Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.
Building resilient community is often a complicated process to be gained by interorganizational collaboration. Since patterns of interorganizational relations among governments and sectors are constantly changing due to internal and external factors in the field of emergency management, understanding the dynamic nature of interorganizational collaboration is a critical step for improving a community’s ability to bounce back from a catastrophic event. From two theoretical perspectives, this research aims to examine the essential role of working across levels of governments and sectors in building resilient community by focusing on sources of community resiliency and a strong commitment. The empirical evidence highlights the importance of studying resilience as a way to understand the motivation and incentive for organizations to work jointly during emergency response. The study of organizational resilience also draws attention for the importance of various forms of interorganizational collaboration such as formal and informal relations. It also highlights how local organizations can utilize their relations to seek resources without necessarily jeopardizing their ability to perform their core organizational functions.
Purpose: The purpose of this study was to examine the characteristics of suicide attempters visiting emergency department in a general hospital located at local city. Methods: To investigate the characteristics of suicide attempters, the medical records of 201 suicide attempters were reviewed with a structured analytic sheet. Data were analyzed using ${\chi}^2$ test, two sample t-test, and oneway ANOVA. Results: Among total of 201 suicide attempters, 114 (56.7%) lived in rural areas. 114 (56.7%) were men and most of them (71, 35.3%) lived in rural areas. 155 (77.5%) was the first trier and the most frequently used method was taking pesticides. There were gender and regional differences in the suicide-related characteristics of suicide attempters. Conclusion: The results provide empirical evidences to design and implement strategies at both macro and micro levels to prevent suicide.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제28권5호
/
pp.383-389
/
2002
This is a retrospective study on emergency patients with active oral bleeding. The study was based on a series of 135 patients treated as emergency patients at Wonju Christian Hospital, from Jan. 1, 1997, to Dec. 31, 2001. The postoperative bleeding was the most frequent cause of active oral bleeding in emergency room and bleeding from trauma and medically compromised (bleeding disorders) patients were next in order of frequency. In the injury of maxillofacial vessels, peak incidence was occurred in the inferior alveolar vessel (42.9%), followed by the submucosal vessel of lip & cheek, the superior alveolar vessel, and sublingual vessels. The most common disease of bleeding disorders was vascular wall alteration (infection, etc), followed by liver disease, thrombocytopenic purpura, anti-coagulation drugs in order. In the characteristics of dental diseases on bleeding disorders, periodontal disease and alveolar osteitis (osteomyelitis) were more common. The hemostasis was most obtained by use of wound suture, simple pressure dressing, drainage for infection control and primary interdental wiring of fracture. In the complication group, the infrequent incidence was showed in vomiting, hypovolemic shock, syncope, recurred bleeding & aspiration pneumonia. In the uncontrolled oral bleeding, the injured vessels were suspected as skull base & ethmoidal vessels. In this study, authors found that the close cooperation between the dentistry (Oral and maxillofacial surgery) and the medicine (emergency & internal medicine) was the most important for early proper control of active oral bleeding. And then post-operative wound closure, drainage for infection control and previous systemic evaluation of bleeding disorders were critical for the prevention of postoperative bleeding in the local dental clinic.
Park, Sung Woo;Oh, Tae Suk;Choi, Jong Woo;Eom, Jin Sup;Hong, Joon Pio;Koh, Kyung S.;Lee, Taik Jong;Kim, Eun Key
Archives of Plastic Surgery
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제42권1호
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pp.28-33
/
2015
Background Topical anesthetics, such as eutectic mixture of local anesthetics (EMLA) cream, can be applied to reduce pain before minor procedure. This trial evaluated EMLA as pretreatment for facial lacerations and compared pain, discomfort and overall satisfaction. Methods This trial included consecutive emergency department patients ${\geq}16years$ of age who presented with simple facial lacerations. At triage, lacerations were allotted to either the routine processing group or EMLA pretreatment group according to date of admission. Initially, the emergency department doctors inspected each laceration, which were dressed with saline-soaked gauze. In the pretreatment group, EMLA cream was applied during wound inspection. The plastic surgeon then completed primary closure following the local injection of an anesthetic. After the procedure, all patients were given a questionnaire assessing pain using the 10-point visual analog scale (VAS) ("no pain" to "worst pain"). All questionnaires were collected by the emergency department nurse before discharge. Results Fifty patients were included in the routine processing group, and fifty patients were included in the EMLA pretreatment group. Median age was 39.9 years, 66% were male, and the average laceration was 2.67 cm in length. The EMLA pretreatment group reported lower pain scores in comparison with the routine processing group (2.4 vs. 4.5 on VAS, P<0.05), and lower discomfort scores during the procedure (2.0 vs. 3.3, P=0.60). Overall satisfaction was significantly higher in the EMLA pretreatment group (7.8 vs. 6.1, P<0.05). Conclusions Pretreating facial lacerations with EMLA topical cream aids patients by reducing pain and further enhancing overall satisfaction during laceration treatment.
