• Title/Summary/Keyword: Emergency Report

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A Study on the Occurrences and Policy Development for Accident Prevention (한국의 사고발생 실태와 사고예방을 위한 정책 연구)

  • 이경자;이정렬;강규숙;한정석
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.362-371
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    • 1995
  • There is no national system to manage, evaluate, and analyse the information about accidents, even though it is necessary for accident prevention policies and health promotion of the general public. The existing studies are, also limited as they focus only on particular group(for example : inpatients, emergency room patients) or on particular geographic areas. Thus the results of the studies cannot be ap-plied to the general public. In order to overcome these limitations, this research focuses on data collection and analysis from accident information for the general population. By providing the analysis on types and causes af accidents, this research aims to produce the basic data necessary for accident prevention policy development. The specific aims of this research are to : 1. Analyse the actual occurrences and characteristics of accidents. 2. Suggest for the accident prevention policies and safety education. Accident report form three major newspaper printed in Korea between January 1, 1989 and December 31, 1993 were collected, and the cause, place, time, and personal injury related to the accidents were classified and then analyzed by de-scriptive statistics. The results of this research conclude : 1. The number of accidents reported by the three newspapers were 2155. 2. The highest proportion of accidents were as follows ; occurred during the June-August(31.2%), Sunday(24.8%), and 5 p.m. (7.6%) of the day. 3. The highest proportion of the accident occurred in Seoul(33. l%), Kyunggi province(14.5%), Kangwon province (7.8%), and Kyungnam prov-ince(6.7%) were next highest. 4. The main causes include car accidents(32.4%), drowning(10.9%), falls(8.8%), explosion(7.1%), and poisoning(5.8%). 5. Slightly more than half of injuries(50.5%) and about two fifths of deaths(40.3%) were caused by car accidents. Therefore, the most serious type of accidents were car accidents. 6. The number of males in accidents were almost three times higher than that of females(males 72.3%, females : 27.7%). 7. The age group from 10 to 19 years old represents the highest proportion(21%) of accidents. 8. The number of the accidents in Korea, based on the information collected from the newspapers, is estimated to be 14, 367 per year. The number of in-juries is estimated to be 88, 480 persons, and the number of deaths 29, 007 respectively. It is said that ninety percent of accidents can be prevented. Several accidents prevention policies are suggested here. 1. Safety education should be done more actively throughtout life, with special emphasis on safety education for children. 2. Safety measures for children(halmets for cycling, children car seats, seats belts, and so on) should be emphasized. 3. An injury surveillance system should be initiated. The initiation of injury reporting system in each factory and school could contribute considerably to the reduction of accidents.

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Implant esthetic restoration with bone graft in the extended maxillary anterior area: A case report (확장된 상악전치부 결손부위에 골이식을 동반한 임플란트 심미수복 증례)

  • Jeong, Ji-Won;Park, Sang-Yong;Kim, Yoon-Young;Park, Won-Hee;Lee, Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.3
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    • pp.298-305
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    • 2016
  • The maxillary anteriors play an important role in esthetics. Therefore after extraction, it is crucial to preserve the hard tissue and soft tissue in order to promote esthetics of restoration. There are several challenges when restoring the maxillary anteriors via implant. Some of the challenges are be maintaining consistency with neighboring teeth in terms of shade, form, and texture : as well as having harmonious emergency with the gingival margin. In this case, a traumatized patient with crown-root fracture of the maxillary central and lateral incisors is presented. The cracked teeth were extracted, and implants were inserted with bone grafts to compensate the volume of damaged area of the maxillary anterior. Cantilever implant prosthetics were planned while precise adjustments to the gingival area were made using customized impression coping to perform the esthetic restorations. The final outcome of the treatment was satisfying in both esthetic and utilitarian perspective.

The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study

  • Cho, Won-Tae;Cho, Jae-Woo;Kim, Jinil;Kim, Jin-Kak;Oh, Jong-Keon;Kim, Hak Jun;Kim, Namryeol;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.139-145
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    • 2016
  • Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

A Study on the Development of Facility Model for Safety Training Class in School (학교 내 안전체험교실의 시설모형 개발 연구)

  • Park, Sung-Chul;Ahn, Yoo-Jeong;Song, Byung-Joon;Cho, Jin-ll
    • The Journal of Sustainable Design and Educational Environment Research
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    • v.16 no.2
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    • pp.19-33
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    • 2017
  • The purpose of this study is to derive education programs for safety training class, create unit spaces and present components and methods of utilizing the spaces for the development of facilities models closely related to various policy, operation plan and facility construction projects promoted by related institutions such as the Ministry of Education, schools, architects and companies. This study is divided into five steps. First, we reviewed the literature related basic directions for safety education and facility plan, second, field survey included both field conditions such as spatial size and facility configuration and analysis of operating conditions like hours of operation and personnel. Base on literature review and field survey, it were used to analyze strengths and weaknesses of existing safety training classes, and five facility models was developed based on the Delphi method and expert participatory design. The result show that the facility models (drafts) of safety training class were developed as follows: (1)the facility model for traffic safety(pedestrian safety, vehicle safety, subway safety) (2)the facility model for first aid(emergency rescue, how to report) (3)the facility model for disaster safety(fire evacuation safety, life earthquake safety) (4)the facility model for elevator safety(elevator safety, escalator safety) (5)the facility model for drugs and violence safety (smoking drinking, sexual harassment safety, food safety) The safety training class can be composed by combining or separating each module according to affordable space size of each school.

