Browsing by Author "van Dijk, Monique"

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    An evaluation of nutritional practice in a paediatric burns unit
    (2010) Vijfhuize, Sanne; Verburg, Manon; Marino, Luise; van Dijk, Monique; Rode, Heinz
    Introduction. Burn injuries evoke a systemic metabolic response with profound effects on organ function, susceptibility to infection, wound healing, growth and development, and mortality. Children are especially vulnerable to nutritional deficiencies owing to their limited energy reserves. Methods. We evaluated the feeding practice in a paediatric burns unit. All children admitted to the unit were studied for a minimum of 3 consecutive days. Patients were divided into two groups: those with burns less than 20% (group 1) and burns ≥20% of total body surface area (TBSA) (group 2). Dietary prescriptions, intake, compliance with feeding practices, and the use of supplementary nutrition were assessed. Under-feeding and over-feeding were defined when there was a discrepancy between prescribed and actual food intake. Results. Forty children (mean age 5.8 years) were studied. They sustained between 2% and 55% TBSA burns. Inadequate caloric intake was seen in 19 of 29 patients and in 9 of 11 patients in groups 1 and 2, respectively. In contrast, excess protein supplementation was seen in 24 of 29 group 1 patients and 6 of 11 group 2 patients. The dietician’s food prescription was followed for 170 of 211 days; prescription compliance was correct in only 39 of 211 days. Conclusion. Adequate nutrition is essential for burns patients, but several factors can lead to either under- or over-feeding. A daily dietary consumption chart and evaluation of compliance are essential for each patient. There should be greater acceptability of tube enteral feeding.
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    Open Access
    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.