We report a case of fatal aortic tumor embolism presenting as acute paraplegia. A four-year-old girl was referred from a local hospital with sudden paraplegia and a poor medical condition. A neighbor had noticed her fall from a bike, and she could not walk. She had no previous illness. Emergency spine MRI revealed no remarkable findings. During the process of evaluation, her general condition deteriorated progressively. Chest and abdominal CT showed a large mass in the left lung field, and a diagnosis of aortic occlusion was made. An emergency transfemoral embolectomy was attempted. However, the patency of the aorta was not recovered. On pathological examination of tissues taken from the embolectomy, a pleuro-pulmonary blastoma was found. The patient died 22 hours after the onset of her symptoms. We describe a possible mechanism for the tumor embolism. To the best of our knowledge, this is the first case report of aortic occlusion caused by an embolic malignancy, presenting as acute paraplegia.
Evacuation Time Estimate (ETE) can provide decision-makers with a likelihood to implement evacuation of a population with radiation exposure risk by a nuclear power plant. Thus, the ETE is essential for developing an emergency response preparedness. However, studies on ETE have not been conducted adequately in Korea to date. In this study, different cohorts were selected based on assumptions. Existing local data were collected to construct a multi-model network by TSIS-CORSIM code. Furthermore, several links were aggregated to make simple calculations, and post-processing was conducted for dealing with the stochastic property of TSIS-CORSIM. The average speed of each cohort was calculated by the link aggregation and post-processing, and the evacuation time was estimated. As a result, the average cohort-based evacuation time was estimated as 2.4-6.8 h, and the average clearance time from ten simulations in 26 km was calculated as 27.3 h. Through this study, uncertainty factors to ETE results, such as classifying cohorts, degree of model complexity, traffic volume outside of the network, were identified. Various studies related to these factors will be needed to improve ETE's methodology and obtain the reliability of ETE results.
The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.
Objectives : In this paper, We pointed out medico-historical meaning of Hyang'yak Kugŭppang (鄕藥救急方, Medical Recipes of Local Botanicals for Emergency Use), a medical book of Koryŏ Dynasty, breaking from the existing analysis view based on Hyang'yak (鄕藥), local herbs produced in Korean Peninsula. Methods : For that purpose, we analyzed the clinical characteristics of the diseases and symptoms, strategies of treatment, therapeutic tools, drug formulations, composition of herbal formulas in Hyang'yak Kugŭppang. Results : The following characteristics were confirmed in Hyang'yak Kugŭppang. First, it contained a way to cope with the diseases and symptoms that do not have to check the exterior, interior, cold, and heat. Also, it introduced basic strategies such as reducing, facilitating flow, draining downward, warming, or tonifying, etc. It mainly included herbal medicine as the therapeutic tools, and introduced formulas composed by single herb than complex recipes. It suggested external applications more than internal use, and proposed formulations in the form of decoctions or powders, etc. The herbs of formulas were used by experience without explanations of nature & taste, efficacy of each herbs. Conclusions : Hyang'yak Kugŭppang is a book of medical recipes for emergency use that has been distributed to help gentries, even if they do not have professional medical knowledge, to instantly cope with diseases and symptoms with medicines that are easy to obtain. Previous researches has analyzed the value of Hyang'yak Kugŭppang as a collection of information of hyang'yak, and used it as a historical basis of the uniqueness of Korean medicine. Since Hyang'yak Kugŭppang is not a book specialized for herbs, but rather a clinical medical book that introduces recipes for specific symptoms of diseases, if we pay attention to the clinical characteristics of Hyang'yak Kugŭppang, it will provide an opportunity to describe Koryŏ or Korean medicine in a new way.
The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.
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