Field Hockey-Related Injuries Treated in US Emergency Departments, 2000 to 2020.

OBJECTIVE: To describe the epidemiology of field hockey-related injuries of patients aged 6 to 24 years who were treated in US emergency departments from 2000 to 2020. DESIGN: The researchers conducted a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS). SETTING: The NEISS collects data on recreational activity-related and consumer product-related injuries treated in US Eds. PATIENTS: Patients aged 6 to 24 years who were treated for field hockey-related injuries in Eds from 2000 to 2020. INDEPENDENT VARIABLES: The researchers analyzed characteristics that included age, body part injured, injury diagnosis, disposition from the ED, injury locale, injury mechanism, contact, and equipment type. MAIN OUTCOME MEASURES: All cases of field hockey-related injuries were identified using the NEISS product code for field hockey (1295). RESULTS: There were an estimated 82 639 (95% CI = 45 536-119 742) field hockey-related injuries for patients aged 6 to 24 years treated in US emergency departments from 2000 to 2020. The rate of field hockey-related injuries per 100 000 population did not significantly change from 7.4 in 2000 to 7.4 in 2011 (slope = 0.048; P = 0.581) but significantly decreased from 7.4 in 2011 to 3.7 in 2019 (slope = -0.40; P = 0.018). As player age increased, the risk of injury due to contact with equipment increased ( 13 years: RR = 0.90; 95% CI = 0.82-0.98, 19-24 years: RR = 1.17; 95% CI = 1.06-1.29). Concussions or traumatic brain injuries accounted for 9.2% of injuries and were most associated with contact with the ball. CONCLUSION: Although there was a decrease in the field hockey-related injuries, field hockey remains an important source of injuries for children and young adults.

Pediatric Dance-Related Injuries Treated in Emergency Departments in the United States, 2000-2020.

OBJECTIVE: This study investigated the characteristics and trends of children aged 3 to 19 years treated in US emergency departments for dance-related injuries. METHODS: Retrospective analysis of data from the National Electronic Injury Surveillance System from 2000 through 2020 was conducted. RESULTS: An estimated 489,119 children received emergency treatment for a dance-related injury, averaging 23,291 children annually, and the rate of injury increased 68.1% during the 21-year study period. Girls accounted for 80.3% and children aged 15 to 19 years accounted for 46.5% of cases. Sprains/strains were the most frequent diagnosis (44.4%), and lower extremities were the most commonly injured body region (56.4%). Compared with other body regions, patients aged 3 to 10 years were more likely to sustain head/neck injuries (odds ratio, 3.94, 95% confidence interval, 3.42-4.52) than 11- to 19-year-olds. Falls and noncontact mechanisms of injury accounted for 35.6% and 32.1% of injuries, respectively. Unstructured dance activity was associated with 30.8% of dance-related injuries overall and 67.0% among children aged 3 to 5 years. Ballet/pointe dancers frequently sustained lower extremity sprains/strains (39.2%). Compared with other dance types, break dancing was more commonly associated with injuries to an upper extremity than other body regions (odds ratio, 4.76, 95% confidence interval, 3.66-6.19). CONCLUSIONS: The rate of pediatric dance-related injuries treated in US emergency departments is increasing. Unstructured dance activity was an important source of dance-related injury, especially among children aged 3 to 5 years. The injury diagnosis and body region injured varied by child age and type of dance. Additional targeted prevention efforts should be implemented that address the injury characteristics of dancer subgroups.

Magnet Injuries in Children: An Analysis of the National Poison Data System from 2008 to 2019.

