Factors associated with Parental Knowledge and Attitudes towards Concussions in the Republic of Korea.

Background: This study investigated the status and evaluated factors associated with knowledge and attitudes regarding concussions among Korean parents of children aged 6-18 years. Methods: A cross-sectional online survey was employed to collect data from a panel of parents in the Republic of Korea in 2023. To assess knowledge and attitudes regarding concussions, participants completed a validated questionnaire. The outcome variables of the total knowledge and total attitude scores, which ranged from 0 to 30 and 7 to 49, respectively, were categorized into three levels based on approximately 33% increments. We conducted multivariable ordinal logistic regression analyses with the participants' and their children's demographics and characteristics as covariates. Results: A total of 260 parents responded to the survey and demonstrated moderate concussion-related knowledge (median total score, (Inter Quartile Range (IQR) 18-22.5)). The respondents exhibited favorable attitudes toward concussions (median total score, 39 (IQR 34-43)). Multivariate ordinal regression analysis for outcomes revealed that, except for the careers of healthcare providers (adjusted odds ratio (AOR) 3.15, 95% confidence interval (CI), 1.13-8.75), no factors were associated with parental concussion-related knowledge. Among the factors, none exhibited a statistically significant association with concussion-related parental attitudes. Conclusion: Our results confirmed the knowledge-attitude gap regarding concussions among Korean parents and novel strategies are warranted to improve parental knowledge and attitudes.

Efficacy and safety of ketamine alone and ketamine-dexmedetomidine combination for sedation for brain computed tomography in paediatric patients with head injuries: A retrospective study.

OBJECTIVE: To compare the efficacy and safety of ketamine alone with those of ketamine-dexmedetomidine combination for sedation during brain CT in paediatric patients with head injuries. METHODS: We retrospectively analysed the data of paediatric patients who underwent sedation for brain CT at the ED. We included patients aged 6 months to 6 years with American Society of Anesthesiologists physical status I or II. The sedative protocol involved the administration of intramuscular (IM) ketamine 3 mg/kg (K), ketamine 2 mg/kg with dexmedetomidine 1.5 µg/kg (KD) or ketamine 1.5 mg/kg with dexmedetomidine 1.5 µg/kg (low-KD). The primary and secondary outcomes were sedation failure and adverse events, respectively. RESULTS: We included 77 patients; among them, 28, 23 and 26 were in the K, KD and low-KD groups, respectively. In multivariable analysis, the combination groups (KD and low-KD groups) were significantly associated with a lower possibility of sedation failure compared to the K group (adjusted odds ratio, 0.12; 95% confidence interval, 0.02-0.56). Moreover, there were no significant differences in adverse events between the groups, and the sedation-related time variables also did not significantly differ among the three groups. CONCLUSIONS: Our findings indicated that a combination of IM ketamine-dexmedetomidine provides effective sedation for paediatric patients undergoing brain CT without significant adverse events. Further research is needed to investigate the potential benefits of using lower doses of ketamine in combination.

Prioritization of Injury Prevention and Management Programs and Research and Development (R&D) Projects: Survey Using the Delphi Technique and Analytic Hierarchy Process.

We prioritized injury prevention and management programs, and research and development (R&D) projects using the Delphi method and analytic hierarchy process (AHP) for national plan. We summarized 21 programs and 31 R&D projects based on opinions collected in the opinion survey and brainstorming. Expert panel evaluated program and project relevance in the two Delphi rounds to make consensus. Total scores were calculated by adding criterion weights calculated through the AHP multiplied by the average of scores for each program and project. The top three programs were "Integrated Management System for Injury Data," "Comprehensive Injury Surveillance System," and "Transport System Improvement Program for Major Trauma." The top three R&D projects were researches on "Identification of Vulnerable Workers Injuries to Strengthen Protections," "Data Integration on Injury and Disability," and "Using Public Health Big Data to Identify Injury Status and Risk Factors." Experts highly rated the programs to improve injury surveillance system.

Correction: Evaluation of class participation in non-face-to-face CPR training for medical students.

[This corrects the article DOI: 10.1371/journal.pone.0278273.].

A scoping review of remote facilitation during simulation-based healthcare education.

