• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.181-189
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• 2019

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor, confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.

• 한국간호교육학회지
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• 제19권1호
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• pp.52-59
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• 2013

Purpose: This study was performed to identify in nursing students the effects of simulation practice for hemorrhagic patients. Methods: Subjects were sophomore nursing students in Daegu (n=133). A self describing performance questionnaire which included knowledge, skill and attitude towards bleeding patients was given. Consent was received from students. The data was analyzed by ANOVA with Scheffe's test and Mann-Whitney U test using the SPSS 12.0 Program. Result: Subjective and objective knowledge and skill showed significant improvement in the control group, especially in assessment, correct medication administration, explaination of NPO and preparing the crash cart for a cardiac arrest. Objective knowledge and skill was significantly higher in the control group although attitude was not. Conclusion: Simulation practice was an effective education method for improving knowledge, skill and attitude in nursing students.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제12권3호
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• pp.63-67
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• 1990

Electrical burns of the lips are most frequently seen in small children, who are apt to chew on electrical cord or plug, the ends of extension cords in their mouth, saliva creates a short circuit across the terminals within the plug, causing an electrical burn. Tissue destruction with electrical burns is sudden and extensive. Extensive, deep coagulation necrosis is instaneously produced by the extreme temparatures of electrical arc. If the child is well grounded, the circuit flow through his body may cause cardiac arrest. The purpose of this report is to document two cases of electrical lip burn and reconstruction of the lip defect with some local flap techniques. For case 1, Z plasty & V-Y plasty and lengthening of the commissure and in case 2, Abbe flap technique was used and scar was revised later. Z-plasty and V-Y plastry were used for scar release and Abbe flap was designed on lower lip to meet the need of upper lip. For short of right lip width, lengthening of the commissure was done. We are to report the improvement with forementioned operation on the patient of electrical burn upon the lip.

• 대한의용생체공학회:의공학회지
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• 제38권4호
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• pp.211-217
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• 2017

During the emergency situation such as cardiac arrest, cardiopulmonary resuscitation(CPR) is the most important treatment to maintain patient's blood circulation. Since the quality of CPR can not be easily measured or evaluated by the eye, an assistive device with an accelerometer can help to assess the pressure depth of CPR. In this study, we propose a single frequency analysis method to reduce the error of the accelerometer by extracting only one frequency component from the Fourier transform process. To verify the effectiveness of the single frequency analysis, acceleration data at CPR conditions were measured at a sampling rate of 50 / sec using a wristband equipped with an acceleration sensor. Then, We compared the existing distance estimation method and the single frequency analysis method using the measured data. The amplitude value proportional to the compression depth was obtained by applying the single frequency analysis method.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.363-366
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• 2010

Vertebral artery (VA) injury is a rare and serious complication of cervical spine surgery; this is due to difficulty in controlling hemorrhage, which can result in severe hypotension and cardiac arrest, and uncertain neurologic consequences. The authors report an extremely rare case of a 56-year-old woman who underwent direct surgical repair by end-to-end anatomosis of an unanticipated VA injury during C2 pedicle screwing. Postoperatively, the patient showed no neurological deterioration and computed tomography angiography of the VA demonstrated normal blood flow. Although direct occlusion of an injured VA by surgical ligation or endovascular embolization has been used for management of an unanticipated VA injury during surgery, these methods may be associated with significant morbidity and mortality. However, despite its technical demand, microvascular primary repair can restore normal blood flow and minimizes the risk of immediate or delayed ischemic complications. Here we report an iatrogenic VA injury during C2 pedicle screwing, which was successfully treated by end-to-end anastomosis.

• 한국응급구조학회지
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• 제22권2호
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• pp.23-33
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• 2018

Purpose: To investigate the perception of paramedic students about core competence and methods of disaster response. Methods: A self-reported questionnaire was completed by 210 paramedic students in Jeollado from March 2 to April 2, 2018. It comprised 57 questions on topics such as general characteristics (6), related experience (11), cognition of core competence (15), and knowledge of disaster response methods (25). Data were analyzed by means of a frequency analysis, a t-test, an ANOVA, and the Pearson's correlation coefficient using SPSS WIN 21.0. Results: The average score of the participants on disaster response core competence was 3.21. The statement "In case of a disaster, I know the duties of medical staff" scored the second highest, at 3.58, and "In the case of disaster, I can conduct the basic treatment" scored the highest ar 3.59. The average score for the disaster response methods was 3.31. Within the section, the statement "I know what I need to do in the case of burn patients" scored 3.59 and "I know what I need to do in the case of a cardiac arrest patient" scored the highest at 3.93. Conclusion: It is necessary to develop a training module considering the diverse types of disasters and a standardized education program for simulation similar to real-life situations.