OBJECTIVE: To examine, using the National Poison Data System (the data warehouse for poison control centers in the US), magnet foreign body injuries in pediatric patients. We sought to report demographic data, outcome data, and case trends between 2008 and 2019. STUDY DESIGN: We conducted a retrospective analysis of the National Poison Data System for patients younger than 19 years of age with a magnet "exposure," which poison centers define as an ingestion, inhalation, injection, or dermal exposure to a poison. RESULTS: A total of 5738 magnet exposures were identified. Most were male (3169; 55%), <6 years old (3572; 62%), with an unintentional injury (4828; 84%). There were 222 patients (3.9%) with a confirmed medical "effect," defined as signs, symptoms, and clinical findings not including therapeutic interventions (eg, endoscopy). There was a 33% decrease in cases from 418 (2008-2011) to 281 per year (2012-2017) after high-powered magnet sets were removed from the market. Calls subsequently increased 444% to 1249 per year (2018-2019) after high-powered magnet sets re-entered the market. Cases from 2018 and 2019 increased across all age groups and account for 39% of magnet cases since 2008. CONCLUSIONS: Significant increases in magnet injuries correspond to time periods in which high-powered magnet sets were sold, including a 444% increase since 2018. These results reflect the increased need for preventative or legislative efforts.

A Year of Child Injury Prevention on Instagram.

Injury is the leading cause of death for children but little is known about what types of injury prevention messages are communicated on Instagram. Conducted in the United States, the aim of this study was to better understand child injury prevention messages on Instagram to develop recommendations for the future. Informed by Social Cognitive Theory, a quantitative content analysis was conducted on all Instagram posts from selected organizations from May 2018 through April 2019. Of the 818 injury prevention posts, almost all included an image (575, 70%) or video (211, 26%). Of the 575 images, 245 (42.46%) had in image that did not match the topic of the post. Regarding injury prevention recommendations, 579 posts (71%) provided a clear action that parents should take. For these posts, 115 (20%) had an image that communicated the desired safety recommendation, but many more (285, 50%) did not; in 23 cases it was not clear if there was a match or not. There are missed opportunities for child health and injury organizations to reach parents and caregivers through Instagram. Posts made during the study period often lacked specificity about action-oriented measures and failed to utilize images that demonstrated the recommended practices. Organizations posting on Instagram and other social media platforms should provide clear action tips and utilize images that depict child injury prevention recommendations.

Sledding-Related Injuries Among Children and Adults Treated in US Emergency Departments From 2008 to 2017.

OBJECTIVE: To describe the epidemiology of sledding-related injuries among children and adults treated in US emergency departments (EDs). DESIGN: The researchers performed a retrospective analysis using data from the National Electronic Injury Surveillance System (NEISS). SETTING: The NEISS collects data on consumer products-related and sports-related injuries treated in US EDs from approximately 100 hospitals that represent a probability sample of >5000 hospitals. PATIENTS: Children (≤19 years of age) and adults who were treated for sledding-related injuries in EDs from 2008 to 2017. INDEPENDENT VARIABLES: The researchers analyzed characteristics that included sex, body part injured, injury diagnosis, disposition from the ED, injury locale, injury mechanism, and sled type. MAIN OUTCOME MEASURES: All cases of sledding-related injuries were identified using NEISS product codes for sleds (1217), toboggans (1273), snow disks (1274), and snow tubes (1299). RESULTS: An estimated 220 488 patients [95% confidence interval (CI): 169 839-271 137] were treated in EDs for sledding-related injuries. Overall, the injury rate decreased significantly for both children and adults. Children accounted for 69.7% of the injury cases. Fractures were the most common injury diagnosis for children (23.9%) and adults (27.4%). Compared to adults, children were more likely to sustain a head injury [relative risk (RR): 1.91 (95% CI: 1.73-2.13)] and be diagnosed with a concussion or closed-head injury (CHI) [RR: 1.58 (95% CI: 1.35-1.84)]. Most patients were injured by a collision (63.2%). Snow tube and disk riders were more likely to sustain a concussion or CHI compared to sled and toboggan riders [RR: 1.53 (95% CI: 1.18-1.99)]. Injuries predominantly occurred when patients collided with objects in the environment (47.2%). CONCLUSIONS: Although sledding-related injuries decreased over the study period, more research and education to prevent these injuries is needed. The injury patterns and risk of injury type differed by age, with more head injuries sustained by children. Sledding should be performed in obstacle-free areas to reduce the risk of collision and while wearing helmets to mitigate head injuries.

Pinterest Homemade Sunscreens: A Recipe for Sunburn.