BACKGROUND: Remote facilitation is a synchronous distance education method where instructors facilitate a lesson, in real-time, in physically separate conditions. In this scoping review, we aimed to describe types of remote facilitation used in a healthcare simulation, the influences on learner outcomes, and related factors. METHODS: We accessed PubMed, EMBASE, CINAHL, ERIC, and Web of Science using our search strategies. Five reviewers performed the review using the Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews (PRISMA-ScR) framework, and the Johanna Briggs Institute (JBI) guidelines. RESULTS: We included a total of 29 articles presenting 28 simulation studies. The most common tool was videoconferencing (n = 26, 89.7%). Knowledge improvement was the most frequently measured outcome. There was no significant difference in learning outcomes between the two teaching modes. There were differences in learners' preferences and satisfaction with remote facilitators before and after COVID-19. CONCLUSIONS: Our scoping review indicates that remote facilitation has been widely accepted in many healthcare professions using various types of simulation modalities. Remote facilitation can be used to overcome logistical problems of synchronous multi-location education, and to improve learner knowledge, skills, and confidence measured by instructor evaluation or self-assessment.

Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008-2015.

BACKGROUND: Although inequality in traumatic brain injury (TBI) by individual socioeconomic status (SES) exists, interventions to modify individual SES are difficult. However, as interventions for area-based SES can affect the individual SES, monitoring or public health intervention can be planned. We analyzed the effect of area-based SES on hospitalization for TBI and revealed yearly inequality trends to provide a basis for health intervention. METHODS: We included patients who were hospitalized due to intracranial injuries (ICIs) between 2008 and 2015 as a measure of severe TBI with data provided by the Korea National Hospital Discharge Survey. Area-based SES was synthesized using the 2010 census data. We assessed inequalities in ICI-related hospitalization rates using the relative index of inequality and the slope index of inequality for the periods 2008-2009, 2010-2011, 2012-2013, and 2014-2015. We analyzed the trends of these indices for the observation period by age and sex. RESULTS: The overall relative indices of inequality for each 2-year period were 1.82 (95% confidence interval, 1.5-2.3), 1.97 (1.6-2.5), 2.01 (1.6-2.5), and 2.01 (1.6-2.5), respectively. The overall slope indices of inequality in each period were 38.74 (23.5-54.0), 36.75 (21.7-51.8), 35.65 (20.7-50.6), and 43.11 (27.6-58.6), respectively. The relative indices of inequality showed a linear trend for men (P = 0.006), which was most evident in the ≥ 65-year age group. CONCLUSION: Inequality in hospitalization for ICIs by area-based SES tended to increase during the observation period. Practical preventive interventions and input in healthcare resources for populations with low area-based SES are likely needed.

Analyzing willingness for extracorporeal cardiopulmonary resuscitation in refractory ventricular fibrillation.

Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory ventricular fibrillation/ventricular tachycardia in out-of-hospital cardiac arrest has recently been recommended for selected patients with favorable prognostic features. We aimed to identify factors affecting the willingness of emergency physicians to implement extracorporeal cardiopulmonary resuscitation (ECPR). We conducted a factorial survey with nine experimental vignettes by combining three different scene time intervals and transportation time intervals. Emergency physicians reported willingness to implement ECPR (1-100 points). Respondent characteristics that could affect the willingness were studied. Multilevel analysis of vignettes and respondent factors was conducted using a mixed-effects regression model. We obtained 486 vignette responses from 54 emergency physicians. In the case of longer scene time intervals, there was a significant difference in the willingness scores at 9 and 12 min transportation time intervals. When the pre-hospital time interval was > 40 min, emergency physicians demonstrated lower willingness to implement ECPR. Clinical experience of 15-19 years showed a significant favorable effect on willingness to implement extracorporeal membrane oxygenation (ECMO). However, the mean willingness scores of EPs for ECMO implementation were more than 75 across all vignettes. In ECPR, the prehospital time interval is an important factor, and the willingness of emergency physicians to implement ECMO could be mutually affected by scene time intervals, transportation time intervals, and total prehospital time.

Evaluation of class participation in non-face-to-face CPR training for medical students.

