• Title/Summary/Keyword: Emergency surgery

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AN CLINICAL ANALYSIS ON THE DENTAL EMERGENCY PATIENTS VISITING THE EMERGENCY ROOM OF DENTAL HOSPITAL OF WON-KWANG UNIVERSITY (단독 치과 병원 치과응급실 내원 환자의 임상적 분석)

  • Keum, Ki-Chun;Paeng, Jun-Young;Choi, Bo-Young;Choi, Jung-Gu;Oh, Se-Ri;Lee, Jun;Choi, Moon-Ki;Kwon, Kyung-Hwan;Oh, Seung-Hwan;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.1
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    • pp.35-40
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    • 2009
  • Dental emergency varies from toothache to trauma of oromaxillofacial area. Recently, the number of emergency cases after dental treatment is increasing because surgical treatments such as implant installation rise. Dental emergency patients have been looking for emergency room of general hospital and they could be treated only when the dentist of night duty exists. Although there are many analyses on the dental emergency patients visiting general hospitals, research on the dental treatment only has not been provided enough. We anticipated different aspects between the dental emergency patients visiting independent dental hospital and general hospitals. We analyzed dental emergency patients' chief complaints and received procedures for almost 1-year period in Won-Kwang dental hospital in Dae-jeon where there had been no dental emergency settings. With this 1574 patients' result, we tried to find appropriate treatment plans regarding dental emergency patients occurring at night and holidays.

Retrospective Study on the Flow and Characteristics of Dental Emergency Patients in Chosun University Hospital

  • Lee, Sung-Suk;Kim, Su-Gwan;Oh, Ji-Su;Moon, Seong-Yong;You, Jae-Seek;Yu, Kyoung-Hwan;Jo, Ji-Ho;Park, Jin-Sung;Yang, Wang-Sik;Seo, Dong-Kook
    • Journal of Korean Dental Science
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    • v.8 no.1
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    • pp.10-15
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    • 2015
  • Purpose: The aim of the present study is to assess the importance of proper treatment timing for dental emergency patients by characterizing current patient care in the emergency room. Materials and Methods: A retrospective chart review of 3,211 patients who visited the Chosun University Hospital's dental emergency department (Gwangju, Korea) was conducted from January 1, 2011 to May 31, 2014. Information regarding age, gender, onset date, main causes, and diagnoses were collected and analyzed. The main causes were divided into six categories: assault, household/play, sports, traffic, work, and others. Result: Emergency visits were more common for men (69%), and the ratio of males to females was 2.2:1 On average, the major cause was household/play (49.8%), followed by others (18.9%), traffic (16.6%), assault (9.1%), sports (2.9%), and work (2.6%). The most frequent diagnosis on average was dental trauma with 82.4%, followed by infection (10.7%), others (4.7%), and bleeding (2.2%). Conclusion: The main reasons for visits to the dental emergency department are dental trauma, dental infection, bleeding, and others. The most frequent reason for dental emergency patients to visit the emergency department was dental trauma (82.4%).

Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction

  • Choe, Eun Ju;Lee, Yong Kang;Jeon, Han Ho;Choi, Jong Won;Park, Byung Kyu;Won, Sun Young;Seo, Jeong Hun;Lee, Chun Kyon;Cho, Yong Suk
    • Journal of Digestive Cancer Reports
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    • v.9 no.2
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    • pp.43-49
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    • 2021
  • Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

Management of Severe Trauma Patients in the Emergency Intensive Care Unit (응급중환자실에서의 중증외상환자 치료)

  • Kim, Ji-Ju;Suh, Gil-Joon;Jeong, Ki-Young;Kwon, Woon-Yong;Kim, Kyung-Su;Lee, Hui-Jai;Kim, Yeong-Cheol;Choi, Seok-Ho;Lee, Young-Ho;Lee, Kyung-Hag;Han, Kook-Nam;Jae, Hwan-Jun;Kim, Hyo-Cheol
    • 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.

Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims? (응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가?)

  • Lee, Kyung Won
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.19-25
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    • 2007
  • Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

Changes in patterns of plastic surgery emergencies at a level I trauma center in India during the COVID-19 pandemic

