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Editor,—I write to point out an error in a recent paper by Poustie and colleagues.1 The authors state that there is no computer package available in the United Kingdom for calculating percentage weight for height (%WFH). This is incorrect, and for many years there has been available just such a package entitled W4H, under the copyright of Great Ormond Street Hospital for Children NHS Trust. The programme can be used with any version of Windows from 3.1 upwards, Excel, and on Psion hand held computers. The programme was produced by the Eating Disorders Research Team at Great Ormond Street and can be purchased from me at the address given below.
Answers to quiz on page 164.
- Adult respiratory distress syndrome and sand aspiration. The spirometry findings suggest air trapping by grains of sand, causing blockage of inspiration and expiration via a ball valve mechanism. 2. A CT scan of the lungs and a bronchoscopy, with diagnostic and therapeutic lavage. 3. Drowning and near drowning account for a significant morbidity and mortality in children, especially in seawater areas. The incidence of aspiration of mud, sand, and aquatic vegetation is less well known. A high index of suspicion is required as management may include diagnostic and therapeutic endobronchial/alveolar lavage. Initial clues to significant aspiration include increased peak airway pressures during mechanical ventilation and the appearance of a sand bronchogram on the x ray.
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