The characteristics and causes of accidental injuries from power tools in patients presenting to two Queensland emergency departments.

Mr James Hughes1,Mrs Chantelle Judge2, Dr  Rob Eley2,3, A/Prof Kirsten Valmuur4,5, Dr Georgia Livesay2, Miss Monica Miyakawa-Liu3, Dr Mary Boyde2,6, A/Prof Cliff Pollard4, Dr Nathan Brown7,3
1Royal Brisbane & Women’s Hospital / Queensland University Of Technology, Herston, Australia, 2Emergency Department, Princess Alexandra Hospital, Woolloongabba, Australia, 3Faculty of Medicine, University of Queensland, Herston, Australia, 4Jamieson Trauma Instutite, Herston, Australia, 5Australian Centre for Health Services Innovation, School of Public Health, Queensland University of Technology, Kelvin Grove, Australia, 6School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia, 7Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital, Herston, Australia

Introduction: Power tools are a common cause of unintentional injuries, which are a major burden to healthcare, productivity and quality of life.  Many people injured by power tools seek treatment at emergency departments (EDs).  Our aim was to determine the prevalence, characteristics and common causes of unintentional injuries from power tools in patients presenting to two major metropolitan EDs.
Method: Clinical databases were used to retrospectively identify and review all ED presentations due to unintentional injury from power tools between 2005 and 2015.  We collected data related to patient demographics, types of power tools and body parts involved, mode of arrival and discharge status.  We also conducted a prospective, qualitative interviewer-administered survey plus follow-up at three months of 186 patients in 2016/17 to collect information about the causes and consequences of power tool-related injuries.
Results: There were 4763 presentations identified with unintentional injury from power tool use representing 0.37% of all ED presentations. Yearly power tool-related presentations ranged in number from 300 to 497 but there was no change in rate per 1000 presentations over time. Women accounted for fewer than 5% of power tool-related presentations with lawnmowers associated with half the injuries in women. Overall, power saws and grinders contributed to 54% of injuries, with 48% of injuries affecting an upper limb and 30% affecting the head or neck (including 16% involving fragment infiltration into eyes).  Interviews revealed that “lapses in concentration”, “tool modification”, and “inappropriate uses of tool” were commonly associated with injuries.  Recovery periods exceeded one month in 24% of interviewed patients and three months in 16% of interviewed patients.
Conclusions: Power tool-related ED presentations vary in causes, severity, and outcomes.  Many injuries may be preventable.  Injury rates may decrease with better education of power tool users, adherence to safety measures and use of protective equipment.

Mr Hughes is the Nurse Research Manager at the Emergency and Trauma Centre, Royal Brisbane and Women’s Hospital. The is a jointly appointed position with Queensland University of Technology and partly funded through the Emergency Medicine Foundation. His research interests include pain management in the ED, patient flow and capacity building in emergency research. He is currently finishing off his PhD in pain care at QUT.