Push scooter-related injuries in adults: an underestimated threat? Two decades analysed by an emergency department in the capital of Switzerland

BackgroundThe number of people conducting cycling and skating sports in Switzerland is rising; likewise, we notice an increase in patients visiting our emergency department for adults due to push scooter accidents. In 2001, our emergency department published the first article worldwide on push scooter-related injuries. Nearly two decades later, we want to review the interim period—collect data, compare it with other studies and evaluate the current impact of push scooter accidents in our adult patient population.ObjectiveTo investigate data on the incidence, severity, treatment and approximate costs of push scooter-related injuries in adults who presented to our emergency department from 2000 to 2017.Materials and methodsFor this descriptive retrospective study, data were collected in the Department of Emergency Medicine at Inselspital (University Hospital), Berne, Switzerland, from October 2000 to September 2017. We used two clinical reporting systems during that period: Qualicare from 2000 to April 2012 and Ecare from May 2012 to 2017.Results165 patients were included, aged 16–80 years. The accidents were mainly classified as unspecified falls in 139 cases (84.24%). 21 patients (12.73%) were wearing a helmet at the time of the accident, while the remaining 144 (87.27%) were not. The most common injuries suffered were fractures in 73 patients (44.24%). 92 patients (55.76%) sustained an impact to the head. The most common treatment was surgery in the operating theatre (59 patients, 35.76%). The mean total cost per case was SFr7566.65 (emergency room visit, hospital stay and outpatient controls for the initial case).ConclusionThe incidence of push scooter-related injuries in adults in our patient population is small but rising. Nevertheless, the resulting injuries are potentially life-threatening and can lead to persistent medical impairment.

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Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.207 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Poletto ◽

G Perri ◽

F Malacarne ◽

B Bianchet ◽

A Doimo ◽

...

Keyword(s):

Emergency Department ◽

Initial Phase ◽

Mainland China ◽

Hospital Setting ◽

Academic Hospital ◽

Significant Difference ◽

Before And After ◽

Life Threatening ◽

The Mean ◽

Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

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The nutritional status of nurses working shifts: A pilot study in Turkey

Revista de Nutrição ◽

10.1590/1678-98652016000400013 ◽

2016 ◽

Vol 29 (4) ◽

pp. 589-596 ◽

Cited By ~ 2

Author(s):

Semra NAVRUZ VARLI ◽

Saniye BILICI

Keyword(s):

Nutritional Status ◽

Night Shift ◽

Study Data ◽

University Hospital ◽

Control Group ◽

Study Group ◽

Food Services ◽

Food Record ◽

The Mean ◽

Female Nurses

ABSTRACT Objective: This study was carried out to determine the nutritional status of shift-working female nurses at a university hospital in Ankara, Turkey. Methods: A total of 110 volunteer female nurses (n=56 control group, n=54 study group) were included in the study. A questionnaire with a three day food record collected the study data. Results: The mean daily energy intake of the study group was higher than that of the control group (1756±659 kcal versus 1694±431 kcal, p>0.05). While the carbohydrate intake (196.3±85.5 g versus 185.9±54.7 g) and fat intake (79.5±29.5 g versus 77.1±22.6 g) were higher in the study group, the protein intake was higher in the control group (59.4±17.6 g versus 57.6±21.6 g). The mean iron intake was statistically higher in the control group (10.6±2.9 mg versus 10.0±4.0 mg, p<0.05). Conclusion: To improve night shift workers' performance and nutritional status it is important to provide accessible, healthy, and quality food services.

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A Double Triage and Telemedicine Protocol to Optimize Infection Control in an Emergency Department in Taiwan During the COVID-19 Pandemic: Retrospective Feasibility Study (Preprint)

10.2196/preprints.20586 ◽

2020 ◽

Author(s):

Chien-Hao Lin ◽

Wen-Pin Tseng ◽

Jhong-Lin Wu ◽

Joyce Tay ◽

Ming-Tai Cheng ◽

...