• Journal of Chest Surgery
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• 제16권2호
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• pp.184-189
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• 1983

Between 1958 and 1982, 70 patients have undergone pericardiectomy for constrictive pericarditis at the Thoracic Department of Seoul National University Hosp. 58 males and 12 females, with an average age of 27 years [ranging 3 to 60 years], of which 55% were between 10 and 30 years old, were treated. Eight patients died, of whom 4 were in the immediate postoperative period, less that 24 hours after operation. The cause of death was myocardial failure in 3 patients and hypotension during operation in one patient. The remaining four deaths occurred between the fifth and eighteenth postoperative day, and the causes of death varied: bilateral phrenic nerves injury, congestive heart failure, dissemination of tuberculosis, and cardiac arrest. Two patients suffered from congestive heart failure pre-and postoperatively due to the associated valvular heart disease. There were 8 wound infections on which resulted in perichondritis of costal cartilages requiring segmental resection 2 months later. There was one postoperative bleeding requiring immediate reopening for bleeding control. Tuberculosis was confirmed as the cause of constrictive carditis in 27 patients [39%]. Acute pyogenic pericarditis was precursor in 8 patients [11%]. In 2 patients [2.9%], the constrictive pericarditis developed following OHS. Both suffered from congestive heart failure postoperatively due to the residual valvular heart disease. In the others, the cause of the constrictive pericarditis was considered idiopathic or non-specific inflammation.

• Journal of Chest Surgery
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• 제31권5호
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• pp.536-539
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• 1998

기관무명동맥루는 기관절개술후 드믈게 발생하는 합병증으로 사망률이 높은 질환이며, 치료는 신속한 외과적 처치가 관건이 된다. 환자는 과거력상 30년전에 폐결핵으로 좌측전폐절제술을 시행받았으며 그 동안 경과 양호하였으나 최근 2개월간 급성호흡부전으로 기관절개술을 시행받고 호전되어 11 mm 실리콘 Montgomery T-tube로 교환 후, 3일째 발생한 기관무명동맥루에 의한 절개창주위의 다량의 출혈과 기도폐쇄에 의한 심정지를 일으켰다. 기관무명동맥루에서 Utley maneuver와 무명동맥을 절단봉합하여 지혈에 성공하였고, 이에 지혈방법, 수술수기에 관하여 보고하는 바이다.

• 대한기관식도과학회지
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• 제3권1호
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• pp.185-187
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• 1997

Acquired tracheal dilatation is a state of abnormal tracheal dilatation developing from various causes. Tracheomalacia and tracheal dilatation can develop in respiratory distress patients with prolonged endotracheal intubation with assisted positive-pressure ventilation due to positive airway pressure and high cuff pressure. The authors have recently experienced one case of respiratory failure, cardiac arrest, and whole body emphysema after tracheostomy and portex tube insertion were performed to patient with the endotracheal intubation with assisted positive-pressure ventilation for two weeks in the septic shock resulted from colon perforation, who developed tracheal dilatation. We summarize diagnostic and therapeutic strategies of acquired tracheal dilatation for the prevention of emergency status and the management for that patients.

• Journal of Chest Surgery
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• 제51권6호
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• pp.406-409
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• 2018

Aortocaval fistula (ACF) occurs in <1% of all abdominal aortic aneurysms (AAAs), and in 3% to 7% of all ruptured AAAs. The triad of clinical findings of AAA with ACF are abdominal pain, abdominal machinery bruit, and a pulsating abdominal mass. Other findings include pelvic venous hypertension (hematuria, oliguria, scrotal edema), lower-limb edema with or without arterial insufficiency or venous thrombus, shock, congestive heart failure, and cardiac arrest. Surgery is the main treatment modality. We report successful surgical treatment in a patient with a ruptured AAA with ACF who presented with cardiogenic shock.