E-Cigarette Burns and Explosions: What are the Patterns of Oromaxillofacial Injury?

PURPOSE: With the recent increase in popularity of electronic cigarette use in the United States, its harmful effects are not only limited to smoke inhalation, but also to the possibility of e-cigarette device malfunction. The purpose of this review is to characterize oromaxillofacial trauma secondary to electronic cigarette device explosion. METHODS: For this systematic review, PubMed and Embase were searched in October 2019 using the following search terms: e-cigarette burns, e-cigarette injury, and e-cigarette explosions, which yielded 400 studies. Basic science research, animal studies, non-English studies, and reports of non-oromaxillofacial injuries were excluded. Study subject demographics, mechanism of trauma, injury type, treatment, and sequelae were recorded and analyzed. RESULTS: Of all studies, 20 studies met inclusion criteria, including 14 case reports and 6 case series, with a total of 21 study subjects. For cases that reported sex, 100% were male (20) with a mean age of 29.5 years. Most common lacerations and/or burns involved the lips (10/21), tongue (8/21), soft palate and/or hard palate (4/21), and nose (5/21). Thirteen subjects underwent surgeries including oral-maxillofacial surgery or dental implants (7/13), bone graft repair (3/13), open reduction and internal fixation for preservation of sinus outflow tracts (2/13), foreign body removal from the cervical spine (1/13), and iridectomy (1/13). Reported complications included bone loss secondary to traumatic fracture, tinnitus and hearing loss, lip paralysis secondary to persistent edema, major depressive disorder/ post-traumatic stress disorder, persistent sinusitis, photophobia, and bilateral axillary and hand contractures. CONCLUSIONS: Electronic cigarette device malfunction and explosion carries great risk for acute oromaxillofacial trauma that may be disfiguring. With the increasing popularity of electronic cigarette use, clinicians and patients should be advised regarding dangers of electronic cigarette use.

Gender disparity in speakers at a major academic emergency medicine conference.

BACKGROUND: Although women make up a substantial portion of the workforce in emergency medicine, they remain under-represented in academia. METHODS: This study investigates trends in the representation of female speakers at the American College of Emergency Physicians scientific assembly-the largest academic emergency medicine conference in the world. Publication profiles, speaking duration and gender composition of speakers were collected and compared over a 3-year period. RESULTS: The authors described increased representation of female speakers at the conference from 2016 to 2018, as well as an upward trend in women's actual speaking time. CONCLUSION: This upward trend in women's representation may translate to more opportunities for female engagement in academic emergency medicine. Despite the increasing representation of women, male speakers outnumbered female speakers all 3 years, demonstrating that a speaker gender gap persists in academic emergency medicine.

Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals.

PURPOSE: To estimate the incidence of patients presenting to emergency departments (EDs) as a result of facial trauma sustained from skateboarding. PATIENTS AND METHODS: The National Electronic Injury Surveillance System (NEISS) database was queried for skateboard-related head and face fractures, contusions, abrasions, and lacerations from 2009 through 2018. We identified 2,519 reported injuries, extrapolating to a national incidence of 100,201 injuries. Fractures accounted for 14.1% of these visits. There were 355 ED visits for fractures, extrapolating to an estimated 11,893 visits nationally. Entries were tabulated for demographic information, fracture type, mechanism of injury, and disposition. RESULTS: Patients sustaining injury to the head and face were aged 16 years, on average, and predominantly male patients (85.9%). Most patients sustaining fractures were male patients (87.9%), with a mean age of 18 years. The most common fracture types included unspecified skull fractures (31%), nasal fractures (29%), and mandibular fractures (18%). The most common mechanism of injury was falling off the skateboard while riding (76.9%). Collisions with motor vehicles also accounted for a substantial proportion of the injuries (7.3%). CONCLUSIONS: A substantial number of ED visits were a result of skateboarding-related facial trauma. Given the neurologic outcomes of head trauma and functional consequences of facial fractures, especially among adolescents, our findings suggest that injury prevention programs and more aggressive helmet use may be necessary to reduce morbidity and hospitalization.

Head, Face, and Neck Fractures Secondary to Ladder-Related Injuries Treated in United States Emergency Departments in 2009-2018.

BACKGROUND: Ladders are a commonly used piece of equipment; however, their use is accompanied by a significant potential for injury. Fractures of the head, face, and neck are potential consequences of ladder use and can be devastating due to potential for severe sequalae. OBJECTIVES: To describe the frequency and pattern of ladder-related head, face, and neck fractures from 2009-2018. METHODS: The National Electronic Injury Surveillance System (NEISS) was searched for ladder-related head, face, and neck fractures treated in U.S. emergency departments. Demographics, mechanism of injury, fracture type, setting in which fracture occurred, and patient disposition were analyzed. RESULTS: There were 601 total cases (weighted national estimate of 20,450 total cases) of ladder-related head, face, and neck fractures obtained from the NEISS from 2009 to 2018. The mean age of injury was 53 years, and the majority of cases occurred in home settings. Approximately 25% of the cases were patients aged older than 65 years. The majority of fractures in individuals younger than 18 years and older than 46 years of age resulted in admission. The most commonly fractured locations included the face (51.0%), followed by cervical spine (28.3%) and cranial (20.7%) fractures. CONCLUSIONS: Admission rates for ladder-related head, face, and neck fractures are substantially higher than those previously reported for all types of ladder-related injuries. Injury and admission patterns vary by age. Rigorous safety precautions may be indicated for the high-risk groups identified by this study, especially the elderly.

Women's representation at an academic dermatology conference: trending upwards, but not equal yet.

Although women make up a significant portion of the workforce in dermatology, they remain underrepresented in academia. This study investigates the number of male and female symposium speakers at the American Academy of Dermatology annual meetings over a three-year period and compares research productivity and academic rank between the men and women invited to speak. The results demonstrate a steady increase in the representation of female symposium speakers at the conference from 2016 to 2018, although a higher proportion of invited male speakers hold professorships and leadership positions. This upward trend in women's representation may translate to more opportunities for female engagement in academic dermatology. Although women make up over 60% of residents in dermatology, they are not proportionally represented in this conference sample. This imbalance in representation demonstrates that further interventions to increase the representation of female professors and chairs may be necessary.