BACKGROUND: Cardiopulmonary resuscitation (CPR) education requires that learners practice key skills to promote mastery. Our aim in this study was to evaluate differences in post-education performance and class participation during CPR training between face-to- face (FF) and non-face-to-face (NFF) learning formats. METHODS: This was a randomized controlled study of third-year medical students from two university hospital, allocated to either the FF or NFF format for CPR education. The learning scenario addressed single-person CPR, consisting of chest compression only, and excluded breathing. The Kahoot! application was used for NFF. Between-group comparisons for class participation and CPR skills were based on video recordings. RESULTS: Seventy students participated in our study, with 35 randomly allocated to the FF and NFF groups. There were no between-group differences in terms of age, sex, previous basic life support training, and willingness and confidence in performing CPR. Compared to the FF group, the NFF group demonstrated significant differences during CPR, including fewer calling for assistance and using of defibrillator (p = 0.006), as well as fewer checking for breathing (p = 0.007), and fewer counting during chest compression (p = 0.006). Additionally, < 30% of learners in the NFF group completed rhythm analysis after the last defibrillator shock delivery and resumed immediate chest compression (p < 0.001). All students in both groups passed the post-training assessment. CONCLUSION: Class participation in NFF learning was lower than that in FF learning. Although the post-education evaluation in the NFF group was not inferior, efforts on promoting active participation in NFF learning are required.

Bicycle Injury Prevention Education Using 360° Virtual Reality Experiences of Accidents and Computer-Based Activity.

Injury prevention programs for children and adolescents need to be immersive and interactive. This study assessed a bicycle injury prevention program using technology-based education based on the Activated Health Education model and evaluated its effect on environmental factor awareness and attitude toward helmet-wearing. Using virtual reality technology, elementary and middle school students could experience simulated bicycle accidents. It was followed by an awareness phase that included a 30-min lecture where students self-learned and discussed risk-preventive factors. Students then developed user-created content and customized helmets they were given. We assessed students before the program, immediately afterward, and one month after the program. The number of respondents who said they were aware of surrounding bicycle lanes increased from 75.3% (pre-program) to 92.5% (one month after). Those who said they wore helmets often or always rose from 14.3% (pre-program) to 32.5% (one month later). The number needed to treat helmet-wearing behavior was approximately four, meaning that four people were required to participate in the program to have an impact on one person's helmet-wearing. We found that virtual reality and computer-based activities can help children and adolescents experience bicycle accidents, be aware of risk factors, and change their behaviors responsibly.

Extremity Injuries during Sporting Activities According to Life Course: Focusing on Fractures.

Background: The increased participation in sports has led to an increased number of sports-related injuries. We aimed to identify the incidence of sports-related injuries by life course and the risk factors for sports-related extremity fractures. Methods: We analyzed data of patients with sports-related extremity injuries from Emergency Department-based national injury surveillance systems, obtained from Jan 2013 to Dec 2016. A multiple logistic regression analysis was performed to identify risk factors of extremity fracture by life course after adjusting for sex, injury season, injury time, injury place, sports type, and mechanism of injury. Results: Overall, 23385 patients met our inclusion criteria. Soccer injuries were most common in the 5-14-year (32.4%), 15-24-year (43.0%), and 25-44-year groups (32.7%), and hiking injuries were most common in the 45-64-year (23.6%) and ≥65-year age groups (38.0%). The upper extremity injury and fracture rates were higher in the younger-age group; nevertheless, the injury and fracture rates of the lower extremities increased with increasing age. Moreover, the rate of hip and thigh injuries and fractures increased significantly in the ≥65-year age group. Conclusion: The incidence and severity of sports injuries are affected by player factors and the sports activity itself. The age of players is a major determinant that affects their medical and physiologic conditions and the sport of choice. The strategy for preventing sports injuries should be structured based on age.

Unintended beneficial effects of COVID-19 on influenza-associated emergency department use in Korea.

BACKGROUND: Non-pharmaceutical interventions, including hand hygiene, wearing masks, and cough etiquette, and public health measures such as social distancing, used to prevent the spread of coronavirus disease 2019 (COVID-19), could reduce the incidence rate of respiratory viral infections such as influenza. We evaluated the effect of COVID-19 on the incidence of influenza in Korea. METHODS: This retrospective study included all patients who visited five urban emergency departments (EDs) during the influenza epidemic seasons of 2017-18, 2018-19, and 2019-20. Influenza was defined as ICD-10 codes J09, J10, and J11, determined from ED discharge records. The weekly incidence rates of influenza per 1000 ED visits during the 2019-20 season, when COVID-19 became a pandemic, were compared with those of 2017-18 and 2018-19. The actual incidence rate of the 2019-20 season was compared with the predicted value using a generalized estimation equation model based on 2017-18 and 2018-19 data. RESULTS: The weekly influenza incidence rate decreased from 101.6 to 56.6 between week 4 and week 5 in 2020 when the first COVID-19 patient was diagnosed and public health measures were implemented. The weekly incidence rate during week 10 and week 22 of the 2019-20 season decreased most steeply compared to 2017-18 and 2018-19. The actual influenza incidence rate observed in the 2019-20 season was lower than the rate predicted in the 2017-18 and 2018-19 seasons starting from week 7 when a COVID-19 outbreak occurred in Korea. CONCLUSIONS: The implementation of non-pharmaceutical interventions and public health measures for the COVID-19 epidemic effectively reduced the transmission of influenza and associated ED use in Korea. Implementing appropriate public health measures could reduce outbreaks and lessen the burden of influenza during future influenza epidemics.

