• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.113-121
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• 2010

Purpose: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. Methods: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. Results: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. Conclusion: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.7-16
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• 2021

Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

• Journal of Advanced Navigation Technology
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• v.27 no.4
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• pp.356-364
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• 2023

Sophisticated Air Navigation System has contributed to enhancing the capacity of airspace capacity, leading to an efficient airspace environment. However, it has acted as a factor increasing the probability of collision. When an aircraft fails to maintain vertical separation and instead exhibits lateral positional errors, it does not necessarily lead to a collision. However, as the lateral positional accuracy increases, the randomness of aircraft positions decrease, resulting in an elevated probability of collisions. Consequently, The International Civil Aviation Organization has introduced Strategic Lateral Offset Procedures(SLOP), intentionally deviating aircraft from the centerline of airways. Likewise, South Korea also operates Offset procedure. The Y579 was operated using the Offset before its conversion to a dual airway and the analysis of the Offset track revealed that it was being operated similarly to a unidirectional dual airway. This paper develops a safety assessment methodology applicable to unidirectional dual airways, and applies it to perform a safety assessment of the Y579 Offset procedure.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.127-134
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• 2003

An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.

• The Korean Journal of Emergency Medical Services
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• v.10 no.2
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• pp.35-42
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• 2006

Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.

• Tuberculosis and Respiratory Diseases
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• v.72 no.5
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• pp.401-408
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• 2012

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

• IMMUNE NETWORK
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• v.10 no.4
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• pp.109-114
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• 2010

The molecular mechanisms involved in the pathogenesis of chronic obstructive pulmonary disease (COPD) are poorly defined. Accumulating evidences indicate that chronic inflammatory responses and adaptive immunity play important roles in the development and progression of the disease. Recently, it has been shown that IL-17 producing CD4 T cells, named Th17 cells, which have been implicated in the pathogenesis of several inflammatory and autoimmune diseases, are involved in airway inflammation and COPD. In addition, we and others suggest that autoimmunity may play a critical role in the pathogenesis of COPD. Here, we will review the current understanding of roles of Th17 cells and autoimmune responses in COPD.

• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.3
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• pp.173-179
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• 2015

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.4
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• pp.527-538
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• 2009

Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

• Tuberculosis and Respiratory Diseases
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• v.57 no.1
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• pp.72-77
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• 2004

Background : A tracheobronchial obstruction in lung cancer is associated with significant morbidity and mortality due to dyspnea, cough, hemoptysis, and recurrent respiratory infection. It is well known that one of standard treatments is photodynamic therapy (PDT) in tracheobronchial obstruction after radiotherapy, chemotherapy, and/or surgery. We reported here the role of PDT in airway obstruction in patients advanced lung cancer. Method : Pre-treatment protocol consisted of clinical, radiologic, and bronchoscopic examination, pulmonary function test, and assessment of Karnofsky performance status. A 2 mg/kg of porfimer sodium was injected intravenously, and then followed by cylindrical and/or interstitial irradiation with 630 nm of laser after 48 hours. The repeated bronchoscopy for debridement of necrotic tissue and re-illumination was performed after 48 hours. Result : Improved airway obstruction and selective tumor necrosis were achieved by photodynamic therapy in all cases. Dyspnea and performance status were improved in three cases. A purulent sputum, fever and hemoptysis were improved in one of five cases. After PDT, all patients showed temporarily aggravation of dyspnea, two of five showed febrile reaction for a few days and nobody presented photosensitivity reaction, hemoptysis and respiratory failure. Conclusion : Our experiences of PDT are effective in palliation of inoperable advanced lung cancer in terms of tracheobronchial obstruction.