Electric scooter injuries at Auckland City Hospital

AIM

Since the introduction of shared electric scooters to Auckland in October 2018, there have been multiple reports of injuries. We aim to examine the pattern of injuries sustained while riding electric scooters in patients presenting to hospital.

METHODS

We conducted a retrospective analysis of patients who presented to Auckland City Hospital Emergency Department (ED) between 15 October 2018 and 22 February 2019. Patients were firstly identified by ED staff and noted in a logbook, and secondly by searching the Trauma Registry database. Outcomes of interest were injuries, imaging, alcohol and helmet use, length of stay and interventions.

RESULTS

There were 180 patients identified. The median length of stay was 4.0 hours, interquartile range (IQR) 18.4 hours. One-third of patients were admitted or transferred. Common injuries were contusions, abrasions and lacerations (65.6%), fractures (41.7%) and head injuries (17.2%). One in five patients (22.2%) required an operation. Only three patients wore a helmet. Of all patients, 23.3% had consumed alcohol, and of those with head injuries; 41.9% had consumed alcohol.

CONCLUSION

This study highlights the significant number of electric scooter-related injuries, including severe head injuries. While the majority of presentations are categorised as minor trauma, these cases have placed additional demand on health system resources. This mode of transport would benefit from greater regulation, including a zero blood alcohol limit, night-time curfews, reduced speed limits and consideration of mandatory helmet use.

Management of acute sigmoid volvulus in a provincial centre-a 20-year experience

AIM

At our institution there has been a long-standing early operative approach to large bowel volvulus as well as initial decompression with rigid sigmoidoscopy. The primary aim of this study was to investigate the safety and efficacy of this approach on reducing readmissions and complications. Secondary aims were to investigate the safety and efficacy of bedside rigid sigmoidoscopy in decompression of sigmoid volvulus and investigate the sensitivity of abdominal x-ray in the diagnosis of acute large bowel volvulus.

METHOD

A retrospective study was conducted on all patients presenting with acute obstruction due to large bowel volvulus between 1 January 1998-1 January 2018.

RESULTS

Thirty-four patients with acute sigmoid volvulus were identified that met the inclusion criteria with a median age of 81 years. The majority of patients 27/34 (79%) were booked for surgery on the first admission. Readmissions were reduced in the index operative group 1/20 (5%) vs the non-operative decompression group 3/4 (75%) RR 0.07 (CI 0.01-0.49 P=0.01).

CONCLUSION

Early sigmoid colectomy was associated with low morbidity and found to be safe in the elderly, and the results suggest that early surgery is associated with reduced readmissions and a low complication rate, with index surgery preferable to urgent elective surgery. Rigid sigmoidoscopy is a safe method of decompression as a bridge to index surgery and was not associated with any complications in this series.