Feel the Burn! Fireworks-related Otolaryngologic Trauma

2021 ◽  
pp. 000348942110081
Author(s):  
Alexander J. Straughan ◽  
Luke J. Pasick ◽  
Vrinda Gupta ◽  
Daniel A. Benito ◽  
Joseph F. Goodman ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Penetrating Trauma ◽  
The United States ◽  
Neck Injuries ◽  
Chi Square ◽  
Injury Surveillance System ◽  
Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

Nonfatal All-Terrain Vehicle–Related Head and Neck Injuries to Children Treated in US Emergency Departments

2020 ◽  
Vol 59 (13) ◽  
pp. 1141-1149
Author(s):  
Daniel Li ◽  
Kris R. Jatana ◽  
Sandhya Kistamgari ◽  
Gary A. Smith
Keyword(s):  
Head And Neck ◽  
Emergency Departments ◽  
Surveillance System ◽  
Emergency Treatment ◽  
Closed Head Injury ◽  
Neck Injuries ◽  
Medical Outcomes ◽  
Injury Surveillance System ◽  
Injury Mechanisms ◽  
Closed Head

This study investigates children <18 years old with nonfatal all-terrain vehicle (ATV)–related head and neck injuries treated in United States emergency departments by analyzing data from the National Electronic Injury Surveillance System from 1990 to 2014. An estimated 279 391 children received emergency treatment during the 25-year study period. The number of injuries remained relatively constant from 1990 to 1997, increased by 142.9% from 1997 to 2007, and then decreased by 37.4% from 2007 to 2014. The most common diagnoses were concussion/closed head injury (32.6%) and fracture (32.6%); 15.4% of children were admitted. The most common injury mechanisms include ejection (30.0%), crash (18.8%), and rollover (15.8%). Patients who were injured on a street/highway were 1.49 times (95% confidence interval = 1.11-1.99) more likely to be admitted than patients injured at other locations. Although the number of nonfatal ATV–related head and neck injuries decreased during the latter part of the study period, they remain common and can have serious medical outcomes.

Pediatric Cheerleading Injuries Treated in Emergency Departments in the United States

2017 ◽  
Vol 56 (11) ◽  
pp. 985-992 ◽  
Author(s):  
Nada Naiyer ◽  
Thiphalak Chounthirath ◽  
Gary A. Smith
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Injury Rate ◽  
The United States ◽  
Common Mechanism ◽  
Injury Surveillance System ◽  
Injury Mechanisms ◽  
States Data ◽  
Closed Head

This study investigates the epidemiology of cheerleading injuries to children in the United States. Data were analyzed from the National Electronic Injury Surveillance System for children 5 through 18 years of age treated in US emergency departments for cheerleading injuries from 1990 through 2012. An estimated 497 095 children ages 5 to 18 years were treated in US emergency departments for a cheerleading injury during the 23-year study period, averaging 21 613 injured children per year. From 1990 to 2012, the annual cheerleading injury rate increased significantly by 189.1%; and from 2001 to 2012, the annual rate of cheerleading-related concussion/closed head injury increased significantly by 290.9%. Falls were the most common mechanism of injury (29.4%) and were more likely to lead to hospitalization (relative risk = 2.47; 95% confidence interval = 1.67-3.68) compared with other injury mechanisms. The rising number and rate of pediatric cheerleading injuries underscore the need for increased efforts to prevent these injuries.

