Friday 24 January 2020

Children at risk from outdated medical procedure, doctors warn

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Eilish O'Regan

Eilish O'Regan

Children who need biopsies to find out if they have cancer or tubes inserted to help them breathe are being put under unnecessary risk, doctors have warned.

Dr John Donnellan, a paediatric radiologist in Temple St Hospital said the failure to hire specialists with the necessary expertise means these children are having to undergo a general anaesthetic instead of a local anaesthetic.

Children who are subjected to recurrent general anaesthetics are at risk of developmental disorders.

An interventional radiologist could carry out this work using a local anaesthetic but there are none of these specialists employed in children's hospitals.

In the case of children a surgeon is involved and it is a much bigger procedure, taking a few days to organise, he told the annual conference of the Irish Medical Organisation in Sligo.

In contrast, there are 58 interventional radiologists employed in adult public hospitals.

It means adult patients can have a minimally invasive local anaesthetic as part of a day procedure.

"If you are an adult in Ireland and you need a biopsy or central line placed it is a twenty minute procedure. It has a very low complication rate.

"If you are a child  and you need the same procedure you need a general anaesthetic with all the complications that arise.

"Developmental delay has been linked with multiple general anaesthetics in children. There is undeniable risk to children getting recurrent general anaesthetics," he added.

"Apart from the developmental delay a child who gets a tube placed so they can breath risks aspiration.

"All of these procedures can be performed under local anaesthetic or light sedation with image guidance.

"You have to make a two centimetre cut in the child's neck to lift up a vein. A paediatric interventional radiologist can do that with no scalpel.

"There is no potentially disfiguring wound in the child.

"These children can range in age from 24 hours of age up to 16 years in the Irish setting.

"We may be trying to diagnose solid organ tumours like kidney cancer, liver cancer or the child may have developmental delay or neurological problems.

"They could be children with swallowing problems or spina bifida or cerebral palsy."

Dr Donnellan said a local anaesthetic is performed on an ad hoc basis on some children by one or two of the radiologists working in the children's hospitals who have training.

"There is cohort of people trained and we should not be denying this to the children of Ireland."

Meanwhile,the conference was told that some parents are now objecting to having their daughter receive the vaccine to protect against cervical cancer in school because of unfounded "scare stories" about its side effects.

Dr Ann Moran, a public health doctor in the mid-west said they recently received a "fair few phonecalls” asking that their daughters not be given the second dose of the human papilloma virus (HPV) vaccine.

“These are girls who received the first dose last September and who are now due the second dose. There has been about a 10pc drop off at two large schools in the Midwest,” she told the annual meeting of the Irish Medical Organisation (IMO) in Sligo.

The fear was linked mostly to a television programme which examined side effects which some parents were attributing to the vaccine including a form of chronic fatigue syndrome.

An expert group set up the European Medicines Agency has dismissed any such link.

Dr Ilona Duffy, a GP in Monaghan said the risks of " scaremongering" in relation to vaccines had already been seen in previously in unfounded fears over the Measles, Mumps and Rubella (MMR) vaccine, which had wrongly linked it to autism.

“We know this vaccine (HPV) works, the international evidence is there. We need a strong, loud message to tell people this is a safe vaccine,” she said.

Dr John Duddy, incoming IMO president said peoples’ fears were “based on ignorance and lack of knowledge”. Children who need biopsies to find out if they have cancer or tubes inserted to help them breathe are being put under unnecessary risk, it was claimed yesterday.

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