• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.3
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.10.2-10
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• 1982

The laryngeal foreign bodies are not common among the foreign bodies in the air and food passage, however, it would cause fatal airway obstruction without performing immediate endoscopic removal or emergency tracheostomy procedure. It is our intent to report three cases of laryngeal foreign bodies, and to discuss diagnostic procedures, preventive measures and management of this problems.

• The Korean Journal of Emergency Medical Services
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• v.10 no.2
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• pp.53-62
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• 2006

Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.45-47
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• 2018

Thyroid hematoma secondary to a blunt trauma is a rare problem. Despite the rarity, it can be a life-threatening condition with tracheal compression. Both surgical exploration and conservative management have been suggested for thyroid hematoma. However, there is still controversy on the optimal treatment. A 67-year old man who progressed severe dyspnea and neck swelling was transferred to the emergency department with a blunt anterior neck trauma after traffic accident. Contrast enhanced neck computed tomography scan showed huge hematoma within the right thyroid gland and slight tracheal deviation without prominent airway obstruction. One day later, anterior neck swelling was aggravated and the patient was intubated to prevent airway obstruction. After 3 days, hematoma resolution was revealed and extubation was done. We report this case with a review of literature.

• 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 Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.9-15
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• 2016

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5292-5298
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• 2012

The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.10a
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• pp.306-308
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• 2022

The purpose of this study is to compare and analyze the sniffing position and the modified ramped position, which was created by using a specially designed instrument, to improve the performance of advanced airway management during endotracheal intubation. The study included 30 students from the Department of Emergency technology, N University, who had completed advanced cardiac life support and advanced airway management. The randomized crossover study was conducted with the students who were randomly assigned into two groups; Sniffing position and Modified ramped position. As a result of the study, the modified ramped position showed better glottal vision than the sniffing posture, and there was a significant difference in speed time. In the subject's subjective ease, confidence, and preference, the modified ramped position showed better results than the sniffing posture. Therefore, it is considered that modified ramped position during endotracheal intubation will help improve the performance of advanced airway management.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2360-2367
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• 2013

The purpose of this study was to improve the paramedics skills to manage advanced airway by comparing speed and success rate between endotracheal intubation and laryngeal mask airway(LMA) insertion in a moving ambulance. Sixty subjects were randomly recruited and samely divided into control group and experimental group. And they were asked to join a practical experiment using dummy model. Data analysis was done by SPSS WIN 14.0 Version. As a result of this research, in terms of difference in speed according to patient's intubation posture, the speed of control group was indicated to be good in sniffing position(t=-4.038, p<.001). There was no difference in speed between two groups in neutral position. In the neutral posture given the endotracheal intubation, tooth fracture occurred in 16 people(53.3%). There was no difference in success rate between two groups. As for a change in self-confidence before and after experiment, the post self-confidence was indicated to have been enhanced in both groups. In conclusion, it is effective to use LMA in the traumatic patient who is unable to receive endotracheal intubation in sniffing position. It is very important for the paramedics to receive the continuous training of the airway management skills.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.28-30
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• 2016

Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.