Purpose: This study analyzed the characteristics of pediatric patients’ (≤ 18 years) intentional injury-related visits to the emergency department (ED) using National Emergency Department Information System data from January 1 through December 31, 2023, providing foundational evidence for prevention strategies and policy development. Methods: The injuries were categorized into unintentional and intentional, and relevant characteristics were compared between the 2 categories. The intentional injuries were further divided into self-harm and violence. Percentages were calculated for each variable and compared using the chi-square or Fisher exact tests. Results: Among 301,852 pediatric patients, those with intentional injuries showed higher proportions of girls, adolescents, visits in the wee hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists, than those with unintentional injuries. The pediatric patients with self-harm injuries showed higher proportions of girls, adolescents, visits in the wee or morning hours, visits via firehouse ambulances, injuries by collision, by penetration, or by poisoning, hospitalization or inter-facility transfer, Korean Triage and Acuity Scale levels 1-3, an ED length of stay of 2 hours or longer, and primary care by psychiatrists as well as by orthopedic surgeons or pediatricians, than those with violence injuries. Conclusion This study highlights the need to develop strategies per age and sex for preventing self-harm among pediatric patients, and to ensure safe and effective psychiatric care in EDs. In addition, the prevention of child abuse requires a multidisciplinary approach that includes preventive education programs, mandatory reporting in EDs, and the adoption of screening tools such as the Finding Instrument for Non-accidental Deeds.

Purpose: The authors aimed to identify the factors affecting interhospital transfer (“transfer”) of severe pediatric patients who visited to an emergency department (ED). Methods: Using the Korean National ED Information System, we analyzed high-acuity patients aged 18 years or younger who visited EDs of local or regional emergency centers nationwide. The high acuity was defined as a Korean Triage and Acuity Scale 1-2. To investigate the factors associated with transfer, a multilevel modeling was selected, examining independent variables at both individual- and hospital-levels with transfer as a dependent variable. Results: A model consisting of variables at individual- and hospital-levels showed the factors as follows: mode of arrival(self-transport: odds ratio, 0.48 [95% confidence interval, 0.38-0.61]; other ambulances: 0.41 [0.24-0.71]; compared with firehouse ambulance), visit at 18:00-07:59 (0.75 [0.64-0.88]), intentional injury (1.59 [1.03-2.47]; compared with non-injury), decreased level of consciousness (drowsy: 1.94 [1.33-2.84]; stupor: 4.08 [2.99-5.57]; coma: 1.81 [1.26-2.60]; compared with alert), severe illness diagnosis (1.49 [1.12-1.98]), the number of all beds in EDs (1.02 [1.01-1.04]), and acceptance for treatment (0.92 [0.87-0.98]; with increment of 1%). Conclusion This study confirms that both individual-level and hospital-level factors affect the transfer risk of severe pediatric patients in EDs. The study suggests the needs for direct transportation to specialized pediatric treatment facilities, and concentrated support for the pediatric emergency medical centers and pediatric trauma centers.

Objective: The Public Health Disaster Response Team (PHDRT) has been organized by the Community Health Center since 2016 under the National Disaster Response Frame. They are mobilized when a Mass-Casualty-Incident is expected to occur. This study sheds light on the disaster medical system by analyzing the awareness of the PHDRT on the disaster medical management capacity. Methods: To develop the questionnaire, a literature review was conducted. The questionnaire was distributed and obtained after inspecting the survey questionnaire filled out by the PHDRT. There were 254 samples. The data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. Results: Research has proven that the awareness of the disaster medical management capacity was 3.11 (rating 1-5). In detail, organizational capacity received the highest agreement score (3.54±0.84), while the budget and organization management was below the midpoint (2.73±0.83). Significant positive correlations were found between the capacity components, particularly the organizational capacity and cooperation system (r=0.71, P<0.01). The awareness was significantly different according to sex, age, job (type), total career, and task weight. The factors influencing the awareness of disaster medical management capacity included age, total career, and task weight. Conclusion The findings from awareness analysis suggest that national and systemic supports, as well as personal efforts, are necessary to strengthen the disaster medical management capacity.