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Making physiotherapy more accessible
2 12
Injury,15, 2 12-2 1 3
Printed in Great Brjtajn
Abstracts BURNS Calorie
requirements
in burned children
This study evaluated the efficacy of a surface area formula in estimating the daily calorie requirements of 52 severely burned children. Calorie requirements were calculated according to a standard formula (1800 Kcal per square meter of body surface area per day plus 2200 Kcal per square meter of body surface area burned per day). Using the weight on the 14th day after the bum as a baseline the patients were divided into 2 groups. Patients in group 1 received the calories recommended by the formula and gained weight. Patients in group 2 failed to receive the number of calories recommended by the formula and lost weight. Hildreth M., Carvajal H. F. (1982) Calorie Requirements in Burned Children: A Simple Formula to Estimate Daily Calorie Requirements. Burn Cure 3, 78. Sepsis in paediatric
burn patients
This study came to the conclusion that the risk factors of sepsis were age, fluid resuscitation, and area of body burned. Over-resuscitation appeared to cause a high risk of sepsis and there was reduced risk in children aged 5-9 years as compared to those aged O-4 years. Increased area of bum showed increased probability of sepsis. Osboume R. H., BufIler P. A. and Traber D. L. (1982) Multiple Logistic Risk Function Probability Model for Predicting Sepsis in Paediatric Bum Patients. Burn Care 3, 85. Child abuse through
burning
Between 16-20 per cent of paediatric bum admissions are due to child abuse. The children are usually infants or toddlers with a mean age of 20 to 36 months. The mortality in abused children is higher than in accidental bums. If abused children are returned to their homes the likelihood of repeated injuries varies from 30 per cent to 70 per cent with a long-term mortality as high as 40 per cent. Deitch E. A. and Staats M. (1982) Child Abuse Through Burning. Burn Care 3, 89.
ORGANIZATION PREVENTION Making
TOPICS
physiotherapy
AND ACCIDENT
more accessible
Allowing general practitioners to send patients directly to physiotherapy departments reduced delays
without increasing loads. Consultants were able to spend more time on other tasks than confirming patients’ needs for treatment. Emphasis was placed on short courses of instruction and advice rather than long courses of treatment and practitioners acted accordingly. Ellman R., Adams S. M., Reardon J. A. and Curwen I. H. M. (1982) Making physiotherapy more accessible: open access for general practitioners to a physiotherapy department. Br. Med. J. 284, 1 173. BACTERIOLOGY Antimicrobial
AND
INFECTION
prescribing
The closing articles in this series deal with the last main group of antimicrobial agents for clinical use and sum up. In the words of Professor Geddes: ‘When contributors to this series have been specific about doses and duration of therapy, they were taking a necessary short-cut. In reality, to be effective and safe, antibiotic therapy must be tailored to the individual patient. There are no ‘standard’ regimens that can be followed blindly, even when the cause of infection is known’. He then goes on to indicate the reasons for individual attention and the ways in which this may best be achieved, but bearing in mind the need from time to time to rely, at least at first, on intelligent guesswork. His lists of first and second choices of drugs to be used contain a reassuring proportion of familiar names. Cohen J. and Geddes A. M. (1982) Good antimicrobial prescribing. Lancer 2, 532. Clinical
uses of penicillins
This article reviews the many conditions in which for all the increasing resistance of many organisms one or other of the penicillins is still effective. Ball A. P. (1982) The clinical uses of penicillins. Luncet 2, 196. THORACIC Hepatic
AND ABDOMINAL
INJURIES
resection
Seven patients were referred to the Hepatobiliary Unit at Hammersmith Hospital. Six of these had had previous operations and 4 had two laparotomies each before referral. They were all seriously ill as a result of bleeding or liver necrosis and infection. Further laparotomy was carried out to control the bleeding, for removal of dead tissue and drainage. Hepatic resection was performed in all patients and 3 of the 7 died after operation.
