• Title/Summary/Keyword: Non-emergency

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Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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Prognostic Value of Computed Tomography and Gradient-echo Magnetic Resonance Imaging in Diffuse Axonal Injury (미만성 축삭 손상에서 전산화단층촬영과 경사에코 자기공명영상을 이용한 예후의 평가)

  • Jung, Nam-Ki;Jin, Sang-Chan;Choi, Woo-Ik
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.122-131
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    • 2012
  • Purpose: Diffuse axonal injury (DAI) is clinically defined as a coma of over six hours in a head trauma victim without a focal mass lesion. The emergency physician usually resuscitates and stabilizes a comatose head trauma victim in the emergency Department. After assessment and treatment, the prognosis is very important to both the victim and the physician. The prognosis for DAI is based on Glasgow Coma Scale (GCS) and other imaging data. We investigated the prognostic value of computed tomography (CT) and gradient-echo magnetic resonance imaging (GRI) for head trauma victims with DAI. Methods: Fifty-three(53) head trauma victims of DAI were enrolled in this study from 2007 to 2012. During the study period of six years, data on trauma victims were collected retrospectively. We analyzed the differences in the Glasgow Outcome Scale (GOS) result between the CT and the GRI modalities. Results: We classified the study group by using GOS. Between the good outcome subgroup (GOS scores of 4 and 5) and the poor outcome subgroup (GOS score of 1-3), there were no statistical difference in sex, age, initial vital signs and initial GCS score. The good outcome subgroup had non-hemorrhage on CT(52%), which was correlated with good outcome and a shorter awakening time, while a larger number and a deeper location of hemorrhagic lesions on in GRI were correlated with poor outcome in DAI. Conclusion: We conclude that the existence of hemorrhagic lesions on CT, and the number and location of those lesions on GRI had good prognostic value for head trauma victims with DAI.

Characteristics of Wrist Injuries in Snowboarding (스노보드 손상 환자에 있어서 손목 손상의 특성)

  • Kim, Yeong Jun;Lee, Kang Hyun;Cha, Kyoung Chul;Kim, Hyun;Hwang, Sung Oh;Oh, Jin Rok
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.29-36
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    • 2009
  • Purpose: The purpose of this study was to analyze the characteristics and severity of wrist injuries in snowboarding. Methods: December 2005 to February 2008, Snowboarders who experienced wrist injures were included in this study. On the basis of the medical records and radiographic evaluation, the severity of distal radius fracture was classified according to the Arbeitsgemeinschaft fur Osteosynthesefragen/Association for the Study of Internal Fixation (AO/ASIF) classification. Results: Most of the injured snowboarders were a either of the beginner (35 cases, 46.1%) or the intermediate (27 cases, 35.5%) level. The most common cause of injury in snowboarding was a slip down (60 cases, 78.9%). Comminuted and articular fractures classified as AO types A3, B, and C, which required surgical reduction, made up 42.3% of the distal radial fractures in snowboarders. When we analyzed the differences in severity between the educated and the non-educated groups, an A2 type injury in the AO classification was the most common type of injury in the educated group (20 cases, 38.5%), it means less severe fractures ocurred in the educated group (p=0.045). The most frequent injury mechanism of fractures was slip down (48 cases, 63.2%), and a slip down backwards was the dominant type of slip down (36 cases, 75.0%) (p=0.031). Conclusion: Among the snowboarders in this study who suffered self-down injury to the wrist, more fractures were associated with a backwards slip down than with a forward slip down due to over extension. For educated snowboarders the severity of fracture was lower than it was for uneducated snowboarders.

The management of breast implant-associated anaplastic large cell lymphoma in the setting of pregnancy: seeking for clinical practice guidelines

  • Elia, Rossella;Maruccia, Michele;De Pascale, Aurelia;Di Napoli, Arianna;Ingravallo, Giuseppe;Giudice, Giuseppe
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.373-377
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    • 2021
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a recently described form of T-cell non-Hodgkin lymphoma now formally recognized by the World Health Organization classification of lymphoid neoplasms. The aim of this paper is to report the first case of BIA-ALCL diagnosed in a pregnant patient. It is well known that BIA-ALCL appears as an indolent lymphoma with a good prognosis when diag-nosed at early stages and clinical guidelines for its management have been clearly published. Nevertheless, they lack a standardized approach for BIA-ALCL during pregnancy. With limited experience in our case, treatment has been safely postponed after term without affecting patient's overall prognosis and without fetal complication. The fact that the disease was diagnosed at an early stage (stage I) undoubtedly influenced the course of treatment. A multidisciplinary approach weighing the risks and benefits of treatment is of paramount importance in order to ensure the best possible outcome for both the mother and her child and clinical update guidelines should be issued.

