• Title/Summary/Keyword: Emergency death

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A Case of Acute Poisoning with Dry Ice (드라이아이스에 의한 급성 중독 1례)

  • Hwang, Soon-Young;Jung, Jin-Hee;Eo, Eun-Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.5 no.1
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    • pp.43-45
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    • 2007
  • Carbon dioxide is the fourth most abundant gas in the earth's atmosphere, and it is widely used in the chemical industry. Solid carbon dioxide is commonly known as dry ice. At low concentration, carbon dioxide appears to have little toxicological effect. At higher concentrations, however, it can produce an increased respiratory rate, tachycardia, cardiac arrhythmia, loss of consciousness, convulsion, and even death. Management of carbon dioxide poisoning requires the immediate removal of an individual from the toxic environment and administration of oxygen. It is important to know the concentration of carbon dioxide to which a patient has been exposed. We report a case of acute poisoning from solid carbon dioxide in a patient presenting with drowsiness and diminished mental capacity when she arrived in the emergency department. She recovered completely after administration of oxygen with conservative treatment.

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An Initial Clinical Experience of EMT Students (응급구조과 학생의 첫 임상 실습 경험에 대한 연구)

  • Baek, Mi-Lye
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.95-108
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    • 2003
  • This study was conducted to identify an initial clinical experience of EMT students, so to better understand their' experience in clinical training. The subjects were 30 EMT students of C department of Emergency Medical technology in C city, who were demonstrating at the emergency room in C, T, S, W city. This study was approached by phenomenological method, collected data were analyzed by Colaizzi's method. the results were as a follows. From the protocol, significant statements were organized into 34 formulated meanings. from the formulated meanings, 21themes were identified, organized into 8 theme clusters, and then categories. EMT students got experienced 'tension resulting from new situation', 'fear in contacting with patients', 'lack of knowledge and skill', 'confidence feeling from being adapted', 'facing up to Paramedic role', 'experience of death' and 'stress'. The results of this study are to use as basic data for students attending clinical experience for the first time.

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Poisoning in Korean Children and Adolescents

  • Woo, Jae Hyug;Ryoo, Eell
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.233-239
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    • 2013
  • Drug intoxication in children and adolescents is not uncommon in Korea. But the tendency of intoxication is changing with some factors, such as national surveillance system, Naderism and increasing concern among physicians. But the death rate of intoxication among adolescents is increasing in spite of decreasing total death rate of intoxication among children and adolescents. Therefore the physician must be concerned about the basic management of intoxication and figure out the common toxic substance among children and adolescents.

The Height of Fall as a Predictor of Fatality of Fall (추락 후 사망 예측인자로서의 추락 높이)

  • Suh, Joo Hyun;Eo, Eun Kyung;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.101-106
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    • 2005
  • Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was $36.5{\pm}19.4$ years old. 110 were male and 35 were female. Mean height of fall was $11.1{\pm}8.5m$. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is $8.9{\pm}5.8m$ for 94 survivors and $15.2{\pm}11.0m$ for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between 'below 13.5m group' and 'above 13.5m group', but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient's death.

Initial D-dimer level as early prognostic tool in blunt trauma patients without significant brain injury (중증 뇌손상이 없는 둔상 환자에서 초기 중증도 예측인자로서 D-dimer의 역할)

  • Sohn, Seok Woo;Lee, Jae Baek;Jin, Young Ho;Jeong, Tae Oh;Jo, Si On;Lee, Jeong Moon;Yoon, Jae Chol;Kim, So Eun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.430-436
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    • 2018
  • Objective: The purpose of this study was to evaluate whether or not the d-dimer level indicating hyperfibrinolysis could be a predictor of early poor outcome (massive transfusion, death within 24 hours) associated with trauma-induced coagulopathy in blunt trauma without significant brain injury. Methods: This study was a retrospective observational study using 516 blunt trauma patients without significant brain injury. The poor outcome group, including patients receiving massive transfusion and those who died within 24 hours, consisted of 33 patients (6.4%). The variables were compared between the poor outcome group and good outcome group, and logistic regression analysis was performed using statistically significant variables. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the poor outcome prediction ability of the initial d-dimer level. Results: The poor outcome group showed more serious anatomical, physiological, and laboratory data than the good outcome group. In the ROC curve analysis for evaluation of the poor outcome prediction of the d-dimer level, the area under the curve value was 0.87 (95% confidence interval [CI], 0.84-0.90) while the cut-off value was 27.35 mg/L. In the logistic regression analysis, the high d-dimer level was shown to be an independent predictor of poor outcome (adjusted odds ratio, 14.87; 95% CI, 2.96-74.67). Conclusion: The high d-dimer level (>27.35 mg/L) can be used as a predictor for the poor outcome of patients with blunt trauma without significant brain injury.

The pre-hospital analysis of patients with suicide attempts in Gangwon-do (일개 도 지역 자살 시도 환자에 대한 병원전 단계 분석)

  • Kim, Gi Whan;Cho, Jun Hwi;Moon, Joong Bum;Park, Chan Woo;Shin, Myoung Cheol;Kim, Ka Eul;Lee, Joon Seok;Park, Yoon Soo;Ohk, Taek Geun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.687-698
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    • 2018
  • Objective: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. Methods: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. Results: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. Conclusion: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.

