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ObjectiveThe increasing frequency of bicycle-related injuries is due to the growing elderly population and their increasing physical activity. This study aimed to compare the protective effects of helmets on bicycle-related injuries in elderly individuals compared with those in younger adults.MethodsData from the Korean emergency department–based Injury In-depth Surveillance database from eight emergency departments during 2011–2016 were retrospectively analysed. The subjects sustained injuries while riding bicycles. Cases with unknown clinical outcomes were excluded. Covariates included mechanism, place and time of injury. The primary outcome was traumatic brain injury (TBI) incidence, and the secondary outcomes were in-hospital mortality and severe trauma. The effects of helmets on these outcomes were analysed and differences in effects were determined using logistic regression analysis. Subsequently, the differences in the effects of helmets use between age groups were examined by using interaction analysisResultsOf 7181 adults, 1253 were aged >65 years. The injury incidents showed a bimodal pattern with peaks around ages 20 and 50 years. Meanwhile, the helmet-wearing rate showed a unimodal pattern with its peak at age 35–40 years; it decreased consistently with age. By multivariate analysis, helmet-wearing was associated with a reduced TBI incidence (OR 0.76; 95% CI 0.57 to 0.99) and severe trauma (OR 0.78; 95% CI 0.65 to 0.93). The effects of helmets increased in elderly individuals (TBI (p=0.022) and severe trauma (p=0.024)).ConclusionThe protective effects of helmets on bicycle-related injuries are greater for elderly individuals, thus reducing TBI incidence.

Background For the basic life support (BLS) renewal course, we have devised a new educational programme entitled a small-group-discussion (SGD) programme using personalised video-based debriefing. Objective We compared the efficacy in BLS skill improvement of the SGD programme with the currently used practice-while-watching (PWW) programme, which uses a standardised education video. Method This was a prospective, cluster randomised study, conducted in a single centre, over 6 months from May 2009 to October 2009. Training was performed in two groups of participants, each group with a different renewal education programme. The efficacy of the programmes was compared using the modified Cardiff test and skill-reporting manikins. Results Results from 2169 participants were analysed: 1061 in the SGD programme group and 1108 in the PWW programme group. There were no differences between groups on the pretest, either in compression or non-compression skills. However, on the post-test, the SGD programme gave better results for both compression skills and non-compression skills. Conclusions The new SGD renewal programme is more effective than the PWW programme for improving skills in BLS renewal training.

Purpose Therapeutic hypothermia has become the standard treatment for unconscious patients in cardiac arrest. Although various body parts, including the oesophagus, rectum, bladder and tympanum, can be used for measurement of the core temperature, the oesophageal temperature is preferred because of its accuracy and stability. We first investigated the success rate and procedure time of oesophageal temperature probe (ETP) insertion according to the insertion method. Methods The conventional method involved blind insertion through nasal orifices. The alternative method was insertion with Magill9s forceps or long forceps under visualisation using a direct laryngoscope. The new method was performed as follows: (1) insertion of another endotracheal tube (ETT) orally into the oesophagus; (2) insertion of a temperature probe into the hole of the ETT; (3) removal of the ETT. To compare the success rates and procedure times according to the insertion method, we collected data retrospectively from the prospective Samsung Medical Centre hypothermia database and medical records. Results A total of 91 cases were examined. Insertion was performed using the conventional method in 36 cases, the alternative method in 26, and the new method in 29. Rates of success on the first attempt were 63.9%, 65.4% and 100%, and procedure times were 33.2±13.6, 33.3±17.8 and 27.0±7.9 min, for the conventional, alternative and new methods, respectively. The initial success rates and procedure times were significantly different among the three groups (p Conclusions The new ETP insertion method had a better first attempt success rate than the conventional method and the alternative method.

The International Liaison Committee on Resuscitation (ILCOR) recommends that strategies should be implemented that promote cardiopulmonary resuscitation (CPR) training in the workplace. Non-medical employees at a hospital were therefore trained to conduct basic life support (BLS). Subject background information, test results and survey findings were examined and factors affecting BLS skill acquisition were studied.Of 1432 non-medical employees at a hospital trained to conduct BLS, 880 agreed to participate in the survey. The training course consisted of a single session of 3 h of lectures, practice and testing. Skill acquisition was assessed using a 13-item skill checklist and a 5-point overall competency scale. The effects of age, gender, type of job, educational status, a previous history of CPR training and level of subject-perceived training difficulty were examined.According to total checklist scores, subjects achieved a mean (SD) score of 8.66 (3.57). 22.3% performed all 13 skills. Based on 5-point overall competency ratings, 43.7% of subjects were rated as "competent", "very good" or "outstanding". Age (40 years andor=40 years) was the only factor that significantly affected skill acquisition (skill acquisition by thoseor=40 years of age was poorer than by those aged40 years).Traditional BLS training is less effective in individuals agedor=40 years.