Guidelines for safe transportation of children in wheelchairs

Article Abstract:

Laws that have mandated the use of child safety restrains in cars have led to a decrease in injuries and deaths. Children with disabilities who are transported in wheelchairs would similarly benefit from wheelchair restraint devices. However, despite the increased transportation of disabled children that has occurred following passage of several laws, this safety issue has not been addressed. The methods by which 63 children were transported were investigated, and guidelines for their safe transportation were formulated. Children were observed at treatment programs and at a summer camp. Transportation safety was scored for chair position and use of restraint belts and wheel restraints. Of 50 children transported by agencies, all but 12 had a safety score of less than 2 out of a possible score of 6. Of 13 children transported by families, all but 1 scored less than 2. Only 11 were transported facing forward, 11 used chest and lap restraints, and only 3 wheelchairs used safe restraint systems. No mechanism existed for documenting transportation-related injuries. Health care professionals should begin to advocate safer transportation methods for disabled children, and professionals should collaborate with schools about this issue. Educational and financial aid for transporting disabled children would benefit the families of these children. Public statements by the American Academy of Pediatrics may influence public policy in this area, as it did for child safety restraints. (Consumer Summary produced by Reliance Medical Information, Inc.)

Safety and security measures, Disabled children, Transportation, Wheelchairs

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Hydrocele in Kawasaki disease: importance in early recognition of atypical disease

Article Abstract:

Most children who contract Kawasaki disease (KD) have persistent fevers and most of the following symptoms: reddened mouth, conjunctivitis, swelling, redness or peeling of the arms or legs, a trunk rash, and swelling of the lymph glands in the neck. The cause of the disease is unknown, and if recognized within 10 days, it is treated with gamma globulin and high doses of aspirin or other salicylates. A significant rate of cardiovascular complications is associated with untreated KD, including aneurysms (ballooning of arteries due to thinning of the vessel wall). Some children have atypical KD (AKD), in that many of the expected symptoms are not present. These children are reported to have a very high rate of coronary complications as well as high mortality. Diagnosis is difficult, leading to delayed therapy. Two cases of KD and three cases of AKD in which hydrocele (fluid accumulation within a sac in the scrotal area) occurred are described; hydrocele was apparent within the optimum treatment period. This is the first report of hydrocele in KD, although autopsies of infants with KD have reported a high rate of testicular or spermatic cord arteritis (inflammation of the artery), which may contribute to formation of the hydrocele. Further research of the reliability of this potential sign of KD is needed, but physicians should consider KD in infants with acute fevers and hydrocele. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Kawasaki disease, Kawasaki syndrome, Hydrocele

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