Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea

( Maro Kim ),( Dongbum Suh ),( Jin Hee Lee ),( Hyuksool Kwon ),( Yujin Choi ),( Joo Jeong ),( Sola Kim ),( Soyun Hwang ),( Joong Wan Park ),( You Hwan Jo ) 대한외상학회 2022 大韓外傷學會誌 Vol.35 No.1

Purpose: The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR, 3.88; 95% confidence interval, 1.33-11.36) and operating an ePMD while intoxicated (AOR, 2.78; 95% confidence interval, 1.52-5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

Pain Passport as a tool to improve analgesic use in children with suspected fractures in emergency departments

Hwang, Soyun,Choi, Yoo Jin,Jung, Jae Yun,Choi, Yeongho,Ham, Eun Mi,Park, Joong Wan,Kwon, Hyuksool,Kim, Do Kyun,Kwak, Young Ho The Korean Pain Society 2020 The Korean Journal of Pain Vol.33 No.4

Background: In the emergency department (ED), adequate pain control is essential for managing patients; however, children with pain are known to receive less analgesia than adults with pain. We introduce the Pain Passport to improve pain management in paediatric patients with suspected fractures in the ED. Methods: This was a before-and-after study. We reviewed the medical records of paediatric patients who were primarily diagnosed with fractures from May to August 2015. After the introduction of the Pain Passport, eligible children were enrolled from May to August 2016. Demographics, analgesic administration rates, time intervals between ED arrival and analgesic administration, and satisfaction scores were obtained. We compared the analgesic prescription rate between the two periods using multiple logistic regression. Results: A total of 58 patients were analysed. The baseline characteristics of subjects during the two periods were not significantly different. Before the introduction of the Pain Passport, 9 children (31.0%) were given analgesics, while after the introduction of the Pain Passport, a significantly higher percentage of patients (24/29, 82.8%) were treated with analgesics (P < 0.001). The median administration times were 112 (interquartile range [IQR], 64-150) minutes in the pre-intervention period and 24 (IQR, 20-74) minutes in the post-intervention period. The median satisfaction score for the post-intervention period was 4 (IQR, 3-5). The adjusted odds ratio for providing analgesics in the post-intervention period was 25.91 (95% confidence interval, 4.36-154.02). Conclusions: Patient-centred pain scoring with the Pain Passport improved pain management in patients with suspected fractures in the paediatric ED.

Efficacy of low-dose nebulized epinephrine as treatment for croup: A randomized, placebo-controlled, double-blind trial

Lee, Jin Hee,Jung, Jae Yun,Lee, Hyun Jung,Kim, Do Kyun,Kwak, Young Ho,Chang, Ikwan,Kwon, Hyuksool,Choi, Yoo Jin,Park, Joong Wan,Paek, So Hyun,Cho, Jun Hwi Elsevier 2019 The American journal of emergency medicine Vol.37 No.12

<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>Croup treatment usually involves a single dose of systemic dexamethasone combined with nebulized epinephrine. However, the optimal dose of <SMALL>L</SMALL>-epinephrine remains unclear. We examined whether a low dose (0.1 mg/kg) was inferior to the conventional dose (0.5 mg/kg) of 1:1000 nebulized <SMALL>L</SMALL>-epinephrine in patients with moderate to severe croup.</P> <P><B>Methods</B></P> <P>This randomized double-blind clinical non-inferiority trial was conducted in three pediatric emergency departments from May 2015 to October 2017. Children 6 months to 5 years old with moderate to severe croup (Westley scale scores 3–11) were eligible. Subjects were randomly assigned to the conventional dose (0.5 mg/kg: maximum 5 mg) or low dose (0.1 mg/kg; maximum 1 mg) group. All subjects received 0.6 mg/kg dexamethasone. Croup scores and other vital signs were measured before and at 30, 60, 90, and 120 min after nebulized <SMALL>L</SMALL>-epinephrine administration. The primary outcome was the change in croup score after 30 min.</P> <P><B>Results</B></P> <P>The final analysis included 84 patients. The groups did not differ significantly in terms of demographic parameters. At 30 min after treatment with nebulized <SMALL>L</SMALL>-epinephrine, the croup scores in both groups were significantly reduced from the baseline values (<I>p</I> < 0.05) and did not differ between the two groups (<I>p</I> = 0.42). Neither blood pressure nor heart rate differed between the two groups.</P> <P><B>Conclusions</B></P> <P>Low-dose 1:1000 <SMALL>L</SMALL>-epinephrine was not inferior in croup score reduction to the conventional dose in patients with moderate to severe croup.</P> <P>Clinical trial No: NCT01664507, KCT0002318.</P>

The Association Between Inter-Hospital Transfers and the Prognosis of Pediatric Injury in the Emergency Department

Jung Darjin,Jung Jin Hee,Kim Jin Hee,Jue Jie Hee,Park Joong Wan,Kim Do Kyun,Jung Jae Yun,Lee Eui Jun,Lee Jin Hee,Suh Dongbum,Kwon Hyuksool 대한의학회 2024 Journal of Korean medical science Vol.39 No.1

Background: Inter-hospital transfers of severely injured patients are inevitable due to limited resources. We investigated the association between inter-hospital transfer and the prognosis of pediatric injury using the Korean multi-institutional injury registry. Methods: This retrospective observational study was conducted from January 2013 to December 2017; data for hospitalized subjects aged < 18 years were extracted from the Emergency Department-based Injury in Depth Surveillance database, in which 22 hospitals are participating as of 2022. The survival rates of the direct transfer group and the interhospital transfer group were compared, and risk factors affecting 30-day mortality and 72- hour mortality were analyzed. Results: The total number of study subjects was 18,518, and the transfer rate between hospitals was 14.5%. The overall mortality rate was 2.3% (n = 422), the 72-hour mortality was 1.7% (n = 315) and the 30-day mortality rate was 2.2% (n = 407). The Kaplan-Meier survival curve revealed a lower survival rate in the inter-hospital transfer group than in the direct visit group (log-rank, P < 0.001). Cox proportional hazards regression analysis showed that interhospital transfer group had a higher 30-day mortality rate and 72-hour mortality (hazard ratio [HR], 1.681; 95% confidence interval [CI], 1.232–2.294 and HR, 1.951; 95% CI, 1.299–2.930) than direct visit group when adjusting for age, sex, injury severity, and head injury. Conclusion: Among the pediatric injured patients requiring hospitalization, inter-hospital transfer in the emergency department was associated with the 30-day mortality rate and 72- hour mortality rate in Korea.