• Journal of Dental Anesthesia and Pain Medicine
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• v.15 no.2
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• pp.77-83
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• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• The Korean Journal of Emergency Medical Services
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• v.10 no.1
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• pp.13-21
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• 2006

Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.173-178
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• 2017

Purpose: Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER. Methods: We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups. Results: A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034). Conclusions: In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

• The Korean Journal of Emergency Medical Services
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• v.20 no.3
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• pp.37-47
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• 2016

Purpose: The purpose of the study was to establish an education curriculum subject program design for the department of emergency medical technology based on National Competency Standards (NCS) key competencies. Methods: A self-reported questionnaire was completed by 180 level 1 emergency medical technicians in K area from June 15 to 20, 2016. Except for 14 incomplete questionnaires, 141 data were analyzed. The study instrument included general characteristics of the subjects (7 items) and importance and satisfaction levels for 10 key competencies including 34 items of subfactors by a Likert 5-point scale using Borich Needs Assessment Model. A locus for focus model (LF model) was used to derive the top priority key competencies for the education curriculum. Data were analyzed by SPSS v. 20.0. Results: The order of education needs of the program included interpersonal competency (1.442), communication competency (1.384), problem solving competency (1.185) and professional ethics competency (1.149). In the LF model, the required jey competencies included interpersonal competency, communication competency, professional ethics competency, and problem solving competency. Conclusion: The study results coincided with standard education curriculum guidelines. Our resluts can provide a valid reference for the department of emergency medical technology.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.26-35
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• 2019

Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.578-584
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• 2018

Objective: This study examined the initial partial pressure of carbon dioxide ($PCO_2$) as a possible indicator of prehospital ventilation and its association with prehospital i-gel in out-of-hospital cardiac arrest (OHCA) patients. Methods: The demographics and arrest parameters, including i-gel insertion and initial arterial blood gas analysis, of OHCA patients who visited the emergency department were analyzed retrospectively. Linear regression analysis was performed to examine the association between i-gel insertion and the initial $PCO_2$. Results: A total of 106 patients were investigated. Fifty-six patients had prehospital i-gel insertion and 50 patients did not have a prehospital advanced airway. The initial $PCO_2$ was higher in the i-gel group than the no advanced airway group (105.2 mmHg [77.5-134.9] vs. 87.5 mmHg [56.8-115.3], P=0.03). Prehospital i-gel insertion was associated with a higher initial $PCO_2$ level (${\beta}$ coefficient, 20.3; 95% confidence interval, 2.6-37.9; P=0.03). Conclusion: Prehospital insertion of i-gel was associated with higher initial $PCO_2$ values in OHCA patients compared to no advanced airway.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.215-227
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• 2011

Purpose: This research was done to identify relationships among job stress, fatigue, job satisfaction, and commitment to organization in emergency department nurses. Methods: Research participants were 513 nurses who worked in the emergency department of 17 tertiary centers and 28 secondary hospitals. Data collection for this descriptive correlational study was done from May to July 2010 using self report questionnaires, and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient with the SAS 9.2 program. Results: There were statistically significant differences in organizational commitment according to age, religion, total clinical experience, emergency department experience, current position, frequency of night shift, average sleep hours, wage level, numbers of beds in unit, and reason for working. A positive correlation was found between job stress and fatigue, and between job satisfaction and commitment to organization for the emergency department nurses and a negative correlation between job stress and Job satisfaction, and fatigue and Job satisfaction. Conclusion: Results of this research indicate that job stress in emergency department nurses was the principal variable affecting job satisfaction and commitment to organization along with fatigue. Appropriate stress management strategies based on identification of job stress for these nurses should lead to development of improved management of nursing manpower and a reduction in stress.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.15-20
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• 2007

Purpose: To analyze the general characteristics and clinical aspects of the organochlorine intoxicated patients in Korea. Methods: We prospectively evaluated the organochlorine intoxicated patients visiting to the 38 emergency medical centers in Korea from the 1, Aug. 2005 to the 31, Jul. 2006. Results: There were 38 patients intoxicated by the organochlorine during the study periods. The mean age of patients was 55.1 years old. The mean amount of the organochlorine intoxicated is 246.1 mL. The most frequent place where the patients got and took the organochlorine was their home. Twenty eight patients(73.7%) intended to suicide. Nine patients out of 38 patients(23.7%) were died and they all intended to suicide. Conclusion: There were 38 patients intoxicated by the organochlorine during the study periods. The suicidal attempts and the number of the dead were higher in Korea than the developed countries.

• Journal of Trauma and Injury
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• v.26 no.1
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• pp.6-13
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• 2013

Purpose: Sulforaphane is a naturally-occurring isothiocyanate abundant in broccoli. It has been suggested as a promising antioxidant. In this study, the therapeutic effect of sulforaphane in paraquat intoxication was investigated. Methods: Paraquat was administered via the tail vein, after which sulforaphane or a vehicle (4% DMSO) was administered intraperitoneally 15 minutes after paraquat administration. Histological injury, lipid peroxidation, plasma cytokine (IL-6, IL-10), and nitric oxide were measured. In addition, the effect of sulforaphane on survival in paraquat-intoxication was observed. Results: Regarding histological injury, lipid peroxidation, and plasma cytokine and nitric-oxide response, sulforaphane administration showed no protective effects in paraquat-intoxicated rats. Rather, it increased mortality (log rank p=0.03) and caused lipid peroxidation, as well as plasma cytokine and nitric-oxide production, to be increased. Conclusion: Sulforaphane had no therapeutic effect on paraquat-intoxicated rats; rather, it increased mortality.