Background: In many large hospitals in Switzerland, adolescents 16 years and older are treated in adult emergency departments (ED). There have been few publications about this specific patient population, especially in Switzerland. This study aims to provide an overview of emergency presentations of adolescents between 16–18 years of age when compared to adults and focuses on their principle complaints. Methods: We conducted a single-centre, retrospective, cross-sectional study of all patients aged 16 years and older presenting to the adult ED at the University Hospital (Inselspital) in Bern, Switzerland, from 2013 to 2017. This analysis gives an overview of emergency presentations of adolescents between 16–18 years of age in this time period and compares their consultation characteristics to those of adult patients. Results: Data of a total of 203,817 patients who presented to our adult ED between 2013 and 2017 were analysed. Adolescents account for 2.5% of all emergency presentations. The number of ED presentations in the reviewed time period rose for adults (+2368, 95% CI: 1695, 3041, p = 0.002 consultations more per year; +25% comparing 2013 with 2017), while adolescent presentations did not significantly increase (p = 0.420). In comparison to adult patients, adolescents presented significantly more often during the night (39.1% vs. 31.5%, p < 0.001), as walk-ins (54.2% vs. 44.9%, p < 0.001), or with less highly acute complaints at triage (21% vs. 31%, p < 0.001). They were more likely to be discharged (70.8% vs. 52.2%, p < 0.001). We found a significant association between the two age groups and principle complaints. In comparison to adults, trauma and psychiatric problems were significantly more common among adolescents. Conclusions: Our data showed that complaints in adolescent patients under 18 years of age significantly differ from those in older patients. The artificial age cut-off therefore puts this vulnerable population at risk of receiving inadequate diagnostic testing and treatment adapted only for adults. Additional studies are needed on the reasons adolescents and young adults seek ED care, as this could lead to improvements in the care processes for this vulnerable population.

Background: Adolescents aged sixteen to eighteen years are mostly treated in adult emergency departments. In a study at our tertiary adult emergency department (ED) at the University Hospital in Bern (Inselspital), Switzerland, we found that adolescents significantly more often present with psychiatric problems than adults. The study at hand aimed to characterise those adolescents presenting to the ED triaged with a chief complaint regarding mental health. Furthermore, the goal was to assess sex differences in terms of diagnosis, suicidal ideation, substance use, as well as social impact. Methods: We conducted a single-centre, retrospective review of presentations to our adult ED related to the mental health of adolescents aged 16 to 18 years, covering the period from January 2013 to July 2017. Anonymised data were extracted from medical reports referring to the ED visits that were triaged as mental-health-related, and we assessed these for diagnosis, acute and previous suicidal ideation, history of self-harm, external aggression, substance use and social problems. We focused on patient characterisation and defining sex differences. Results: Data were analysed for a total of 612 consultations by adolescents who presented to our ED with problems related to mental health. Women accounted for 61.1% of cases. The most frequent diagnoses were reactions to severe stress and adjustment disorders (19.1%), followed by alcohol use disorders (17.6%), intentional self-harm (17.3%), and affective disorders (13.7%). Males had lower odds for intentional self-harm (OR 0.10, 95% 0.05–0.21, p < 0.001) as well as disorders of personality and behaviour (OR 0.09, 95% 0.21–0.37, p < 0.001), whereas they had higher odds of being admitted due to use of alcohol (OR 2.51, 95% 1.65–3.83, p < 0.001). Of all cases, 31.7% reported acute suicidal ideation, with a significantly lower odds ratio in males (OR 0.58, 95% 0.41–0.84, p = 0.004). The most common source for referral to the ED was family members (25.2%). Males had twice the odds of reporting alcohol consumption as well as use of cannabis (in both cases p < 0.001). In 27.9% of all cases, familial problems were reported, with males having significantly lower odds of being exposed to these (OR 0.64, 95% 0.44–0.94, p = 0.021), whereas they had higher odds of reporting educational problems (OR 1.68, 95% 1.04–2.72, p = 0.035). Conclusions: Adolescents aged sixteen to eighteen years presenting to the ED with problems related to mental health are an important subgroup of ED presentations and should be thoroughly assessed for suicidal ideation, substance use, as well as familial and educational problems. Assessment and establishment of post-ED care are of particular importance in this vulnerable patient group.

