The American journal of emergency medicine
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Skateboarding and motorized boards are popular as a recreational activity and mode of transportation. Prior studies have investigated injury patterns from these activities in the pediatric population, but there is little data in the adult population. This study aims to investigate and compare the type and severity of injuries associated with skateboarding and motorized boards. ⋯ Our study shows a high prevalence of upper extremity injuries, regardless of board type. Motorized boards are associated with a higher risk of multiple fractures and hospital admission. Motorized boards likely have increased risk due to their ability to sustain elevated speeds.
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Various scoring systems are utilized to assess severe trauma patients, with one of the most commonly used tools being the International Classification of Diseases Injury Severity Score (ICISS) criteria derived from the Survival Risk Ratio (SRR) calculated using diagnostic codes. This study aimed to redefine the severe trauma scoring system in Korea based on the SRR for diagnostic codes, and subsequently evaluate its performance in predicting survival outcomes for trauma patients. ⋯ The newly developed ICISS-2020, utilizing a nationwide emergency patient database, demonstrated relatively good performance (accuracy, specificity, PPV, LR+, and AUROC) in predicting survival outcomes for patients with trauma.
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Acute pain management is a critical component of prehospital and emergency medical care. Opioids are effective; however, the risks and side-effects of opioids have led providers to use low-dose ketamine (LDK) for safe and effective treatment of acute pain. ⋯ LDK is a safe and effective option for acute pain treatment. It can be used as an alternative therapy to opioids or used in conjunction with them to reduce opioid exposure through its opioid-sparing effect. Importantly, LDK is available in a variety of formulations including intramuscular, intravenous, and intranasal, making it an effective acute pain treatment option in both the prehospital and ED settings. LDK holds promise as an emergency treatment in the evolving landscape of acute pain management.
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Multicenter Study
Factors influencing secondary overtriage in trauma patients undergoing interhospital transfer: A 10-year multi-center study in Hong Kong.
With the development of regionalised trauma networks, interhospital transfer of trauma patients is an inevitable component of the trauma system. However, unnecessary transfer is a common phenomenon, and it is not without risk and cost. A better understanding of secondary overtriage would enable emergency physicians to make better decisions about trauma transfers and allow guidelines to be developed to support this decision making. This study aimed to describe the pattern of secondary overtriage in Hong Kong and identify its associated factors. ⋯ Interhospital transfer is an essential component of the trauma system. However, over one-fifth of the transfers were considered unnecessary in Hong Kong, and this could be considered to be an inefficient use of resources as well as cause inconvenience to patients and their families. We have identified related factors including blunt trauma, AIS <3 scores for head or neck, thorax, abdomen and extremities, and opportunities to establish and improve on transfer protocols. Further research should be aimed to safely reduce interhospital transfers in the future to improve the efficiency of the Hong Kong trauma system.