with the MTS, and patient, nurse and triage characteristics associated with pain assessments were studied. Also, nurses' reasons for not assessing pain at triage were studied. ⋯ Pain assessments at triage are conducted infrequently because of insufficient education, conducting activities at triage that are not necessary for estimating urgency and a lack of clarity in the MTS guidelines. Changes in these areas are necessary to improve the reliability and validity of pain assessments and the MTS.
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To gather data on the ages and weights of children aged between 1 and 16 years in order to assess the validity of the current weight estimation formula 'Weight(kg)=2(age+4)' and the newly derived formula 'Weight=3(age)+7'. ⋯ Weight estimation is of paramount importance in paediatric resuscitation. This study shows that the current estimation formula provides a significant underestimate of children's weights. When used to calculate drug and fluid dosages, this may lead to the under-resuscitation of a critically ill child. The formula 'Weight=3(age)+7' can be used over a larger age range (from 1 year to puberty) and allows a safe and more accurate estimate of the weight of children today.
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The recent popularity of domestic trampolines has seen a corresponding increase in injured children. Most injuries happen on the trampoline mat when there are multiple users present. This study sought to examine and simulate the forces and energy transferred to a child's limbs when trampolining with another person of greater mass. ⋯ Current guidelines are clear that more than one user on a trampoline at a time is a risk factor for serious injury; however, the majority of injuries happen in this scenario. The model predicted that there are high energy transfers resulting in serious fracture and ligamentous injuries to children and that this could be equated to equivalent fall heights. This provides a clear take-home message, which can be conveyed to parents to reduce the incidence of trampoline-related injuries.
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On 12 May 2008, the Wenchuan earthquake, registering 8 on the Richter scale, hit the Sichuan province, China. Management of the rescue efforts and characteristics of casualties were studied. ⋯ The Wenchuan medical rescue effort presented several problems. The experience is reflected in these points: (1) establish an effective command and communication centre to ensure that medical rescue resources are deployed in time; (2) treat the wounded within the first 7 days; (3) prepare healthcare resources for both surgical and general medicine services; (4) establish contingency rescue plans with a coordinated effort; (5) insist on the principles of triage and adopt flexible evacuation and transfer methods.