TY - JOUR
T1 - Anxiety reaction in children during removal of their plaster cast with a saw
AU - Katz, K.
AU - Fogelman, R.
AU - Attias, J.
AU - Baron, E.
AU - Soudry, M.
PY - 2001
Y1 - 2001
N2 - We have had experience of an 18-month-old boy with a cardiomyopathy who died a few minutes after removal of his cast with a saw, apparently from a malignant cardiac arrhythmia triggered by anxiety. We therefore examined the anxiety reaction to this method of removal of a plaster cast in 20 healthy children; ten were provided with hearing protectors and ten were not. The level of anxiety was assessed by measuring the heart rate, a known physiological indicator of anxiety, before, during and five minutes after removal of the cast. The noise level was also measured. The results showed a mean increase in heart rate during the procedure of 27.9 beats per minute (bmp) (26.9%) in the children with no hearing protectors and 10.4 bmp (11.1%) in children who used hearing protectors (p<0.001). Five minutes after the procedure the heart rate had returned to the baseline rate in all patients. We recommend that hearing protectors should be used in children undergoing removal of a plaster cast to decrease the anxiety reaction. If possible, clinicians should avoid the use of a saw for this purpose in children with a cardiomyopathy.
AB - We have had experience of an 18-month-old boy with a cardiomyopathy who died a few minutes after removal of his cast with a saw, apparently from a malignant cardiac arrhythmia triggered by anxiety. We therefore examined the anxiety reaction to this method of removal of a plaster cast in 20 healthy children; ten were provided with hearing protectors and ten were not. The level of anxiety was assessed by measuring the heart rate, a known physiological indicator of anxiety, before, during and five minutes after removal of the cast. The noise level was also measured. The results showed a mean increase in heart rate during the procedure of 27.9 beats per minute (bmp) (26.9%) in the children with no hearing protectors and 10.4 bmp (11.1%) in children who used hearing protectors (p<0.001). Five minutes after the procedure the heart rate had returned to the baseline rate in all patients. We recommend that hearing protectors should be used in children undergoing removal of a plaster cast to decrease the anxiety reaction. If possible, clinicians should avoid the use of a saw for this purpose in children with a cardiomyopathy.
UR - http://www.scopus.com/inward/record.url?scp=0035028060&partnerID=8YFLogxK
U2 - 10.1302/0301-620X.83B3.10487
DO - 10.1302/0301-620X.83B3.10487
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AN - SCOPUS:0035028060
SN - 0301-620X
VL - 83
SP - 388
EP - 390
JO - Journal of Bone and Joint Surgery - Series B
JF - Journal of Bone and Joint Surgery - Series B
IS - 3
ER -