Head and Neck Injuries Associated With Cell Phone Use

Airway, breathing, cellphone: a new vital sign?

INTRODUCTION

In emergency medicine, triage encompasses more than the initial prioritization of treatment; it also includes decisions about the most suitable level of care and disposition for each patient. However, the increasing use of mobile technology by patients in the emergency department (ED) introduces a new factor. This study aims to explore the relationship between patients' cellphone use at the time of initial assessment and final disposition in the ED.

METHODS

A prospective, cross-sectional study was conducted on 292 patients who presented to the ED between 9/1/2021 and 8/9/2022. Patients were stratified into two cohorts based on their behavior during the initial assessment: actively using a cell phone (n = 32) or not using a cell phone (n = 259). Final disposition was dichotomously recorded as admission or discharge. Hospital admission, hospital observation, and admission to the ED observation unit were consolidated into the combined category of admission.

RESULTS

Patients not actively using their cell phone on initial assessment exhibited a discharge rate of 64%, while those engaged with their cellphones displayed notably higher dismissal rates at 94%. The calculated odds ratio (OR) of 8.4 (95% confidence interval: 1.96-36.0, p = 0.004) underscores a significantly heightened likelihood of dismissal among individuals actively using their cellphones, suggesting a potential association between cellphone use and a reduced probability of hospital admission.

CONCLUSION

The study suggests an association between cellphone use during initial ED assessment and higher discharge rates. While this introduces a novel concept, the study's potential contribution to more informed and efficient triage decisions warrants careful consideration in future research and clinical applications.

The deflection of fatigued neck

The human neck is a unique mechanical structure, highly flexible but fatigue prone. The rising prevalence of neck pain and chronic injuries has been attributed to increasing exposure to fatigue loading in activities such as prolonged sedentary work and overuse of electronic devices. However, a causal relationship between fatigue and musculoskeletal mechanical changes remains elusive. This work aimed to establish this relationship through a unique experiment design, inspired by a cantilever beam mechanical model of the neck, and an orchestrated deployment of advanced motion-force measurement technologies including dynamic stereo-radiographic imaging. As a group of 24 subjects performed sustained-till-exhaustion neck exertions in varied positions-neutral, extended, and flexed, their cervical spine musculoskeletal responses were measured. Data verified the occurrence of fatigue and revealed fatigue-induced neck deflection which increased cervical lordosis or kyphosis by 4-5° to 11°, depending on the neck position. This finding and its interpretations render a renewed understanding of muscle fatigue from a more unified motor control perspective as well as profound implications on neck pain and injury prevention.

Safe stairway negotiation: Role of distractions and handrail use

INTRODUCTION

This study sought to examine stairway safety by identifying associations between fall-related events on stairways, distractions, gait speed, drifting, as well as handrail use and proximity.

METHOD

Video recordings captured 11,137 observations of stair users in two public stairways and recorded distractions (e.g., looking at a mobile device, talking on a mobile device, using earbuds or headphones, holding a mobile device, or talking with a peer), gait speed (m/s), drifting (change of direction), as well as handrail use and proximity to a handrail.

RESULTS

In our sample, consisting of primarily young adults (observed 18-40 years old), we found that when a distraction was present, gait speed was reduced (p <.001), drifting increased (p <.001), and handrail use negatively impacted (p <.001) compared to stair users who were not distracted.

CONCLUSIONS

These results indicate that distractions, such as mobile devices, used during stair negotiation can reduce handrail use and increase behaviors associated with fall-related events.

PRACTICAL APPLICATIONS

Mobile device use during stairway negotiation increases the likelihood of distraction-induced events. Stair users should be encouraged to limit or avoid mobile device use in public stairway environments. Mobile manufacturers and mobile app developers could aim to develop strategies or mobile app alerts to reduce the impact of distractions (e.g., mobile device use) during stair negotiation to lessen the health and financial burden associated with fall-related events on stairways.

Increasing Incidence of Hand and Distal Upper Extremity Injuries Associated With Electric Scooter Use

PURPOSE

Electric scooters (e-scooters) have seen an increase in popularity in cities across the United States as a form of recreation and transportation. The advent of ride-sharing applications allows anyone with a smartphone to easily access these devices, without any investment or experience required. In this study, the authors analyze scooter-related injuries of the hand and upper extremity.