Social media, specifically Pinterest with more than 175 million users, has changed the way people seek and share health information. Recent consumer interest in natural products has led to an increase of shared recipes for homemade products including sunscreen. Homemade sunscreen products are risky because they are not regulated or tested for efficacy like commercial sunscreens. With rising skin cancer rates, the use of effective broadband sunscreen is critical to reduce incidence of skin cancer. This study used directed content analysis to examine how homemade sunscreens were portrayed on Pinterest. Using the search terms, homemade sunscreen and natural sunscreen, researchers sampled every fifth pin to collect 189 relevant pins. A codebook was developed, pilot tested, and used to code pins. Two researchers coded pins and interrater reliability was established at 90%. Of the 189 pins, the majority of pins (95.2%) positively portrayed the effectiveness of homemade sunscreens and 68.3% recommended recipes for homemade sunscreens that offered insufficient UV radiation protection. Sun Protection Factor (SPF) claims were made in 33.3% of pins with a range of SPF 2 to SPF 50. In this sample of pins, 41.8% of pins had been saved by other users ranging from one to more than 21,000 times. Social media is a powerful source of health information. However, this study revealed widespread interest and acceptance of insufficient sun protection information. Pinterest and the interest in homemade recipes for sunscreen present an opportunity for public health professionals to proactively engage on social media. Abbreviations: US: United States; SPF: sun protection factor; USFDA: United states food and drug administration; UV: ultraviolet.

Veterinary-Prescribed Buprenorphine Ingestion in a 2-Year-Old Girl.

INTRODUCTION: Ingestion of buprenorphine by young children is on the rise and can lead to life-threatening consequences and death. Exposure most often occurs when a child acquires the medication intended for adult use. However, buprenorphine is also prescribed by veterinarians and may be sent home, typically in non-child-resistant packaging, to be administered to the family pet. CASE: A previously healthy 2-year-old girl weighing 11.36 kg was found with a 1-mL syringe containing 0.6 mg/mL of buprenorphine in her mouth. The syringe had been in a plastic bag provided to the family by their veterinarian for the family dog. She was hospitalized for 24 hours but remained asymptomatic and was discharged healthy. This type of exposure to buprenorphine has not previously been described in the literature. CONCLUSIONS: Having this unsecured medication in the home increases the potential risk of exposure for young children and associated health consequences. Pediatricians should be aware of the potential dangers that veterinary pharmaceuticals can pose and educate parents about proper storage of medications. In addition, veterinarians should take extra precautions when dispensing these medications to pet owners with children.

Maternal Knowledge, Attitudes, and Behavioral Intention after Exposure to Injury Prevention Recommendations in the News Media.

INTRODUCTION: Injury prevention recommendations are frequently presented in the media. Parental understanding and response to these recommendations remain uninvestigated. METHODS: A nationally representative sample of 1,081 mothers completed a cross-sectional survey measuring knowledge, attitudes, and behavioral intention after watching/reading video news stories and print articles on two child safety topics. RESULTS: Of the 1,081 respondents, 33% reported hearing little about injury prevention in the media in the past 30 days, and 32% reported never hearing about injury prevention. Nearly one-half (46%) reported the injury prevention studies they had previously read or heard about in the media were confusing to them at least some of the time. The proportion of mothers who recalled the correct key statistic presented in the story varied by safety topic and medium in which the story was presented. A greater proportion of mothers correctly recalled information from the story narrative than the statistics. Mothers also rated the most interesting part of the story differently based on safety topic and medium. A small proportion were not planning to follow the safety recommendations after viewing the news story. CONCLUSIONS: There are gaps in making injury news stories understandable and memorable for mothers in order to encourage behavioral change.

Exploring Lactation Consultant Views on Infant Safe Sleep.

