Serious injuries related to the Segway® personal transporter: a case series.

STUDY OBJECTIVE: We describe a case series of emergency department (ED) visits for injuries related to the Segway® personal transporter. METHODS: This was a retrospective case review using a free-text search feature of an electronic ED medical record to identify patients arriving April 2005 through November 2008. Data were hand extracted from the record, and further information on admitted patients was obtained from the hospital trauma registry. RESULTS: Forty-one cases were included. The median age was 50 years, and 30 patients (73.2%) were women. Twenty-nine (70.7%) of the patients resided outside the District of Columbia, Maryland, and Virginia, and 32 (78.1%) arrived between June and September. Seven (17.1%) patients had documented helmet use. Ten (24.4%) were admitted. Four patients (40% of admitted patients) required admission to the ICU. CONCLUSION: The severity of trauma in this case series of patients injured by the use of the self-balancing personal transporter is significant. Further investigation into the risks of use, as well as the optimal length and type of training or practice, is warranted. A distinct E-code and Consumer Product Safety Commission's product code is needed to enable further investigation of injury risks for this mode of transportation.

Attitudes of teenagers and their parents to Pennsylvania's graduated driver licensing system.

OBJECTIVES: To determine the attitudes of teens and parents in Pennsylvania (PA) towards the enhanced graduated driver licensing (GDL) system implemented in 2000, and to assess their understanding of teen crash risk. METHODS: Cross-sectional survey of teen drivers and their parents. Eligible teens were 16 or 17 years old when they obtained their first learner's permits in 2000. A simple random sample of 2500 was obtained from 48,372 meeting inclusion criteria. Questions were based on previous surveys and pre-tested in focus groups. ANALYSIS: Chi-square, McNemar, or t-tests, as appropriate. RESULTS: A total of 1561 surveys (811 parents and 750 teens) were included in the analysis. There were no differences between the sample and teen respondents. Their junior license had been achieved by 735 (98%) teens and had been driving unsupervised for a mean of 14.1 months (SD 4.89). Greater than ninety percent (90%) of parents approved of the overall system, the six-month learner phase, and the requirement for parental certification of 50 hours of supervised driving. The teens' reactions were less positive than the parents' (p < 0.001), but only 16% reported a negative overall reaction. 31.4% of the teens reported not completing the required 50 hours of supervised driving. 70.6% of parents felt the nighttime driving restriction was "just right" at 11 pm but 54.0% of teens preferred that it be returned to 12 mn (p < 0.001). When asked about the crash rate for teen drivers, 72.8% of teens and 74.0% of parents chose rates 2 to 100 times less than the reported crash rate (p = 0.8). CONCLUSIONS: In PA, the primary stakeholders, teen drivers and their parents, were poorly informed about teen crash risk. Parents were very positive and teens are generally neutral or weakly positive about the new restrictions imposed by the enhanced graduated driver licensing system. Better understanding of the crash rate for teen drivers might increase approval of system restrictions, enhance compliance, and further strengthen the system.

Increasing rates of emergency department visits for elderly patients in the United States, 1993 to 2003.

STUDY OBJECTIVE: In 2005, the Centers for Disease Control and Prevention reported increasing emergency department (ED) visit rates per 100 people. The greatest increase in visit rate was among individuals 65 years and older. Given that older ED visitors have longer lengths of stay in the ED, are more likely to be admitted, and compose a growing proportion of the American population, this finding could have a significant negative effect on ED crowding. The first step toward addressing this issue is a better understanding of the nature of these visits. METHODS: We performed trend analysis for persons aged 65 years and older using 1993 to 2003 National Hospital Ambulatory Medical Care Survey data, an annual national sample of visits to the EDs of nonfederal general and short-stay hospitals. SAS 9.1 computed population estimates and standard errors for number of ED visits. Annual census data were used to compute visit rates per 100 persons. A least-squares test for trend determined slopes and 95% confidence intervals. RESULTS: Visits for patients aged 65 to 74 years increased 34% during the study period. The visit rate for blacks increased 93% to 77 visits per 100 population, whereas the rate for whites increased 26% to 36 visits per 100. The admission rate did not change significantly during the study period. The number of visits at which 3 or more medications were prescribed increased 44%. The increased visits occurred primarily in the category of "other and undefined" diagnoses (90% increase). CONCLUSION: If these trends continue, ED visits in the United States for the 65- to 74-year-old group could nearly double from 6.4 million visits to 11.7 million visits by 2013.