Keyword(s):

Emergency Department ◽

Infection Control ◽

Exposure Time ◽

University Hospital ◽

Conventional Group ◽

Patient Questionnaire ◽

Total Exposure ◽

Evaluation Time ◽

Total Exposure Time ◽

The Mean

BACKGROUND Frontline health care workers, including physicians, are at high risk of contracting coronavirus disease (COVID-19) owing to their exposure to patients suspected of having COVID-19. OBJECTIVE The aim of this study was to evaluate the benefits and feasibility of a double triage and telemedicine protocol in improving infection control in the emergency department (ED). METHODS In this retrospective study, we recruited patients aged ≥20 years referred to the ED of the National Taiwan University Hospital between March 1 and April 30, 2020. A double triage and telemedicine protocol was developed to triage suggested COVID-19 cases and minimize health workers’ exposure to this disease. We categorized patients attending video interviews into a telemedicine group and patients experiencing face-to-face interviews into a conventional group. A questionnaire was used to assess how patients perceived the quality of the interviews and their communication with physicians as well as perceptions of stress, discrimination, and privacy. Each question was evaluated using a 5-point Likert scale. Physicians’ total exposure time and total evaluation time were treated as primary outcomes, and the mean scores of the questions were treated as secondary outcomes. RESULTS The final sample included 198 patients, including 93 cases (47.0%) in the telemedicine group and 105 cases (53.0%) in the conventional group. The total exposure time in the telemedicine group was significantly shorter than that in the conventional group (4.7 minutes vs 8.9 minutes, P<.001), whereas the total evaluation time in the telemedicine group was significantly longer than that in the conventional group (12.2 minutes vs 8.9 minutes, P<.001). After controlling for potential confounders, the total exposure time in the telemedicine group was 4.6 minutes shorter than that in the conventional group (95% CI −5.7 to −3.5, P<.001), whereas the total evaluation time in the telemedicine group was 2.8 minutes longer than that in the conventional group (95% CI −1.6 to −4.0, P<.001). The mean scores of the patient questionnaire were high in both groups (4.5/5 to 4.7/5 points). CONCLUSIONS The implementation of the double triage and telemedicine protocol in the ED during the COVID-19 pandemic has high potential to improve infection control.

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Diagnosis and Treatment of Acute Gout at a University Hospital Emergency Department

The Open Rheumatology Journal ◽

10.2174/18743129014090100021 ◽

2015 ◽

Vol 9 (1) ◽

pp. 21-26 ◽

Cited By ~ 2

Author(s):

Naomi Schlesinger ◽

Diane C Radvanski ◽

Tina C Young ◽

Jonathan V McCoy ◽

Robert Eisenstein ◽

...

Keyword(s):

Emergency Department ◽

Retrospective Chart Review ◽

University Hospital ◽

Diagnosis And Treatment ◽

Acute Gout ◽

Inflammatory Drug ◽

Ed Visits ◽

Inflammatory Drugs ◽

The Mean ◽

Anti Inflammatory

Background : Acute gout attacks account for a substantial number of visits to the emergency department (ED). Our aim was to evaluate acute gout diagnosis and treatment at a University Hospital ED. Methods : Our study was a retrospective chart review of consecutive patients with a diagnosis of acute gout seen in the ED 1/01/2004 - 12/31/2010. We documented: demographics, clinical characteristics, medications given, diagnostic tests, consultations and whether patients were hospitalized. Descriptive and summary statistics were performed on all variables. Results : We found 541 unique ED visit records of patients whose discharge diagnosis was acute gout over a 7 year period. 0.13% of ED visits were due to acute gout. The mean patient age was 54; 79% were men. For 118 (22%) this was their first attack. Attack duration was ≤ 3 days in 75%. Lower extremity joints were most commonly affected. Arthrocentesis was performed in 42 (8%) of acute gout ED visits. During 355 (66%) of ED visits, medications were given in the ED and/or prescribed. An anti-inflammatory drug was given during the ED visit during 239 (44%) visits. Medications given during the ED visit included: NSAIDs: 198 (56%): opiates 190 (54%); colchicine 32 (9%) and prednisone 32 (9%). During 154 (28%) visits an anti-inflammatory drug was prescribed. Thirty two (6%) were given no medications during the ED visit nor did they receive a prescription. Acute gout rarely (5%) led to hospitalizations. Conclusion : The diagnosis of acute gout in the ED is commonly clinical and not crystal proven. Anti-inflammatory drugs are the mainstay of treatment in acute gout; yet, during more than 50% of ED visits, anti-inflammatory drugs were not given during the visit. Thus, improvement in the diagnosis and treatment of acute gout in the ED may be required.

