Common Accidents in Paediatric Practice; Current Evidence for a 4-Pronged Strategic Framework for Prevention
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Abstract
Accidents are inadvertent untoward events that lead to injuries or diseases. In the healthcare setting, both patients and healthcare workers are at risk of being victims. By virtue of children’s evolving developmental maturity, caring for them puts all parties more at risk. Having a comprehensive framework to prevent accidents in paediatric practice is therefore crucial.
This paper aims to utilize the primordial, primary, secondary and tertiary levels of prevention to detail the strategies for preventing needle stick injury, exposure to blood-borne infections, post-injection traumatic neuropathy, post injection abscess, Nicolau syndrome, fluid overload, and drug overdose in paediatric healthcare settings.
Preventing the selected injuries and disorders involves a multidisciplinary team of paediatricians, paediatric surgeons, orthopaedic surgeons, burns and plastic surgeons, neurosurgeons, toxicologists, pharmacists, microbiologists, infectious disease physicians, anaesthetists, and public health physicians.
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References
I. Bonilla-Escobar FJ, Gutiérrez MI. Injuries are not accidents: Towards a culture of prevention. Vol. 45, Colombia Medica. 2014.
II. Katz D, Elmore J, Wild D, Lucan S. Jekel’s Epidemiology, Biostatistics, Preventive Medicine, and Public Health. 4th ed. Philadelphia: Saunders, Elsevier; 2014. 173–180 p.
III. Caplan G. Principles of preventive psychiatry. 1964;
IV. Nte A, Yaguo-Ide L. Preventive Paediatrics. In: Azubuike JC, Nkanginieme KEO, Ezechukwu C, Nte AR, Adedoyin OT, editors. Paediatrics and Child Health in a Tropical Region. 3rd ed. Lagos: Educational Printing and Publishing; 2016. p. 73–92.
V. Gillman MW. Primordial prevention of cardiovascular disease. Vol. 131, Circulation. Am Heart Assoc; 2015. p. 599–601.
VI. Offord DR. Selection of levels of prevention. Addictive behaviors. 2000;25(6):833–42.
VII. Boyce JM, Pittet D. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infection Control & Hospital Epidemiology. 2002;23(S12):S3–40.
VIII. Panlilio AL, Cardo DM, Grohskopf LA, Heneine W, Ross CS. Updated US Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. Morbidity and Mortality Weekly Report: Recommendations and Reports. 2005;54(9):1-CE.
IX. WHO. Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents and children: recommendations for a public health approach. World Health Organization; 2014.
X. Schillie SF, Murphy T v, Sawyer M, Ly K, Hughes E, Jiles R, et al. CDC guidance for evaluating health-care personnel for hepatitis B virus protection and for administering postexposure management. 2013;
XI. Moorman AC, de Perio MA, Goldschmidt R, Chu C, Kuhar D, Henderson DK, et al. Testing and Clinical Management of Health Care Personnel Potentially Exposed to Hepatitis C Virus — CDC Guidance, United States, 2020 [Internet]. Morbidity and Mortality Weekly Report: Recommendations and Reports. 2020 [cited 2022 Aug 1]. Available from: https://www.cdc.gov/mmwr/volumes/69/rr/rr6906a1.htm?s_cid=rr6906a1_w
XII. Barron C, Cocoman A. Administering intramuscular injections to children: what does the evidence say? Journal of Children’s and Young People’s Nursing. 2008;2(3):138–44.
XIII. CDC. Vaccine Administration: Needle Gauge and Length [Internet]. Vaccine Recommendations and Guidelines of the ACIP. 2022 [cited 2022 Aug 1]. Available from: https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/administration.html
XIV. van Mulder TJS, van Nuffel D, Demolder M, de Meyer G, Moens S, Beyers KCL, et al. Skin thickness measurements for optimal intradermal injections in children. Vaccine. 2020;38(4):763–8.
XV. Hiraishi Y, Nandakumar S, Choi SO, Lee JW, Kim YC, Posey JE, et al. Bacillus Calmette-Guerin vaccination using a microneedle patch. Vaccine. 2011;29(14):2626–36.
XVI. Jung Kim H, Hyun Park S. Sciatic nerve injection injury. Journal of International Medical Research. 2014;42(4):887–97.
XVII. Alonge IAO, Akinwola MO. Post-injection sciatic neuropathy: a five-year review of cases managed in a paediatric hospital in Ibadan, Nigeria. African Journal of Physiotherapy and Rehabilitation Sciences. 2010;2(1):10–3.
XVIII. Arslan GG, Özden D. Creating a change in the use of ventrogluteal site for intramuscular injection. Patient Prefer Adherence. 2018;12:1749.
XIX. Mishra P, Stringer MD. Sciatic nerve injury from intramuscular injection: a persistent and global problem. Int J Clin Pract. 2010;64(11):1573–9.
XX. Hawkridge A, Hatherill M, Little F, Goetz MA, Barker L, Mahomed H, et al. Efficacy of percutaneous versus intradermal BCG in the prevention of tuberculosis in South African infants: randomised trial. Bmj. 2008;337.
XXI. Chiannilkulchai N, Kejkornkaew S. Safety concerns with glass particle contamination: improving the standard guidelines for preparing medication injections. International Journal for Quality in Health Care. 2021;33(2):mzab091.
XXII. Urakova N, Urakov A. Osmotic Activity of Drugs is an Important Factor of Their Local Action at the Injection Site: What We Don’t Use to Prevent Post-Injection Abscesses. Journal of Pharmaceutical Research International. 2021;647–50.
XXIII. James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Contact Dermatitis and Drug Eruptions . 13th ed. Elsevier; 2020. 92–139 p.
