• Title/Summary/Keyword: 응급치료

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Development of a Methodology for Oxygen Partial Pressure Increase : Example of Veterinary Hyperbaric Chambers (고압산소챔버 내의 산소분압 적정 증가 방안 개발 : 동물실험용 챔버 대상)

  • Wang, Soon-Joo;Kim, Eun;Kang, Pooreun
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2023.11a
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    • pp.351-352
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    • 2023
  • 동물용 고압산소치료 시 산소를 통한 가압은 이미 있는 공기를 제거하고 산소로 대치시키는데 효율성이 떨어져서 100%에 가까운 산소분압을 구현하는데 어려움이 있고, 그 방법도 표준화되지 않았다. 따라서 어떠한 방식의 산소가압이 신속하고 효율적으로 100%에 가까운 산소분압을 구현할 수 있는지에 대한 방안을 개발하고 표준화할 필요가 있다. 동물용 고압산소치료를 활용한 동물실험이나 동물의 치료 중 가압 단계에서 간헐적 환기 방법이 더 신속하게 100%에 가까운 산소 분압을 보이므로 향후 표준 지침 개발을 위한 중요한 기반 연구와 제안으로 활용 가능하다. 이는 재난 기반으로의 고압산소챔버의 활용을 위한 기초 자료가 될 것이다.

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Characteristics and Trends of Ski Injuries (스키손상의 특징과 경향)

  • Ha, Kee-Young;Kim, Yang-Su;Ryoo, Seung-Joon;Koh, In-Jun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.153-157
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    • 2003
  • Purpose: To identify injuries and profile the characteristics of injured skiers and to use this information in designing injury-prevention programs and protective equipment. Materials and Methods: Injured skiers treated at a clinic of a ski resort located in Kangwon province in Korea were reviewed from 1998 to 2001. An injury was defined as any accident occurred during alpine skiing that required medical treatment. All injured skiers were asked to fill in a questionnaire which documented the mechanism of injury, their experiences , and the slope where they were injured Results: 1197 patients experienced ski injuries over a three-year-period. The overall incidence of ski injuries was 6.4 injuries per 1000 skiers. There was a slightly higher proportion of men than women and the mean age was in the third decade. The injury rate was higher for beginners and for less difficult slopes . The sprain and ligament injuries were most common and knee injuries accounted for 30$\%$ of all ski injuries . Conclusion: In our study , ski injuries occurred more often compared with foreign reports. it was concluded that an insufficient injury prevention system, an increasing number of skiers and a growing proportion of beginners was responsible for such a result.

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Identifying and feeding patients that require nutritional support (영양보강요법이 요구되는 환축 가려내기와 섭생방법)

  • Bartges Joseph W.
    • Journal of the korean veterinary medical association
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    • v.38 no.1
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    • pp.63-67
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    • 2002
  • 비록 심한 두뇌손상을 입은 고양이에게 응급의학 처치(Immediate medical concerns)를 시행할 때, 여러분은 중요한 치료요소가 남게 된다는 것을 알게 되는 데 그것은 손상 또는 아픈 동물들에게 적절한 영양을 공급해 주는 것이 그들의 회복에 촉진역할을 한다는 것이다.

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Assessment and Methods of Nutritional Support during Atropinization in Organophosphate and Carbamate Poisoning Cases (아트로핀으로 치료하는 유기인계와 카바메이트 중독 환자의 영양지원 평가와 방법)

  • Park, Jong-uk;Min, Young-gi;Choi, Sangcheon;Ko, Dong-wan;Park, Eun Jung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.123-129
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    • 2020
  • Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.

A Study on the Effect of Basic Life Support Training on the First Responsive Police Officers

  • Jo, Byung-Tae;Kim, Seon-Rye
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.175-182
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    • 2019
  • The study was conducted to verify the effect of basic life support training on the skill ability of police officers. The subjects of this study were 10 experimental group and 10 comparative group with voluntary consent after explaining the theory and significance of the training experiment at the police station located in K. The education program used in this study consists of theoretical education and practical training, and the theoretical education is 60 minutes and the practical training is 30 minutes. The measurement tool for basic resuscitation performance was measured based on the 'CPR and ECG Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care' presented by the American Heart Association. The results are as follows. The experimental group showed higher performance skills than the traditional control group in field confirmation performance skills, primary evaluation performance skills (A, B, C, medical evaluation), and BLS performance skills (heart compression, artificial respiration, medical evaluation) which are the basic resuscitation performance skills. In conclusion, this study confirmed that the theory and practice education program is more effective in improving the clinical performance of police officers than the traditional lectures and practice education, so it is possible to apply this simulation education program to the cardiac arrest patient emergency treatment.

Is hyperbaric oxygen therapy more effective than normobaric oxygen therapy for improving acute neuropsychologic status due to carbon monoxide poisoning? (고압산소치료가 정상압 산소치료에 비해 일산화탄소 중독의 급성 신경-정신 상태 개선에 더 효과적인가?)