Objectives The purpose of this qualitative study was to explore the infant safe sleep beliefs and occupational practices of lactation consultants and to determine if lactation consultants give advice to clients that is consistent with the American Academy of Pediatrics' recommendations on this topic. Methods Focus groups were conducted with certified lactation consultants in two cities in Ohio. Participants discussed the role of lactation consultants, the infant sleep advice they provide to women, their views on the American Academy of Pediatrics' infant safe sleep recommendations and related policies, and perceived benefits and barriers associated with providing infant safe sleep education as part of their work. A member-checking session was held to ensure the credibility of the findings. Results Four focus groups were conducted with 22 certified lactation consultants between September and November 2015. Major themes that emerged included: lactation consultants' beliefs regarding the importance of bedsharing for supporting breastfeeding success; their disagreement with the infant safe sleep recommendations of the American Academy of Pediatrics; their frustration with policies that restrict consultants' ability to discuss bedsharing; and the impact of infant safe sleep policies on their work and the advice they provide. Conclusions for Practice Lactation consultants interact with mothers of newborns at a critical time for infant safe sleep decision-making and may influence a woman's choices related to this topic. Women may not be receiving messages from lactation consultants that are consistent with the infant safe sleep recommendations of the American Academy of Pediatrics.

Infant Safe Sleep: A Survey of the Knowledge, Attitudes, and Behaviors of Obstetric Physicians.

Obstetricians may be a pregnant woman's primary professional source of information about her infant prior to the birth, but infant safe sleep knowledge, attitudes and behaviors of this population are unknown. This study explores obstetric physicians' knowledge, attitudes, and behaviors related to Sudden Infant Death Syndrome and infant safe sleep and identifies barriers as well as enabling and/or reinforcing factors associated with providing infant safe sleep education in the prenatal environment. A cross-sectional survey was conducted with obstetric physicians who provide prenatal healthcare to women in Ohio. Surveys were sent to all licensed physicians included in the registry of the State Medical Board of Ohio with "obstetrics," "obstetrics and gynecology," or "maternal and fetal medicine" as their primary specialty (n = 1771). The response rate was 30%, with 418 physicians included in the analysis. Many participants were knowledgeable about infant safe sleep recommendations; however, only 55% indicated that it was important for obstetric physicians to discuss Sudden Infant Death Syndrome and/or infant safe sleep with prenatal patients. Many participants (70%) perceived barriers to providing infant safe sleep education, however most (82%) indicated interest in doing so. Participants' knowledge and attitudes were significant predictors of whether they discuss this topic with patients. Obstetric physicians can influence the infant safe sleep decisions that women make. Improving obstetricians' knowledge and attitudes about infant safe sleep and supporting physicians who wish to provide education on this topic may help to ensure that women are receiving frequent and consistent infant safe sleep messaging throughout the prenatal period.

Carbon Monoxide Alarm and Smoke Alarm Use Among Parents Recruited From a Pediatric Emergency Department.

Although the proper installation and maintenance of carbon monoxide (CO) and smoke alarms can protect individuals from residential CO-related and fire-related injuries, these devices are underutilized. We describe characteristics associated with self-reported CO and smoke alarm use of parents recruited from a pediatric emergency department to improve CO alarm use. Parents of children ≤ 18 years (N = 299) reported socio-demographic characteristics and CO and smoke alarm ownership and practices. We assigned participants to a behavioral profile and a Precaution Adoption Process Model stage based on their self-reported CO and smoke alarm use. Most participants (71%) did not have CO alarms in their homes, but reported owning at least one working smoke alarm (98%). Participants who reported "perfect" CO alarm behavior (defined as having a working CO alarm, one near a sleeping area, with batteries replaced every 6 months; 9%) were more likely to earn a higher income, own their home, and have lived at their current residence for at least 2 years. Participants who reported "perfect" smoke alarm behavior (defined as having a working smoke alarm on every level, with batteries replaced every 6 months; 49%) were more likely to rent their home, receive federal assistance, and have lived at their current residence for at least 2 years. Interventions to increase correct CO alarm use are necessary.

Paediatric emergency department-based carbon monoxide detector intervention: a randomised trial.