Long-term outcome of delayed neuropsychiatric sequelae after carbon monoxide poisoning (일산화탄소중독에서 지연신경정신장애의 장기적인 예후)

  • Yoo, Joo Young;Kim, Gap Teog;Koh, Chan Young
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.519-528
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    • 2018
  • Objective: Delayed neuropsychiatric sequelae (DNS) following carbon monoxide (CO) poisoning, which may result from a demyelinating leukoencephalopathy, is a disease with a poor prognosis. This study examined the factors affecting the long-term prognosis of DNS and the efficacy of hyperbaric oxygen therapy (HBOT) in patients with DNS. Methods: This retrospective study included 84 patients with DNS following CO poisoning from January 2013 to June 2016. HBOT was given to 24 patients. The patients were divided into an improvement group and non-improvement group based on their clinical condition on a telephone interview at intervals between 3 months and 3 years after the onset of DNS. The improvement group was defined as having Cerebral Performance Category (CPC) scores in their daily life that improve to 1 or 2 grade. Results: Of the 594 patients, DNS were found in 18.2%, and 70.2% (59 of 84) of the patients with DNS improved. The prognostic factors for the improvement of DNS were an age of 45 years or less (odds ratio [OR], 12.068; 95% confidence interval [CI], 2.393-60.858; P<0.005), CPC score of 1 or 2 group at the time of DNS onset (OR, 12.361; 95% CI, 3.161-48.330; P<0.005), and a lucid interval longer than 20 days (OR, 5.164; 95% CI, 1.393-19.141; P<0.01). HBOT was not associated with the improvement of DNS in CO poisoning (OR, 0.467; 95% CI, 0.172-1.269; P>0.1). Conclusion: Patients aged less than 45 years, low grade CPC score of 1 and 2, and lucid interval longer than 20 days are more likely to have a good prognosis. On the other hand, HBOT failed to produce a benefit for DNS patients.

Deformation and permeability evolution of coal during axial stress cyclic loading and unloading: An experimental study

  • Wang, Kai;Guo, Yangyang;Xu, Hao;Dong, Huzi;Du, Feng;Huang, Qiming
    • Geomechanics and Engineering
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    • v.24 no.6
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    • pp.519-529
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    • 2021
  • In coal mining activities, the abutment stress of the coal has to undergo cyclic loading and unloading, affecting the strength and seepage characteristics of coal; additionally, it can cause dynamic disasters, posing a major challenge for the safety of coal mine production. To improve the understanding of the dynamic disaster mechanism of gas outburst and rock burst coupling, triaxial devices are applied to axial pressure cyclic loading-unloading tests under different axial stress peaks and different pore pressures. The existing empirical formula is use to perform a non-linear regression fitting on the relationship between stress and permeability, and the damage rate of permeability is introduced to analyze the change in permeability. The results show that the permeability curve obtained had "memory", and the peak stress was lower than the conventional loading path. The permeability curve and the volume strain curve show a clear symmetrical relationship, being the former in the form of a negative power function. Owing to the influence of irreversible deformation, the permeability difference and the damage of permeability mainly occur in the initial stage of loading-unloading, and both decrease as the number of cycles of loading-unloading increase. At the end of the first cycle and the second cycle, the permeability decreased in the range of 5.777 - 8.421 % and 4.311-8.713 %, respectively. The permeability decreases with an increase in the axial stress peak, and the damage rate shows the opposite trend. Under the same conditions, the permeability of methane is always lower than that of helium, and it shows a V-shape change trend with increasing methane pressures, and the permeability of the specimen was 3 MPa > 1 MPa > 2 MPa.

