E-scooter and E-bike injury pattern profile in an inner-city trauma center in upper Manhattan.

BACKGROUND: Electric bikes and scooters are becoming popular means of short-distance transportation in major cities. Regulations for safe riding established by ride-sharing companies and local governments have not been effectively implemented. Inner-city hospitals are at the frontline of receiving traumas related to e-bikes and e-scooters and are receiving an increasing number of injuries. The works of literature reporting these injuries are limited. METHOD: This study reviewed all the trauma activations at a major trauma center in NYC from 04/2019 to 08/2021. Patients with e-bike and e-scooter injuries were included in the study. Socio-demographics of riders, passengers, injury patterns, and outcomes were reviewed. Logistics regression was used to analyze the factors associated with Injury Severity Scale. RESULTS: We reviewed 1979 patient charts of trauma activation in the Emergency Department. We included 88 scooters, 24 E-bike, and 5 nonrider scooter injuries. 91% were male and 9% were Female victims. The majority were African American patients (34%) and Hispanic patients (46%). 87% belonged to the 18-50 years age group, and 13% were above 50 years and below 18 years were excluded from the study. 36% of victims were under the influence of drugs or alcohol and only 25% of riders wore helmets. 58% of patients were discharged from the ED, 42% required hospital admission, and 14% required ICU care. Odds of non-mild injury (moderate to critical injury) in comparison to mild injury were significantly greater with increasing age. CONCLUSIONS: The use of e-bikes and e-scooters is increasing as a means of affordable short-distance transportation but with evidence of significant injuries with varying severity. These findings suggest a need to review public policy regarding e-bike and electric scooter use regulations for the safety of riders and pedestrians; Driving While Intoxicated (DWI) law enforcement, mandatory helmet, education, speed control, creation of special lanes, and no car zones.

Prevotella bivia: A Rare Cause of Zuska's Breast Disease.

Zuska's breast disease is a rare disorder leading to recurring subareolar abscess typically in obese patients with a history of smoking. The pathophysiology is a combination of ductal obstruction from squamous metaplasia and infection usually by anaerobic and gram-positive bacteria. Zuska's breast disease does not have a single standardized treatment partly attributed to the lack of physician awareness of the disorder. The initial management should include smoking cessation, anaerobic and gram-positive antibiotic coverage, and drainage of abscesses if present.

Type 2 Necrotizing Soft Tissue Infection: A Disastrous Diagnosis Not To Be Missed.

Necrotizing soft tissue infections (NSTIs) are severe, life-threatening forms of infection. Tissues from the epidermis to the deep musculature may be affected. This includes necrotizing forms of cellulitis, myositis, and fasciitis. Delayed diagnosis can lead to widespread tissue loss, limb loss, and mortality, representing a group of infectious surgical emergencies requiring time-sensitive aggressive debridement. This article presents a unique case with a particularly ambiguous and vague presentation of type 2, group A streptococcal NSTI in an intravenous drug abuser. This rapidly spreading infection subjected her to profound morbidity, with loss of all four extremities. Type 2 NSTIs are particularly challenging to diagnose as they often present without classic signs of skin changes, subcutaneous air, and crepitus. They also spread more rapidly and, as such, have a higher morbidity and mortality rate than type 1 NSTIs. We are striving to increase physician awareness of such cases, with the aim of earlier recognition and earlier limb and life-saving interventions.