BACKGROUND: Although non-fire-related carbon monoxide (CO) poisoning is almost entirely preventable, over 400 people die and 20 000 people are injured each year in the USA from unintentional CO poisoning. Thus, there is a critical need for evidence-based interventions for preventing CO poisoning and increasing the proper use and installation of CO detectors. METHODS: A randomised, controlled trial (Project CODE, a Carbon Monoxide Detector Education intervention) with 2-week and 6-month follow-up home observations was conducted in 299 parents of children aged ≤18 years recruited in the emergency department of a level 1 paediatric trauma centre. The intervention group received an educational tool, a spiral-bound, laminated booklet that resembled a CO detector containing theory-based safety messages based on the precaution adoption process model, a plug-in CO detector and 9 V battery. The control group received a one page flyer on CO poisoning prevention. RESULTS: Although the difference was not statistically significant, mean CO knowledge score increased at a greater rate for the intervention group than the control group. Intervention group parents were more likely to exhibit 'safe' CO detector use than control group parents at the 2-week follow-up (RR: 2.75; 95% CI 2.06 to 3.69) and 6-month follow-up (RR: 2.78; 95% CI 2.06 to 3.76), after adjusting for self-reported CO detector use behaviour at enrolment and annual per capita income. CONCLUSIONS: An emergency department-delivered intervention containing a theory-based educational tool paired with a CO detector can be an effective method for increasing knowledge about CO poisoning, for prevention and for appropriate use of a CO detector. TRIAL REGISTRATION NUMBER: NCT00959478.

Child Passenger Safety in the Somali Communities of Columbus, Ohio.

Children (particularly low-income minorities and refugees) are at high risk for serious injury or death from motor vehicle crashes. Interpreter-assisted data collection included key informant interviews, focus groups and face-to-face surveys with the Somali community of Columbus, Ohio about child passenger safety. Measurements included prevalence of child safety seats use, awareness and knowledge of and barriers to proper use in order to inform development, implementation, and initial evaluation of a culturally-appropriate intervention for Somali families. Somali parents regarded child passenger safety as an important topic, but many reported improper restraint behaviors of one or more children and/or did not have an adequate number of child safety seats. Few parents reported having child safety seats installed by a professional technician. Child passenger safety practices in the Somali communities of Columbus are a public health concern that should be addressed with culturally-appropriate interventions.

Distribution and Evaluation of a Carbon Monoxide Detector Intervention in Two Settings: Emergency Department and Urban Community.

The objective of this study was to describe changes in carbon monoxide (CO) safety knowledge and observed CO detector use following distribution of a CO detector use intervention in two environments, a pediatric emergency department (Ohio) and an urban community (Maryland). A total of 301 participants completed the 6-month follow up (Ohio: n = 125; Maryland: n = 176). The majority of participants was female, 25­34 years of age, and employed (full or part time). We found that CO safety knowledge did not differ between settings at enrollment, but significantly improved at the follow-up visits. The majority of CO detectors observed were functional and installed in the correct location. Of those with CO detectors at follow up, the majority had not replaced the battery. The success of the intervention varied between settings and distribution methods. The majority of participants showed improved knowledge and behaviors. Improved device technology may be needed to eliminate the need for battery replacement.

Dental injuries sustained by high school athletes in the United States, from 2008/2009 through 2013/2014 academic years.

BACKGROUND/AIM: Risk of dental injuries is present in a variety of sports. Mouthguards are effective yet underutilized. This study aimed to estimate the rate of dental injuries among high school athletes and investigate the utilization of mouthguards across multiple high school sports. MATERIALS AND METHODS: Athlete exposure and dental injury data were collected during the 2008/2009 through 2013/2014 academic years from a large sample of high schools in the United States as part of the National High School Sports-Related Injury Surveillance Study. RESULTS: There were 222 dental injuries sustained during 24,787,258 athlete exposures for a rate of 0.90 per 100,000 athlete exposures. The rate of dental injuries in competition (1.8) was three times higher than the rate in practice (0.6) (RR: 3.1, 95% CI: 2.3-4.0). Rates of dental injuries varied by sport with the highest rates in girls' field hockey (3.9) and boys' basketball (2.6). Dental injuries most commonly occurred as a result of contact with another player (61.3%) and contact with a playing apparatus (31.5%). For the majority of dental injuries, the athlete was not wearing a mouthguard (72.5%). Among injuries where athletes were wearing mouthguards, the majority were self-fitted (95.9%). CONCLUSIONS: Although dental injuries were relatively uncommon, the majority occurred while the athlete was not wearing a mouthguard. As previous studies have shown that mouthguards are effective in preventing injuries, all high school athletes participating in a sport that places them at risk of sustaining a dental injury should wear a mouthguard consistently in both competition and practice.

