Emergency department electric scooter injuries after the introduction of shared e-scooter services: A retrospective review of 3,331 cases

doi:10.5847/wjem.j.1920-8642.2022.002

Abstract

Abstract:

BACKGROUND: To determine the frequency, characteristics, and use of resources related to electric scooter (e-scooter) injuries in the emergency department (ED) of a major metropolitan area hospital.
METHODS: We performed a retrospective review of all ED presentations related to e-scooter injuries at a level I trauma center between May 2017 and February 2020. We identified ED presentation data, injury-related data, patients’ clinical course after evaluation, injury diagnosis, surgical procedures, and ED readmissions.
RESULTS: A total of 3,331 patients with e-scooter injuries presented to the ED over a 34-month period. There was a 6-fold increase in e-scooter-related injuries presenting to the ED, from an average of 26.9 injuries per month before the introduction of shared e-scooter services in August 2018 to an average of 152.6 injuries per month after its introduction. The average injury rate during weekdays was 3.27 per day, with the majority of injuries occurring in the afternoon. The most common mechanism of injury was rider fall (79.1%). There were a total of 2,637 orthopedic injuries, of which 599 (22.7%) were fractures. A total of 296 (8.9%) patients were hospitalized following the initial ED admission, and 462 surgeries were performed within 7 days of ED arrival.
CONCLUSIONS: The introduction of the shared e-scooter services is associated with a dramatic increase in e-scooter injuries presenting to the ED. E-scooter use carries considerably underestimated injury risks of high-energy trauma and misunderstood mechanisms of injuries. These injuries challenge the healthcare system, with a major impact on both EDs and surgical departments.

Key words: E-scooter, Scooter, Emergency department

Ittai Shichman, Or Shaked, Shai Factor, Ahuva Weiss-Meilik, Amal Khoury. Emergency department electric scooter injuries after the introduction of shared e-scooter services: A retrospective review of 3,331 cases[J]. World Journal of Emergency Medicine, 2022, 13(1): 5-10.

Figures/Tables 5

Table 1

Figure 1.

Figure 2.

Figure 3.

Table 2

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Parameters	Values
Age, years, mean (SD)	32.3 (11.8)
Age group
16-25 years	889 (26.7)
25-40 years	1,849 (55.5)
40-60 years	441 (13.2)
≥60 years	152 (4.6)
Sex, male	1,991 (59.8)
Time of day
00:00-05:59	525 (15.8)
06:00-11:59	795 (23.8)
12:00-17:59	1,113 (33.4)
18:00-23:59	898 (27.0)
Mechanism of ED transport
Emergency medical services	1,153 (34.6)
Self-presented	2,178 (65.4)
Australasian Triage Scale
1 - Immediately life threatening	36 (1.1)
2 - Imminently life threatening	82 (2.5)
3 - Potentially life threatening	1,016 (30.5)
4 - Situational urgency	1,801 (54.1)
5 - Less urgent	240 (7.2)
Unknown	156 (4.6)
Trauma room activation	41 (1.2)
Imaging
X-Ray	2,342 (70.3)
Any CT	985 (29.6)
Head CT	531 (15.9)
ED treatment
Analgesics	1,344 (40.3)
Antibiotics	207 (6.2)
Tetanus toxoid	723 (21.7)
Blood alcohol concentration (≥0.08 mg/dL)
Positive	56 (1.7)
Negative	70 (2.1)
Missing	3,205 (96.2)
Helmet use
Yes	138 (4.1)
No	122 (3.7)
Unknown	3,071 (92.2)
Mechanism of injury
Rider fall	2,635 (79.1)
Rider collision	536 (16.1)
Pedestrian vs. e-scooter	160 (4.8)
ED LOS, mean (SD)	4 hours and 55 minutes (3 hours and 44 minutes)

Parameters	Values
Orthopedic injuries, n (% of total cohort)	2,637 (79.2)
Contusion/laceration	1,941 (58.3)
Sprain/dislocation	97 (2.9)
Fractures	599 (18.0)
Non-orthopedic injuries, n (% of total cohort)	741 (22.2)
Head	581 (17.4)
Thoracic	115 (3.5)
Abdomen	45 (1.4)
Hospital admissions, n (% of total cohort); [% of admissions]
Orthopedic	126 (3.8); [42.6]
General surgery	40 (1.2); [13.5]
Neurosurgery	48 (1.4); [16.2]
Other	82 (2.5); [27.7]
Total	296 (8.9)
Surgeries, n (% of total cohort); [% of surgeries]
Orthopedic	358 (10.7); [77.5]
General surgery	14 (0.4); [3.0]
Neurosurgery	9 (0.3); [1.9]
Other	81 (2.4); [17.6]
Total	462 (13.9)
Direct transfer to operating room, n (% of surgeries)	76 (16.4)
Emergency department readmissions, n (% of total cohort)
24 hours	73 (2.2)
7 days	182 (5.5)
30 days	93 (2.8)
Total	348 (10.4)

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