The burden of prosthetic hip dislocations in the United States is projected to significantly increase by 2035

2020 ◽  
pp. 112070002092361
Author(s):  
Kevin Pirruccio ◽  
Ajay Premkumar ◽  
Neil P Sheth
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Hip Dislocation ◽  
The United States ◽  
Injury Surveillance System ◽  
Cross Sectional ◽  
Hip Implant ◽  
Total Hip ◽  
National Burden ◽  
Linear Regression Modeling

Introduction: Prosthetic hip dislocation is a common, costly complication of total hip arthroplasty (THA). Despite this, the national burden of prosthetic hip dislocations remains uncharacterised in the United States, especially pertaining to injuries occurring years after the index procedure. This study examines historical and projected national estimates of prosthetic hip dislocations presenting to U.S. emergency departments between 2000 and 2035. Methods: We conducted a cross-sectional, retrospective epidemiological study using narratives in the National Electronic Injury Surveillance System (NEISS) database (2000–2017) to identify an estimated 64,671 prosthetic hip implant dislocations presenting to U.S. emergency departments. Estimates for the prevalence of individuals living with a total hip implant were derived from the literature. Results: The national estimate of prosthetic hip dislocations presenting to U.S. emergency departments rose significantly ( p < 0.001) between 2000 ( n = 2395; 95% CI, 1264–3526) and 2017 ( n = 8094; 95% CI, 4276–11,912). These increases are likely driven by increased numbers of people living with THA overall, since between 2000 and 2017, the average incidence of prosthetic hip dislocation (0.14%; CI 0.08–0.21%) in patients living with hip implants has not changed significantly. Linear regression modeling (R2 = 0.7, p < 0.01) projected an increasing number of dislocations through 2035, predicting 10,446 national cases per year by this date. Conclusions: Driven by increases in THA, the annual volume of prosthetic hip dislocations presenting to U.S. emergency departments has increased significantly since 2000 and is projected to continue to rise sharply. Future advances in surgical technique, prosthesis design, and injury prevention policies aimed at decreasing the rate of THA dislocation would help alleviate this mounting national health burden.

Pediatric Playground-Related Injuries Treated in Hospital Emergency Departments in the United States

2017 ◽  
Vol 57 (5) ◽  
pp. 584-592 ◽  
Author(s):  
Sarah L. Adelson ◽  
Thitphalak Chounthirath ◽  
Nichole L. Hodges ◽  
Christy L. Collins ◽  
Gary A. Smith
Keyword(s):  
Emergency Departments ◽  
Closed Head Injury ◽  
Injury Rate ◽  
The United States ◽  
Injury Surveillance System ◽  
Safety Standards ◽  
Average Patient ◽  
Impact Attenuation ◽  
Standards And Guidelines ◽  
Hospital Emergency Departments

This study analyzed pediatric playground-related injuries data from the National Electronic Injury Surveillance System. An estimated 5 025 440 children <18 years were treated in US emergency departments for playground-related injuries during 1990-2012, averaging 218 497 children annually. The average patient age was 6.5 years. The overall annual injury rate declined during 1990-2007 ( P < .001) and then increased during 2007-2012 ( P < .001). The climbing equipment–related injury rate remained constant during 1990-2009 and then increased during 2007-2012 ( P = .014). The concussion/closed head injury rate increased during 1990-2008 ( P < .002) with the rate almost doubling from 2008-2012 ( P < .001). Falls accounted for 76.7% of all injuries and 87.7% of injuries to the upper extremities. Injuries resulted in hospitalization for 4.3% of patients. Despite current playground safety standards and guidelines, a large number of playground-related injuries continue to occur. Revised impact attenuation criteria for playground surfacing materials should be implemented and evaluated to more adequately prevent fall-related upper extremity fractures.

scholarly journals Child Development and Pediatric Sport and Recreational Injuries by Age

2014 ◽  
Vol 49 (6) ◽  
pp. 780-785 ◽  
Author(s):  
David C. Schwebel ◽  
Carl M. Brezausek
Keyword(s):  
United States ◽  
Emergency Department ◽  
Emergency Departments ◽  
Injury Risk ◽  
The United States ◽  
Emergency Department Visits ◽  
Sociocultural Factors ◽  
Childhood And Adolescence ◽  
Injury Surveillance System ◽  
Sport And Recreation

