• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.136-141
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• 2015

Purpose: Continuous intravenous access is imperative in emergency situations. Ultrasound-guided internal jugular vein (IJV) catheterization was investigated in critically ill pediatric patients to assess the feasibility of the procedure. Methods: Patients admitted to the pediatric intensive care unit between February 2011 and September 2012 were enrolled in this study. All patients received a central venous catheter from attending house staff under ultrasound guidance. Outcome measures included successful insertion of the catheter, cannulation time, number of cannulation attempts, and number and type of resulting complications. Results: Forty-one central venous catheters (93.2%) were successfully inserted into 44 patients (21 males and 23 females; mean age, $6.54{\pm}1.06$ years). Thirty-three patients (75.0%) had neurological disorders. The right IJV was used for catheter insertion in 34 cases (82.9%). The mean number of cannulation attempts and the mean cannulation time was $1.57{\pm}0.34$ and $14.07{\pm}1.91$ minutes, respectively, the mean catheter dwell time was $14.73{\pm}2.5$ days. Accidental catheter removal was observed in 9 patients (22.0%). Six patients (13.6%) reported complications, the most serious being catheter-related sepsis, which affected 1 patient (2.3%). Other complications included 2 reported cases of catheter malposition (4.6%), and 1 case each of arterial puncture (2.3%), pneumothorax (2.3%), and skin infection (2.3%). Conclusion: The results suggest that ultrasound-guided IJV catheterization can be performed easily and without any serious complications in pediatric patients, even when performed by visiting house staff. Therefore, ultrasound-guided IJV catheterization is strongly recommended for critically ill pediatric patients.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.188-195
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• 2015

Purpose: The purpose of this study was to evaluate the appropriateness of the replacement time intervals of 18 gauge peripheral intravenous catheters (PICs) by investigating the development of phlebitis. Methods: The subjects were 200 hospitalized patients over 18 yrs old aged who have 18 gauge PICs placed for surgery. After the insertion of PICs, the researcher monitored the insertion site daily for 96 hours for any signs of phlebitis. Results: Phlebitis developed in 25.7% of patients. Patients who developed phlebitis were significantly older and were receiving fluids with faster infusion rate. However, patients with and without phlebitis were not different by gender, insertion site, fluid osmolality, or pH of drugs administered. The incidence rate of phlebitis was higher than 10%(12.9%) starting 24~48 hours after the insertion of 18 gauge PICs. Conclusion: It is recommended to replace 18 gauge PICs within 24~48 hours after insertion. Close monitoring of the PICs insertion site for the signs of phlebitis is recommended.

• Journal of Korean Clinical Nursing Research
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• v.26 no.1
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• pp.59-74
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• 2020

Purpose: The purpose of this study is to investigate new nurses' needs for intravenous infusion therapy training by analyzing the current training status. Methods: This study examined the needs for intravenous infusion therapy training with 159 new nurses. The measurement tool consisted of 93 items developed based on intravenous therapy-related studies, and was evaluated on a 4-point Likert scale. For data analysis, SPSS/WIN 25.0 was used, and frequency, percentage, average, standard deviation, paired t-test, were performed. Results: The demand for intravenous therapy education was analyzed using a questionnaire composed of 8 areas, 16 sub-areas, and 93 items. According to the findings, post-ward placement intravenous therapy education(83.7%) is conducted more often than in preliminary education (72.2%). The demand for intravenous infusion therapy education did not differ significantly in preliminary and post-ward placement education (t=-.89, p=.376). While therapy skills were preferred in preliminary education, there were high demands for education content related to blood transfusion, central venous catheter, and drug use in continuing education. As for preferred teaching methods, lecture (38.2%) and simulation (26.7%) were most answered for preliminary education, while a range of methods were preferred for continuing education including lecture (31.1%), clinical practice (20.6%), preceptor training (19.8%), simulation (16.8%), and self-study (11.6%). Conclusion: For efficient training, it is required to provide different education contents and methods for each stage.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.155-159
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• 1998

