Objective: This study analyzed the characteristics and accident patterns of electric scooter accidents using in-depth survey data from 23 hospital emergency rooms (ER) in Korea. The characteristics of accident types were examined depending on alcohol consumption. Methods: An in-depth investigation was conducted on ER patients involved in electric scooter accidents between 2014 and 2021. The research focused on variables such as age, time of ER visit, alcohol use, emergency room discharge outcome, injury severity, and areas of injury. Results: One thousand nine hundred and sixty-two electric scooter injuries were examined. The riders belonged predominantly to the 20-39 years age group (60.40%), and most were males (69.67%). Visits to the ER peaked between 6 pm and 12 am (36.29%). Alcohol was implicated in 24.52% of the accidents. Head and neck injuries occurred commonly (60.70%). The number of accidents increased from 4 to 843. Moreover, alcohol-related incidents surged annually, except during 2014-2015. The alcohol use group comprised more males than the non-alcohol use group (79.42% vs. 66.51%). Accidents occurred more commonly in the 20-39 years age group (76.92% vs. 55.03%), and a higher proportion of emergency room visits occurred between 0 am and 6 am (58.84% vs. 39.43%). Cases with severe Excess Mortality Ratio-adjusted Injury Severity Scores were more frequent (29.29% vs. 12.97%), and head and neck injuries were more common (83.78% vs. 53.21%). Conclusion The regulations for licensing, alcohol use, and helmet compliance should be enforced to reduce the incidence of alcohol-related electric scooter accidents in the younger population.

Objective: We aimed to investigate the characteristics of frequent emergency department (ED) users in Korea. Methods: We analyzed the Korea Health Panel Study data of a sampled population from the 2005 Population Census of Korea data, and adults (age ≥18 years) who visited the ED at least once a year between 2014 and 2017 were included in the study. People who visited three or more times a year were classified as frequent users. We compared demographic, socioeconomic, and health-related factors between nonfrequent and frequent users. We used a multivariable logistic regression analysis to determine factors related to frequent ED visits. We also compared the characteristics of ED use in both nonfrequent and frequent users. Results: A total of 5,090 panels were included, comprising 6,853 visits. Frequent users were 333 (6.5% of all panels), and their ED visits were 1,364 (19.9% of all ED visits). In the multivariable regression analysis, medical aid coverage (adjusted odds ratio [aOR] of the National Health Service coverage, 0.55; 95% confidence interval [CI], 0.40–0.75), unemployment (aOR of employment, 0.72; 95% CI, 0.56–0.91), prior ward admission in a year (aOR, 2.14; 95% CI, 1.67–2.75), and frequent outpatient department use (aOR, 1.72; 95% CI, 1.35–2.20) were associated with frequent use. Moreover, frequent users visited the ED of public hospitals more often than than nonfrequent users (19.2% vs. 9.8%). Medical problems rather than injury/poisoning were the more common reasons for visiting the ED (84.5% vs. 71.2%). Conclusion We found that frequent ED users were likely to be those with socioeconomic disadvantage or with high demand for medical service. Based on this study, further studies on interventions to reduce frequent ED use are required for better ED services.

Background: We aimed to investigate changes in the clinical characteristics of pediatric poisoning patients who visited the emergency department (ED) before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Poisoning cases below age 18 who visited the ED from January 2018 to December 2021 were retrospectively analysed. The study period was then divided into pre-COVID-19 and COVID-19 pandemic to compare poisoning patterns. Results: During the study period, 86,153 visits to the pediatric ED had been recorded, with 625 patients being included the final analysis. During the COVID-19 period, the proportion of poisoned patients increased from 0.62% to 0.98%. The average age of the patients was higher in the COVID-19 period, with 53.4% of the cases being intentional (pre-COVID-19, 32.5%; P < 0.001). Moreover, 70.4% of poisoning cases during the COVID-19 period were caused by drugs (pre-COVID-19, 60.6%; P = 0.038). More patients underwent decontamination and laboratory investigation during the COVID-19 period than during the previous period (P= 0.007 and P < 0.001, respectively). The length of ED stay and the proportion of hospitalisation were significantly greater during the COVID-19 period. After analysing accidental poisoning cases, we found that antipyreticsonsteroidal anti-inflammatory drugs and respiratory drugs were more common in the pre-COVID-19 group, whereas iron/vitamins, cardiovascular drugs and hormones were more common in the COVID-19 group. After analysing intentional poisoning cases, we found that 73.6% and 76.4% of the patients in the pre-COVID-19 and COVID-19 group had a history of psychiatric disease, respectively. Although no difference was observed in the frequency of previous first suicide attempts, 19.0% of the patients in the COVID-19 group attempted suicide more than three times. Conclusion During the COVID-19 pandemic, intentional poisoning cases, especially in adolescence, increased and were treated more. Many of the patients with intentional poisoning had a history of mental illness or suicide in the past. Therefore, it seems that policy consideration for mentally vulnerable adolescents during this new pandemic period is necessary.

