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Legal Issues in Adolescents

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Dr Himabindu Singh, Hyderabad    15 January 2018

  1. The rate of crime amongst youth has increased to 40% and almost 56% of the crimes are done by youngsters in the age group 16-25 years.
  2. Creating awareness on medicolegal issues by parents, teachers and stake holders is important since it impacts the lives of adolescents.
  3. Knowledge about POCSO Act, Juvenile Justice Act, legal age of marriage and consent for sex, Narcotic drugs and Psychotropic Substances Act, Child Labour Act, Laws regarding pornography, Motor Vehicle Act, media literacy, etc., among adolescents needs to be enhanced.
  4. Teaching adolescents self discipline is the way out.
  5. Good communication between parents and children helps develop a nurturing environment, helps in sharing concerns, gives scope for guidance and nonintrusive supervision.
  6. Monitoring their digital activities, peer groups and early detection of deviation which is likely to become a legal issue should be taken up by gatekeepers of adolescent health.
  7. Enhancing life skills is protective and avoids conflict with law.

Workshop on Modes of NIV

  1. There are several modes of noninvasive ventilation depending upon the machine that is used.
  2. Commonly used modes in NIV:
  1. HFNC: High Flow Nasal Cannula Oxygen Therapy
  2. CPAP: Continuous Positive Airway Pressure
  3. S MODE: Spontaneous Mode
  4. ST MODE: Spontaneous Timed Mode
  5. PCV: Pressure Control Ventilation
  6. AVAPS/IVAPS: Average Volume Assured Pressure Support
  7. NAVA MODE: Neurally Adjusted Ventilatory Assist Mode.

3.   Three main variables define the modes:

  1. Trigger – what initiates the breath
  2. Limit – that which terminates inspiration
  3. Cycle – that which switches from inspiration to expiration.

4.    Choice of NIV Modes depending upon the type of pathology:

Pathology causing respiratory failurePreferred mode/suitable mode
Acute respiratory failureCPAP/S/ST/PCV
Cardiogenic pulmonary edemaCPAP/ST
OSACPAP/ST
Restrictive lungST/AVAPS
Obstructive lung diseaseST/AVAPS

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