Parental Acceptance Of Emergency Department Paediatric Forearm Manipulations In A UK District Hospital Emergency Department Based On The Swedish Pyramid Questionnaire

Description

The presentation conducted by Jacob Koris, a trauma and orthopedic Registrar in Thames Valley, focused on the acceptability of pediatric forearm manipulation in Accident & Emergency (A&E) departments. He outlined the background of their study, emphasizing the importance of following BOAST guidelines for the early management of pediatric forearm fractures, which advocate manipulating and casting children as a primary intervention in A&E.



Koris discussed a problem observed in their initial data collected through April 2021, where less than half of eligible patients received the necessary manipulation. He noted that factors such as logistical issues, clinician preferences, and parental choices often affected the manipulation rates, with feedback indicating that parents typically dislike this procedure.



Utilizing a validated Swedish Pyramid Questionnaire to assess parental acceptability after manipulation, Koris reviewed responses from 44 out of 77 parents invited, revealing a high satisfaction level (average of 9.4 out of 10) with the procedure, despite some expressed anxiety regarding their child's well-being. The study also led to a significant improvement in manipulation rates from less than 50% to 94% after sharing results with A&E, demonstrating the effectiveness of the questionnaire as a tool to address barriers.



Koris concluded by highlighting the advantages of implementing this intervention, not just for patients but for the hospital and healthcare system as well, and suggested future plans for further evaluation against children requiring surgical intervention.

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