Epidural neurolysis with phenol has appeared in literature since 1960. Complications due to accidental subdural block is a rare and unexpected sensory and/or motor disturbance, but it does occur. A 74 years old woman had postherpectic neuralgia for 3 weeks and VAS score of 10. She was treated with intercostal nerve block and intravenous infusion of lidocaine for 7 days and VAS score decreased to 6. To proceed further, we decided to perform epidural neurolysis with 4% phenol 1.5 ml. During thoracic epidural catherization, we encountered unexpected subdural catheterization in subdurographic finding, but we could not precisely rule out subdural catheterization. We had to check CT for exact location of catheter tip. We then performed subdural neurolysis with phenol. This procedure reduced VAS score to between 3 and 4, and we removed the catheter. She had no complication.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.116-120
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• 2024

External nasal splints are commonly used for immobilization following nasal fracture reduction or rhinoplasty procedures. The literature documents the use of various materials like thermoplastic materials, aluminum, Orthoplast, fiberglass, plaster of Paris, and polyvinyl siloxane. These materials are bulky, time-consuming, expensive, and cumbersome to use, and have been associated with complications including contact dermatitis and epidermolysis. Furthermore, they cannot be retained if the situation warrants prolonged stabilization and immobilization. We introduce a new technique using readily available scalp vein catheter flanges as an external nasal stent. The technique is easy to master, inexpensive, and limits edema and ecchymosis, while stabilizing the reconstructed nasal skeleton in position during the healing period.

• Advances in pediatric surgery
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• v.14 no.1
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• pp.67-74
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• 2008

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.553-556
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• 2004

Bacillus species are aerobic, gram-positive, spore forming rods, and they are usually found in the surrounding environment. If they are isolated in the clinical specimen, they are generally considered as contaminants rather than a true pathogen. Infection with Bacillus licheniformis is usually associated with the immunocompromised state, trauma, an indwelling intravenous catheter or an intravenous drug abuser. This infection is easily controlled by removal of the catheter and surgical debridement of the local infected tissue as well as an appropriate antimicrobial therapy. We reported here on a case of Bacillus licheniformis bacteremia associated with a bronchoscopic procedure in an immune competent patient.

• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.454-458
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• 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

• Tuberculosis and Respiratory Diseases
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• v.71 no.2
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• pp.134-138
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• 2011

Trousseau's syndrome is an unexplained thrombotic event that precedes the diagnosis of an occult visceral malignancy or appears concomitantly with the tumor. Upper extremity deep vein thrombosis is prevalent in patients with a central venous catheter. Furthermore, a peripheral intravenous injection may cause upper extremity deep vein thrombosis as well. However, a deep vein thrombosis has not been reported in the form of Trousseau's syndrome with a catastrophic clinical course triggered by a single peripheral intravenous injection. A 48-year-old man presented with a swollen left arm on which he was given intravenous fluid at a local clinic due to flu symptoms. Contrast computed tomgraphy scans showed thromboses from the left distal brachial to the innominate vein. The patient developed multiple cerebral infarctions despite anticoagulation treatment. He was diagnosed with stomach cancer by endoscopic biopsy to evaluate melena and had a persistently positive lupus anticoagulant. After recurrent and multiple thromboembolic events occurred with treatment, he died on day 20.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.2
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• pp.105-109
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• 2012

The gag reflex is a physiological reaction, but, an exaggerated gag reflex can be a severe limitation not only to treat dental caries but also to do oral exam. Procedures such as surface anesthesia of the palate and pharyngeral area, sedation, or general anesthesia can be options as behavioral management. But, there are no golden rule for the sever gag reflex patients. We present a case report of propofol intravenous sedation using TCI pump for simple dental treatment. A 44-year-old man, who had past history of general anesthesia for dental treatment because of severe gag reflex, was scheduled intravenous sedation for simple dental treatment. After 8 hour fasting he entered the clinic for persons with disabilities. We explained about intravenous deep sedation and got informed consent. First, we kept intravenous catheter (22G) in the arm and started monitoring ECG, non-invasive blood pressure, pulse oximetry and end-tidal $CO_2$ through nasal cannula. We started propofol infusion with TCI pump at the target concentration of 3 mcg/ml. The patient became sedated, but he showed involuntary movement during dental treatment, so we increased the target concentration to 4 mcg/ml. We finished the dental treatment without complications during 30 min. And after 40 min recovery room stay he was discharged without any complications.