Healthy lifestyle factors, cardiovascular comorbidities, and the risk of sudden cardiac arrest: A case-control study in Korea.

AIMS: We investigated the impact of healthy lifestyle factors and cardiovascular comorbidities for sudden cardiac arrest. METHODS: A case-control study, including patients with sudden cardiac arrest aged 20-79 years and community-based 1:2 matched controls, was conducted from September 2017 to December 2020. All participants completed a structured questionnaire. Using multivariable logistic regression, we assessed cardiovascular comorbidities (diabetes, hypertension, dyslipidaemia, myocardial infarction, congestive heart failure, arrhythmia, and stroke) and healthy lifestyle factors (low red meat consumption, low fish consumption, high fruit consumption, high vegetable consumption, current non-smoking, regular exercise, and adequate sleep duration) as sudden cardiac arrest risk factors. RESULTS: Among 3027 eligible cases, informed consent was obtained from 949 (31.3%) cases. A total of 1731 controls were enrolled. Cardiovascular comorbidities, except dyslipidaemia, were associated with an increased risk of sudden cardiac arrest, whereas all healthy lifestyle factors were associated with a decreased risk. Relative to patients in the 0-2 healthy lifestyle factors group, the adjusted odds ratio (95% confidence interval) for sudden cardiac arrest was 0.25 (0.16-0.40) in patients with 3 healthy lifestyle factors, 0.08 (0.05-0.13) in patients with 4 healthy lifestyle factors, and 0.04 (0.03-0.06) in patients with over 5 healthy lifestyle factors. When the number of healthy lifestyle factors was analysed as a continuous variable, each additional factor was associated with a significant decrease in the likelihood of sudden cardiac arrest (adjusted odds ratio [95% confidence interval]: 0.41 [0.36-0.46]). CONCLUSION: The increased risk of sudden cardiac arrest by cardiovascular comorbidities could be significantly reduced with healthy lifestyle factors.

Clinical Characteristics Associated with Physical Violence in the Elderly: A Retrospective Multicenter Analysis.

BACKGROUND: Elder abuse is predicted to increase with the rapid population ageing in many countries. Violent injury is influenced by individual factors as well as interpersonal and social relationships, with different manifestations based on changes in the socioeconomic position of older adults. We comparatively investigated the clinical and injury characteristics of physical violence in the elderly with those in another age group. METHODS: We included elderly patients (age ≥65 years) who visited six emergency departments (ED) with violence-induced injuries in 2017. The control group comprised patients aged 45-64 years, selected by 1:2 matching based on hospital and sex. Data were extracted from the National Emergency Department Information System and electronic medical records. Both groups were compared for injury mechanism, injury location, activity during injury, diagnosis, and clinical outcomes. RESULTS: Among the 316,944 patients who presented to the 6 ED, 89,178 (28.1%) had traumatic injuries, and 1.6% and 4.5% of injuries were sustained due to violence in the ≥65 and 45-64 year age groups, respectively. There were no significant intergroup differences in the perpetrator (P=0.27), body parts affected (P=0.63), and diagnosis (P=0.23), whereas the older adult group had a significantly higher proportion of traumatic injury by fall (P=0.01), at road and traffic facilities (P=0.01), during work (P=0.01), and multiple injuries (P<0.01). CONCLUSION: The increase in non-regular workers in the elderly after retirement may have increased the risk of traumatic workplace injuries. As workplace injuries may be a new risk factor for physical violence in the elderly, institutional workplace injury prevention policy is needed.

Joinpoint Regression About Injury Mortality and Hospitalization in Korea.

