ED data are useful sources of information for identification of high-risk sub-groups to target intervention opportunities, though it is not a reliable source of data for incidence or trend estimation in its current unstandardised form. Improving the accuracy and consistency of identification, documenting and coding of alcohol involvement at the point of data capture in the ED is the most desirable long-term approach to produce a more solid evidence base to support policy and practice in this field.

aOR, adjusted odds ratio; APHIRST, Australasian Paediatric Head Injury Rules Study; BSS, bicycles, push scooters and skateboards; CI, confidence interval; CT, computed tomography; ED, emergency department; HT, head trauma; IQR, interquartile range; OR, odds ratio; RCH, Royal Children's Hospital; RV, recreational vehicle.

There is a need for more effective ways of identifying the degree of alcohol involvement in injuries among young people presenting to EDs.

Contrary to public perception generated by media, 'glassing' incidents, particularly at licensed venues, constitute a relatively small proportion of all alcohol-related violence. The current study highlights the predominance of young men injured following alcohol-related violence, demonstrating a key focus area within the population for aiming prevention strategies.

Objective. This study reviews modifiable risk factors associated with fatal and nonfatal injury from low-speed vehicle runover (LSVRO) incidents involving children aged 0–15 years. Data Sources. Electronic searches for child pedestrian and driveway injuries from the peer-reviewed literature and transport-related websites from 1955 to 2012. Study Selection. 41 studies met the study inclusion criteria. Data Extraction. A systematic narrative summary was conducted that included study design, methodology, risk factors, and other study variables. Results. The most commonly reported risk factors for LSVRO incidents included age under 5 years, male gender, and reversing vehicles. The majority of reported incidents involved residential driveways, but several studies identified other traffic and nontraffic locations. Low socioeconomic status and rental accommodation were also associated with LSVRO injury. Vehicles were most commonly driven by a family member, predominantly a parent. Conclusion. There are a number of modifiable vehicular, environmental, and behavioural factors associated with LSVRO injuries in young children that have been identified in the literature to date. Strategies relating to vehicle design (devices for increased rearward visibility and crash avoidance systems), housing design (physical separation of driveway and play areas), and behaviour (driver behaviour, supervision of young children) are discussed.

Objective: To determine if the use of a modified adult protocol that uses cervical spine imaging on presentation for the assessment of cervical spine injury in children improves clinical outcome. Methods: This is a case series study on all consecutive trauma patients presenting from April to July 2000 inclusive to the ED of a major paediatric trauma hospital. Children presenting to the ED with potential cervical spine injury (CSI) were identified using standard selection criteria. Patient demographics, mechanism of injury, method and time of presentation, associated injuries, radiological investigation and clinical outcome were recorded. The major outcome measures for this study were: time to clearance of the cervical spine, length of stay in the ED and admission to an in‐hospital bed. Data were analysed for compliance to the protocol, this being the standard assessment pathway of cervical spine clearance used by our trauma service. Results: The trauma registry identified 1721 trauma presentations during the 4‐month study period; 208 presentations representing 200 children with potential CSI were entered into the study. Males represented 72.5% of the study population, having a mean age of 8.32 years, although 29% were less than 5 years of age. The majority of presentations (69%) occurred outside of normal working hours. In 17.8% of cases the cervical spine was cleared based on clinical assessment alone, half less than 5 years of age. Compliance to the protocol occurred in 78% of presentations. However, when examined by age group, children 5 years of age or above were 1.5 times more likely to comply with the protocol as compared with younger children. Adequate plain imaging was not obtained in 18% of presentations, this group almost exclusively less than 5 years of age. There were no missed injuries and no short or long‐term neurological sequelae reported during this study. There were no differences in time to clearance, length of stay and admission rate between compliant and non‐compliant groups. Conclusions: Modified adult protocols for cervical spine clearance offer guidance in managing the majority of children suffering blunt trauma. However, we recommend caution in rigidly applying such protocols, especially to children of young age.

No abstract

This study explores the patterns and features of methamphetamine-related presentations to emergency departments (EDs) in Queensland. Despite an overall decrease in the use of methamphetamine in Australian, an increase in the use of the crystalized form of methamphetamine has been noted over recent years. A descriptive observational study was utilized to analyse emergency department (ED) injury surveillance data sourced from Queensland Injury Surveillance Unit (QISU) from 2005 to 2017. Data were analysed for presentations related to stimulants (n = 564) with methamphetamine (n = 250) included as a subcategory. Descriptive statistics were used to identify patterns and features of presentations related to methamphetamines. The relationship between demographic variables, service type variables, and drug type was assessed using chi-square and z-tests. Results included the following: 84.4% of methamphetamine-related presentations were allocated a triage score of 1, 2, or 3; 14.8% of all methamphetamine-related presentations required police involvement; 18% were brought in by ambulance; and 15.6% exhibited behaviour that was either, agitated, aggressive, or violent in nature. Methamphetamine-related presentations more frequently required police or ambulance services and more often included aggression or agitation. Methamphetamine-related presentations to ED have a high acuity and often require other emergency resources (police and ambulance). There is a need to develop policy for managing aggressive and agitated people presenting to EDs as a result of methamphetamine use and to further explore the experience of personnel (police and ambulance) managing persons under the influence of methamphetamine.