METHODS

The National Electronic Injury Surveillance System (NEISS) was queried to look for injuries related to the use of e-scooters between 2010 and 2019. Data collected included demographic information, the location of the injury, the injury diagnosis, and disposition. National estimates (emergency room visits in the United States) were calculated using the weight variable included in the NEISS database. Miscoded reports were excluded. As a corollary, Google Trends data were utilized to establish a correlation between e-scooter-related injuries and the relative number of e-scooter hits on the Google search engine.

RESULTS

From 2010 to 2019, there were 730 e-scooter-related injuries reported to the NEISS database. This corresponds to an estimated 26,412 injuries nationally during this time period. The incidence of scooter-related injuries increased by over 230% (2,130 national injuries in 2010; 7,213 national injuries in 2019; relative difference 5,083). Injuries most commonly occurred in patients aged 10 to 18 years (30.3%). The most frequent site of injury was the wrist (41.9%). The most common injury diagnosis was fracture (55.3%). Additionally, there was a correlation between the number of Google Trends e-scooter hits and the number of injuries during this time period.

CONCLUSIONS

The incidence of e-scooter-related upper extremity injuries increased dramatically in the United States between 2010 and 2019.

CLINICAL RELEVANCE

As novel e-scooter-sharing apps become increasingly popular, it is imperative that users are educated about the risk of injury and that use of proper protective equipment is encouraged.

Risk of Accidents or Chronic Disorders From Improper Use of Mobile Phones: A Systematic Review and Meta-analysis

Background

Mobile phone use has brought convenience, but the long or improper use of mobile phones can cause harm to the human body.

Objective

We aimed to assess the impact of improper mobile phone use on the risks of accidents and chronic disorders.

Methods

We systematically searched in PubMed, EMBASE, Cochrane, and Web of Science databases for studies published prior to April 5, 2019; relevant reviews were also searched to identify additional studies. A random-effects model was used to calculate the overall pooled estimates.

Results

Mobile phone users had a higher risk of accidents (relative risk [RR] 1.37, 95% CI 1.22 to 1.55). Long-term use of mobile phones increased accident risk relative to nonuse or short-term use (RR 2.10, 95% CI 1.63 to 2.70). Compared with nonuse, mobile phone use resulted in a higher risk for neoplasms (RR 1.07, 95% CI 1.01 to 1.14), eye diseases (RR 2.03, 95% CI 1.27 to 3.23), mental health disorders (RR 1.16, 95% CI 1.02 to 1.32), and headaches (RR 1.25, 95% CI 1.18 to 1.32); the pooled risk of other chronic disorders was 1.20 (95% CI 0.90 to 1.59). Subgroup analyses also confirmed the increased risk of accidents and chronic disorders.

Conclusions

Improper use of mobile phones can harm the human body. While enjoying the convenience brought by mobile phones, people have to use mobile phones properly and reasonably.

Orthopaedic Injuries Associated With Cell Phone Use Resulting in Emergency Department Visits: A 20-Year Analysis

INTRODUCTION

Cell phones are an integral part of daily life but are distractors that can contribute to injury. The present study uses a large national emergency department (ED) database to evaluate the frequency, anatomic location, and type of injuries associated with cell phone use. We hypothesize that orthopaedic injuries related to cell phone use have increased over time and affect certain body parts and age groups more than others.

METHODS

The 1999 to 2018 Nation Electronic Injury Surveillance System was queried for cell phone-related injuries leading to ED visits (injuries to the head or face or involving a landline were excluded). Demographics, type of orthopaedic injury, and body part injured were tabulated, and injuries were then classified over time as direct mechanical or cell phone use-associated, as well as related to texting compared with talking.

RESULTS

A weighted national total of 44,599 injuries met inclusion criteria. A marked increase was noted in the incidence of cell phone use-associated injuries over the time (2,900%). Injuries occurred in persons with mean ± standard deviation age of 36.6 ± 19.9 years old, predominantly in women (60.6%), at home (32.8%) or on the street (22.4%), and while walking (31.6%) or driving (18.16%). The distribution of orthopaedic injuries was defined and occurred most frequently in the neck, lower torso/hip, and ankle. The most common types of injuries were sprain/strain (56.8%) and fracture (32.6%). The proportion of fracture injury types was significantly greater in adults aged greater than 65 (P < 0.001). The proportion of injuries related to texting on a cell phone was greatest in the 13- to 29-year-old age group and declined as age increased.

DISCUSSION

Orthopaedic injures related to cell phone use resulting in ED visits have markedly increased over time. The distribution and characteristics of such injuries can be used in targeted public health education and policy development.

