Objective
This study aimed to investigate the characteristics and epidemiological trends of pediatric injuries among patients visiting emergency departments on Jeju Island, Korea. Methods Using a community-level serial cross-sectional analysis, we targeted pediatric patients 18 years or younger who visited emergency departments for injuries over a 10-year period. A comprehensive examination of injury characteristics and epidemiological trends was performed using the data sourced from the Jeju Injury Surveillance System. This included an evaluation of the annual incidence and overall trends in pediatric injury cases. Results The study found toddlers (42.5% of cases) to be the most frequently injured age group. Male patients were more prone to injuries, with a male to female ratio of 1.7:1. Injuries among visitors accounted for 17.3% of cases, with a seasonal spike in summer, evenings, and weekends. Most incidents occurred at home, were predominantly accidental in nature, with adolescents more likely to require emergency medical system services. The common mechanisms of injuries were blunt force (49.2%), slips/falls (22.0%), and motor vehicle collisions (13.2%), leading to bruises, cuts, and sprains. Over the decade, a general increase in pediatric injuries was observed. Accidental injuries initially surged but later stabilized; however, self-harm/suicide and assault/ violence injuries showed a concerning upward trend. Age-specific analysis revealed increasing trends in infants and adolescents. Conclusion The results of the present study underscore the crucial need for targeted injury prevention and resource allocation strategies, particularly for high-risk groups and time of injury, to effectively mitigate pediatric trauma on Jeju Island.

Objective
This study investigated the hospital diagnoses and characteristics of uncooperative prehospital patients suspected of acute stroke who could not undergo a prehospital stroke screening test (PHSST).
Methods
This retrospective observational study was conducted at a single academic hospital with a regional stroke center. We analyzed three scenario-based prehospital stroke screening performances using the final hospital diagnoses: (1) a conservative approach only in patients who underwent the PHSST, (2) a real-world approach that considered all uncooperative patients as screening positive, and (3) a contrapositive approach that all uncooperative patients were considered as negative.
Results
Of the 2,836 emergency medical services (EMS)-transported adult patients who met the prehospital criteria for suspicion of acute stroke, 486 (17.1%) were uncooperative, and 570 (20.1%) had a confirmed final diagnosis of acute stroke. The diagnosis in the uncooperative group did not differ from that in the cooperative group (22.0% vs. 19.7%, P=0.246). The diagnostic performances of the PHSST in the conservative approach were as follows: 79.5% sensitivity (95% confidence interval [CI], 75.5%–83.1%), 90.2% specificity (95% CI, 88.8%–91.6%), and 0.849 area under the receiver operating characteristic curve (AUC; 95% CI, 0.829–0.868). The sensitivity and specificity were 83.3% (95% CI, 80.0%–86.3%) and 75.2% (95% CI, 73.3%–76.9%), respectively, in the real-world approach and 64.6% (95% CI, 60.5%–68.5%) and 91.9% (95% CI, 90.7%–93.0%), respectively, in the contrapositive approach. No significant difference was evident in the AUC between the real-world approach and the contrapositive approach (0.792 [95% CI, 0.775–0.810] vs. 0.782 [95% CI, 0.762–0.803], P>0.05).
Conclusion
We found overestimation (false positive) and underestimation (false negative) in the uncooperative group depending on the scenario-based EMS stroke screening policy for uncooperative prehospital patients suspected of acute stroke.