• Journal of the Korean Society of Radiology
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• v.82 no.5
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• pp.1186-1195
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• 2021

Purpose In the adult emergency department of a university hospital, we investigated the frequency of major discrepancies between the preliminary reports by radiology residents and the final reports by certified radiologists. Materials and Methods Based on CT and MRI scans obtained between December 2016 and November 2019, we selected cases with diagnoses or treatment plans that could be changed due to discrepancies between preliminary and final reports and classified them by the type of discrepancy. We also examined the distributions of the major discrepancies and stratified them by residents' working time zone, experience, and subspecialty. Results Based on the 72137 preliminary reports evaluated, 1348 tests (1.9%) showed major discrepancies. Most of the major discrepancies were false negatives (72.0%), followed by misdiagnosis (26.3%) and false positives (1.7%). Acute findings (87.2%) were more common than non-acute findings (12.8%). The major discrepancy rate increased toward the second half of the 24-hour shift, with the highest rate of 2.9% occurring between 2 am and 4 am. The major discrepancy rate did not vary with experience, and it varied from 0.6% to 4.5% for each subspecialty. Conclusion The major discrepancy rate was less than 2%, and it increased with longer working hours during a 24-hour shift.

• Journal of the Korea Convergence Society
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• v.8 no.1
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• pp.51-59
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• 2017

It is to establish preliminary data about healthcare convergencr of infection control by performing a bacterial contamination test for CT scanner as well as general radiographic systems in the emergency rooms of general hospitals. The period was December 1 ~ December 31, 2015. It is detect in the emergency rooms of 7 medical facilities including 2 in Seoul, and 1 in Gyeonggi-do Province, and 2 in Jeonla-do Province, and 2 in Chungcheong-do Province. The surface contamination strains detected from CT scanner in the radiology department emergency rooms were Micrococcus species(4,5%), Stenotrophomonas maltophilia(9%), Enterococcus faecium(4.5%), Providencia stuartii(4.5), and Gram negative bacilli(4.5%). Also, the surface contamination strains detected from general radiographic system in the radiology department emergency rooms were Providencia stuartii(11%), Klebsiella pneumonia(3.5%), Stenotrophomonas maltophilia(11%), Pantoea species(11%), Acinetobacter baumannii(3.5%), Micrococcus species(3.5%), Escherichia coli(3.5%), Enterobacter species(3.5%), and Gram negative bacilli(11%). Considering that the regions of most detection were all the places closely related to patients, radiologists would have to thoroughly clean with alcohol before and after a test.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate the quality of the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency intensive care unit (ICU) in consultation with intervention radiologists and surgeons. Methods: This was a retrospective observational study conducted in an emergency ICU of a tertiary referral hospital. We enrolled consecutive patients who had been admitted to our emergency ICU with major trauma from March 2007 to September 2010. We collected data with respect to demographic findings, mechanisms of injury, the trauma and injury severity score (TRISS), emergency surgery, angiographic intervention, and 6-month mortality. Then, we compared the observed and predicted survivals of the patients. The Hosmer-Lemeshow test and calibration plots by using 10 groups, one for each decile, of predicted mortality were used to evaluate the fitness of TRISS. P-values of greater than 0.05 represent a fair calibration. Results: Among 116 patients, 12 (10.34%) were dead within 6 months after admission to the ICU, and 29 (25.00%) and 38 (32.80%) patients received emergency surgery and angiographic intervention, respectively. The mean injury severity score and revised trauma score were $36.97{\pm}17.73$ and $7.84{\pm}6.75$, respectively. The observed survival and the predicted survival of the TRISS were 89.66% (95% confidence interval [CI]: 84.03~95.28%) and 69.85% (95% CI: 63.80~75.91%), respectively. The calibration plots showed that the observed survival of our patients was consistently higher than the predicted survival of the TRISS ($p$ <0.001). Conclusion: The observed survival for the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency ICU in consultation with intervention radiologists and surgeons, was higher than the predicted survival of the TRISS.

• Korean Journal of Radiology
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• v.21 no.1
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• pp.68-76
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• 2020

Objective: To survey care providers' willingness to use 2-mSv computed tomography (CT) in their usual practice for adolescents and young adults with suspected appendicitis. Materials and Methods: An ethical committee approved this prospective study. We introduced 2-mSv CT in 20 hospitals through a pragmatic clinical trial. At the final phase of the trial, we invited 698 potentially-involved care providers in the survey regarding their willingness to use 2-mSv CT. Multivariable logistic regression analyses were performed to identify factors associated with willingness. Nine months after the completion of the trial patient recruitment, we surveyed whether the hospitals were using 2-mSv CT in usual practice. Results: The analyses included responses from 579 participants (203 attendings and 376 trainees; 221 radiologists, 196 emergency physicians, and 162 surgeons). Regarding the willingness to immediately change their standard practice to 2-mSv CT, 158 (27.3%), 375 (64.8%), and 46 (7.9%) participants responded as "yes" (consistently), "partly" (selectively), and "no", respectively. Willingness varied considerably across the hospitals, but only slightly across the participants' departments or job titles. Willingness was significantly associated with attendings (p = 0.004), intention to maintain the dedicated appendiceal CT protocol (p < 0.001), belief in compelling evidence on the carcinogenic risk of conventional-dose CT radiation (p = 0.028), and hospitals having more than 1000 beds (p = 0.031). Fourteen of the 20 hospitals kept using 2-mSv appendiceal CT in usual practice after the trial. Conclusion: Despite the extensive efforts over the years of this clinical trial, many care providers were willing to use 2-mSv CT selectively or not willing to use.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.148-157
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• 2019

