To effectively mitigate and reduce the burden of mass casualty incidents (MCIs), preparedness measures should be based on MCIs’ epidemiological characteristics. This study aimed to describe the epidemiological characteristics and outcomes of emergency medical services (EMS)-assessed MCIs from multiple areas according to cause. Therefore, we extracted the records of all MCIs that involved ≥ 6 patients from an EMS database. All patients involved in EMS-assessed MCIs from six areas were eligible for this study, and their prehospital and hospital records were reviewed for a 1-year period. The EMS-assessed MCIs were categorized as being caused by fire accidents (FAs), road traffic accidents (RTAs), chemical and biological agents (CBs), and other mechanical causes (MECHs). A total of 362 EMS-assessed MCIs were identified, with a crude incidence rate of 0.6–5.0/100,000 population. Among these MCIs, 322 were caused by RTAs. The MCIs involved 2,578 patients, and 54.3% of these patients were women. We observed that the most common mechanism of injury varied according to MCI cause, and that a higher number of patients per incident was associated with a longer prehospital time. The highest hospital admission rate was observed for CBs (16 patients, 55.2%), and most patients in RTAs and MECHs experienced non-severe injuries. The total number of deaths was 32 (1.2%). An EMS-assessed MCI database was established using the EMS database and medical records review. Our findings indicate that RTA MCIs create a burden on EMS and emergency department resources, although CB MCIs create a burden on hospitals’ resources.
Objective The objective of this study was to monitor the trend of psychiatric visits and medication prescriptions among people tested for SARS-CoV-2 during the initial phase of coronavirus disease 2019 (COVID-19) pandemic in South Korea.Methods We conducted a population-based cohort study using data from the National Health Insurance Service (NHIS) linked to the Korea Disease Control and Prevention Agency (KDCA) data. The overall trend of psychiatric visits during COVID-19 for each month was compared to the month prior to COVID-19. The number of psychiatric medication prescription records was monitored from January 2019 to May 2020.Results A total of 212,678 individuals were tested for SARS-CoV-2 between January 2020 and May 2020. Among these individuals, 72.1% (n=153,309) did not have pre-existing mental illness, and 27.9% (n=59,369) had pre-existing mental illness. We found that most psychiatric visits were made in March, and patients without pre-existing mental illness significantly increased in psychiatric outpatients during the COVID-19 pandemic (p trend<0.001). In addition, psychiatric medication prescriptions were the most prescribed between March and April 2020.Conclusion We identified a rising trend in psychiatric visits and medication prescriptions among people who were tested for SARSCoV-2 during the initial phase of COVID-19 pandemic in South Korea.
The aim of this study was to investigate factors associated with the decision to transfer, rather than admit, pediatric trauma patients who were initially transported to emergency departments with a high capacity for general emergency care (regional emergency centers, RECs). Methods: In this retrospective analysis of the 2014 emergency medical services (EMS) sample of injured pediatric patients, we included injured patients below 19 years of age who were transported by EMS to an REC. The main exposure variable was age, which was categorized into four groups by 5-year intervals. The primary outcome was the emergency department (ED) disposition of the patients (admission versus transfer). A multivariable logistic regression analysis was conducted to estimate the effect of age group on ED disposition. Results: Data from 2,031 patients were analyzed. The transfer rate was 49.5%. In a univariate analysis, no statistically significant associations were found between severity or age group and ED disposition (19.9% vs. 18.6%, P=0.76; 20.1% vs. 16.8%, P=0.49; respectively). After adjusting for potential covariates, age group had a significant effect on transfer. When compared to 15-19 years old, the younger age groups had higher adjusted odds ratios (aORs) for transfer (0-4 years old, aOR 7.65 [95% CI, 1.24 to 47.38]; 5-9 years old, aOR 14.48 [95% CI, 2.08 to 100.55]; 10-14 years old, aOR 5.03 [95% CI, 10.5 to 26.79]). Conclusion: Younger pediatric patients with moderate to severe trauma are more likely to be transferred to another hospital despite initial transportation to a REC.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective:The aim of this study was to investigate factors associated with the decision to transfer, rather than admit, pediatric trauma patients who were initially transported to emergency departments with a high capacity for general emergency care (regional emergency centers, RECs). Methods: In this retrospective analysis of the 2014 emergency medical services (EMS) sample of injured pediatric patients, we included injured patients below 19 years of age who were transported by EMS to an REC. The main exposure variable was age, which was categorized into four groups by 5-year intervals. The primary outcome was the emergency department (ED) disposition of the patients (admission versus transfer). A multivariable logistic regression analysis was conducted to estimate the effect of age group on ED disposition. Results: Data from 2,031 patients were analyzed. The transfer rate was 49.5%. In a univariate analysis, no statistically significant associations were found between severity or age group and ED disposition (19.9% vs. 18.6%, P=0.76; 20.1% vs. 16.8%, P=0.49; respectively). After adjusting for potential covariates, age group had a significant effect on transfer. When compared to 15-19 years old, the younger age groups had higher adjusted odds ratios (aORs) for transfer (0-4 years old, aOR 7.65 [95% CI, 1.24 to 47.38]; 5-9 years old, aOR 14.48 [95% CI, 2.08 to 100.55]; 10-14 years old, aOR 5.03 [95% CI, 10.5 to 26.79]). Conclusion: Younger pediatric patients with moderate to severe trauma are more likely to be transferred to another hospital despite initial transportation to a REC.
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