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Impact of Age, Sex and Route of Administration on Adverse Events after Opioid Treatment in the Emergency Department: A Retrospective Study

Pain Research and Management ◽

10.1155/2015/316275 ◽

2015 ◽

Vol 20 (1) ◽

pp. 23-28 ◽

Cited By ~ 14

Author(s):

Raoul Daoust ◽

Jean Paquet ◽

Gilles Lavigne ◽

Éric Piette ◽

Jean-Marc Chauny

Keyword(s):

Emergency Department ◽

Adverse Events ◽

Respiration Rate ◽

Tertiary Care ◽

Route Of Administration ◽

Urban Hospital ◽

Opioid Administration ◽

Life Threatening ◽

The Mean ◽

The Impact

BACKGROUND: The efficacy of opioids for acute pain relief in the emergency department (ED) is well recognized, but treatment with opioids is associated with adverse events ranging from minor discomforts to life-threatening events.OBJECTIVE: To assess the impact of age, sex and route of administration on the incidence of adverse events due to opioid administration in the ED.METHODS: Real-time archived data were analyzed retrospectively in a tertiary care urban hospital. All consecutive patients (≥16 years of age) who were assigned to an ED bed and received an opioid between March 2008 and December 2012 were included. Adverse events were defined as: nausea/vomiting (minor); systolic blood pressure (SBP) < 90 mmHg, oxygen saturation (Sat) < 92% and respiration rate < 10 breaths/min (major) within 2 h of the first opioid doses.RESULTS: In the study period, 31,742 patients were treated with opioids. The mean (± SD) age was 55.8± 20.5 years, and 53% were female. The overall incidence of adverse events was 12.0% (95% CI 11.6% to 12.4%): 5.9% (95% CI 5.6% to 6.2%) experienced nausea/vomiting, 2.4% (95% CI 2.2% to 2.6%) SBP < 90 mmHg, 4.7% (95% CI 4.5% to 4.9%) Sat that dropped to < 92% and 0.09% respiration rate < 10 breaths/min. After controlling for confounding factors, these adverse events were associated with: female sex (more nausea/vomiting, more SBP < 90 mmHg, less Sat < 92%); age ≥65 years (less nausea/vomiting, more SBP < 90 mmHg, more Sat < 92%); and route of administration (intravenous > subcutaneous > oral).CONCLUSIONS: The incidence of adverse events associated with opioid administration in the ED is generally low and is associated with age, sex and route of administration.

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Clinical and epidemiological profile of patients with valvular heart disease admitted to the emergency department

Einstein (São Paulo) ◽

10.1590/s1679-45082014ao3025 ◽

2014 ◽

Vol 12 (2) ◽

pp. 154-158 ◽

Cited By ~ 1

Author(s):

Ricardo Casalino Sanches de Moraes ◽

Marcelo Katz ◽

Flávio Tarasoutchi

Keyword(s):

Emergency Department ◽

Heart Disease ◽

Valvular Heart Disease ◽

Descriptive Analysis ◽

Aortic Disease ◽

Left Ventricular ◽

Valve Disease ◽

University Hospital ◽

The Mean ◽

Epidemiological Profile

Objective To evaluate the clinical and epidemiological profile of patients with valvular heart disease who arrived decompensated at the emergency department of a university hospital in Brazil.Methods A descriptive analysis of clinical and echocardiographic data of 174 patients with severe valvular disease, who were clinically decompensated and went to the emergency department of a tertiary cardiology hospital, in the State of São Paulo, in 2009.Results The mean age of participants was 56±17 years and 54% were female. The main cause of valve disease was rheumatic in 60%, followed by 15% of degenerative aortic disease and mitral valve prolapse in 13%. Mitral regurgitation (27.5%) was the most common isolated valve disease, followed by aortic stenosis (23%), aortic regurgitation (13%) and mitral stenosis (11%). In echocardiographic data, the mean left atrial diameter was 48±12mm, 38±12mm for the left ventricular systolic diameter, and 54±12mm for the diastolic diameter; the mean ejection fraction was 56±13%, and the mean pulmonary artery pressure was 53±16mmHg. Approximately half of patients (44%) presented atrial fibrillation, and over one third of them (37%) had already undergone another cardiac surgery. Conclusion: Despite increased comorbidities and age-dependent risk factors commonly described in patients with valvular heart disease, the clinical profile of patients arriving at the emergency department represented a cohort of rheumatic patients in more advanced stages of disease. These patients require priority care in high complexity specialized hospitals.