  • Singh, Veena;Haq, Ansarul;Sharma, Sarsij;Kumar, Sanjeev;Kumar, Aditya;Kumar, Amarjeet;Kumar, Neeraj;Kumar, Anil
    • Journal of Trauma and Injury
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    • v.35 no.2
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    • pp.108-114
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    • 2022
  • Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had major effects worldwide, including sudden and forceful setbacks to the healthcare system. The COVID-19 pandemic has also led to changes in the plastic and reconstructive management of emergency cases, including those due to road traffic accidents. This study analyzed changes in patterns of plastic surgery emergencies and modifications in consultation policies to minimize the exposure of healthcare workers. Methods: Data on plastic surgery emergency calls received from the trauma and emergency department were collected for a period of 2 months before and during lockdown. The data were then analyzed with respect to the cause, mechanism, and site of the injury, as well as other variables. Results: During lockdown, there was a 40.4% overall decrease in the plastic surgery emergency case volume (168 vs. 100). The average daily number of consultations before lockdown was 2.8 as compared to 1.6 during lockdown. Road traffic accidents remained the most common mechanism of injury in both groups (45.8% vs. 39.0%) but decreased in number during the lockdown (77 vs. 39). Household accidents, including burns, were the second most common cause of injury in both phases (7.7% vs. 20.0%), but their proportion increased significantly from 7.7.% to 20.0% in the lockdown phase (P=0.003). The percentage of minor procedures done in the emergency department increased from 53.5% to 72.0% during lockdown (P=0.002). Procedures in the operating room decreased by 73.1% during lockdown (67 vs. 18, P=0.001). Conclusions: The COVID-19 pandemic and lockdown orders in India greatly influenced trends in traumatic emergencies as observed by the plastic surgery team at our tertiary care center. Amidst all the chaos and limitations of the pandemic period, providing safe and prompt care to the patients presenting to the emergency room was our foremost priority.

A Case of Congenital Diaphragmatic Eventration Requiring Emergency Operation (응급 수술을 요하는 선천성 횡경막 내번증 1예)

  • Lee, Seock-Yeol;Lee, Seung-Jin;Park, Hyung-Joo;Lee, Cheol-Sae;Lee, Kihl-Rho
    • Advances in pediatric surgery
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    • v.10 no.2
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    • pp.142-144
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    • 2004
  • A one day old female infant was brought to the emergency room suffering from shortness of breath. An x-ray revealed the gastrointestinal tract in the right thoracic cavity. An emergency operation demonstrated eventration of the diaphragm, and a plication was performed. The baby was discharged without complication and has been followed up in the out patient clinic. Congenital diaphragmatic eventuation requiring emergency operation is rare.

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Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers (권역외상 및 응급센터에서 성형외과의 참여방안)

  • Lim, Nam Kyu;Kang, Dong Hee
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

Infection Status of Hydatid Cysts in Humans and Sheep in Uzbekistan

  • Hong, Sung-Tae;Jin, Yan;Anvarov, Khikmat;Khadjibaev, Abdukhakim;Hong, Samin;Ahmedov, Yusufjon;Otaboev, Utkir
    • Parasites, Hosts and Diseases
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    • v.51 no.3
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    • pp.383-385
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    • 2013
  • Uzbekistan is endemic of cystic echinococcosis (CE). In order to estimate endemicity of CE, we collected data from emergency surgery due to CE in 2002-2010 and also investigated the prevalence of hydatid cysts in the liver and lungs of sheep at an abattoir in Uzbekistan from July 2009 to June 2010. In 14 emergency hospitals, 8,014 patients received surgical removal or drainage of CE during 2002-2010, and 2,966 patients were found in 2010. A total of 22,959 sheep were grossly examined of their liver and lungs, and 479 (2.1%) and 340 (1.5%) of them were positive for the cyst in the liver and lungs, respectively. Echinococcus granulosus is actively transmitted both to humans and sheep, and CE is a zoonotic disease of public health priority in Uzbekistan.

A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY VISITING SANG-GYE PAIK HOSPITAL EMERGENCY ROOM. (상계백병원 응급실에 내원한 구강악안면외과 응급환자에 대한 임상적 연구)

  • Baik, Jee-Seon;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Choi, Min-Hye;Kwon, Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.561-566
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    • 2008
  • This is a retrospective clinical study on 2,955 patients who had visited the Emergency Room of Sang-gye Paik Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 4 years from Aug. 2002 to Dec. 2006. The obtained results were as follows. The total number of patients was 2,955 and the ratio of male to female was 1.72:1. The age distribution peak was the 1st decade (30.8%), followed by the 3rd decade (14.3%) and the 4th decade (14.0%). Trauma (62.3%) was the most frequent cause in dental emergency patients, pulpitis (13.0%) and infection patients were next in order of frequency. In trauma patients group, facial bone injury, tooth injury, soft tissue injury were included and soft tissue injury group was most prevalent, followed by tooth injury group and facial bone group. In total patient, the ratio of admission was 3.5%. We obtained the results of the distribution of primary emergency care in the traumatic injury, causal distribution of the jaw fracture, distribution of related medical department in multiple associated injuries, distribution of emergency care in infection, causal distribution and control methods of oral bleeding, distribution of TMJ disorder. The trauma patient group was major in the dental patients who had visited the emergency room, but other various groups were included. So we should analyze the pattern and the variation of the dental emergent patient to provide the proper treatment.