P081: The summer of the e-scooter: a multicenter evaluation of the emergency department impact of rentable motorized scooters in Calgary

Introduction: Calgary's introduction of rentable electronic scooters (e-scooters) in July of 2019 was met with wild popularity, representing the third most popular launch after Tel-Aviv and Paris. The present study aims to characterize the injury burden seen in all Calgary Emergency Departments (EDs) and Urgent Care Centres (UCCs) attributable to e-scooters since their 2019 introduction. Methods: We retrospectively reviewed all electronic medical records of patients presenting to Calgary EDs or UCCs with the term “scooter” in the triage note, where exclusion criteria are considered for non e-scooter injuries (e.g: non-motorized scooters). Trends in scooter injuries will be compared between April - October 2018 (control arm preceding e-scooter introduction) and April - October 2019. Injury incidence, types, patient demographics, and relative risk compared to bicycle-related injuries will be determined. Descriptive statistics will be calculated. Moreover, 33 ED visits were brought in by EMS and provide information about injury types and locations of injuries involving EMS transport. Results: Preliminary data reveals 540 scooter-related visits (3.10% admitted/transferred) between July 8th and September 30th 2019 (mean age of 28, 56.30% male). Conversely, the number of bicycle-related visits and motor vehicle related injuries were 1482 and 586 (9.90% and 9.70% admitted/transferred) respectively over the same time period suggesting a greater burden but likely a lower per-ride incidence of injury requiring ED or UCC care. Moreover, between July 8th to October 1st 2019, 33 e-scooter presentations involved EMS (21.21% admitted to hospital), where 12.12% involved upper extremity injury, 21.21% were lower extremity injuries, and 6.06% were head injuries (mean age of 34, 48.48% male). Conversely, estimated EMS transfers to EDs or UCCs for bicycle injuries and motor vehicle injuries were 197 and 463 respectively over the same time period. ICU admissions or fatality were not recorded. Conclusion: Representing the most comprehensive study of e-scooter injury patterns in Canada to date, we here demonstrate a significant injury burden attributable to e-scooters following their introduction in Calgary in 2019. Bicycle-related and motor vehicle injuries were both more prevalent in this time period, and required more EMS visits. Further characterization of injury types, injuries and comparison with injury patterns prior to e-scooter introduction is yet to be determined.

Analysis of Emergency Department Visits for Motor Vehicle Injuries in Utah, 2016

ObjectiveTo describe the characteristics of emergency department (ED) visits for motor vehicle injuries in Utah using 2016 syndromic surveillance data.IntroductionMotor vehicle injury is the leading cause of death in injury category in the United States. In 2016, motor vehicle crashes were one of the main causes of death resulting from injury (8.8 per 100,000 population) in Utah. Motor vehicle crashes can lead to physical and economic consequences that impact the lives of individuals and their families. In addition, the treatment of injuries places an enormous burden on hospital Emergency Departments (EDs). Currently; there are no data sources other than syndromic data in the Utah Department of Health to monitor ED visits due to motor vehicle injuries in real time.MethodsUtah participates in the National Syndromic Surveillance Program (NSSP) to which all hospitals in the state submit ED visit data via the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE). ESSENCE was used to analyze 2016 ED visit data. Total population data were obtained from Utah population estimates. Data from 2017 was not included due to major system changes at a major healthcare system that interrupted data feeds resulting in lower than expected data volume.Motor vehicle injury is defined by existing subsyndrome definition in the Centers for Disease Control and Prevention ESSENCE system. All ED visit data were analyzed by querying key terms in the chief complaint field including any mention of: vehicle, wheeler, motorcycle, motor scooter, motor cycle, motor cross, truck, motorbike etc. Exclusion terms included any mention of: car dealership, hit head and car door. Ages were divided into seven groups for data distribution and comparison: 0–17, 18–24, 25–34, 35–44, 45–54, 55–64 and ≥ 65 years.ResultsIn 2016, a total of 28,472 ED visits (2% of total visits) were identified using the motor vehicle injury query. The ED visit rate for motor vehicle injuries was highest among persons aged 18–24 years (1,682 per 100,000 population). Rates continued to decline with increasing age after 18–24 years. The rate of females visiting the ED was higher than males (1,040 versus 826 per 100,000 population respectively; p < 0.01) (Figure 1). The majority of injuries (11722(52%)) were reported between 10:00 a.m. and 5:59 p.m. Injuries were highest August-September (5913(22%)).ConclusionsSyndromic data is a robust source of data for analyzing ED visits due to motor vehicle injuries in real time, and providing information to injury prevention programs for targeting interventions. Our data suggest an increased risk of visiting an ED due to motor vehicle injuries by age group (18-24 year olds), sex (females), month (August-September), and time (10:00 a.m. to 5:59 p.m.). These results do not include visits with incomplete or incorrectly coded chief complaints or discharge codes, patients of motor vehicle injuries who do not present to the ED, or not classified as ‘emergency’ patient class.

Crossing the road while playing a mobile game app – effects of age, environmental load and game complexity

Children are a high-risk group for motor vehicle injuries, and characterized also by extensive use of mobile phones. We investigated the influence of playing a mobile phone game on crossing behavior of children relative to adults. Our hypotheses were that: a) game use will affect pedestrian’s crossing behavior for all age groups; and b) increase in the complexity of the game will cause greater impact on crossing behavior. Twenty-seven children and twenty-one adults (mean=25.3, sd=1.5) participated. Children were divided into two ages; nine children aged 9-10 (mean=9.2, sd=0.4), and eighteen children aged 11-13 (mean=11.9, sd=0.6). The experiment took place in our Dome pedestrian simulator. Twelve simulated street-crossing scenarios, each lasting for 60-90 seconds; six in each environmental load (high/low clutter). Scenarios were presented from a pedestrian point of view, as if they were standing on the curb on one side of the road facing to the other side of a two lane street with two-way traffic. Street surround sounds were embedded in the scene. A dedicated smartphone game was built. The aim of the game was to identify as many dots in a predefined color specified for the participant at the beginning of the game. Identification is implemented by clicking on the desired color dot. The complexity of the game depended on the dots’ appearance rate on the screen, the dots’ growing rate, and the allowed overlap between different dots. Participants were asked to decide when to cross the virtual road, and indicate their decision by pressing a foot pedal. Each pedal step and its time of occurrence was recorded and the scenario was then stopped. In eight out of the twelve scenarios (four in each load), participants were asked to play the game while attempting to cross the road. Safety gap was significantly shorter when the complexity of the game was high and the visual load was low, for all age groups. No change in safety gap was found while using the mobile phone in a high load environment for 11-13 year-olds and adults. Hence, they maintained the same performance, with or without the use of the phone and regardless of game complexity. This was not the case for those aged 9-10, whose performance suffered as a result of the use of the phone, especially in the high level of game complexity. Possibly, in loaded environments the 11-13 and adults balanced their attention between the crossing environment and the game, something they have not done in cases of low environmental load. It seems that, only when the environment was more complex, these two age groups ‘put their phone aside’ and turned their attention on the crossing task, which they may have regarded as more difficult under these conditions. However, children aged 9-10 have not been able to do so. Presumably, the environmental load did not change their behavior.