Context: In 2010, 8.6 million children were treated for unintentional injuries in American emergency departments. Child engagement in sports and recreation offers many health benefits but also exposure to injury risks. In this analysis, we consider possible developmental risk factors in a review of age, sex, and incidence of 39 sport and recreational injuries. Objective: To assess (1) how the incidence of 39 sport and recreational injuries changed through each year of child and adolescent development, ages 1 to 18 years, and (2) sex differences. Design Descriptive epidemiology study. Setting: Emergency department visits across the United States, as reported in the 2001–2008 National Electronic Injury Surveillance System database. Patients or Other Participants: Data represent population-wide emergency department visits in the United States. Main Outcome Measure(s) Pediatric sport- and recreation-related injuries requiring treatment in hospital emergency departments. Results: Almost 37 pediatric sport or recreational injuries are treated hourly in the United States. The incidence of sport- and recreation-related injuries peaks at widely different ages. Team-sport injuries tend to peak in the middle teen years, playground injuries peak in the early elementary ages and then drop off slowly, and bicycling injuries peak in the preteen years but are a common cause of injury throughout childhood and adolescence. Bowling injuries peaked at the earliest age (4 years), and injuries linked to camping and personal watercraft peaked at the oldest age (18 years). The 5 most common causes of sport and recreational injuries across development, in order, were basketball, football, bicycling, playgrounds, and soccer. Sex disparities were common in the incidence of pediatric sport and recreational injuries. Conclusions: Both biological and sociocultural factors likely influence the developmental aspects of pediatric sport and recreational injury risk. Biologically, changes in perception, cognition, and motor control might influence injury risk. Socioculturally, decisions must be made about which sport and recreational activities to engage in and how much risk taking occurs while engaging in those activities. Understanding the developmental aspects of injury data trends allows preventionists to target education at specific groups.

scholarly journals A cross-sectional study of opioid involvement in non-poisoning suicide – risks and prevention opportunities

2020 ◽  
Author(s):  
Maryann Mason ◽  
Suzanne McLone ◽  
Tami Bartell ◽  
Sarah Welch ◽  
Karen Sheehan ◽  
...  
Keyword(s):  
United States ◽  
Suicide Prevention ◽  
The United States ◽  
Cross Sectional Study ◽  
Close Monitoring ◽  
Opioid Epidemic ◽  
Sectional Study ◽  
Opioid Use ◽  
Chi Square ◽  
Cross Sectional

Abstract Background The current opioid epidemic has drawn attention to drug overdose deaths including unintentional and suicide poisoning deaths which peaked in the United States in 2017. Concurrent with the opioid epidemic, the number and rate of suicides in the United States has increased. At the same time, the proportion of suicide deaths across cause of death has shifted and the proportion of suicides by poisoning (including overdose) has decreased. On the face of it, it would appear that the opioid epidemic has not intersected with suicide as signaled by the decline in suicide deaths due to poisoning. However, opioid use and misuse is associated with suicidal ideation and attempts and therefore it is plausible that opioids may play a role in suicide deaths by causes other than poisoning. Objective This study examines opioid involvement (as measured by the presence of opioids but below the lethality threshold) in suicides by causes other than poisoning, Methods A cross-sectional study utilizing Illinois National Violent Death Reporting System data including all suicides toxicology screened for opioids. Chi-square tests were used to compare decedent and incident circumstance characteristics by opioid toxicology screen status. Results Of 1007 non-poisoning suicides screened for opioids, 83.6% (842) were opioid negative and 16.4% (165) were opioid positive. Over half (52.7%) of decedents positive for opioids died by firearm. White race, age 75 and over, and widowed or unknown marital status were associated with opioid positivity. Opioid positivity is linked to testing positive for other substances. One quarter of decedents testing positive for opioids had a history of substance abuse. Twenty eight percent of opioid positive decedents suffered from physical health problems. Conclusion Suicide decedents who are opioid positive and who die from causes other than poisoning have distinct characteristics which suggest an array of suicide prevention efforts – for example -- including information on risk of suicide for opiate users in firearm sales, including suicide prevention counseling in health care settings in which opiates and/or benzodiazepines are therapeutically prescribed, and close monitoring of pain symptoms among patients experiencing chronic pain. ​