Aortocaval Fistula - A case report - (대동맥-대정맥루 -치험 1예-)

  • Cho Kwang-Hyun;Kwon Young-Min;Han Il-Yong;Jun Hee-Jae;Lee Yang-Haeng;Hwang Youn-Ho;Yoon Young-Chul
    • Journal of Chest Surgery
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    • v.38 no.10 s.255
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    • pp.721-724
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    • 2005
  • Aortocaval fistula is a rare complication of abdominal aortic aneurysm, involving less than $1\%$ of all abdominal aortic aneurysms. A 64-years old man with a long history of hypertension and abdominal aortic aneurysm had chest pain, dyspnea, epigastric discomfort and palpable abdominal pulsating mass. Physical examination revealed hypo­tension with a systolic blood pressure of 70 mmHg, a large pulsatile mass and a systolic abdominal bruit. Laboratory data revealed a hemoglobin values of 11.0 g/dL, blood urea nitrogen (BUN) value of 5 mg/dL, and creatine value of $2.5 mg\%$. Abdominal Angio CT showed a 10cm infrarenal abdominal aortic aneurysm with dilatation of the IVC and aortocaval fistula from the aortic aneurysm, which was confirmed at emergency surgery. When the aneurysm was opened and the thrombus was removed, a 1 cm communication was identified between the aorta and IVC. This was controlled with Foley catheters ballooning, and the fistula was closed by continuous suture placed outside the aneurysm. A bifurcated aorto-iliac graft was used to restore arterial continuity. The patient was discharged home after uncomplicated postoperative course.

A study on the Trend Analysis and Road map Design of the Facilities Disaster and Safety Technology in the Country and Oversea (국내외 인적재난 안전기술개발 동향분석 및 로드맵 수립에 관한 연구)

  • Lee, Tae Shik;An, Jae Woo;Song, Cheol Ho;Seok, Geum Cheol
    • Journal of Korean Society of Disaster and Security
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    • v.6 no.3
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    • pp.49-57
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    • 2013
  • This paper is to show the long-term roadmap by analyzing the development trend for the safety technology of facility disaster in the country and abroad, and it is designed to plan the long term and roadmap in response to change the disaster environment. Recently in the country, it is increasing the needs of the long term roadmap design of the facility disaster research development in the facility disaster, by the repidly of the social and the living and the related governments response's changing. The U.S. is going to develop the disaster responding research by planning the its master plans, including the NRF (National Responing Framwork), the NIMS (National Incident Management System), and its sinarios etc.. Japan is going to develop the research planning in the annual report of the disaster prevention, and we going to do the study projects about the facility disaster area with the NEMA (National Emergency Management Agency) and NDMI (National Disaster Management Institute). This paper is showed to design the long term roadmap of the facility disaster's study development, and to minimize the damage of the man and his property, and to set the study development system of the national facility disaster, and furthering to make the resilient planning in changing of the facility disaster's environment.

Fatal plastic bronchitis with eosinophilic casts in a previously healthy child (건강하였던 소아에서 발생한 치명적인 호산구성 증식성 기관지염)

  • Cho, Young Kuk;Oh, Soo Min;Choi, Woo-Yeon;Song, Eun Song;Han, Dong-Kyun;Kim, Young-Ok;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1048-1052
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    • 2009
  • Plastic bronchitis is a rare disease characterized by the recurrent formation of branching mucoid bronchial casts that are large and more cohesive than those that occur in ordinary mucus plugging. Casts may vary in size and can be spontaneously expectorated, but some require bronchoscopy for removal. Plastic bronchitis can therefore present as an acute life-threatening emergency if obstruction of the major airways occurs. Three of 22 reported patients with eosinophilic casts were fatal, with death due to central airway obstruction. Here, we report a child with no history of atopy, allergy, or congenital heart disease who was diagnosed with plastic bronchitis with eosinophilic casts. Although he was administered intravenous (iv) antibiotics; iv corticosteroids; and a vigorous pulmonary toilet regimen, including chest physiotherapy and routine bronchoscopic removal of casts, he had brain death secondary to hypoxic brain damage. Plastic bronchitis can be fatal when casts obstruct the major airways, as in the present case. Clinicians should intervene early if a patient exhibits signs and symptoms consistent with plastic bronchitis.

Primary Non-Hodgkin's Lymphomas Presenting with Extradural Spinal Cord Compression as the Initial Manifestation (초기 증상으로 척수 압박 증세를 보인 원발성 Non-Hodgkin 임파종)

  • Kim, Se Hoon;Lim, Dong Jun;Cho, Tai Hyoung;Park, Jung Yul;Chung, Yong Gu;Lee, Hoon Kap;Lee, Ki Chan;Suh, Jung Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.10
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    • pp.1365-1371
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    • 2000
  • Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

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Clinical Characteristics and Prehospital care in Prehospital Cardiac Arrest Patients by Paramedic's Reports (구급일지를 통한 병원전 심정지 환자의 임상적 특성과 병원전 응급처치)

  • Koh, Bong-Yeun;Park, Young-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1540-1546
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    • 2010
  • In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.