In the pump group, median HbA1C in last 3, 6 & 12months in children on closed loop system were 55,54 and 54 and those on pump without closed loop system were 63, 59.5 and 67.Around 55.5% of children on MDI have normal BMI centiles(2 nd to 91 st centile) and 37% fall into overweight(91 st to 98 th centile) and obese category(greater than 98 th centile) compared to 77% in pump are normal BMI centiles and only 19.2% are overweight/obese.Looking at admissions to hospital in last 1 year with diabetic ketoacidosis, 2 children on MDI and 1 on pump were admitted. There were 8 admissions in MDI and 5 in pump group with high blood glucose and ketones. With regards to admission with hypoglycaemia, 1 in MDI and 5 admissions in pump, out of which 2 are hypoglycaemic seizures. The average length of stay in hospital was less than 72 hours in both groups but 4 children in MDI and 1 child on pump had between 4 to 7 days of hospital stay. Conclusion Our results reflects glycaemic control is better in children on pump compared to MDI. Better BMI control noted on children in pump in contrast to MDI could be a contributing factor for better HbA1c. In the pump group, median HbA1c was better in children on closed loop system. The incidence of hyperglycaemia and ketoacidosis are more in MDI group and hypoglycaemic episodes are more in children on pump.But we cannot oversee the fact that our audit had a small sample size with varying age groups which makes it hard to achieve accurate comparisons.We are planning on ongoing education including the families in consultation, primary care and schools for achieving better glycaemic control as per national standards and then reaudit in few months time.
Patients with injury severity score (ISS) of 8 and above were included in the review. Results A total of 227 records were identified, of these, 26.45% presented with major trauma (ISS>15). 177/227 (78%) of the cohort were aged 16-24 and managed by the adult trauma team while 50 (22%) were aged 10-15 years and managed by the paediatric team. Secondary transfers from trauma units accounted for 24.2% of cases. Weekly and monthly attendance trends are described in figure 1 and 2; These show that most patients above 16 years of age present with traumatic injuries between 22:00 and 8:00 with peaks in presentation in March and October. Between the age of 10 and 15 a daily peak was instead observed between 13:00 and 22:00. Isolated orthopaedic trauma and isolated head injuries were the most common diagnosis among the 10 to 15 age group, while polytrauma was encountered in almost 40% of presentations above 16 years of age. In the cohort examined, a total of 13 patients presented with stabbing injuries and these were mainly found in adolescents aged over 16 (84%). Mortality within 24 hours occurred in 3 patients aged respectively 11, 15 and 20. Among all patients, 19.38% where admitted in intensive care unit, with respectively 6.17% admission in paediatric intensive care and 13.21% admissions in general and neuro intensive care. Mean Inpatient stay for patients with ISS<9 was 5.5 days (±11.65) with similar figures for patients with moderate trauma (5.55 ±6.04 days), whereas, for patients with ISS>15 an average of 14.03 days (±18.23) was observed.
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