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Evolution over 11 years of the characteristics of walk-in patients at the emergency department of a university hospital in Brussels

Journal of Medicine and Life ◽

10.25122/jml-2018-0053 ◽

2019 ◽

Vol 12 (1) ◽

pp. 34-42 ◽

Cited By ~ 1

Author(s):

Merita Hysenbegasi ◽

◽

Ives Hubloue ◽

Rita Vanobberghen ◽

Jan Kartounian ◽

...

Keyword(s):

Emergency Department ◽

Family Physician ◽

University Hospital ◽

The Mean ◽

The University ◽

Standing Problem ◽

Over Time

Walk-in patients who do not require urgent treatment at an emergency department (ED) are a known and long-standing problem. This study aims to investigate the characteristics of walk-in patients visiting the ED over time. During four days in June 2012, all walk-in patients attending the ED of the University Hospital Brussels between 8 AM and 11 PM were recorded. A similar registration took place in the same ED in June 2001. Patients completed a questionnaire about their characteristics and the reason for the encounter. Data of both study periods were compared. The mean age of the patients attending the ED was significantly lower in 2001 (40.9 years) than in 2012 (43.9 years) (p=0,02). In 2001, 81% of the participants had Belgian nationality, but in 2012 this proportion increased to 90% (p=0.008). In 2001 as well as in 2012, 21% of the participants had a referral from their family physician (FP) (p=0.9). The proportion of patients that were aware that FP could also handle some emergencies increased from 17% in 2001 to 29% in 2012 (p=0.003). More patients had complaints that begun less than 24h before they attended the ED (48% in 2001 and 58% in 2012) (p=0.03). The walk-in patients at the ED are getting slightly older and are attending the ED faster after the onset of the complaints. More patients judge their complaints as urgent. However, more patients are getting aware that FP also could handle some emergencies.

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Acute poisoning cases admitted to a university hospital emergency department in Diyarbakir, Turkey

Human & Experimental Toxicology ◽

10.1191/0960327105ht499oa ◽

2005 ◽

Vol 24 (2) ◽

pp. 49-54 ◽

Cited By ~ 23

Author(s):

Cahfer Güloglu ◽

Ismail Hamdi Kara

Keyword(s):

Emergency Department ◽

Suicide Attempts ◽

Biological Effects ◽

Acute Poisoning ◽

University Hospital ◽

Accidental Poisoning ◽

Pesticide Poisoning ◽

Monthly Basis ◽

Ed Visits ◽

The Mean

Aim: This study was conducted to determine the biological effects of acute poisoning, the nature of agents involved and the pattern of poisoning in Diyarbakir City, in the Southeast Anatolian region of Turkey, during 2000. Method: Hospital records of all admissions to the Emergency Department (ED) of Dicle University Hospital following acute poisoning were revised and all data from January to December 2000 were analysed. The present study included 44 (25.9%) male (M) and 126 (74.1%) female (F), a total of 170 patients. The M/F ratio was 1.0/3.5. Results: The mean age of patients was 23.39±6.3 years; 63 (37.1%) of them were under 20 years of age and 147 (86.5%) were under 30 years of age. Most intoxication cases occurred during the summer season (93 of 170 patients). On a monthly basis, admissions during April, May and July were most common (24, 26 and 30 patients, respectively). Sixty-two (36.5%) cases involved accidental poisoning while 108 (63.5%) involved deliberate poisoning. In suicide attempts, intoxications were more common in females (77 cases, 71.3%, P < 0.05), and in unmarried persons (74 cases, 68.5%, P < 0.05). There were only two deaths (1.2%) among the 170 admissions of acute poisonings. One of the deaths was due to pesticide poisoning and the other was due to medical drug abuse. Tachycardia (59, 34.7%), vomiting (55, 32.4%) and loss of consciousness (42, 24.7%) were frequently observed, whereas hypersecretion (15, 8.8%), bradycardia (5, 2.9%), convulsion (8, 4.7%) and hypertension (2, 1.2%) were less frequent. Among pesticide poisoning cases the incidence of convulsion (6, 10.2%), miosis (6, 10.2%), and hypersecretion (12, 20.3%) were significantly higher when compared to other cases (P–0.018, P B < 0.0001 and P B < 0.0001, respectively). Conclusion: In the Southeast Anatolian region of Turkey, pesticide intoxication is common especially among young, unmarried females and most of these intoxications are intentional self-poisonings. The annual rate of poisoning-related ED visits and mortality were found to be within expected ranges; psychoactive agents being the most common cause.