XXIV. Senel E. Nicolau syndrome as an avoidable complication. Vol. 19, Journal of Family and Community Medicine. 2012.
XXV. Gutierrez JJP, Munakomi S. Intramuscular Injection. StatPearls [Internet]. 2022.
XXVI. Kim HJ, Park SK, Park SH. Upper limb nerve injuries caused by intramuscular injection or routine venipuncture. Anesthesia and Pain Medicine. 2017;12(2):103–10.
XXVII. Keskinbora K, Aydinli I. Treatment of neuropathic pain due to sciatic nerve injury following intramuscular injection with gabapentine in a child. Pediatric Anesthesia. 2008;18(11):1134–5.
XXVIII. Jam TE, Nejad RM, Farooqi MSD, Rahimi R, Mousavi SM. Nicolau syndrome following the injection of Pentavalent vaccine: A case report. Tehran University Medical Journal. 2021;79(7).
XXIX. Şenel E, Ada S, Güleç AT, Çaǧlar B. Nicolau syndrome aggravated by cold application after i.m. diclofenac. Journal of Dermatology. 2008;35(1).
XXX. Villarejo FJ, Pascual AM. Injection injury of the sciatic nerve (370 cases). Child’s nervous system. 1993;9(4):229–32.
XXXI. Şencan S, Cüce İ, Gündüz OH. Use of fluoroscopic-guided transsacral block for the treatment of iatrogenic post-injection sciatic neuropathy: Report of three cases. Turk J Phys Med Rehabil. 2019;65(4):406.
XXXII. Villanueva P, Pittet LF, Curtis N. Management of Bacille Calmette-Guérin lymphadenitis and abscess in immunocompetent children: a systematic review. The Pediatric Infectious Disease Journal. 2021;40(11):1037–45.
XXXIII. Jahan T, Nehvi N, Farooq S. Post-vaccination Tubercular Cold Abscess of Thigh of An Infant. Journal of Microbiology and Infectious Diseases. 2020;10(04):234–6.
XXXIV. Mishra D, Mohta A, Arora P. Cold abscess of the thigh in an infant. Kathmandu University Medical Journal. 2013;11(1):86–7.
XXXV. Sedighi P, Sadrosadat ST, Movahedi M, Sedighi I. BCG‐Induced cold abscess as a complication of inadvertent vaccine injection: A case series. Clinical Case Reports. 2022;10(4):e05711.
XXXVI. Nischal K, Basavaraj H, Swaroop M, Agrawal D, Sathyanarayana B, Umashankar N. Nicolau syndrome: An iatrogenic cutaneous necrosis. Journal of Cutaneous and Aesthetic Surgery. 2009;2(2).
XXXVII. Ocak S, Ekici B, Çam H, Taştan Y. Nicolau syndrome after intramuscular benzathine penicillin treatment. Pediatric Infectious Disease Journal. 2006;25(8).
XXXVIII. Maitland K, Kiguli S, Opoka R. Mortality after fluid bolus in African children with severe infection. … England Journal of … [Internet]. 2011 [cited 2016 Feb 9]; Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa1101549
XXXIX. Edelson JB, Orenstein EW, Zaoutis LB, Copelovitch L. Intravenous Fluid Management in the Pediatric Hospital Setting: Is Isotonic Fluid the Right Approach for all Patients? Current Treatment Options in Pediatrics. 2015;1(1).
XL. Lopes CLS, Piva JP. Fluid overload in children undergoing mechanical ventilation. Vol. 29, Revista Brasileira de Terapia Intensiva. 2017.
XLI. Bhandari DB, Mahalle AR, Premendran BJ, Dhande PS. Malfunctioning Pediatric infusion set leading to accidental fluid overload and pulmonary edema. Vol. 30, Journal of Anaesthesiology Clinical Pharmacology. 2014.
XLII. Claure-Del Granado R, Mehta RL. Fluid overload in the ICU: Evaluation and management. Vol. 17, BMC Nephrology. 2016.
XLIII. Hayes W, Paglialonga F. Assessment and management of fluid overload in children on dialysis. Pediatric Nephrology. 2019;34(2).
XLIV. Raina R, Sethi SK, Wadhwani N, Vemuganti M, Krishnappa V, Bansal SB. Fluid overload in critically ill children. Vol. 6, Frontiers in Pediatrics. 2018.
XLV. Allinovi M, Saleem M, Romagnani P, Nazerian P, Hayes W. Lung ultrasound: A novel technique for detecting fluid overload in children on dialysis. Nephrology Dialysis Transplantation. 2017;32(3).
XLVI. Anderson M, Dawson E. Accidents and poisoning. In: Lissauer T, Carroll W, Dinwiddie R, Hall M, editors. The Science of Paediatrics MRCPCH Mastercourse. Edinburgh: Elsevier; 2017. p. 101–17.
XLVII. Proudfoot AT, Krenzelok EP, Vale JA. Position Paper on Urine Alkalinization. Vol. 42, Journal of Toxicology - Clinical Toxicology. 2004.
XLVIII. Ghannoum M, Roberts DM, Bouchard Josee. Enhanced Elimination of Poisons . In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal M, editors. Brenner & Rector’s The Kidney. 4th ed. Elsevier; 2020. p. 2148–73.
XLIX. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, et al. 2020 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021;59(12).
L. Ouellet G, Bouchard J, Ghannoum M, Decker BS. Available extracorporeal treatments for poisoning: Overview and limitations. Seminars in Dialysis. 2014;27(4).
LI. Dişel NR, Akpinar AA, Sebe A, Karakoç E, Sürer S, Turhan FT, et al. Therapeutic plasma exchange in poisoning: 8 years’ experience of a university hospital. American Journal of Emergency Medicine. 2015;33(10).