• Journal of Trauma and Injury
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• 제28권1호
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• pp.1-8
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• 2015

Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas received an emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.687-690
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• 2014

Background: Emergency departments are visited by cancer patients for palliation of cancer-related symptoms, management of treatment-related side effects, oncologic emergencies, co-morbidities, and/or end of life care. In this study, we aimed to identify the characteristics of cancer patients admitted to an emergency medicine department in Southwest Turkey. Materials and Methods: In this retrospective descriptive study, a total of 304 emergency department admissions of 102 patients with cancer due to medical conditions were evaluated. Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression test were used. Results: The majority of patients visiting to emergency departments were male (n=66, 65%) and over 65 years of age (53, 52%). Some 30% (n=31) had a lung cancer diagnosis, 32% (n=33) presentation with dyspnea, 53% (n=55) with metastasis, 30% (n=16) with multiple metastatic lesions in lung, and 68% (n=70) had a poor ECOG performance status (score 3 to 4). Conclusions: Emergency departments have valuable roles in managing and caring for patients with malignancies.

• 대한임상독성학회지
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• 제3권2호
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• pp.122-125
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• 2005

Paraquat, is a widely used for its great effect as a herbicide. But the mortality rate by paraquat intoxication is known to be very high. It is thought to act by changing form to superoxide and peroxide free radical. Almost paraquat intoxication is through ingestion. A few intoxication of paraquat is through skin absorption. But there was no known death case through skin absorption. We experienced a case of a expired patient by paraquat intoxication through skin abrasion and scratching wound. A 75-year-old man was visited emergency room after motorcycle accident during transporting paraquat. He has multiple abrasion and scratching wound on extremities, and pelvic bone fracture. There was no evidence of ingestion of paraquat. But serum/urine gramoxone level was all positive. In spite of wound irrigation and hemoperfusion, his condition was been gone form bed to worse. 2 days after, multiple organ failure and the respiratory arrest were developed and he was expired. Paraquat intoxication through skin wound is extremely dangerous and death by that could possibly happen

• Journal of Trauma and Injury
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• 제35권1호
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• pp.3-11
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• 2022

Purpose: The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR, 3.88; 95% confidence interval, 1.33-11.36) and operating an ePMD while intoxicated (AOR, 2.78; 95% confidence interval, 1.52-5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate the quality of the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency intensive care unit (ICU) in consultation with intervention radiologists and surgeons. Methods: This was a retrospective observational study conducted in an emergency ICU of a tertiary referral hospital. We enrolled consecutive patients who had been admitted to our emergency ICU with major trauma from March 2007 to September 2010. We collected data with respect to demographic findings, mechanisms of injury, the trauma and injury severity score (TRISS), emergency surgery, angiographic intervention, and 6-month mortality. Then, we compared the observed and predicted survivals of the patients. The Hosmer-Lemeshow test and calibration plots by using 10 groups, one for each decile, of predicted mortality were used to evaluate the fitness of TRISS. P-values of greater than 0.05 represent a fair calibration. Results: Among 116 patients, 12 (10.34%) were dead within 6 months after admission to the ICU, and 29 (25.00%) and 38 (32.80%) patients received emergency surgery and angiographic intervention, respectively. The mean injury severity score and revised trauma score were $36.97{\pm}17.73$ and $7.84{\pm}6.75$, respectively. The observed survival and the predicted survival of the TRISS were 89.66% (95% confidence interval [CI]: 84.03~95.28%) and 69.85% (95% CI: 63.80~75.91%), respectively. The calibration plots showed that the observed survival of our patients was consistently higher than the predicted survival of the TRISS ($p$ <0.001). Conclusion: The observed survival for the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency ICU in consultation with intervention radiologists and surgeons, was higher than the predicted survival of the TRISS.

• 대한임상독성학회지
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• 제15권1호
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• pp.17-23
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• 2017

Purpose: Activated charcoal (AC) has been widely used as a universal antidote. Currently, emergency medical centers in Korea cannot administer AC due to discontinuation of the supply of commercial ready-mixed AC suspension. This study was conducted to investigate the proportion of emergency medical centers that administer AC to poisoning patients and provide basic information for emergency physicians and toxicologists. Methods: A prospective telephone survey of all of the included emergency medical institutions was conducted. The type of emergency medical institution, average annual number of patients admitted to the emergency department, annual average number of patients who were poisoned and whether the hospital currently utilizes gastric lavage and administration of AC were determined. Results: AC was administered to poisoning patients in 40% of regional emergency medical centers, 59.3% of local emergency medical centers, and 45.9% of local emergency medical rooms. Overall, 37% of total emergency medical institutions did not administer AC due to discontinuation of the commercial ready-mixed AC suspension. Additionally, 77% of emergency physicians in institutions without AC knew AC is necessary for poisoning patients. The rate of vomiting experienced by the medical staff according to types of charcoal showed that the average rate of vomiting was 33% for commercial ready-mixed activated charcoal suspension and 51% for self-prepared charcoal powder (p=0.02). Conclusion: AC should be secured promptly in emergency medical institutions. Before the supply of commercial ready-mixed AC suspension becomes again it is essential to develop a standardized regimen for self-preparation of charcoal powder and to educate emergency physicians and toxicologists to its use.

• 대한임상독성학회지
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• 제13권1호
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• pp.11-18
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• 2015

Purpose: The aim of this study was to compare the clinical characteristics in emergency endotracheal intubation between patients with acute drug intoxication and medical disease. Methods: Data for airway registry collected in two emergency departments (ED) between April 2006 and March 2010 were reviewed retrospectively. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. Results: A total of 1480 patients were enrolled; 62 patients were classified as belonging to the intubation group after the drug intoxication group. No significant differences in Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, and complications after intubation were observed between patients with acute drug intoxication and medical disease. However, significant difference was observed for indication of emergency endotracheal intubation. While emergency endotracheal intubations were usually performed in medical patients because of failure of airway patency, they were performed in intoxicated patients with the goal of preventing serious complications. Conclusion: Anatomical structures related to endotracheal intubation, the process and clinical outcome of intoxicated patients are not significantly different from those for medical patients.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권1호
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• pp.35-40
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• 2009

Dental emergency varies from toothache to trauma of oromaxillofacial area. Recently, the number of emergency cases after dental treatment is increasing because surgical treatments such as implant installation rise. Dental emergency patients have been looking for emergency room of general hospital and they could be treated only when the dentist of night duty exists. Although there are many analyses on the dental emergency patients visiting general hospitals, research on the dental treatment only has not been provided enough. We anticipated different aspects between the dental emergency patients visiting independent dental hospital and general hospitals. We analyzed dental emergency patients' chief complaints and received procedures for almost 1-year period in Won-Kwang dental hospital in Dae-jeon where there had been no dental emergency settings. With this 1574 patients' result, we tried to find appropriate treatment plans regarding dental emergency patients occurring at night and holidays.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.256-263
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• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• 대한임상독성학회지
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• 제3권1호
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• pp.48-51
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• 2005

Diagostic imaging can help in management of toxicologic emergencies. We report a patient who presented to the emergency department with coma and suppressed respiration after ingestion of unknown substance. We documented chloroform with radiopaque material in bowel on abdominal radiograph. We used activated charcoal and laxative to decontaminate bowel. Hepatotoxicity occurred on 3rd admission day and elevation of liver enzyme reached peak level on 5th admission day. The patient received hemoperfusion, N-acetylsystein and supportive cares. The patient was improved from hepatic dysfunction and discharged without complication on 11th admission day. Radiograph in toxicology may confirm a diagnosis and assist in therapeutic intervention.