• Title/Summary/Keyword: Emergency Report

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Syncope and pneumomediastinum during the maxillary sinus elevation with an air-syringe: a case report (주사기를 이용한 상악동 거상술 시 발생한 실신 및 종격동기종에 관한 증례보고)

  • Kim, Su Wan;Lee, Jonggeun;Song, Ji-Young
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.3
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    • pp.171-176
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    • 2021
  • Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.

Non-hemolytic, Mucinous, Coagulase Negative MRSA Isolated from Urine (소변에서 분리된 비용혈성, 점액성, 응고효소 음성 MRSA)

  • Kim, Jae Soo;Choi, Qute;Jung, Bo Kyeung;Kim, Jong Wan;Kim, Ga Yeon
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.260-264
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    • 2019
  • An 84-year-old woman presented to the emergency department with a chief complaint of pressure sores of the anus. She had a urine catheter when she showed pyuria three times but had no fever. A microscopic examination revealed many grapevine-like Gram positive strains and neutrophils. After 24 hours of urine culture on blood agar, non-hemolytic mucous colonies were found and further enlarged after 48 hours of culture. The capsules were identified after India ink stain. The catalase was positive, but the tube coagulase and latex coagulase were both negative. The S. aureus was identified by Vitek-2 and mass spectrometer Vitek MS V-3 IVD. The strain was confirmed by 16S rRNA gene sequencing and multilocus sequence typing (MLST). The phenotypically atypical MRSA found in the tube coagulase and latex coagulase were both negative. MRSA often show no beta hemolysis as in this case but are rarely latex coagulase-negative. We report a woman whose urine culture showed non-hemolytic, tube coagulase-negative, and latex coagulase-negative MRSA.

A Study on the Analysis of Information Element of COP-Based Situation Panel for Efficient Disaster Management in the Situation Room (상황실의 효율적인 재난관리를 위한 COP기반 상황판 정보요소 분석에 관한 연구: 풍수해를 중심으로)

  • Cho, Jung-Yun;Song, Ju-Il;Jang, Cho-Rok;Jang, Moon-Yup
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.1
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    • pp.393-401
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    • 2021
  • This study derives essential information elements that should be shared in the situation board by utilizing the concept of common operating picture (COP). The COP's concept and actual overseas cases were confirmed, and COP information elements that should be considered for disaster situations were redefined. The COP disaster response information elements were derived by analyzing the standard manual for disaster response and daily situation reports issued in Korea. The information elements were divided into four stages (①Report reception and recognition stages, ②Situation propagation and reporting stages, ③Emergency equipment operation stages, ④Recovery and recovery stages), centered on storm and flood damage. Further analysis of the detailed information elements was conducted to derive the information elements that must be shared in the context board. The information is shared along with spatial and geographical characteristics due to the characteristics of the COP, providing complex information to decisionmakers and officials, enabling diverse access to disaster situations. Furthermore, it is expected that disaster response will be more efficient by sharing the information in common.

A Comparison of the Clinical Competence, Knowledge of Patient Safety Management and Confidence of Patient Safety Management according to Clinical Practice Experience of Nursing Students

  • Lim, Jae-Ran;Song, Hyo-Suk
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.7
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    • pp.65-73
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    • 2021
  • The purpose of this study is to cornpare the differences in clinical competence, knowledge of patient safety management and confidence of patient safety management according to the clinical practice experience of nursing students, Of the 73 nursing students who experienced clinical practice and 35 nursing students who did not experience, a total of 108 students in the third grade were analyzed, In the results of this study, clinical competence(t=.88, p=.377) knowledge of patient safety management(t=-.29, p=.773), and confidence of patient safety management(t=1.11, p=.267) the difference between was not statistically significant in the two groups. In the two groups, the score of the sub-area according to each variable is the lowest. First, the sub-area of the nursing process a lowest score in clinical competence, and the second, the sub-area of measuring knowledge about concept of near miss was the Knowledge of patient safety management. The score was the lowest in, and thirdly, the sub-area of writing an incident report when an error occurred had the lowest score in confidence of patient safety management. Therefore, in order to improve the quality of clinical competence of nursing students, it is necessary to develop a strategic educational guideline to improve the clinical practice education environment, to improve patient safety management capabilities and to cultivate correct attitudes toward patient safety management.