BACKGROUND: Injury is a social problem that causes health and property losses, and it is important to identify the size and trend of injury for efficient prevention and management. Therefore, this study analyzed the trends in injury mortality and hospitalization rates from 2005 to 2019 in Korea. METHODS: Using mortality data by Statistics Korea and Korea National Hospital Discharge In-depth injury survey by the Korea Disease Control and Prevention Agency (KDCA), age standardized rates were calculated for death and hospitalization to analyze trends and annual changes with the joinpoint regression model. In addition, annual changes in the hospitalization rate of the transport accident and fall injuries by age group were analyzed, which are the major causes of injuries. RESULTS: From 2005 to 2019, the injury mortality rate has been on the decline, but the injury hospitalization rate has been on the rise. The annual rate of change varied depending on the injury mechanism, but the mortality rate tended to decrease or remain similar level, while the rate of hospitalization has steadily increased. In addition, by age group, injury mortality and hospitalization rates were high in the elderly. In particular, the hospitalization rate of the elderly was higher when comparing the hospitalization rate of the children in transport accidents and falls. Pedestrian transport accidents tended to decrease under the age of 15, but remained similar for those aged 65 and older, and bicycle accidents tended to increase in both groups. In addition, hospitalization rates were higher in the fall, with both groups showing a statistically significant increase in hospitalization rates caused by falls. CONCLUSION: This study analyzed the trend of injury mortality and hospitalization and found that transport accidents and falls may vary depending on the means or age of the accident. Since injury is a big social problem that is a burden of disease, safety education and legal sanctions for injury prevention should be further improved in the future, especially by prioritizing vulnerable groups by age and detailed mechanisms of injury.

Prioritising Risk Factors for Prescription Drug Overdose among Older Adults in South Korea: A Multi-Method Study.

Older adults are vulnerable to drug overdose. We used a multi-method approach to prioritise risk factors for prescription drug overdose among older adults. The study was conducted in two stages. First, risk factors for drug overdose were classified according to importance and changeability through literature review, determined through 2-phase expert surveys. Second, prescription drug overdose cases during 2011-2015 were selected from a national cohort; the prevalence of 'more important' or 'more changeable' factors determined in stage one was investigated. Scores were assigned according to the Basic Priority Rating Scale formula, reflecting the problem size and seriousness and intervention effectiveness. In the first stage, polypharmacy, old-old age, female sex, chronic disease, psychiatric disease, and low socioeconomic status (SES) were selected as risk factors. In the second stage, 93.9% of cases enrolled had chronic medical disease; 78.3% were using multiple drugs. Low SES was more prevalent than other risk factors. As per the scoring formula, chronic medical disease, polypharmacy, psychiatric disease, low SES, female sex, and old-old age were the most important risk factors in order of priority. Patients with chronic medical disease and those using multiple medications should be prioritised in overdose prevention interventions among older adults.

Instructor-led distance learning for training students in cardiopulmonary resuscitation: A randomized controlled study.

STUDY HYPOTHESIS: Cardiopulmonary resuscitation (CPR) training can increase the likelihood of patient survival and better neurological outcomes. However, conventional learning (CL) has cost, time, and space constraints. This study aimed to evaluate whether laypersons who completed instructor-led distance learning (DL) acquired a level of CPR skill comparable to that achieved via CL training. METHODS: This randomized controlled study recruited students from 28 Korean high schools who were randomized to complete instructor-led DL or CL training. The CL training involved classroom-based face-to-face training, whereas the instructor-led DL training was provided online using a videoconferencing system. RESULTS: The study enrolled 62 students who were randomized to the CL group (31 participants) or the DL group (31 participants). Relative to the CL group, the DL group achieved remarkably similar results in terms of most CPR variables. In addition, the DL group had a significant improvement in the mean compression depth (before: 46 mm [interquartile range: 37-52 mm] vs. after: 49 mm [interquartile range: 46-54 mm], p<0.001). CONCLUSIONS: Instructor-led DL can be a suitable alternative to CL for providing CPR training to laypersons. In settings like the current COVID-19 pandemic, where face-to-face CL is not practical, DL may be a useful tool for delivering CPR training.

The effects of a community-based disaster drill of simulating Disaster Medical Assistance Team (DMAT) on the knowledge and attitudes.