  • Koh, Chan Young;Cho, Hyun Young;Choi, Han Joo
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.509-518
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    • 2018
  • Objective: The evidence that hyperbaric oxygen (HBO) therapy is more effective for improving the acute neuropsychological status (ANS) of carbon monoxide poisoning than normobaric oxygen (NBO) therapy is not convincing. This is because the levels of carboxyhemoglobin (COHb) do not correlate with the clinical severity of carbon monoxide poisoning and there is no universally accepted severity scale of carbon monoxide poisoning. This paper suggests a new scale for the clinical and neurological severity of carbon monoxide poisoning, called the ANS, and assesses the effect of HBO therapy for each level of ANS compared to NBO therapy. Methods: A total of 217 patients who had been hospitalized because of carbon monoxide poisoning from January 2009 to July 2013 were studied. ANS was suggested as a new severity scale of carbon monoxide poisoning considered in the Glasgow Coma Scale, acute neuro-psychologic signs and symptoms, or cardiac ischemia on the initial medical contact. HBO therapy is indicated in those who have a loss of consciousness, seizure, coma, abnormal findings on a neurological examination, pregnancy, persistent cardiac ischemia, level of COHb >25%, or severe metabolic acidosis (pH <7.2). The end point is the day of discharge, and recovery is defined as a normal neuro-psychological status without any sequelae. Results: The levels of troponin T and creatinine increased significantly with increasing ANS score. In the moderate to severe group (ANS 2 and 3), the recovery rate was significantly higher when treated with HBO therapy than with NBO therapy (P=0.030). On the other hand, the development of delayed neuro-psychological sequelae (DNS) did not correlate with any level of ANS, type of oxygen therapy, or recovery on discharge. Conclusion: In the moderate to severe poisoned group, HBO therapy is more effective for improving the ANS from carbon monoxide poisoning than NBO therapy. On the other hand, the development of DNS of HBO therapy is no more preventable than with NBO therapy. Although the level of ANS is low, the patient needs to be provided with sufficient information and a follow-up visit is recommended for any abnormal symptoms because the ANS does not correlate with the development and degree of DNS.

A Case with Transient Hyperammonemia of Newborn (신생아 일과성 고암모니아혈증 1례)

  • Lee, Hee-Kyung;Lee, Beom-Hee;Jin, Hye-Young;Kim, Gu-Hwan;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.87-90
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    • 2010
  • Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea Hyperammonemia in the newborn often leads to severe fatal illness associated with hyperammonemic encephalopathy. Transient hyperammonemia in newborns (THAN) is characterized by self-limiting, transient hyperammonemia during the neonatal period. THAN may have favorable long-term outcomes if it is diagnosed early and appropriately managed. However, severe hyperammonemia can develop even in newborns with THAN, which may require emergent management. Here we report a case of THAN with severe hyperammonemia during the neonatal period that was successfully treated with continuous renal replacement therapy and nitrogen-scavenging medications. Our patient went on to develop normally and has not re-experienced a hyperammonemic episode until 9 months of age without the administration of a protein restricted diet or medications.

Intractable Hemoptysis due to Valvular Heart Disease Treated by Emergency Redo DVR: 1 case report (판막부전증에 의한 대량객혈의 응급 이중판막 재치환술: 1례 보고)

  • 이재훈;전양빈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.423-427
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    • 1997
  • Hemoptysis occurs quite frequently as a consequence of mitral stenosis, but massive, lirE threatening pulmonary hemorrhage is distinctly unusual. We report a 30 year old female who underwent cmcrgcncy rcdo double valve replacement for intractable pulmonary hemorrhage. she underwent mitral valve replacement (lonescu Shirley 27 mm) due to rheumatic valvular heart disease in 1984 and tricuspid valve annuloplasty (Carpentier's rlng 30mm) two years later She was admitted for massive hcmoptysis and dyspnea on the 26th of December, 1995. Medical treatment including transarterial embolization was given but was not satisfactory. Emergency valve replacement (Mitral valve , 51. Judc 29mm and tricuspid valve ; 51. Jude 33mm) was performed and hemoptysis was controlled dramatically 24 hours after surgery.

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Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers (권역외상 및 응급센터에서 성형외과의 참여방안)

  • Lim, Nam Kyu;Kang, Dong Hee
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy for Treatment of Calcium Channel Blockers, Angiotensin II Receptor Blockers, and Metformin Overdose (에크모와 신대체요법을 이용하여 치료한 칼슘채널차단제, 안지오텐신 수용체 차단제, 메트포민 중독 환자 증례)

  • Jeong, Jae Han;Sun, Kyung Hoon;Park, Yong Jin;Kim, Sun Pyo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.165-171
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    • 2018
  • An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.