Injury,15, 2 12-2 1 3
Printed in Great Brjtajn
Abstracts BURNS Calorie
requirements
in burned children
This study evaluated the efficacy of a surface area formula in estimating the daily calorie requirements of 52 severely burned children. Calorie requirements were calculated according to a standard formula (1800 Kcal per square meter of body surface area per day plus 2200 Kcal per square meter of body surface area burned per day). Using the weight on the 14th day after the bum as a baseline the patients were divided into 2 groups. Patients in group 1 received the calories recommended by the formula and gained weight. Patients in group 2 failed to receive the number of calories recommended by the formula and lost weight. Hildreth M., Carvajal H. F. (1982) Calorie Requirements in Burned Children: A Simple Formula to Estimate Daily Calorie Requirements. Burn Cure 3, 78. Sepsis in paediatric
burn patients
This study came to the conclusion that the risk factors of sepsis were age, fluid resuscitation, and area of body burned. Over-resuscitation appeared to cause a high risk of sepsis and there was reduced risk in children aged 5-9 years as compared to those aged O-4 years. Increased area of bum showed increased probability of sepsis. Osboume R. H., BufIler P. A. and Traber D. L. (1982) Multiple Logistic Risk Function Probability Model for Predicting Sepsis in Paediatric Bum Patients. Burn Care 3, 85. Child abuse through
burning
Between 16-20 per cent of paediatric bum admissions are due to child abuse. The children are usually infants or toddlers with a mean age of 20 to 36 months. The mortality in abused children is higher than in accidental bums. If abused children are returned to their homes the likelihood of repeated injuries varies from 30 per cent to 70 per cent with a long-term mortality as high as 40 per cent. Deitch E. A. and Staats M. (1982) Child Abuse Through Burning. Burn Care 3, 89.
ORGANIZATION PREVENTION Making
TOPICS
physiotherapy
AND ACCIDENT
more accessible
Allowing general practitioners to send patients directly to physiotherapy departments reduced delays
without increasing loads. Consultants were able to spend more time on other tasks than confirming patients’ needs for treatment. Emphasis was placed on short courses of instruction and advice rather than long courses of treatment and practitioners acted accordingly. Ellman R., Adams S. M., Reardon J. A. and Curwen I. H. M. (1982) Making physiotherapy more accessible: open access for general practitioners to a physiotherapy department. Br. Med. J. 284, 1 173. BACTERIOLOGY Antimicrobial
AND
INFECTION
prescribing
The closing articles in this series deal with the last main group of antimicrobial agents for clinical use and sum up. In the words of Professor Geddes: ‘When contributors to this series have been specific about doses and duration of therapy, they were taking a necessary short-cut. In reality, to be effective and safe, antibiotic therapy must be tailored to the individual patient. There are no ‘standard’ regimens that can be followed blindly, even when the cause of infection is known’. He then goes on to indicate the reasons for individual attention and the ways in which this may best be achieved, but bearing in mind the need from time to time to rely, at least at first, on intelligent guesswork. His lists of first and second choices of drugs to be used contain a reassuring proportion of familiar names. Cohen J. and Geddes A. M. (1982) Good antimicrobial prescribing. Lancer 2, 532. Clinical
uses of penicillins
This article reviews the many conditions in which for all the increasing resistance of many organisms one or other of the penicillins is still effective. Ball A. P. (1982) The clinical uses of penicillins. Luncet 2, 196. THORACIC Hepatic
AND ABDOMINAL
INJURIES
resection
Seven patients were referred to the Hepatobiliary Unit at Hammersmith Hospital. Six of these had had previous operations and 4 had two laparotomies each before referral. They were all seriously ill as a result of bleeding or liver necrosis and infection. Further laparotomy was carried out to control the bleeding, for removal of dead tissue and drainage. Hepatic resection was performed in all patients and 3 of the 7 died after operation.