• Title/Summary/Keyword: Emergency death

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Modification of HEART Pathway for Patients With Chest Pain: A Korean Perspective

  • Bora Chae;Shin Ahn;Youn-Jung Kim;Seung Mok Ryoo;Chang Hwan Sohn;Dong-Woo Seo;Won Young Kim
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.635-644
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    • 2023
  • Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m2 with the conventional threshold of 30 kg/m2 in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

A Case of Phalloides Syndrome where T-PLS(R)was used for Hemodynamic Support (Phalloides 증후군에서 혈역학적 보조를 위해 T-PLS를 사용한 1례)

  • Kim, Seong-Chun;Kim, Kyu-Seok;Suh, Gil-Joon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.133-136
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    • 2004
  • Phalloides syndrome has usually occurred after incidental mushroom ingestion. It is sometimes difficult to differentiate toxic mushrooms from edible ones, especially in lay person because of their morphological similarities. In Korea, Amanita virosa and Amanita subjunquillea have been reported as a cause of fulminant hepatic failure in mushroom poisoning (phalloides syndrome). We report a case of phalloides syndrome who came to death with fulminant hepatic failure even though we planned liver transplantation and used T-PLS(R) (Twin Pulse Life Support) for hemodynamic support while waiting for the donor.

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Development of the CPR training curriculum (심폐소생술 교육과정 표준화를 위한 연구)

  • Choi, Hea Kyung
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.29-42
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    • 2003
  • The purpose of this study was to development CPR training course to promote wide spread training. The course objectives was based on international Guidelines 2000. The course presents information about the AHA adult Chain of survival and signs of heart attack, cardiac arrest, stroke, and chocking in adult, and includes information about healty heart living and actions to reduce the risk of cardiovascular disease. The course also presents information about the AHA infant and chila Chain of survival, signs of breathing emergencies and chocking in infants and children, prevention of sudden infant death syndrome, and prevention of the most common fatal injuies in infants and children. Vedio-mediated instruction is the primary approach to teaching psycomotor skills.

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Death after Ingestion of MCPP -A Case Report- (MCPP 음독 후 발생한 사망 1례)

  • So Byung Hak;Lee Won Jae;Shim Byoung Yong;Kim Hoon-Kyo;Kim Chi Hong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.45-47
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    • 2005
  • MCPP (2-(2-methyl-4-chlorophenoxy)propionic acid; mecoprop), a hormonal weedkiller has been widely used. Although chronic exposure is generally considered to be mildly toxic to man, acute intoxication can be severe and should thus be taken seriously. We report the case of a patient who died after ingestion of MCPP. A 64-year-old man ingested about 400 ml of $50\%$ MCPP solution. He was stuporous and had an inadequate respiration. He had an hypotension which did not respond to vasopressors and died about twelve hours after ingestion.

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Basic Life Support for Cardiac Arrest during Dental Treatment (치과진료 시 발생한 심정지에서 기본생명구조술)

  • Seo, Kwang-Suk
    • The Journal of the Korean dental association
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    • v.53 no.8
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    • pp.522-529
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    • 2015
  • Cardiac arrest can occur in dental clinics. All dental professionals should be trained to deal with emergency situations that is threatening life. Dental professionals should be familiar with the protocol which include basic life support, advanced life support and specific drugs to be administered in emergencies. Emergency can occur in any dental office without any warnings. Further, it has been noted in recent times there is an increase in a number of medico-legal cases due to rise in a number of death in the dental chair. This review article aims at briefing the basic life support required to manage the medical emergency having life-threatening potential.

A Case Report of Liquid-Lye (NaOH) Ingestion Complicated with Gastroesophageal Perforation (양잿물 음독 후 생긴 위${\cdot}$식도 천공으로 사망한 환자 1례)

  • Yang, Hee-Bum;Yang, Young-Mo;Hong, Sung-Youp
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.99-102
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    • 2005
  • The caustic drugs are classified into acid and alkali. Oral intake of these drugs cause histological injuries to the surfaces of oral cavity, laryngopharynx, and esophagus. Caustic drugs such as detergents and brilliants are easily contacted at homes. However, until now, the epidemiology and the clinical statistics of caustic drug ingestion in Korea were not carried out. This is a case report of sodium hydroxide - lye, a caustic drug more toxic than the others - ingestion with complication of gastroesophageal perforation, rapidly progressed mediastinitis and prompt death in the course of treatment.

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Nuda vida y espacio límite en La transmigración de los cuerpos de Yuri Herrera

  • Michel, Gerardo Gomez
    • Iberoamérica
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    • v.18 no.2
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    • pp.271-295
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    • 2016
  • In dialogue with the concepts of State of Emergency and Bare Life developed by Giorgio Agamben (1998), this paper explores the novel La transmigración de los cuerpos (2013) by Yuri Herrera, to see how the author builds a narrative space where the logic of the state of emergency is a detonator of the fictional plot. This analysis underlines how Herrera articulates a poetics of precariousness and violence to draw a map of desolation and despair recognizable through the cardinal points of death, fear, corruption and an agonizing will to survive. In this unnamed universe the characters' bodies are subject to violence from the State and from criminals.

Factors Associated with Early Death in Patients with Community-Acquired Pneumonia (지역사회획득폐렴에서 조기 사망과 관련된 인자)

  • Park, Hun-Pyo;Seo, Yong-Woo;Lee, Jeong-Eun;Kim, Young-Ho;Jang, Young-Yun;Park, Soon-Hyo;Seo, Chang-Kyun;Jeon, Young-June;Lee, Mi-Young;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.607-613
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    • 2005
  • Background : Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. Methods : From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n = 30) were compared with those of an age and gender matched control population (n = 60). Results : In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p < 0.05 for all), while the arterial pH, systolic pressure, and $PaO_2$ were significant lower (p < 0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). Conclusion : The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.

Prognostic Factors of Acute Poisoning in Elderly Patients (65세 이상 노인 약물 중독 환자의 예후 인자)

  • Kim, Ji-Yoon;Jung, Hyun-Min;Kim, Ji-Hye;Han, Seung-Baik;Kim, Jun-Sig;Paik, Jin-Hui
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.81-87
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    • 2011
  • Purpose: Incidents of suicide attempt and acute poisoning in the elderly population is rising. This study investigated the clinical nature of acute poisoning and differences between the survival and mortality groups in the elderly. Methods: We retrospectively investigated 325 patients with acute poisoning who visited the emergency department. Patients were divided into two groups, one survival and one death group. Information regarding patient sex, age, root cause of poisoning, time of year of poisoning, type of intoxicant, duration of time between intoxicant ingestion and arrival at the emergency department, total length of hospital stay, and any previous suicide attempts and subsequent hospitalization were collected. An initial Glasgow Coma Scale (GCS) and an initial and final Poison Severity Score (PSS) for each patient was calculated. Results: The survival rate for men was higher than for women in this study. The most common reason of drug intoxication was suicide, with accidental ingestion and substance abuse occurring in descending frequency. Seasonal factors were reflected in the data with the highest number of incidents occurring in spring and the lowest number in winter. Compared with the mortality group, the survival group had a lower initial PSS with a higher GCS. Conclusion: We conclude that being female, having suicide as a root cause, agrochemicals as an intoxicant, low initial Glasgow Coma Scale and high initial Poisoning Severity Score, are all associated with poor prognosis.

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