Objective: To evaluate the current status of managing adverse reactions to iodinated contrast media (ICM) for computed tomography in referral hospitals in South Korea compared with hospitals in other countries. Materials and Methods: This survey investigation involved 59 Korean and 15 overseas hospitals using guideline-based questionnaires consisting of 24 items in 7 main categories related to managing adverse reactions to ICM. Results: Informed written consent with risk factor evaluation was appropriately performed in most of the Korean hospitals. There was considerable variability in assessing renal function across the hospitals; serum creatinine level was used as a reference in 76.4% of Korean hospitals. The Korean hospitals preferred a more stringent approach to determining normal renal function (p = 0.01), withholding metformin (p = 0.01), and fasting before ICM exposure (p < 0.001) compared with overseas hospitals. All the Korean hospitals had an emergency protocol and in-hospital system for adverse reactions to ICM. The Korean (87.7%) and overseas hospitals (100%) were similarly equipped with epinephrine (p = 0.332), but only 38.6% of Korean hospitals were equipped with a bronchodilator (p = 0.004). For patients with a previous hypersensitivity reaction to ICM, 62.3% of Korean hospitals pre-medicated with anti-histamine and corticosteroid according to the severity of the previous reaction, and changed the culprit ICM in 52.8%, while skin test was performed in 17%. Conclusion: In general, Korean referral hospitals were well-prepared regarding informed consent, protocol, and an in-hospital system for managing adverse reactions to ICM. Nevertheless, there was considerable variability in details and management, thus requiring standardization by reflecting current guidelines.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.851-858
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• 2020

Coronavirus disease 2019 (COVID-19) is a new infectious disease rapidly spreading around the world, raising global public health concerns. Radiological examinations play a crucial role in the early diagnosis and follow-up of COVID-19. Cross infection among patients and radiographers can occur in radiology departments due to the close and frequent contact of radiographers with confirmed or potentially infected patients in a relatively confined room during radiological workflow. This article outlines our experience in the emergency management procedure and infection control of the radiology department during the COVID-19 outbreak.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.923-933
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• 2023

Purpose To evaluate the sensitivity of corticomedullary-phase imaging for detecting urinary stones in patients with renal colic who visited the emergency department. Materials and Methods This retrospective study included 253 patients with suspected renal colic from two tertiary hospitals in South Korea, who visited the emergency department and underwent CT urography. Two radiologists blinded to the clinical history independently reviewed the corticomedullary-phase images. The sensitivity for identifying urinary stones were evaluated for each reviewer. After the initial evaluation, the images were re-evaluated based on patient history. The sensitivity of re-evaluation were recorded. Results Of 253 patients, 150 (59%) had urinary stones. Among them, significant stones were observed in 138 patients (92%), and obstructive changes on CT in 124 patients (82.7%). For identifying significant urinary stones, the sensitivity was 98.6% (136/138) for both the reviewers. For identifying significant urinary stones with urinary obstruction, the sensitivity was 99.2% (123/124) for reviewer 1, and 100% (124/124) for reviewer 2. The sensitivity for identifying significant stones increased from 98.6% to 100% for reviewer 1, and from 98.6% to 99.3% for reviewer 2 in the re-evaluation session. Conclusion The corticomedullary-phase CT urography was sensitive for diagnosing urolithiasis in patients with acute renal colic who visited the emergency department.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.467-471
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• 2023

The torsion of the uterus is a rare gynecological emergency. It occurs mainly in the gravid uterus and extremely rarely in the non-gravid uterus. In this article, we report a case of a torsion of non-gravid uterus accompanied by a huge intramural leiomyoma with focus on CT and MR imaging findings.

• The Journal of Korean Academic Society of Nursing Education
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• v.14 no.1
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• pp.138-146
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• 2008

Purpose: The first responder's role during a cardiac arrest scene is to initiate CPR. The AHA has recognized and included the first responder's role for improving the survival rate of cardiac arrest patients. Health personnel working in nursing, emergency care, dental hygiene, radiology, and ocular optics frequently confront sudden cardiac arrest while working. This study was to identify the relationship between the educational experience and recognition with the level of knowledge about CPR for college students. Method: Five hundred forty college students enrolled in the department of nursing science, radiological technology, ocular optics, emergency medical technician, or dental hygiene in Daejeon city were surveyed. The tool used was CPR knowledge developed by the authors based on a literature review including 2005 AHA's CPR guideline. Result: The higher educational experience of CPR was, the higher the level of knowledge. The knowledge of the students in nursing or emergency medical technician was higher than students in dental hygiene, radiology, and ocular optics. Conclusion: CPR class should be included in the curriculum for college students in order to improve their accuracy as a first responder to cardiac arresting patients.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.99-111
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• 2008

Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.