Purpose: Only a few studies have been conducted on trampoline-associated injuries in adults, especially in Switzerland. The aim of the present study was to describe the characteristics of trampoline-related injuries in patients older than 16 years of age and track their development over time by comparing two different time periods. Methods and Materials: Data were gathered from the emergency department (ED) of Bern University Hospital. A retrospective design was chosen to allow analysis of changes in trampolining accidents between 2003–2020. Results: A total of 144 patients were enrolled. The number of ED presentations due to trampoline-related injury rose significantly over time. The most common injuries were sprains to the extremities (age group 31–62: 58.4% and age group 16–30: 50.8%), followed by fractures (age group 31–62: 33.3% and age group 16–30: 32.5%). Lower extremities appeared to be the most frequently injured body region (age group 31–62: 20.8% and age group 16–30: 10.0%), although the differences were not statistically significant, p = 0.363. BMI was significantly higher for older than for younger patients (p = 0.004). Conclusion: Over the last two decades, trampoline-related injuries have become more common in patients older than 16 years of age. These are most common in the lower extremities. While most of the patients in the present study only suffered minor injuries, the occasional severe injury might result in long-term disability. As trampoline-related injuries in adults are becoming more common, prevention strategies in public education and safety instructions must be optimised.

Zusammenfassung. Feuerwerkskörper werden häufig zum Feiern von nationalen, kulturellen oder religiösen Anlässen verwendet. Trotz strenger gesetzlicher Regelungen geschehen immer wieder Unfälle im Zusammenhang mit Feuerwerk. Besonders die unvorsichtige Handhabung von Sprengkörpern stellt ein grosses Verletzungsrisiko dar. Methode: Dies ist eine retrospektive Studie basierend auf Daten des UNZ Inselspital Bern im Zeitraum 1. Januar 2013 bis 31. Dezember 2019. Es wurden unter anderem folgende Parameter analysiert: Geschlecht, Alter, Verletzungsmuster und Therapie. Resultate: Es konnten 59 Patientinnen und Patienten in die Studie eingeschlossen werden. Davon waren 81,4 % männlich, das Durchschnittsalter betrug 31 Jahre (Range 16–73; SD = 11,3). Ein Grossteil der Fälle (83,6 %) betraf den Kopf mit Beeinträchtigung der Ohren/des Gehörs sowie Verletzungen der Augen und des Gesichts. Die meisten Verletzungen waren Monotraumata, nur 6,8 % der Verletzungen betrafen mehrere Körperregionen. Insgesamt mussten neun Patienten aufgrund schwerwiegender Verletzungen hospitalisiert werden. Hiervon betraf eine Verletzung die Augen, die restlichen acht Verletzungen betrafen die Hände. Ausschliesslich bei diesen acht Patienten war eine operative Versorgung der Verletzungen nötig. Schlussfolgerung: Feuerwerkskörper sind mit einem beträchtlichen Verletzungsrisiko verbunden, vor allem bei unsicherer Handhabung. Unsere Studie zeigte, dass schwere Verletzungen vor allem die Hände betreffen. Zur Vermeidung solcher Verletzungen wäre eine systematische Datenerhebung von Verletzungen mit Feuerwerkskörpern nötig, da viele Verletzte in kleineren, peripheren Krankenhäusern oder gar nicht vorstellig werden. Anhand dieser Daten liessen sich umfassendere und detaillierte Präventionsstrategien entwickeln, die Verletzungen durch Feuerwerkskörper vorbeugen könnten.