A retrospective analysis of toxic alcohol poisoning (급성 독성 알코올 중독에 대한 후향적 분석)

  • Jin Kim;Yu Jin Lee;Tae Kyu Ahn;Soo Kang
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.143-150
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    • 2023
  • Purpose: This study aimed to compare the clinical features of methanol and ethylene glycol poisoning. Methods: This single-center retrospective observational study included patients with toxic alcohol poisoning who visited a regional emergency medical center. Patients with methanol and ethylene glycol poisoning from January 2004 to June 2023 were selected for the study using diagnostic codes. Results: Twenty-two patients with toxic alcohol poisoning visited during the study period, with 11 patients for each category. Compared to methanol poisoning, ethylene glycol poisoning patients were more likely to have consumed alcohol for suicidal purposes (n=4 [36.36%] vs. n=8 [72.73%]) and were more likely to be drowsy (n=0 vs. n=6 [54.55%], p=0.016). The anion gap (25.43±8.35 mmol/L vs. 13.22±6.23 mmol/L, p=0.001) and lactic acid levels (1.785 [1.3-2.785] mmol/L vs. 9.90 [4.20-11.81] mmol/L, p=0.007) were higher in ethylene glycol poisoning patients than in methanol poisoning patients. Among alcohol dehydrogenase blockers, oral ethanol was administered to 10 patients (45.45%) (n=4 [36.36%] vs. n=6 [54.55%]), and intravenous ethanol was administered to six patients (n=4 [36.36%] vs. n=2 [18.18%]). Fomepizole was administered to two patients (9.09%) each, and renal replacement therapy was non-significantly more common in patients with ethylene glycol poisoning (n=8 [72.73%] vs. n=3 [27.27%], p=0.128). Three patients had delays in diagnosis and treatment, and while there were no fatalities, one patient was left with permanent vision damage. Conclusion: Because these are uncommon types of poisoning and the clinical presentation is difficult to recognize early, healthcare providers should be familiar with toxic alcohol types and screen for them to ensure proper diagnosis and treatment.

A Big Data Analysis of the News Trends on Wireless Emergency Alert Service (뉴스 빅데이터를 활용한 재난문자 뉴스 게재 경향 분석)

  • Lee, Hyunji;Byun, Yoonkwan;Chang, Sekchin;Choi, Seong Jong;Oh, Seunghee;Lee, Yongtae
    • Journal of Broadcast Engineering
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    • v.24 no.5
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    • pp.726-734
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    • 2019
  • This study investigates the number of news and correlated keywords concerning to Korean Wireless Emergency Alert(KWEA). The news was collected using BIGKinds, a news big data system provided by the Korea Press Foundation. When analyzing the annual published news articles, we investigated the frequency of the news grouped by disaster types, and the frequency of the news distinguishing between the earthquake and non-earthquake disasters, and finally the frequency of correlated keywords concerning to the disasters. We found that the KWEA news totaled 182 in 2016 due to the unprecedented powerful KyongJu earthquake, an increase of 20 times over the previous year. Ever since 2016, the news about the KWEA continued to hit high figures consistently. After the peak in KyongJu earthquake in 2016, the proportion of non-earthquakes had also increased in 2017 and 2018. Next, the keyword correlation analysis showed that the KWEA news gave major coverage to the following entities: The Ministry of the Interior and Safety which operates the KWEA, Korea Meteorological Administration, and the general public.

Pitfalls, Complications, and Necessity of Education about REBOA: A Single Regional Trauma Center Study

  • Kim, Sol;Chung, Jae Sik;Jang, Sung Woo;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.153-161
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    • 2020
  • Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center. Methods: A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups. Results: A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60). Conclusions: Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.

Prehospital Care of 119 EMT for Non-traumatic Cardiac Arrest and Improvement to Increase Advanced Care Rate (119 구급대원의 비외상성 심정지 환자의 병원전 처치실태 및 전문 처치율 향상을 위한 개선 방안)

  • Lee, Kyoung-Youl;Yun, Seong-Woo
    • Fire Science and Engineering
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    • v.25 no.5
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    • pp.21-31
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    • 2011
  • This study aimed at evaluating and developing 119 emergency medical technicians' prehospital care for non-traumatic cardiac arrest. Total 322 EMT in Chungnam province and Daejeon city filled out the self-administered questionnaire. The data were analyzed by SPSS 18.0 for descriptive statistics. Among the 322 EMT, 309 (97%) and 169(53%) always or almost performed CPR and AED for nontraumatic cardiac arrest patient, respectively. Among the advanced EMT and nurse, IV were sometimes or not performed at 94.7% and medication including epinephrine which commonly used for survival of cardiac arrest were treated just at 9.3 % (14 person). The reason they did not perform each procedure for airway management, AED or IV was lack of manpower, limit of time or joggle of ambulance and legal restrictions. In conclusion, to increase survival rate of non-traumatic cardiac arrest in out-of-hospital, it is necessary to increase manpower, legal protection of EMS, establishment of standard operating procedure, practice for improvement technique and use of medication for ACLS.