Purpose: This study utilizes the NEDIS (National Emergency Department Information System) database to suggest a predictive model for snakebite and envenomation in Korea by analyzing the geographical distribution and seasonal variation of snakebite patients visiting the ER. Methods: This was a retrospective study on snakebite patients visiting the ER using the NEDIS database from January 2014 to December 2019. The subjects include patients with the KCD (Korea Standard Classification of Disease) disease code T63.0 (Toxic effect of contact with snake venom). Geographical location, patient gender, patient age, date of ER visit, treatment during the ER stay, and disposition were recorded to analyze the geographical distribution and seasonal variation of snakebite patients in Korea. Results: A total of 12,521 patients were evaluated in this study (7,170 males, 54.9%; 5,351 females, 40.9%). The average age was 58.5±17.5 years. In all, 7,644 patients were admitted with an average admission time of 5.04±4.7 days, and 2 patients expired while admitted. The geographical distribution was Gyeongsang 3,370 (26.9%), Cheonra 2,692 (21.5%), Chungcheong 2,667 (21.3%), Seoul Capital area 1,999 (16.0%), Kangwon 1,457 (11.6%), and Jeju 336 (2.7%). The seasonal variation showed insignificant incidences in winter and higher severity in spring and summer than in fall: winter 27 (0.2%), spring 2,268 (18.1%), summer 6,847 (54.7%), and fall 3,380 (27.0%). Conclusion Patients presenting with snakebites and envenomation in the emergency room were most common in the Gyeongsang area and during summer. The simple seasonal model predicted that 436 snakebites and 438 envenomation cases occurred in July and August. The results of this study can be applied to suitably distribute and stock antivenom. Appropriate policies can be formed to care for snakebite patients in Korea.

Objective: The establishment of a proper emergency care system can significantly decrease the number of deaths and disabilities. However, this is neglected in many low- and middle-income countries, including Cambodia. At present, many Cambodian hospitals lack designated emergency departments, formal triage systems, and staff trained in emergency medicine. This study sought to measure the functional capacity of the Cambodian emergency care system corresponding to each hospital level using the Emergency Care Assessment Tool (ECAT). Methods: We conducted a survey from April 19, 2021, to April 27, 2021, by distributing survey sheets to a total of eight Cambodian medical staff who were invited to a hospital in South Korea for an educational program. The ECAT comprises items evaluating the capability of hospitals to perform signal functions for each of the six emergent sentinel conditions that could occur prior to death. We analyzed the data by categorizing the hospitals into basic, intermediate, and advanced levels. Results: Basic-level hospitals had weaknesses in signal functions related to altered mental status and trauma care. The intermediate-level hospital showed weaknesses in signal functions related to respiratory failure, altered mental status, shock, and trauma care. Advanced-level hospitals had weaknesses in signal functions related to respiratory failure, trauma, and shock. Conclusion Our survey shows that most Cambodian hospitals lack the capability to perform the emergency signal functions expected at each level. We believe that this gap can be bridged with proper customized education targeting medical staff based on the level of their hospital and ensuring a proper supply of medical devices.

