Saturday, January 18, 2014

Childhood Accidents - Prevention


DR.P.SELVARAJ ARTICLE ON PREVENTION OF CHILDHOOD ACCIDENT

Ref: - Child who fell in a hole, dug for deep bore well. This catostrophic issue must be give national importance. A national level expert committee to be set up to go into various aspects, specially medical treatment protocol to be observed by any one. Majority of recovered children will need the following:-
AIM:- To design a medical treatment protocol for children who fell inside bore well hole.
1.      Collect all medical data available for these cases that died and take retrospective medical analysis.
2.      Whole body skeletal X-Ray and CT brain for all cases for present and future assessment (some of them may need ventriculostomy).
3.      Rapid aggressive rehydration technique may be carefully employed.
4.      Pulse oxy meter will give a clue for oxygen requirement.
5.      Nil oral for 24hrs.
6.      Hyper baric oxygen and not conventional oxygen. Oxygen under pressure will enter into tissues more easily.
7.      Lytic cocktail therapy will improve the low blood pressure. This will also improve the hypothermia and shock syndrome.
8.      A small whole blood transfusion will help improve
a)      Tissue oxygen level
b)      Tissue iron level
c)      Increase blood pressure
d)      Improves defence mechanism
9.      A defibrillation equipments to deliver low joules of electricity, if child found in, near death state or if their hearts develop any arrhythmia problems or stops abruptly (cardiac, systole).
10.  A suitable engineering technology to pull the child if possible by visualising position of child like laparoscopic technology and see the child through monitor kept above. This will save time to meet medical emergency.
11.  Other supportive measures as per needs like A/C and warmer.

12.  Cryotherapy after consultation with surgeon anaesthetic.    

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