Pediatric Hand Burns Requiring Emergency Care in the United States

2021 ◽  
Author(s):  
Thomas J Sorenson ◽  
William J Mohr ◽  
Ashish Y Mahajan
Keyword(s):  
United States ◽  
Emergency Care ◽  
Census Data ◽  
The United States ◽  
Injury Incidence ◽  
United States Census ◽  
Injury Surveillance System ◽  
Cross Sectional ◽  
White Children ◽  
Epidemiological Characteristics

Abstract Purpose Hand and finger burns represent a relatively common occurrence in children, and serious injuries may require surgical intervention to prevent long-term disability. This study examines the epidemiological characteristics of pediatric patients presenting for emergency care of hand and finger burns within the United States (US). Methods We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years old and evaluated for an isolated hand or finger burn. United States census data from the same period were utilized for determining epidemiological estimates of injury incidence Results During the 10-year study period, an estimated 300,245 pediatric hand and finger burns were treated in 778,497,380 person-years: an incidence rate of 38.6 burns per 100,000 person years. Most treated burns occurred in the 1- to 2-year age group (28.3%) with an approximate 50% reduction in incidence for each 1-year age stratum until stabilizing at 6 years. Most burns occurred in white children (58%), but Black children had a higher incidence than white children when corrected for US population (45.15 burns versus 21.45 burns per 100,000 person-years). The most common etiology was a stove or oven (1595/10420; 15%). Conclusions Pediatric hand and finger burns occurred most frequently in young children from the oven and/or stove. We urge that parents be assertively counseled about potential burn risks to their young children’s hands and fingers, especially once they reach ambulatory age.

A Nationwide Epidemiological Analysis of Finger Infections Presenting to Emergency Departments in the United States From 2012 to 2016

Hand ◽  
2020 ◽  
pp. 155894472091561
Author(s):  
Nicholas J. Lemme ◽  
Neill Y. Li ◽  
Edward J. Testa ◽  
Alexander S. Kuczmarski ◽  
Jacob Modest ◽  
...  
Keyword(s):  
United States ◽  
Emergency Departments ◽  
Hospital Admissions ◽  
The United States ◽  
Common Mechanism ◽  
Injury Surveillance System ◽  
Old Patients ◽  
Common Diagnosis ◽  
Common Causes ◽  
Old Men

Background: There is a paucity of literature exploring the epidemiology of finger infections presenting to emergency departments (EDs) on a national scale. The purpose of this study was to determine the national incidence of and risk factors for finger infections. Methods: Finger infections presenting to EDs between 2012 and 2016 were identified in the National Electronic Injury Surveillance System database. Finger infections were characterized by mechanism and type, with subanalyses for sex, race, and age. Results: Over this 5-year period, finger infections accounted for 80 519 visits to EDs in the United States. The annual incidence increased significantly from 4.4 per 100 000 person-years in 2012 to 6.2 in 2016. The 3 most common causes of finger infections were nail manicuring tools, knives, and doors. The most common diagnosis was finger cellulitis (46.3%). Significantly more men developed finger infections than women (relative risk of 1.4). The highest overall incidence was observed in 40- to 59-year-old men (7.8 per 100 000 person-years). Tenosynovitis resulted in the largest proportion of admissions (25%). Conclusions: We have demonstrated a rising incidence of finger infections presenting to EDs, with 40- to 59-year-old patients most at risk. The most common mechanism was the use of nail manicuring tools, such as nail clippers. Patient education may decrease finger infection incidence from these activities, and early detection of finger infections may be crucial to minimizing hospital admissions and invasive treatments.

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