Injuries associated with bunk beds occurring at schools: results using a US national data base.

OBJECTIVE: To investigate bunk bed injuries occurring across all educational institutions using a national data base. METHODS: National Electronic Injury Surveillance System data for the years 2006-2015 associated with bunk beds was analysed. RESULTS: There were an estimated 639 700 emergency department (ED) visits for bunk bed injuries; 1.3% occurred at school. Those occurring at school were older than those not at school (18.2 vs 12.8 years), and more commonly female (56.4% vs 40.6%), Caucasian (91.7% vs 68.3%) and associated with alcohol (10.8% vs 0.4%). For those occurring at school, the average age for those involving the trunk, upper extremity, lower extremity and head/neck areas was 17.9, 14.9, 19.2 and 18.7 years, respectively (p<10-4). A fracture was present in 6.4%, 52.3%, 21.2% and 9.6% of the trunk, upper extremity, lower extremity and head/neck areas, respectively (p=0.009). Males had a higher percentage of lacerations and females had a higher percentage of internal organ injuries. The vast majority of the fractures and strain/sprains occurred in the extremities; lacerations in the head/neck and contusion/abrasions predominantly involved the extremities and head/neck. CONCLUSIONS: 1.3% of all ED visits due to bunk bed injuries occurred in places of education. The majority of these were during college age. Prevention strategies should be directed at educational institutions and students, as well as following proper bunk bed equipment guidelines. Education regarding alcohol risks might assist college age students.

Demographics and Fracture Patterns of Patients Presenting to US Emergency Departments for Intimate Partner Violence.

Orthopaedic surgeons are in a position to assist in identifying intimate partner violence (IPV) patients. It was the purpose of this study to analyze the demographics and fracture patterns of IPV patients in the United States. Methods: Data from the National Electronic Injury Surveillance System All Injury Program from 2005 through 2013 were used. Injuries due to domestic violence were identified, and statistical analyses accounted for the weighted, stratified nature of the data. Results: There were 1.65 million emergency department visits over nine years for IPV. The median age was 29.8 years, 83.3% were women, and 55.3% occurred at home. The major diagnoses were contusion/abrasions (43.4%), lacerations (16.9%), strain/sprains (15.6%), internal organ injuries (14.4%), and fractures (9.7%). The most common fracture involved the face (48.3%), followed by the finger (9.9%), upper trunk (9.8%), and hand (6.4%). The highest proportion of lower extremity fractures occurred in men, and upper extremity fractures increased with increasing age. The odds of fracture in an IPV patient were greatest in those sustaining an upper extremity injury (odds ratio [OR] = 6.62), lower extremity injury (OR = 6.51), upper trunk injury (4.28), and head/neck injury (OR = 3.08) compared with a lower trunk injury (referent), and women (OR = 1.80) compared with men (referent). Older patients sustaining IPV had higher odds of a fracture (the few patients 10-14 and >65 years old were excluded from this analysis). Conclusions: As this study encompasses the entire United States, these results are germane to all US orthopaedic surgeons. Knowing typical fracture patterns/locations is helpful in identifying IPV patients, although the victim may not fully divulge the history and details of the event. Identification is important for the physical and mental health of the victim, and abuse often continues if intervention does not occur. The odds of a fracture in an IPV patient are greatest when the injury involved the extremities and increased with increasing age of the patient.