An Updated Look at Television-Related Pediatric Head and Neck Injuries: Safer Products and a Shifting Paradigm

ABSTRACT

Television tip-over injuries have been designated a top-five hidden home hazard by the United States Consumer Product Safety Commission. In this study the authors utilize the National Electronic Injury Surveillance System (NEISS) Database to provide an updated look at television-related head and neck injuries in the United States pediatric population. The NEISS Database was accessed for all television-related head and neck injury reports from January 2000 to December 2018 in patients under 18 years of age. Demographic data including age, sex, and race were also obtained. Narrative descriptions of each injury were also individually reviewed and categorized by specific type of injury. Miscoded reports were excluded. Between January 2000 and December 2018, 5944 NEISS reports of television-related injuries met inclusion criteria, corresponding to an estimated total of 159,785 injuries nationally during this period. The average patient age at time of evaluation was 4.11 years with a male predominance of 61.3%. Total number of injuries - and weighted national estimates - remained relatively stable between 2000 and 2006, peaking in 2009 (450 reported cases, 12,004 estimated national total). Between 2009 and 2018 the number of reported injuries, and corresponding national estimates, saw a 75.8% and a 72.1% decrease, respectively. Television-related head and neck injuries have declined dramatically in the United States since 2009. The underlying cause of this decline is likely multifactorial, and additional steps to improve the safety of these products are necessary to continue to ensure the safety of all children in the United States.

Head and Neck Injuries and Electronic Scooter Use in the United States

OBJECTIVE

To quantify electric scooter injuries encountered in United States emergency departments, focusing on the head and neck, to understand the safety impact of these scooters to improve safe usage.

STUDY DESIGN

Retrospective cross-sectional study from January 2009 to December 2019 of patients presenting to United States emergency departments with electric scooter injuries collected from a national database. About 2,823 cases of injuries were related to electric scooter use from January 2009 to December 2019. Stratified weighted counts and incidence rates were estimated for injury characteristics. Piecewise linear regression quantified the yearly change in incidence of injuries before and after introduction of rideshare programs.

RESULTS

The estimated national total of electric scooter cases from 2009 to 2019 was 103,943 (95% CI: 79,650-128,237). Incidence grew in 2019 to 8.63 cases per 100,000 person-years from 4.46 in 2018 to 2.42 in 2017. Head and neck injuries represented 28.5% of total injuries (weighted estimate = 29,610). The most common age group of head and neck injuries before 2018 was ≤17 years, but injuries in 18- to 44-year-olds grew significantly to become the most injured group in 2018 to 2019 (P < .001). From 2009 to 2017, incidence of head and neck injuries fell by 0.02 cases per 100,000 person-years, but cases grew by 1.22 cases per 100,000 person-years post-2017 (P < .001).

CONCLUSION

Injuries following the launch of rideshare electric scooter programs increased significantly, especially in patients 18 to 44 years of age. Head and neck injuries represent many of these injuries. User safety education must be addressed to prevent injury as programs become more pervasive in the United States.

LEVEL OF EVIDENCE

Level 2 Laryngoscope, 2021.

Mobile phones and "inattention" injuries: the risk is real

OBJECTIVE

Mobile phones though indispensable have a flip side, in that they adversely affecting our ergonomics and mobility. They share an etiologic burden on the changed profile of inattention injuries and now have proven to be a necessary evil in the changing lifestyles. We aim to evaluate the role of mobile phones as a causative factor in these head and neck injuries.

METHODOLOGY

We evaluated various injury statistics published throughout the world that attributed the concurrence of neurological injuries to portable handheld communication devices. We evaluated the dangers posed by simultaneous engagement on phone and mobility and examined the impact on walking and field of view. We have also reviewed the current management strategies to combat this new mode of injury. The recent sensation Pokemon Go has been discussed as a case study of a spike in the incidence of injuries due to mobile phone use.

RESULTS

Age>35 yrs is a risk factor for mobile phone use and injuries as they have a higher chance of being distracted (81%) when compared to millennials (70% distracted). The highest incidence was that of head injuries being 33.1% of the estimated total followed by face, including eyelid, eye area, and nose (32.7%); and neck (12.5%). The most common injury diagnoses included laceration (26.3% of estimated total), contusion/abrasion (24.5%), and internal organ injury (18.4%). A heightened sense of self-protection and a multitasking attitude remains at the core of the trouble despite having knowledge of the required behavior.

CONCLUSIONS

The health hazard of mobile phone use driving or walking needs to be highlighted with special emphasis on public education, law adherence, and technological solutions to mitigate the risk. The onus lies on the public as any technological advance would only work on the multitasking strategy and the price would be paid by the vulnerable road users.