Effect of the Application of Hand Washing Education Program for the Children with Intellectual Disability on Hand Washing Frequency and Methods during COVID-19 Pandemic (코로나-19 확산 속에서 손 씻기 교육 프로그램 적용이 지적장애 아동들의 손 씻기 빈도와 방법에 미치는 영향)

  • Son, Sung-Min;Kwag, Sung-Won
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.6
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    • pp.1659-1668
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    • 2020
  • The purpose of this study is to analyze the effect of the application of hand washing education program for the children with intellectual disability on hand washing frequency and methods during COVID-19 Pandemic. Subjects were 14 children with intellectual disability and they participated in the program using visual video materials. Hand washing education program was consisted of introduction, theory education, and practice and it performed 2 times a week, total 16 sessions during 8 weeks. Hand washing theory education was consisted about the importance and application of hand washing, proper hand washing steps and methods, use of hand washing tools, use of hand sanitizers including characteristics, and prevention of skin damage from hand washing. Hand washing assessment was used by hand washing frequence and methods observation report. Hand washing frequency was measured by the hand washing frequency during the daily routine and it was analyzed by the items divided into day and month units. Hand washing methods was measured by the items divided into use of hand washing tools, time, areas, drying methods after hand washing. As the results, after hand washing education program, the hand washing frequence was increased and hand washing methods were improved. Hand washing is much important as a active method to prevent the infection during the COVID-19 Pandemic. Thus, based on this findings, the application of hand washing education program should be considered to increase the hand washing frequency and improve the hand washing methods of the children with intellectual disability.

Prevalence of and Coping Patterns for Allergic Diseases in Preschool and School-age Children in Nam-gu, Ulsan (울산광역시 남구 지역의 미취학 및 학령기 아동의 알레르기질환 유병률 및 대처 양상)

  • Im, Dasom;Pyo, Jeehee;Ock, Minsu
    • Journal of the Korean Society of School Health
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    • v.34 no.3
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    • pp.133-150
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    • 2021
  • Purpose: The epidemiologic understanding of allergic diseases, including prevalence and risk factors, is needed for allergy management. This study identified the prevalence of and coping patterns for various types of allergies, such as asthma, allergic rhinitis (AR), atopic dermatitis (AD), allergic conjunctivitis (AC), food allergy (FA), and drug allergy (DA), in Nam-gu, Ulsan, one of the most industrialized districts in Korea. Methods: A cross-sectional study was performed using a self-report multiple choice questionnaire. The International Study of Asthma and Allergies in Childhood (ISAAC) and other measures were reviewed to develop the questionnaire. Data was collected from May 9th to November 30th of 2018. Descriptive and frequency analyses were performed to apprehend the prevalence of symptoms, diagnostic rates, diagnosis dates, treatment history, and others. Results: By randomized sampling, 9,102 children from 25 nurseries, 25 kindergartens, and 15 elementary schools participated in the study. The prevalence of asthma, AR, AD, AC, FA, and DA were 11.1%, 48.7%, 15.5%, 17.6%, 15.1%, and 2.0%, respectively. The respective rate of ever being diagnosed with asthma, AR, AD, AC, FA, and DA were 4.2%, 38.4%, 25.5%, 23.3%, 9.7%, and 1.1%, respectively. Last year's allergy related school absenteeism rates were 10.8%, 4.1%, and 1.3% for asthma, AR, and AD, respectively. Lastly, 59.2% of the participants considered air pollution as the most challenging factor in allergy management. Conclusion: This study comprehensively investigated the current state of various allergic diseases in Nam-gu, Ulsan. The study's findings are expected to be applied to strategies for decreasing the socioeconomic burden of allergic diseases.

Structural Static Test of Pylon for External Attachment Separation Load (외부장착물 분리하중에 대한 파일런 구조 정적시험)

  • Kim, Hyun-gi;Kim, Sungchan;Hong, Seung-ho;Choi, Hyun-kyung;Cho, Sang-hwan;Park, Hyung-bae
    • Journal of Aerospace System Engineering
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    • v.16 no.1
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    • pp.104-109
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    • 2022
  • The bomb rack unit (BRU) installed inside the pylon serves to fix external attachments such as external fuel tank or external weapon, and also serves to separate external attachments in case of emergency. In particular, the load generated when the external attachment is separated from the BRU is called the punching load. In this study, we present the results of a structural static test performed to verify the structural integrity of the pylon under the BRU punching condition acting on it. In the structural static test report, we present the implementation method for the separation load of the external attachment and the test profile for the BRU punching load condition, and compared the error between the load input signal and the feed-back signal to determine the appropriateness of load control in each test. Furthermore, we compared the strain results obtained in the numerical analysis and structural test at the main positions of the specimen. As a result, it was shown that the load of the actuators were properly controlled within the allowable error range in each test, and the numerical analysis effectively predicted the test result. Finally, through structural static tests conducted by design limit load and design ultimate load, we verified that the aircraft pylon dealt with in this study has sufficient structural strength for external attachment separation condition.