Mouthguard BITES (behavior, impulsivity, theory evaluation study): what drives mouthguard use among high school basketball and baseball/softball athletes.

Although mouthguards are effective, inexpensive, easy to use, and readily available, this form of protective equipment has been underutilized. "Impulsive delay discounting" (an index of impulsive behavior) among high school athletes may help explain their decision making regarding use of protective equipment such as mouthguards. We investigated the relationship between high school baseball, softball, and basketball players' mouthguard use, impulsive delay discounting, and the precaution adoption process model (a behavior change theory). A convenience sample of boys' and girls' basketball and baseball/softball players at 21 high schools in the Greater Columbus, Ohio, metro area completed a self-administered survey that captured their demographic information, knowledge, attitudes, and beliefs regarding mouthguard use, impulsive delay discounting, and precaution adoption process model stage. We surveyed a total of 1636 students (55.9 % male, 43.8 % female, 0.3 % unknown). Only 12.3 % reported using a mouthguard either every time or sometimes during practice or competition. The primary reasons reported for not wearing mouthguards were they were not required to (65.3 %) and that the athletes could not breathe or talk while wearing one (61.5 %). These reasons were consistent across sex and sport. Most athletes reported that their coaches (87.3 %) and parents (64.5 %) had never talked to them about wearing a mouthguard. Lower precaution adoption process model stage was significantly associated with higher impulsivity (p < 0.001) and higher delayed discounting (p = 0.016) after adjusting for school, sport, and sex. Voluntary mouthguard use among high school athletes playing basketball and baseball/softball remains low despite the risk of dental injury in these sports. Effective, evidence-based, targeted, and tailored interventions to improve adolescent athletes' use of mouthguards to prevent sports-related dental injuries should be based on the specific behavioral and social factors influencing each athlete's decision making regarding use of mouthguards.

Characteristics of nontrauma scene flights for air medical transport.

INTRODUCTION: Little is known about the use of air medical transport for patients with medical, rather than traumatic, emergencies. This study describes the practices of air transport programs, with respect to nontrauma scene responses, in several areas throughout the United States and Canada. METHODS: A descriptive, retrospective study was conducted of all nontrauma scene flights from 2008 and 2009. Flight information and patient demographic data were collected from 5 air transport programs. Descriptive statistics were used to examine indications for transport, Glasgow Coma Scale Scores, and loaded miles traveled. RESULTS: A total of 1,785 nontrauma scene flights were evaluated. The percentage of scene flights contributed by nontraumatic emergencies varied between programs, ranging from 0% to 44.3%. The most common indication for transport was cardiac, nonST-segment elevation myocardial infarction (22.9%). Cardiac arrest was the indication for transport in 2.5% of flights. One air transport program reported a high percentage (49.4) of neurologic, stroke, flights. CONCLUSION: The use of air transport for nontraumatic emergencies varied considerably between various air transport programs and regions. More research is needed to evaluate which nontraumatic emergencies benefit from air transport. National guidelines regarding the use of air transport for nontraumatic emergencies are needed.

The Tension Between AAP Safe Sleep Guidelines and Infant Sleep.

