Category: audit

Bronchiolitis and high-flow nasal prongs: audit

Thanks to Priya Shenton, Suzana Lazarovska, David Krieser and Bindu Bali for their work on this audit.




Key points:

  1. High-flow nasal cannulae have been proposed as an intervention that may supports inspiratory effort in bronchiolitis and may reduce the need for transfer to paediatric intensive care units
  2. This study did not show a reduction in transfer rate out of Sunshine hospital to the Royal Children’s hospital after the introduction of high-flow nasal cannula
  3. Reasons may include small sample size and staff unfamiliarity with a new intervention
  4. Further study is ongoing, with recruitment begun on a prospective randomized trial, managed by the Paediatric Research in Emergency Departments International Collaborative (PREDICT)

Tibial plateau fractures

Missed tibial plateau fractures - reg teaching Jan 17


Thanks Emily Hunter for this presentation.

Key points:

  1. Tibial plateau fractures can be subtle and actively searching for secondary signs of fracture on plain imaging is important
  2. Consider further imaging (eg CT knee or oblique views) if mechanism consistent or patient unable to weight bear
  3. Initial management is non weight bearing and zimmer splint with expedited orthopaedic follow up and imaging