Objective: We aimed to investigate the epidemiological characteristics and trends of carbon monoxide (CO) poisoning in the National Emergency Department Information System (NEDIS). Methods: Using the NEDIS data from 2014 to 2018, we included patients who had visited the emergency department (ED) with CO poisoning (T58.0 in 7th Korean Standard Classification of Diseases [KCD-7]). We excluded patients with an uncertain time of onset, uncertain intentionality of poisoning, mental state, and unknown clinical outcome. We surveyed age, sex, time of onset, the intentionality of poisoning, mental state, results of emergency treatment, the proportion of admissions to intensive care units (ICU), the outcome of hospitalization, and the regional distribution. We analyzed the rate of incidence and trends of CO poisoning in patients using time series analysis. Results: A total of 18,533 patients, including 10,671 (57.6%) males and 7,862 (42.4%) females, with a mean age of 40.38±18.41 years, were included in this study. Gyeonggi Province (n=6,354, 34.3%) had the highest distribution of patients, followed by Seoul (n=3,357, 18.1%). The incidence of unintentional CO poisoning was more frequent in January and December, and less frequent in August and September. However, the incidence of intentional CO poisoning showed no seasonal variation. The severity, ICU hospitalization rate, and mortality rate for intentional CO poisoning were higher than unintentional CO poisoning (4.1% vs. 0.8%, 29.9% vs. 16.7%, and 2.0% vs. 0.8% respectively) (P<0.001). Applying Winter’s additive method, we could predict that the rate of unintentional CO poisoning would continue to increase and the seasonal fluctuation, such as cases increasing in January-December and decreasing in August-September, would also increase. Conclusion Intentional CO poisoning showed higher severity than unintentional CO poisoning. In the time series analysis, the rate of unintentional CO poisoning and seasonal fluctuation is predicted to increase.

Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.

Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.

OBJECTIVE: Among emergency department patient complaints, complaints related to medical malpractice can often lead to lawsuits. This study examined the reasons for medical malpractice complaints and find ways to improve the medical process and patient satisfaction in an emergency department. METHODS: This study analyzed 269 official complaints of emergency department patients between January 1, 2007, and December 31, 2016. From these complaints, 100 complaints of medical malpractice were analyzed and the complaints of the non-medical process, such as unkindness, cost, facilities and the others, were excluded. The patients' age, sex, relationship between the patient and complainer, insurance state and visiting hour were analyzed. Details of the medical malpractice complaints were assessed and classified into four reasons: diagnosis, examination, treatment, and explanation. This study attempted to analyze the hospital's response to the complaints made during the medical process. RESULTS: Among the 100 medical malpractice complaints, 75 occurred at night duty; 40 were related to treatment, 32 to diagnosis, 22 to examination, and six to explanation. Among the treatment, wound problems were the most frequent reason for 23 cases. The hospital made financial compensation to 16 of its patients. CONCLUSION: The medical malpractice complaints occurred mainly at night. Treatment, especially wound problems, was the most frequent reason for the complaints. The rate of monetary compensation was higher than that of the other studies.
Compensation and Redress ; Diagnosis ; Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Insurance ; Malpractice ; Patient Satisfaction ; Retrospective Studies ; Wounds and Injuries

OBJECTIVE: Smart glasses can provide sonographers with real-time ultrasound images. In the present study, we aimed to evaluate the utility of smart-glasses for ultrasound-guided peripheral venous access.METHODS: In this randomized, crossover-design, simulation study, 12 participants were recruited from the emergency department residents at a university hospital. Each participant attempted ultrasound-guided peripheral venous access on a pediatric phantom at intervals of 5 days with (glasses group) or without (non-glasses group) the use of smart glasses. In the glasses group, participants confirmed the ultrasound image through the lens of the smart glasses. In the non-glasses group, participants confirmed the ultrasound image through the display viewer located next to the phantom. Procedure time was regarded as the primary outcome, while secondary outcomes included the number of head movements for the participant, number of skin punctures, number of needle redirections, and subjective difficulty.RESULTS: No significant differences in procedural time were observed between the groups (non-glasses group: median time, 15.5 seconds; interquartile range [IQR], 10.3 to 27.3 seconds; glasses group: median time, 19.0 seconds; IQR, 14.3 to 39.3 seconds; P=0.58). The number of head movements was lower in the glasses group than in the non-glasses group (glasses group: median, 0; IQR, 0 to 0; non-glasses group: median, 4; IQR, 3 to 5; P<0.01). No significant differences in the number of skin punctures or needle restrictions were observed between the groups.CONCLUSION: Our results indicate that smart-glasses may aid in ensuring ultrasound-guided peripheral venous access by reducing head movements.
Emergency Service, Hospital ; Eyeglasses ; Glass ; Head Movements ; Needles ; Pilot Projects ; Punctures ; Skin ; Ultrasonography ; Wireless Technology