• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.35-45
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• 2018

Purpose: The purpose of this study was to compare laryngoscopic views and ease of use and success of intubation, via the percentage of glottic opening (POGO) scale when using the Miller blade and Macintosh blade in paraglossal approach. Methods: Forty intern doctors were randomized for laryngoscopy to be performed in a crossover manner. They performed endotracheal intubation with Miller blade and Macintosh blade in two airway scenarios: normal airway and difficult airway with edema. We observed the rate of successful intubation, time required for visualizing the glottis, time to complete endotracheal intubation, ease of intubation, and the POGO scale. Results: In the normal airway, there was no difference in intubation between the two endoscopes. In the difficult airway, the time for visualizing the glottis (7.80 versus 10.24 sec; p=.006), the time to tube passage (19.38 versus 23.03 sec; p=.038) and the time to complete endotracheal intubation (21.84 versus 28.54 sec; p=.022) with Miller blade was shorter than with Macintosh blade. The POGO scale(%) of the Miller blade was higher than that of the Macintosh blade's (62.25 versus 56.32; p=.030). Conclusion: Compared to the Macintosh blade, Miller blade provided better visualization of the glottis and POGO scale, and faster time to completion of endotracheal intubation.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.3
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• pp.163-181
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• 2017

In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation. Many studies and guidelines have suggested RBCT is considered when hemoglobin levels recorded are 7 g/dL for general patients and 8-9 g/dL for patients with cardiovascular disease or hemodynamically unstable patients. However, RBCT is occasionally an essential treatment during surgeries and it is often required in emergency cases. We need to comprehensively consider postoperative bleeding, different clinical situations, the level of intra- and postoperative patient monitoring, and various problems that may arise from a transfusion, in the perspective of patient safety. Since orofacial surgery has an especially high risk of bleeding due to the complex structures involved and the extensive vascular distribution, measures to prevent bleeding should be taken and the conditions for a transfusion should be optimized and appropriate in order to promote patient safety.

• Journal of Technologic Dentistry
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• v.28 no.1
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• pp.177-198
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• 2006

This study purposed to offer basic data for safety education of the dental laboratory technology after the investigation of how much the students in the dept. of dental laboratory technology are aware of the danger of each instrument, equipment or laboratory procedure that they use during laboratory and how much they demand safety education for this. The objects for this study were 423 students who were in the dept. of dental laboratory technology. In this regard, four colleges which have the dept. of dental laboratory technology were randomly selected to do a questionnaire survey. SPSS 12.0 was used to analyze the collected data. The results were as follows: As for satisfaction with their major, the respondents answered Satisfied (59.1%), Average (35.5%) and Dissatisfied (5.4%). In terms of the production process of a partial denture, they considered casting, polishing the casting body, polishing denture and burn out were most dangerous in order. As for the production process of a full denture, what they regarded as the most dangerous in order was polishing denture, deflasking and wax wash. Regarding the laboratory procedures of porcelain material, casting, trimming casting body, polishing porcelain material and burn out were the most dangerous procedures that they perceived. With regard to materials for use, alcohol, polishing, metal and wire were the most dangerous ones they thought. As for the handling characteristics of each material, small towns showed a higher demand for safety of the handling characteristics of alcohol. In terms of school year and sex, juniors and girls had higher scores in the demand for safety of the handling characteristics of acid. Regarding the handling characteristics of each equipment and instrument, all of small towns, juniors and girls showed the highest demand for safety of the handling characteristics of alcohol lamps. With regard to scores in the demand for safety of other characteristics, all of small towns, juniors and girls had the highest demand for safety of emergency treatment. Concerning the demand for safety education by the completion of safety education, in terms of each material, highest was the demand for safety of acid from the group which completed safety education. In regard to equipments and instruments, when it came to the demand for safety of the handling characteristics of casting machine, the educated group's demand for safety of acid was higher. Regarding other characteristics, the group which was not educated gained higher scores in the demand for safety of emergency treatment. 11. In all areas(materials, machines and others), small towns, girls and juniors showed higher scores in the demand for safety. Based on the above results, it was found that when students conduct the laboratory of dental technology, they would think that many materials, instruments or equipments for use are very dangerous. However, safety education was not fully given to them. Regarding the scores in the damned for safety education, the highest was 4.16 and the lowest was 3.43, which suggests that the scores were generally very high. In this regard, it is necessary to continue delivering a systematic safety education of materials, equipments or instruments used during the laboratory of dental technology. Therefore, through the analysis of each material, instruments or facility used in every laboratory and each process, safety accident types and accident risk factors should be investigated to develop educational materials for this. Moreover, it is required to open safety education as a single course of study or insert safety contents of all materials and machines into the class of dental laboratory instrument or dental materials for the purpose of a systematic and thorough safety education to prevent a safety accident during laboratory.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.4
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• pp.275-280
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• 1993

The 2nd, 3rd, 4th 6th cranial nerve and the ophthalmic division of the 5th cranial nerve are derived from the optic foramen and superior orbital fissure. When these contents are attacked by a trauma the superior orbital fissure syndrome or the more severe orbital apex syndrome are onsetted. As their treatment we can consider the conservative treatment with the hypertonic solution and steroid. Also we can consider the more radical surgery. But their indications are debatable. As the emergency state the treatment plan requires rapid decision and very much considerations equaly. And the legal problems can be happened.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.1
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• pp.69-74
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• 2015

