Poor compliance with child safety restraint use while travelling.

Road traffic accidents are a leading cause of death of children. It is the law that all children should be appropriately secured when traveling in vehicles. The aim of this study was to evaluate parental conformity with these regulations and to test if advice given at a Paediatric outpatient clinic could improve compliance. Two groups were assigned, an intervention group (parents given an information leaflet and a clear explanation about appropriate restraints for their children) and a non-intervention group (received no information). They were contacted again after 2 months and asked regarding compliance. A total of 394 children from 186 families were initially given the questionnaire. Nearly one third of children (29.2%) were not using any restraint while travelling rising to 35.3% on follow up. This study concluded that once off parental education made negligible difference to an already inconsistent and haphazard approach to compliance with safety regulations.

Provision of adolescent services by Irish paediatricians.

A postal questionnaire was undertaken to assess the current facilities available for adolescents in Irish hospitals. A previous survey showned that no facilities existed whereas this survey demonstrates some improvements but adolescents are still admitted to adult wards, have inappropriate waiting facilities at outpatients and a limited number of joint Paediatric-Adult clinics. The ability of paediatricians to assess risk taking behaviour and the provision of age appropriate information at ward and outpatient level was assessed. The results demonstrate there is need for improvement in all aspects of adolescent care in Irish hospital services. This needs to be addressed promptly as 66% of the paediatricians surveyed were considering the development adolescent services in their hospitals.

Straddle injuries--is current practice safe?

Genital injuries may be markers of sexual abuse and child protection issues should be considered when case present. This study evaluates the quality of history taking and the physical examination of children who present with straddle injuries to an accident and emergency department. A retrospective analysis of the accident and emergency case notes of children who presented over a 12-month period with straddle injuries was undertaken. A scoring system of risk factors was devised to help identify children at risk of sexual abuse and applied to the case notes. The results showed that the documentation of injuries was inadequate in the majority of cases, increasing the risk that cases of sexual abuse may be missed. Core questions which aid in the selection of children who require further evaluation have previously been identified. Utilizing the information from our findings we have devised a protocol for the assessment of children with straddle injuries which includes an action plan for the management of such cases.