The First Neonatal Case of Panton-Valentine Leukocidin-Positive Staphylococcus aureus Causing Severe Soft Tissue Infection in Korea

  • You Hoon Kim;Seung Hyun Shin;Hyeri Seok;Dae Won Park;Young Hwan Park;Yoonsun Yoon;Yun-Kyung Kim
    • Pediatric Infection and Vaccine
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    • v.30 no.3
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    • pp.152-158
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    • 2023
  • Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

Thrombolytic Therapy for Thrombosis of Prosthetic Mitral Valve - A Case Report - (인공 승모판막에 생긴 혈전의 혈전용해 치료 - 1례 보고 -)

  • Kang, Shin-Kwang;Kim, Si-Wook;Won, Tae-Hee;Ku, Kwan-Woo;Na, Myung-Hoon;Yu, Jae-Hyun;Lim, Seung-Pyung;Lee, Young;Jeong, Jin-Ok
    • Journal of Chest Surgery
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    • v.35 no.11
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    • pp.826-830
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    • 2002
  • Prosthetic valve thrombosis(PVT) may be a life-threatening complication requiring prompt intervention. This is a case report of thrombolytic therapy for thrombosis of prosthetic mitral valve. A 47 year-old male admitted to the emergency room for abrupt onset of dyspnea. He had undergone mitral valve replacement(On-Ⅹ valve, 29mm) for mitral stenosis 8 months ago. The patient's international normalized ratio(INR) on admission was 1.09. The mechanical clicks were muffled and rales were heard in both lung fields. A transesophageal echocardiography(TEE) revealed prosthetic valve thrombosis with increased transvalvular pressure gradient(34 mmHg). The patient's condition needed to intubation for mechanical ventilation due to hemodynamic compromise, however his wife and relatives refused the surgical intervention due to financial problems. The patient was transferred to the cardiac care unit and we decided to perform thrombolytic therapy. A bolus of 1,500,000 IU of urokinase was given, followed by a drip of 1,500,000 IU for 1 hour. The patient did not improved hemodynamically; therefore, we gave 100 mg of tissue plasminogen activator(t-PA) for over 2 hours. During that time mechanical clicks were audible and hemodynamics of the patient improved progressively. A TEE showed disappearance of thrombus and decreased pressure gradient(1.7 mmHg) after 6 hours of thrombolytic therapy. The patient was recovered without any neurologic sequale and was discharged with administration of warfarin.

An analysis of one-year experience of pediatric observation unit: The first report in Korea (소아 관찰병실 운영에 대한 분석)

  • Lee, Jee Young;Choi, Ui-Yoon;Lee, Soo Young;Lee, Ji-Young;Lee, Byong Chan;Hwang, Hui Sung;Mok, Hye Rin;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.622-628
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    • 2007
  • Purpose : While pediatric observation units (POU) have become a common practice in hospitals throughout developed countries, there has been no report about POUs in Korea so far. The aims of this study were to analyze our one-year's experience of the POU and to decide which disease entities are suitable for the POU. Methods : All children admitted from March 2006 to February 2007 to the POU at the Department of Pediatrics in Our Lady of Mercy Hospital were included in this study. Data were collected from retrospective reviews of their medical records. Results : There were a total of 1,076 POU admissions. Median age of patients was 2.4 years and median length of hospital stay 14.0 hours. The most common diagnoses were gastroenteritis (42.7%), pharyngotonsillitis (19.1%), bronchiolitis (7.8%), pneumonia (5.5%) and febrile seizure (5.2%). Overall, 7.5% of the POU patients required subsequent inpatient admissions due to hospital stays of longer than 48 hours. The disease entities that were most likely to require inpatient admission were pneumonia (17.0%), febrile seizure (12.5%) and asthma (11.5%). Diseases that allowed successful discharge from the POU were gastroenteritis (4.6%), upper respiratory tract infection (5.8%), such as otitis media and pharygnotonsillitis and seizure disorder (6.4%). Compared with the previous year when the POU was not in operation, there was a statistically significant reduction in the average length of hospital stays (from 4.69 to 3.75 days), as well as a rise in the bed turnover rate (from 78.8 to 98.2 patients/bed). Conclusion : Our study shows that the POU is efficient for the management of children with certain acute illnesses. Based on this study, we suggest that the POU be used as a new modality which links between the outpatient, inpatient, and emergency departments in the field of pediatrics in Korea.