Datura Stramonium Intoxication of Which Resulted in Changing Mentality - A Case Report - (흰꽃독말풀 열매 달인 물 복용 후 발생한 의식 변화 환자 1례)

  • You Je-Sung;Nam Yeoun-Woo;Lee Jin-Hee;Chung Sung-Pil;Kim Seung-Ho;Park In-Cheol
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.1
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    • pp.52-54
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    • 2006
  • Datura stramonium is a wild growing plant, consumption of which can result in severe toxicity. It contains a variety alkaloids include atropine, hyoscamine, and scopolamine that can all cause anticholonergic poisoning. It has been use of herb medicine in Korea. Side effects from ingesting Datura stramonium include dry mouth, blurred vision, photophobia, and may be followed by hyperthermia, confusion, agitation, hallucination, and aggressive behavior. In severe toxicity, it can cause seizure, coma, life-threatening arrhythmia, and death. We experienced one patient who developed stupor mentality caused by Datura stramonium. Severe presentation, especially mental change of Datura stramonium should draw attention. Poisoning associated with Datura stramonium can be prevented through educational public health program.

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RADIATION DAMAGE IN THE HUMAN BODY ACUTE RADIATION SYNDROME AND MULTIPLE ORGAN FAILURE

  • AKASHI, MAKOTO;TAMURA, TAIJI;TOMINAGA, TAKAKO;ABE, KENICHI;HACHIYA, MISAO;NAKAYAMA, FUMIAKI
    • Nuclear Engineering and Technology
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    • v.38 no.3
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    • pp.231-238
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    • 2006
  • Whole-body exposure to high-dose radiation causes injury involving multiple organs that depends on their sensitivity to radiation. This acute radiation syndrome (ARS) is caused by a brief exposure of a major part of the body to radiation at a relatively high dose rate. ARS is characterized by an initial prodromal stage, a latent symptom-free period, a critical or manifestation phase that usually takes one of four forms (three forms): hematologic, gastrointestinal, or cardiovascular and neurological (neurovascular), depending upon the exposure dose, and a recovery phase or death. One of the most important factors in treating victims exposed to radiation is the estimation of the exposure dose. When high-dose exposure is considered, initial dose estimation must be performed in order to make strategy decisions for treatment as soon as possible. Dose estimation can be based on onset and severity of prodromal symptoms, decline in absolute lymphocyte count post exposure, and chromosomal analysis of peripheral blood lymphocytes. Moreover, dose assessment on the basis of calculation from reconstruction of the radiation event may be required. Experience of a criticality accident occurring in 1999 at Tokai-mura, Japan, showed that ARS led to multiple organ failure (MOF). This article will review ARS and discuss the possible mechanisms of MOF developing from ARS.

A Design for Medical Information System of Emergency Situation Prediction using Body Signal (생체신호를 이용한 응급상황 예측 의료정보 시스템의 설계)

  • Park, Sun;Kim, Chul Won
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.3 no.4
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    • pp.28-34
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    • 2010
  • In this paper, we proposes a emergency medical information system for predicting emergency situation by using the body's vital signs. Main research of existing emergency system has focused on body sensor networks. The problem of these studies have a delay of the emergency first aid since occurring of an emergency situation send a message of emergency situation to user. In the serious situation, patients of these problem can lead to death. To solve this problem, it need to the prediction of emergency situation for doing quickly the First Aid with identify signs of a pre-emergency situations until an emergency occurs. In this paper, the sensor network technology, the security technology, the internet information retrieval techniques, data mining technology, and medical information are studied for the convergence of medical information systems of the prediction of emergency situations.

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Attitude toward Death in Nursing Students (간호학생의 죽음에 대한 태도)

  • Jung, Sun-Young;Lee, Eun-Kyung;Kim, Bo-Hye;Park, Jin-Hwa;Han, Min-Kyoung;Kim, In-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.2
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    • pp.168-177
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    • 2011
  • Purpose: The purpose of this study was to investigate the attitude toward death in Korean nursing students. Method: The sample consisted of 365 baccalaureate nursing students. The questionnaires included questions on sociodemographics and death-related characteristics of the participants, and the Fear of Death and Dying Scale (FODS) to measure the attitude toward death. Result: The mean of the FODS score was 2.63 out of 4, so the participants had a slightly negative attitude toward death. There were statistically significant differences between gender, religion, religion activity, perceived health status, experience of parents' death, experience of friend's death, and overall FODS score. Among the four subscales of overall FODS, the score of the fear of death of self was significantly higher in the participants who experienced clinical practice and who experienced patient's death in the intensive care unit compared to the emergency room. Conclusion: Based on the study results, educational programs to change the attitude toward death are required before clinical practice. Programs need to consider nursing students' gender and religion, and give opportunity to share experiences and feelings about death of family or friend. In addition, using standardized patients and simulators is advised in the need for simulation training.