OBJECTIVES: To understand tension mothers experience when attempting to follow American Academy of Pediatrics safe sleep guidelines and enhancing infant and parental sleep. METHODS: Surveys and focus groups were conducted from November 2022 and March 2023 with United States-based English-speaking mothers of infants <6 months of age recruited via social media and who reported a nonrecommended sleep position and/or location ≥2 times the prior week. RESULTS: Twenty-five mothers participated in focus groups and surveys. A total of 80% reported holding or rocking their infant to sleep; 76% fed their infant to sleep. Almost all were aware of the ABCs (Alone, Back, Crib) of safe sleep and intended to follow them before delivery. Many felt that ABCs were unrealistic and placed their infants in nonrecommended locations or positions because they perceived them as more comfortable and helping their infant fall and stay asleep. Mothers were more likely to use nonrecommended practices when they were awake or sleeping nearby and believed they could closely monitor their infant. Some questioned whether ABCs were the only way to achieve safe sleep. Some prioritized other safety concerns (eg, fall prevention) over sudden infant death syndrome or sudden unexpected infant death prevention. Mothers expressed confidence about getting their baby to sleep in general but were less confident that they could do this while following guidelines. CONCLUSIONS: Despite awareness of the ABCs, mothers regularly engaged in nonrecommended practices with the goal of improving their own and their infant's sleep. Interventions focused on improving infant and parental sleep while maintaining sleep safety are needed.

Pediatric Martial Arts-Related Injuries Treated in Emergency Departments in the United States From 2004 to 2021.

BACKGROUND: Participation in martial arts has been increasing for several years, with millions of children and adolescents engaging in the sport annually. Yet, the most comprehensive examination of martial arts-related injuries was completed almost 2 decades ago. PURPOSE: To describe the epidemiology of martial arts-related injuries presenting to US emergency departments (EDs) among pediatric patients. STUDY DESIGN: Descriptive epidemiological study. METHODS: Data were obtained from the National Electronic Injury Surveillance System for patients aged 3 to 17 years who were treated in US EDs from 2004 through 2021. RESULTS: A total of 5656 cases were included in the analysis. An estimated 176,947 children (95% CI, 128,172-225,722) were treated for martial arts-related injuries in US EDs. The rate of martial arts-related injuries per 10,000 children increased from 1.43 in 2004 to 2.07 in 2013 (slope = 0.07; P = .005) and then decreased to 1.44 in 2021 (slope = -0.10; P = .02). The mean injury rates were 2.22 per 10,000 children aged 12-17 years and 1.15 per 10,000 children aged 3-11 years. The most common injuries occurred in children aged 6 to 11 years (39.3%), were strains/sprains (28.4%), and were associated with falling (26.9%). The mechanism of injury differed by the style of martial arts. Compared with other activity types (formal class, horseplay, and unspecified), competition carried a 2.56 times greater risk of head/neck injuries and a 2.70 times greater risk of traumatic brain injuries. CONCLUSION: Martial arts are a significant source of injuries for children aged 3 to 17 years. To continue decreasing the injury rate, the creation and implementation of standardized risk-mitigation rules and regulations that could be applied to all martial arts styles are recommended.

Lacrosse-related injuries in boys and girls treated in U.S. emergency departments, 2000-2016.

BACKGROUND: Lacrosse is one of the fastest-growing sports in the United States. Its rules regarding permitted contact differ by sex and age. There are no known studies using a nationally representative data set to analyze lacrosse injury patterns over several years by sex and age in the youth population. METHODS: A retrospective analysis was performed using data from the National Electronic Injury Surveillance System for youth aged 11-18 years who were treated for lacrosse-related injuries in U.S. emergency departments from 2000 to 2016. Based on our review of the case narratives, we created and coded a new injury-mechanism variable. We generated national estimates from 6406 cases. RESULTS: An estimated 206,274 lacrosse-related injuries to youths aged 11-18 years were treated in U.S. emergency departments from 2000 to 2016. The rate of injuries per 10,000 significantly increased from 1.9 in 2000 to a peak of 5.3 in 2012 (p < 0.0001), followed by a significant decrease to 3.4 in 2016 (p = 0.020). Injury mechanism, body part injured, and diagnosis differed by sex. Boys were 1.62 times (95% confidence interval (95%CI): 1.25-2.09) more likely than girls to be injured by player-to-player contact. Girls were 2.21 times (95%CI: 1.96-2.49) more likely than boys to have non-contact injuries. Overall, as age increased, the percentage of injuries from lacrosse sticks decreased and player-to-player contact increased. CONCLUSION: Despite additional protective regulations in the sport, lacrosse is an important source of injury where we continue to see differences by sex and age. This study supports the continuation, modification, and addition of rules aimed at reducing lacrosse injury risk.