• Journal of Trauma and Injury
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• v.36 no.3
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• pp.295-297
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• 2023

Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient's hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.3
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• pp.264-269
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• 2015

Although sodium hypochlorite is the most frequently used canal irrigant during endodontic treatment, its complications are not as well recognized as its effectiveness. This report demonstrates that sodium hypochlorite extrusion during endodontic treatment can cause severe complications. A 5-year-old boy experienced immediate pain and swelling, ecchymosis in surrounding tissues, and profuse bleeding from the root canal during endodontic treatment, because of accidental extrusion of sodium hypochlorite. The patient was hospitalized, and analgesics and antibiotics were prescribed. Accidental extrusion of the irrigating solution occurs more frequently in teeth with immature apices, root resorption, and apical perforations; therefore, caution is needed. When such complications occur, proper management and medications are needed.

• Child Health Nursing Research
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• v.3 no.2
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• pp.131-141
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• 1997

The purpose of this study was to propose for protection of childhood injury or accident and to provide safety measures. Data was collected from 2,052 who visited emergency room of E University Hospital during 1 year period from January to December, 1996. The results were as follows : 1. The most common type of accident was fall down (53.4%). 2. Male patients outnumbered female by the ratio of 1.68 : 1. 3. The highest incidence rate of accidents were observed in children between 1-3 years age group(34.9%). 4. Accidents were seasonally more frequent in spring(28.2%). 5. Accidents mainly took place at home (63%). 6. The time of accidental occurrence appeared to be predominantly high during a day 8 : 00 PM to 0 : 00 AM (35.l%). 7. The most frequent involved part of body was head and face (74%). 8. Most patients discharged from the hospital in good condition(85.4%). Through clinical analysis, in the relation to accident, there were statistically significant difference in sex, age, season, injury place(all p=0.000).

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.7 no.1
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• pp.29-32
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• 2011

There are a lot of dental emergency situations and accidental aspiration or ingestion of a dental instrument is one of the common accidents in dental practice especially on disabied or pediatric patient with negative behavior. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. This is a case of an accident during the treatment of a 18 months male patient with caries of anterior deciduous teeth. During the treatment, the gauze was used by waterproofing instead of a rubber dam. #4 round bur (approximately 2.2cm long) which was put on the tray was cling to the gauze and the bur was fell into the patient's throat. The bur was 2.2cm long and very sharp so it could not be passed spontaneously through the pylorus, so we tried to remove the bur by esophagogastroduodenoscopy. Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.47-53
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• 1997

Accidental ingestion of caustic substance is one of the common problems among children around the world. Acid intake accounts for a mere 5% of all reported cases of corrosive ingestion in the West. Because of the esophageal sparing effect of acid, clinically significant esophageal involvement after acid ingestion occurs in only 6 to 20 percent of the instances. Despite effort of prevention, 7% to 15% of children sustaining caustic esophageal burns develop esophageal strictures. If balloon dilatation or bougie dilatation fails to resolve the esophageal strictures, successful outcome following replacement by colon or stomach has been reported in children. But the complications and morbidity following these operations are still relatively high. Seven patients with corrosive-acid induced esophageal strictures who were operated upon at the Department of Pediatric Surgery, Seoul National University Children's Hospital from 1991 to 1995 were reviewed. Primary resection and anastomosis was performed in all of 7 patients. The stricture involved short segments of the esophagus at the level of the lower cervical and the upper thoracic vertebra. The operations were approached through a left cervical incision or a left thoracotomy. In one patient, operative repair of anastomotic leakage was done, and three patients required re-resection of anastomotic strictures postoperatively, and one patient required a third operation(reversed gastric tube) due to an anastomotic stricture. The other anastomotic leaks, strictures or pulmonary complications were resolved with conservative treatment. In conclusion, primary resection and anastomosis of the esophagus was performed successfully on the 6 of 7 children with acid induced corrosive esophageal strictures. This approach is physiologic, especially in children who should have a long life expectancy, and recommended for the treatment of short-segment acid induced corrosive esophageal strictures.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.595-604
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• 2013

Purpose: The purpose of this study was to identify risk factors for pediatric inpatients falls. Methods: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. Results: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. Conclusion: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.

• Journal of dental hygiene science
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• v.14 no.2
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• pp.264-268
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• 2014

There are a lot of dental emergency situation. Especially on disabled or pediatric patient with negative behavior, accidental aspiration or ingestion of foreign body (ex: dental instrument) is one of the common accidents in dental procedure. Dentists and dental hygienists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental treatment, especially on the disabled. This is a case of an accident during the dental treatment of 14-year-old female patient with cerebral palsy. During scaling, prolonged retained primary tooth which had resorbed roots was fell into left bronchi. So we tried to remove the crown by endotracheal approach. Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them need endoscopic or surgical removal. Moreover aspiration into broncho-trachea can be more serious events and must be treated as emergency situation.

• Clinical and Experimental Pediatrics
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• v.63 no.5
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• pp.184-188
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• 2020

Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

• Journal of Korean Clinical Nursing Research
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• v.25 no.2
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• pp.142-150
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• 2019

Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.136-141
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• 2015

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.