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A team of doctors work round the clock at the Accident Service of the LRH, meeting the need for specialised treatment for children

Children are often at risk in a world that is designed for adults. They take chances, lack judgment and fall victim to the carelessness of grown-ups. When injured they require specialised treatment that takes their particular needs into consideration.

The Accident Service of the Lady Ridgeway Hospital for Children (LRH) is equipped for just such cases. On a typical day it handles a constant flow of children with all manner of injuries: falls, burns, poisoning, dog bites, road accidents and more commonly, accidents that happen at home.

“The injury pattern is different in children, and this should be taken into account during treatment,” says Dr. Chandima Suriyarachchi, Consultant Paediatric Surgeon at LRH. Since their bodies are still in the formation stage, thought should be given to the long term consequences, he says.

For example, he says, a cut should be sutured in a manner that causes minimal scarring so that the child won’t have to fear embarrassment or disfigurement which could have a psychological effect on him or her. For this, special tapes and glues are used in the case of minor cuts and larger wounds are sutured with stitches inside the skin that minimize scarring. Even in the case of fractures, the fracture pattern and method of treatment are different from that of an adult.

The Medical Staff at the LRH Accident Service have all been trained in paediatric care. Working round the clock, on average they handle over 85 admissions a day, most of who are discharged within 24 hours. Those requiring a longer stay are transferred to the wards of the relevant paediatric surgeon in charge of the Accident Ward on that day. The paediatric specialists at LRH include five General Surgeons, Orthopaedic Surgeons, Plastic Surgeons, Eye Surgeons, Cardiothoracic and ENT specialists.

An Outpatient Clinic treats minor injuries then and there, while there is also an Emergency Treatment Unit, an Observation Ward, a Mini Theatre, X-Ray facilities and a Pharmacy. However, the hospital lacks the facilities to treat severe head injuries, as there is no Paediatric Neurosurgeon or the facility to take emergency CT scans.

The most common type of injury the doctors encounter are from falls, says Dr. Suriyarachchi, and the second most common is poisoning. While toddlers in the age-group of one to five are more prone to accidents at home, older children are often brought in with injuries sustained in the playground or from road accidents.

Dr. Suriyarachchi attributes the rising number of children having home accidents to the negligence of their care-givers. With more parents being away from home, the increase in single parents, adolescent mothers and parents with drug and alcohol related problems, children are often left in the care of domestics who do not sometimes have the best interests of the child at heart, he says.

For very young children even a home could be a danger zone and nothing could substitute for the constant supervision of the child. He points out that a majority of home accidents could have been avoided.

Three-wheelers and motorcycles are a major cause of road accidents among young children, he adds. Children can easily tumble out of a three-wheeler and many parents neglect to get their child to wear a helmet before taking them on a motorcycle. Children also easily get their feet and ankles burned on motorcycles or caught between the spokes of the cycle’s wheel.

Such injuries are seen almost daily at the Accident Service. Dr. Suriyarachchi stresses the need for community awareness programmes to educate children as well as adults on safety methods as well as a need to implement stricter safety regulations for children who are pedestrians or passengers.