BOAST Compliance Audit: Paediatric Forearm Fractures in the Emergency Department
Background
Why this project was needed
Angulated forearm fractures in skeletally immature children require timely assessment and definitive manipulation under appropriate analgesia and sedation. The British Orthopaedic Association Standards for Trauma (BOAST) set out clear requirements for neurovascular assessment, analgesia administration, consent and imaging. Compliance with these standards at St Thomas' Emergency Department had not been formally audited.
Aims
What the project set out to achieve
To audit compliance with BOAST standards for the management of paediatric angulated forearm fractures presenting to St Thomas' Emergency Department.
Objectives
Specific measurable steps
- Identify all skeletally immature patients presenting with angulated forearm fractures between September and October 2022.
- Assess documentation of neurovascular status (radial pulse, CRT, nerve function) at presentation.
- Audit pain score recording and adequacy of analgesia.
- Review availability of orthogonal X-rays and consent documentation prior to manipulation.
Discussion
Community experience and questions
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