• 한국응급구조학회지
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• 제25권2호
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• pp.145-156
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• 2021

Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

• Journal of Trauma and Injury
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• 제32권2호
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• pp.107-110
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• 2019

Bilateral chylothorax due to blunt trauma is extremely rare. We report a 74-year-old patient that developed delayed bilateral chylothorax after falling off a ladder. The patient had a simple 12th rib fracture and T12 lamina fracture. All other findings seemed normal. He was sent home and on the 5th day visited our emergency center at Halla Hospital with symptoms of dyspnea and lower back pain. Computer tomography of his chest presented massive fluid collection in his right pleural cavity and moderate amounts in his left pleural cavity with 12th rib fracture and T11-12 intervertebral space widening with bilateral facet fractures. Chest tubes were placed bilaterally and chylothorax through both chest tubes was discovered. Conservative treatment for 2 weeks failed, and thus, thoracic duct ligation was done by video assisted thoracoscopic surgery. Thoracic duct embolization was not an option. Postoperatively, the patient is now doing well and happy with the results. Early surgical treatment must be considered in the old patient, whom large amounts of chylothorax are present.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.82-88
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• 2016

Purpose: Sonongraphic examinations such as extended Focused Assessment with Sonography in Trauma (eFAST) are widely used in Emergency Departments. This study is designed to determine student achievement by teaching medical college students through short training. Methods: 38 participants in their 3rd year of medical school were enrolled in this study. An Emergency Medicine physician trained the students to 2 hours of theoretical training followed by 2 hours of hands on training. Results: The average age of students was $28.1{\pm}3.4$, with 21 male students. The average of pre-educational test results were $60.4{\pm}8.9$ and post-educational exam results were $80.1{\pm}14.5$ (p<0.001). The average success rate of eFAST was 87.5%. But success rate of each items were lowest in checking the hepatorenal recess and the splenorenal recess, each success rate, 65.8% and 68.4%, consecutively. The questionnaires filled out after the study showed that the students were highly interested in this education and that they found the education easy to understand. They also answered that eFAST education is necessary in the medical college curriculum. Conclusion: This study shows that eFAST can be effectively taught to students through short training.

• 한국응급구조학회지
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• 제24권3호
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• pp.55-63
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• 2020

Purpose: This study aimed to establish effective training strategies and methods by comparing the effects of 360° virtual reality video and first-person video in non-face-to-face practical lectures. Methods: This crossover study, implemented May 18-31, 2020, included 27 participants. We compared 360° virtual reality video and first-person video. SPSS version 25.0 was used for statistical analysis. Results: The 360° virtual reality video had a higher score of experience recognition (p=.039), vividness (p=.045), presence (p=.000), fantasy factor (p=.000) than the first-person video, but no significant difference was indicated for satisfaction (p=.348) or interest (p=.441). Conclusion: 360° virtual reality video and first-person video can be used as training alternatives to achieve the standard educational objectives in non-face-to-face practical lectures.

• 대한임상독성학회지
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• 제13권1호
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• pp.11-18
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• 2015

Purpose: The aim of this study was to compare the clinical characteristics in emergency endotracheal intubation between patients with acute drug intoxication and medical disease. Methods: Data for airway registry collected in two emergency departments (ED) between April 2006 and March 2010 were reviewed retrospectively. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. Results: A total of 1480 patients were enrolled; 62 patients were classified as belonging to the intubation group after the drug intoxication group. No significant differences in Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, and complications after intubation were observed between patients with acute drug intoxication and medical disease. However, significant difference was observed for indication of emergency endotracheal intubation. While emergency endotracheal intubations were usually performed in medical patients because of failure of airway patency, they were performed in intoxicated patients with the goal of preventing serious complications. Conclusion: Anatomical structures related to endotracheal intubation, the process and clinical outcome of intoxicated patients are not significantly different from those for medical patients.