Despite preventative efforts, aspiration and ingestion of foreign bodies during clinical dental procedures occasionally occur. Careful clinical and radiographic examination and prompt emergency management can prevent potentially serious consequences. In this report, we describe a case of accidental foreign body ingestion and discuss prevention and management of dental instrument aspiration and ingestion.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.2
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• pp.135-138
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• 2017

Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl ($100{\mu}g$), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to $38cmH_2O$ and plateau pressure increased from 20 to $28cmH_2O$. We maintained anesthesia because we were unable to access the airway, which was covered with surgical drapes, and tidal volume was delivered. At the end of surgery, we found a longitudinal fold inside the tube with a fiberoptic bronchoscope. The patient was reintubated with another tube and ventilation immediately improved. We recognized that the tube was obstructed due to dissection of the inner layer.

• Journal of Korean Dental Science
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• v.7 no.1
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• pp.43-47
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• 2014

Few dental procedures are potentially life-threatening. Note, however, that a dental extraction can result in preventable death. Severe post-extraction bleeding can occur, which may give rise to an alarming situation if there is any delay in detecting and managing the problem. The most immediate danger for a healthy patient with severe post-extraction hemorrhage is airway compromise. Acute airway obstruction from post-extraction hematoma is relatively uncommon, but it may occur with fatal consequences if there is any reluctance to maintain the airway clearance. Therefore, dentists and oral and maxillofacial surgeons should have clear understanding of the problem and measures to control it. Active bleeding that is not controlled by local measures in a dental office should be referred to the nearest hospital emergency department as soon as possible for appropriate management.

• Journal of Korean society of Dental Hygiene
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• v.10 no.2
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• pp.283-295
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• 2010

Objectives : It surveyed the recognition level of oral health in class teachers who have influence of students' oral health knowledges and behaviors in our country, developed a program available for supplementing reinforcement in school oral health education, and planned the knowledge contents necessary for school oral health education hereafter. Methods : To arrange the basic data necessary for school oral health program, it carried out questionnaire survey by personal self-administration targeting 460 teachers for 19 elementary schools where are located in Jinhae city from May 7, 2007 to June 13. The following conclusions were obtained. Results : 1. The path of acquiring oral health knowledge was shown the high frequency with 23.9% and 23.3%, respectively, through publicity brochure and dental clinic. As for the opinion about the aim of maintaining dental hygiene, the prevention of dental caries was the highest with 53.7%. 2. The opinion about which the regular visit to the dentist is very effective for preventing dental caries accounted for 56.7%. The opinions about which the limit to sugar intake and the use of dental floss are effective for preventing dental caries accounted for 52.2% and 46.3%, respectively. 3. The opinion about which the fluoridation beverage intake and the sealant are effective for preventing dental caries accounted for 33.9% and 33.0%, respectively. 4. The opinion about which the regular toothbrushing without toothpaste has a little effect and has no effect on preventing dental caries accounted for 42.6% and 38.5%, respectively. Conclusions : The elementary-school age period, which is the most core field out of the whole oral health, is the important period that is formed the basis of lifelong oral health care. It surveyed the recognition level of oral health in class teachers who are in charge of direct health care while making continuous life with students, and developed program available for supplementing reinforcement in school oral health education. Through this, there will be necessity for cultivating ability available for properly managing oral health for the whole life by allowing elementary-school students, who will be led to future adults' oral health, to be formed the attitudes toward the rationally oral health care.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.1
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• pp.109-116
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• 2016

Sedation is an indispensable part of contemporary pediatric dentistry. The Korean Academy of Pediatric Dentistry (KAPD) organized the dental sedation committee to help members perform safer and more effective sedation. The committee surveyed 111 members who practice dental sedation to figure out the present state of sedation in 2014. According to the survey, 86% of the respondents indicated that they were interested in continuing education of sedation. The most interesting topic was sedation related emergency management, followed by safe dosages of sedative drugs. However, it is not realistic to establish the recommended dosages as a guideline since the selection of agents and dosages depend on various factors. In order to provide successful sedation, pediatric dentist should make an individual sedation plan for each procedure. It is important to understand not only the properties of each sedative, but also interactions with other drugs. This article reviews useful information of commonly used agents for dental sedation and summarizes the recommended dosages from the Physicians' Desk Reference (PDR) and some famous pediatric dentistry textbooks.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.269-279
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• 2021

The purpose of this study is to evaluate the effect of the spread of a new type of coronavirus infection (COVID-19) on the mental state in school-age children and parents focusing on the aspects of sleep disorders and depression. A questionnaire survey was conducted for 123 parents and 108 school-age children who visited Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong from April 2, 2020 through April 25, 2020, via the direct writing method. Participants were assessed with Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder (GAD)-7, Center for Epidemiology Scale for Depression. Logistic regressions were used with a level of significance of 5%. The prevalence of GAD, depression, and poor sleep in parents were 34.1%, 17.1% and 44.7%, respectively. The prevalence of GAD in children was 20.4%. Logistic regression showed that stress from Emergency Alert Messages about COVID-19 was associated with GAD and depression in parents. In children, the degree of emotional change after COVID-19 was associated with GAD. This study confirmed that there was a change in the psychological status of children and guardians due to the epidemic of coronavirus disease-2019, and it would be necessary to consider their psychological status during dental treatment.