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Clinical Profile of Diabetic Ketoacidosis among Children in Eastern Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i4.21985 ◽

2019 ◽

Vol 15 (4) ◽

pp. 226-229

Author(s):

Dipak Muktan ◽

Lisa Tamang Ghising ◽

Rupa Rajbhandari Singh

Keyword(s):

Diabetic Ketoacidosis ◽

Pediatric Intensive Care ◽

Study Data ◽

Newly Diagnosed ◽

Duration Of Symptoms ◽

Life Threatening ◽

Awareness Programs ◽

The Mean ◽

Precipitating Factor

Background: Diabetic ketoacidosis (DKA) is a life threatening complication which is the most common reason for hospital admission in children with Type 1 Diabetes. This study was carried out to determine the clinical characteristics of children admitted with Diabetic Ketoacidosis. Methods: Descriptive retrospective study was conducted at B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. A total of 25 children of less than 20 years old diagnosed with Diabetic ketoacidosis who were admitted to the pediatric ward and pediatric intensive care unit from January 2013 to December 2017 were included in the study. Data were collected via hospital records of patients. Results: The mean age at presentation was 10.5 ± 4.5 years. Sixteen (64%) children were newly diagnosed as diabetes while, nine (36%) children were known cases of diabetes. The most common precipitating factor for DKA was omission of insulin 6 (24%). Twelve (48%) children had presented with severe DKA. Polyuria 23 (92%) was the commonest symptom followed by polydipsia 22 (88%), weight loss 17 (68%), abdominal pain 13 (52%), vomiting 13 (52%) and unconsciousness 8 (32%). The mean duration of symptoms before presentation was 11.3 ± 5.7 days. Mean HbA1c at presentation was 10.4 ± 2.2. Conclusion: Majority of the patients was newly diagnosed as diabetes who presented with Diabetic ketoacidosis. Omission of insulin was the main precipitating factor. Polyuria was the most common presenting symptom. Proper follow up care of diabetes and community awareness programs should be emphasized to reduce the incidence of Diabetic ketoacidosis.

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Analysis of mortality in the emergency department at a university hospital in Pleven

Journal of International Medical Research ◽

10.1177/0300060517707901 ◽

2017 ◽

Vol 45 (5) ◽

pp. 1553-1561 ◽

Cited By ~ 1

Author(s):

Petko Hristov Stefanovski ◽

Radev Vladimir Radkov ◽

Tsankov Lyubomir Ilkov ◽

Tonchev Pencho Tonchev ◽

Todorova Yoana Mladenova ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Acute Myocardial Infarction ◽

Emergency Department ◽

Terminally Ill ◽

University Hospital ◽

Age Group ◽

The Mean ◽

Demographic Patterns ◽

Oncological Pathology

Objective To identify the demographic patterns of mortality, the time spent before death in the emergency department (ED), and the causes of fatal outcomes. Methods We performed a 5-year (01/01/2011 to 01/01/2016) retrospective analysis of all non-traumatic deaths in the ED of the UMHAT – Pleven. To extract the necessary information, we used the registers in the ED until the patients’ death. Results Among 156,848 patients in the study period, 381 died and the mortality rate was 2.4/100000. The male:female ratio was 1.48:1. The 71–80 years age group was the most affected. The mean (SD) age of patients who died in the ED was 69.9 ± 8.4 years. Most non-traumatic deaths (222 cases) were due to cardiovascular disease. Most patients (70.9%) died within 2.3 h after arrival. The factors contributing to mortality included poverty, transporting the patient to hospital too late, and a lack of developed care centres for terminally ill patients. Conclusion Most patients die within approximately 2 h after arrival at the ED. The main cause of death is acute myocardial infarction. Pulmonary embolism remains unrecognized in most patients (69%). Oncological pathology is among the main causes (7.4%) of mortality.

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