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Introduction: Trauma is a major and increasing global health concern in the recent world is now the leading cause of death among people less than 18 years old. Methods: This is a retrospective cross sectional study done in Emergency Department of B.P.Koirala Institute of Health Sciences. Patients aged less than 16 years were included with history of Trauma from January 1st 2013 to 31st December 2013.The details of patient were taken from computerized medical records of the hospital. The data Demographic data, Pattern of injury, Mode of injury, Diagnosis and outcomes were tabulated in Microsoft excel. Results: Total 3958 pediatrics patient were enrolled in this study. Male: Female=3.6:1,Mean age 9.6±3.2 years, fall injury & RTAs common modes and fractures of limbs, soft tissue injuries and cut injuries were common patterns. Conclusions: Injury is a serious problem for children in Low Income countries like Nepal.

BACKGROUNDEmergency Medical Care in Nepal is gradually improving with an increase in dedicated emergency departments with skilled manpower and availability of equipment, mostly in medical colleges and secondary to tertiary care centres.

Patients triaged as ATS 2 were seen in a timely fashion. Seriously ill patients requiring resuscitation present commonly to this ED. This is a big challenge for junior doctors. Improved training, treatment protocols and equipment are needed to help manage this burden.

Introduction: Pain is a common presentation to the emergency department but often overlooked with little research done on the topic in Nepal. We did an observational retrospective study on 301 patients in the emergency ward of BP Koirala Institute of Health Sciences with the objective of finding the practice of analgesia. The specific focus was on the time to analgesia, drugs for analgesia and method of pain assessment. Methods: Case file analysis of patients discharged home after presenting with pain was performed. Time to analgesia and other factors were analyzed with descriptive statistics. Results: Diclofenac injection intramuscular (80%) was the commonest analgesic used. Assessment methods and record keeping were poor. Pain in the abdomen was the commonest. The median time to analgesia from triage was 45 minutes (IQR 30 to 80) and the median time to analgesia from doctor evaluation was 40 minutes (IQR 20 to 70). Conclusions: Time to analgesia from triage and doctors assessment in our set up is comparable to others. The quality of documentation is poor. Problems with pain identification and assessment may lead to inadequate analgesia so reinforcing the use of pain descriptor at triage itself with pain score would be helpful in adopting a protocol based management of pain. Keywords: analgesia; emergency; Nepal.