Browsing by Author "Van As, A B"

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    Animal attacks - a red herring of child abuse?
    (2006) Van As, A B; Kalebka, Robert R; Van der Heyde, Yolande
    Injuries sustained as a result of attacks by domestic animals, particularly canines, are occasionally encountered at the Red Cross Children’s Hospital Trauma Unit in Cape Town. Less than 1% of admissions are directly attributable to animal attacks. Animal attacks causing lethal injuries are very rare and should be assessed carefully. We recently dealt with two fatalities attributed to animal attacks.
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    Dog bite injuries in children - a review of data from a South African paediatric trauma unit
    (2007) Dwyer, J P; Douglas, T S; Van As, A B
    Background and objective. Dog bites are a major cause of preventable traumatic injury in the paediatric population. We aimed to determine the epidemiology of dog bite injuries in a group of South African children with a view to developing potential preventive strategies. Design, setting, subjects. A retrospective review was done of patients presenting with dog bite injuries to the trauma unit at the Red Cross War Memorial Children's Hospital in Cape Town over a 13.5-year period. Results. We identified 1 871 children treated for 2 021 dog bite injuries during the study period. Dog bites accounted for 1.5% of all trauma unit presentations. Male children accounted for 68% of the patients. Children under 6 years of age were more likely to have sustained injuries to the head, face or neck, while children older than 6 years more commonly received injuries to the perineum, buttocks, legs or feet. Younger children were more likely to be attacked at home and older children outside the home. The most frequent injuries were superficial, and the majority of patients were treated with simple medication, dressing or suturing. There were no dog bite-related fatalities. Conclusion. The relationship between the geographical location of dog attacks on children and the age groups attacked suggests that strategies to prevent dog bites should target both parents supervising younger children at home, and older children who encounter dogs outside the home.
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    Evaluation of pain incidence and pain management in a South African paediatric trauma unit
    (2011) Thiadens, Tessa; Vervat, Elleke; Albertyn, Rene; van Dijk, Monique; Van As, A B
    OBJECTIVES: To evaluate pain incidence and pain management in a South African paediatric trauma unit, and to compare the usefulness of 5 different assessment tools. DESIGN: A prospective observational study, using the Numerical Rating Scale for pain (NRS pain), Numerical Rating Scale for anxiety (NRS anxiety), the Alder Hey Triage Pain Score (AHTPS), the COMFORT behaviour scale and the Touch Visual Pain Scale (TVPS). All patients were assessed at admission; those who were hospitalised were again assessed every 3 hours until discharge. RESULTS: A total of 165 patients, with a mean age of 5.3 years (range 0 - 13), were included. NRS scores were indicative of moderate to severe pain in 13.3% of the patients, and no pain in 24% at admission. Two-thirds of the patients received no analgesics; for them, NRS pain, AHTPS and TVP scores were lower than the scores for the other children. CONCLUSION: Pain and anxiety incidences in this paediatric trauma unit are relatively low. Implementation of a standard pain assessment tool in the emergency department triage system can improve pain management. The AHTPS is the most promising for use in non-Western settings.
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    Profile of children with head injuries treated at the trauma unit of Red Cross War Memorial Children's Hospital
    (2004) Lalloo, R; Van As, A B
    Objective. To describe the profile of childhood head injury patients treated in a trauma unit. Design. A retrospective record-based study. Setting. The trauma unit of the Red Cross War Memorial Children’s Hospital. Subjects. Children (under 13 years of age) presenting with head injuries between January 1991 and December 2001. Results. Of the almost 94 000 records, more than one-third were children presenting with head injuries. Fifty-nine per cent were boys, with more than half the sample under 5 years of age. The majority of children presented with superficial lacerations and abrasions, mostly affecting the scalp and skull. Injuries were mainly caused by falls from a variety of heights, and traffic-related injuries. Almost twothirds of traffic-related injuries involved children as pedestrians being struck by a motor vehicle. More than 60% of injuries occurred in or around the child’s own home. Conclusions. Head injuries in children are a significant cause of morbidity. Prevention, especially in the home and on the streets, needs urgent attention.
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    Short emergency department length of stay attributed to full-body digital radiography - a review of 3 paediatric cases
    (2006) Koning, Lizanne; Douglas, Tania S; Pitcher, Richard; Van As, A B
    Multiple casualties strain the resources of emergency departments. Two polytraumatised patients arriving simultaneously can overwhelm a small community hospital, while the capacity of a large urban emergency department does not extend beyond the treatment of 3 - 4 severely injured patients at the same time using the routine trauma protocol.1 Emergency department overcrowding because of multiple casualties leads to increased length of stay and can have an adverse effect on patient outcome. Variations from the norm in trauma management, particularly during the initial assessment and resuscitation phase of care, during a multiple casualty incident, has been associated with 10% and 9% incidence of preventable morbidity and mortality, respectively.2 Inadequate evaluation may contribute to up to 30% of early deaths in children with polytrauma.3