BACKGROUND: We evaluated the effects of community-based disaster drill of simulating disaster medical assistance team on the knowledge and the attitudes. METHODS: Eight hours disaster drills, including didactic lectures, table simulation, and outdoor field simulation, were developed for participants who were recruited from community health centers, emergency departments, fire stations, emergency medical technicians' academy, and emergency information center in the Seoul Metropolitan City area from 2006 to 2008. We surveyed on the knowledge and the attitude using designed questionnaire before and after drill. We compared changes using t-test and repeated measure ANOVA. RESULTS: In this study, 14 community-based drills were performed and 525 (79.4%) people responded to both pre- and post-drill survey. Of these, the doctor was the second common occupation (26.9%) after volunteer students (47.1%). Overall, knowledge and attitude score significantly increased from 3.9±1.0 to 4.3±0.9 (p<0.001) and from 21.4±3.4 to 22.4±3.2 (p<0.001), respectively. The difference among professional license groups between pre- and post-drill knowledge level was significant (p=0.03), while the difference among jobs for attitude between pre- and post-drill was not different (p=0.78). CONCLUSION: Disaster drills on the establishment and operation of DMAT may affect both knowledge and attitude of participants positively.

Risk Factors for Intracranial Injury Caused by Falls at Home in Korea Using Data from the Emergency Department-based Injury In-depth Surveillance (2011-2018).

BACKGROUND: Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home. METHODS: Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed. RESULTS: In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74-15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08-6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03-4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02-1.88) in females and 0.56 (95% CI, 0.48-0.66) in males. CONCLUSION: In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

Characteristics of injuries according to types of personal mobility devices in a multicenter emergency department from 2011 to 2017: A cross-sectional study.

ABSTRACT: Personal mobility devices (PMDs) have emerged as new factors in motor vehicle accidents, and related injuries are increasing. We aimed to describe the characteristics of PMD-related injuries presented to emergency departments (EDs) through a cross-sectional study for 7 years.This study is a multicenter cross-sectional study using the Emergency Department-based Injury In-Depth Surveillance database in South Korea. We identified all PMD-related injuries from 2011 to 2017 based on text searching. We categorized them into 3 groups based on their distinguishable characteristics: electric standing scooter (E-scooter), electric self-balancing wheel (E-wheel), and electronic board (E-board).A total of 448 PMD-related injuries were observed during the observation period. E-scooter-, E-wheel-, and E-board-related injuries occurred in 284, 138, and 26 cases, respectively. Most patients were between the ages of 19 and 59 years (69.2%), men (66.3%), and injured because of leisure activity (61.2%). The mechanism of injury was mostly traffic accidents (75.2%), but regarding injuries involving E-wheel and E-board, 25.4% and 30.8% of patients slipped from the device. The most commonly injured body part was the head, which accounted for 58.1% of E-scooter injuries, 38.4% of E-wheel injuries, and 53.9% of E-board injuries. Only 6 of all patients wore a helmet at the time of accident.PMD users and PMD-sharing programs are increasing, and more accidents are expected in the future. As PMDs are convenient to move and more people are willing to use them, proper riding and safety rules based on the type of PMD are needed to reduce the risk of injury. The results of this study can be used as basic data for developing safety policies.

Association between Survival and Time of On-Scene Resuscitation in Refractory Out-of-Hospital Cardiac Arrest: A Cross-Sectional Retrospective Study.

It is estimated that over 60% of out-of-hospital cardiac arrest (OHCA) patients with a shockable rhythm are refractory to current treatment, never achieve return of spontaneous circulation, or die before they reach the hospital. Therefore, we aimed to identify whether field resuscitation time is associated with survival rate in refractory OHCA (rOHCA) with a shockable initial rhythm. This cross-sectional retrospective study extracted data of emergency medical service (EMS)-treated patients aged ≥ 15 years with OHCA of suspected cardiac etiology and shockable initial rhythm confirmed by EMS providers from the OHCA registry database of Korea. A multivariable logistic regression analysis was conducted for survival to discharge and good neurological outcomes in the scene time interval groups. The median scene time interval for the non-survival and survival to discharge patients were 16 (interquartile range (IQR) 13-21) minutes and 14 (IQR 12-16) minutes, respectively. In this study, for rOHCA patients with a shockable rhythm, continuing CPR for more than 15 min on the scene was associated with a decreased chance of survival and good neurological outcome. In particular, we found that in the patients whose transport time interval was >10 min, the longer scene time interval was negatively associated with the neurological outcome.