• 대한임상독성학회지
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• 제15권2호
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• pp.94-100
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• 2017

Purpose: Acute acetaminophen intoxication is a common occurrence that can cause lethal complications. In most domestic emergency departments, clinicians tend to treat acetaminophen intoxication based on patients' history alone, simply due to the lack of a rapid acetaminophen laboratory test. We performed a 20-month study of intoxication patients to determine the correlation between the history of patients and serum laboratory tests for acetaminophen. Methods: We took blood samples from 280 intoxication patients to evaluate whether laboratory findings detected traces of acetaminophen in the sample. Patients were then treated according to their history. Laboratory results came out after patients' discharge. Agreement between patients' history and laboratory results were analyzed. Results: Among the 280 intoxicated patients enrolled, 38 patients had positive serum acetaminophen concentrations; 18 out of 38 patients did not represent a history suggesting acetaminophen intoxication. One patient without the history showed toxic serum acetaminophen concentration. Among the patients with the history, two patients with toxic serum acetaminophen concentration did not receive N-acetylcysteine (NAC) treatment due to their low reported doses, while other 2 patients without significant serum acetaminophen concentration did receive NAC treatment due to their high reported doses. Conclusion: This study showed a good overall agreement between history and laboratory test results. However, some cases showed inconsistencies between their history and laboratory test results. Therefore, in treating intoxication patients, a laboratory test of acetaminophen with rapid results should be available in most domestic emergency departments.

• 한국화재소방학회논문지
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• 제31권5호
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• pp.95-106
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• 2017

본 연구는 2012년부터 2016년까지 5년간의 (구)국민안전처 내부 소방행정자료와 통계연보, (구)소방방재청 통계와 통계청 자료 등을 활용, 우리나라 의용소방대의 소방 활동과 각종 대민봉사 지원활동 전반에 대한 통계분석을 통해 현실적 문제점을 도출하여 개선방안을 모색하였다. 연구결과는 첫째, 농촌지역 특성을 고려한 의용소방대 정원관리제도 보완 둘째, 의용소방대 내부적 갈등요인 해소를 위한 교양교육제도 강화 셋째, 의용소방대장 등 관리계층 대원들의 조직운영 리더십 역량강화 넷째, 지역여건에 맞는 의용소방대 교육 훈련제도 확립 다섯째, 의용소방대 대형재난현장 활동 보상제도 개선이다. 본 연구결과는 향후, 우리나라 의용소방대 발전의 기초자료로 활용되기를 기대한다.

• Childhood Kidney Diseases
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• 제2권1호
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• pp.69-72
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• 1998

Thromboemolism is one of the severe complications of nephrotic syndrome. And arterial thromboembolism is rare than venous thromboembolism. Hypercoagulability is the main pathophysiologic factors of thromboembolism in nephrotic syndrome with severe hypoalbuminemia. We experienced one case of arterial thromboembolism which occured in right common iliac artery. It was seen in a 6 year-old male child that presented with generalized edema and rigth ankle joint pain. Emergency embolectomy and anticoagulant therapy (heparin and antithrombin III) was performed. He didn't have to be amputated and recovered to self ambulation. This is an uncommon case that successful recovery was possible by early diagnosis and invasive surgical management with proper anticoagulant therapy.

• Journal of Korean Neurosurgical Society
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• 제46권2호
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• pp.165-167
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• 2009

Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.318-321
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• 2009

Tension pneumocephalus may follow a cerebrospinal fluid(CSF) leak communicating with extensive extradural air. However, it rarely occurs after diagnostic lumbar puncture, and its treatment and pathophysiology are uncertain. Tension pneumocephalus can develop even after diagnostic lumbar puncture in a special condition. This extremely rare condition and underlying pathophysiology will be presented and discussed. The authors report the case of a 44-year-old man with a basal skull fracture accompanied by pneumothorax necessitating chest tube suction drainage, who underwent an uneventful lumbar tapping that was complicated by postprocedural tension pneumocephalus resulting in an altered mental status. The patient was managed by burr hole trephination and saline infusion following chest tube disengagement. He recovered well with no neurologic deficits after the operation, and a follow-up computed tomography (CT) scan demonstrated that the pneumocephalus had completely resolved. Tension pneumocephalus is a rare but serious complication of lumbar puncture in patients with basal skull fractures accompanied by pneumothorax, which requires continuous chest tube drainage. Thus, when there is a need for lumbar tapping in these patients, it should be performed after the negative pressure is disengaged.