Lee, Hee Jung;Park, So Yoon;Lee, Young Hwan;Do, Byung Soo;Lee, Sam Bum
Clinical and Experimental Pediatrics
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v.48
no.10
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pp.1061-1067
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2005
Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.
Journal of the Korea Academia-Industrial cooperation Society
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v.10
no.11
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pp.3418-3426
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2009
The purpose of this study was to investigate the feasibility of field operation protocol for cardiopulmonary resuscitation(CPR) in person with non-traumatic arrest. This study was performed from May 1 through June 27, 2008, and subjects were 150 students who are attending the department of Emergency Medical Service in J and K universities which located in Jeollabuk-do and Jeollanam-do areas. Practical conformance was verified using by nonequivalent control group pretest-posttest design. This study divided into two groups; experimental group that employed field operation protocol and control group that applied conventional CPR protocol, and comparative analyzed statistically the necessary time of the items of each protocol. The results indicated that each performance time of 18 items was reduced over 3 seconds except 5 items(assessment of consciousness, airway control, two times of artificial respiration, check of circulation, and five cycles of CPR). And time of 6 items(intubation, peripheral intravenous line, reassessment of consciousness, pupil reaction, carotid artery pulse, and vital sign) was minimized more than 60 seconds, and total performing time was shortened 110.85 seconds. The results suggested that total performing time in pre and post test where the protocol was applied for two groups showed a statistically significant decrease(t=-6.580, p=.000). Consequently, field operation protocol for cardiopulmonary resuscitation(CPR) in person with non-traumatic arrest will be a available manual which support prompt and accurate decision making, and improve emergency medical service.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.3
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pp.417-422
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2019
Hemodynamically unstable pelvic fractures show a remarkably high mortality rate of 40% to 60%. However, their standard of care remains controversial. We report here a case of a 78-year-old woman who was admitted to the Emergency Department with pelvic pain following a fall. Based on pelvic radiography, she was diagnosed with an unstable pelvic fracture. Her blood pressure was 60/40 mmHg, and owing to her unstable vital signs, emergency angiography was performed without computed tomography (CT). Both internal iliac arteries were embolized without sub-branch selection for prompt control of pelvic bleeding. Following embolization, her vital signs were stabilized. Subsequent CT revealed free intra-abdominal air, suggesting bowel perforation had occurred and necessitating emergency laparotomy. An approximately 1 cm-sized free perforation of the small intestine was identified intraoperatively, and primary closure was performed. A retroperitoneal hematoma identified intraoperatively was not explored further because it was a non-expanding and non-pulsatile mass. The patient was admitted to the Intensive Care Unit and transferred to the general ward on postoperative day 3. In this case, the hemodynamically stable pelvic fracture with bowel perforation was successfully and safely treated by prompt angioembolization without conducting CT.
Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.
By securing golden time, this study analyzed the effects of an emergency vehicle priority system in Cheongju, North Chungcheong province. Until the scene of a fire is reached, severe obstacles in the street, such as traffic congestion, cars coming forward, non-cooperative vehicles etc., are significant. To solve these problems of road obstacles, it is essential to adopt an emergency vehicle priority system. From April 2017 to June 2018 (1 year and 2 months, 426 days), the dispatch time and date, fire truck moving distance and required time, traffic signal control section and pass time, and shortening time, were measured. This study selected 140 cases consisting of five heavy traffic and frequent dispatch routes out of 293 cases. The effects of the emergency vehicle priority system were excellent. Overall, it took 3 min 3 s to pass 1 km on an uncontrolled traffic signal section. On the other hand, it took 1 min 23 s to pass 1 km on the same section that was controlled. The shortening time to pass 1 km was 1 min 40 s, showing a 45.4% reduction. This means that the 15 min driving time can be reduced to 6 min and 49 s. From this result, an emergency vehicle priority system should be implemented nationwide as soon as possible.
The purpose of the water distribution system is gradually changing to increase the flexibility for responding to various abnormal situations. In addition, it is essential to improve resilience through preparing emergency plans against water supply failure. The most efficient way is emergency interconnections which supply water from interconnected adjacent blocks. To operate successful interconnections, it is essential to evaluate the supply performance in spatial and temporal aspects. The spatial and temporal aspects are dominated by its interconnected pipes and interconnected reservoirs respectively. In this study, an emergency interconnection scenario where problem occurred in reservoir 1 at 0:00hr in A city, Korea. An Advanced-Pressure Driven Analysis model was used to simulate the volume and inflow volume of the interconnected reservoirs. Based on the hydraulic analysis results, a multi-dimensional evaluation of the supply performance was conducted by applying possible water supply range indicator (PWSRI) and possible water supply temporal indicator (PWSTI) which are based on fuzzy membership functions. As a result, it was possible to evaluate the supply performance on the sides of consumers in spatio-temporal aspects and to review whether established plans mitigate the damage as intended. It is expected to be used for decision making on structural and non-structural emergency plan to improve the performance of an emergency interconnection.
Objective : This study is an experimental study which is designed to examine the differences between knowledge and self-confidence before and after theory education(CPR PPT material) based on guidelines of CPR and emergency cardiac treatment of American Heart Association(AHA, 2005) and video self-instruction program for the general public by Korean Association of Cardiopulmonary Resuscitation(KACPR), trace CPR performance ability after CPR and AED education and investigate the accuracy of artificial respiration and chest compression, and know the difference in CPR performance abilities including AED. Methods : Subjects of this study include ground crews and staffs at M airport in G province equipped with emergency equipments for CPR according to Art. 47, Sec. 2 of Emergency Medical Law, airport police, rent-a-cops, security guard, quarantine officer, custom officer, and communication, electricity, civil engineering, facility management staff, airport fire fighting staff, air mechanic, traffic controller, and airport management team among airport facility management staffs. They were given explanation of necessity of research and 147 of 220 subjects who gave consent to this research but 73 who were absent from survey were excluded were used as subjects of this study. of 147 subjects, there were 102 men and 45 women. Results : 1) Knowledge score of CPR was $6.18{\pm}0.87$ before instruction and it was increased to $15.12{\pm}1.78$ after instruction, and there was statistically significant difference. 2) Self-confidence score in CPR was $3.16{\pm}0.96$ before instruction and it was increased to $7.05{\pm}0.75$ after instruction, and there was statistically significant difference. 3) Total average score in CPR performance ability after instruction was 7.46 out of 9, performance ability was highest in confirmation of response as 144(97.95%), follwed by request of help as 140(95.25%) and confirmation of respiration as 135(91.83%), and lowest in performing artificial respiration twice(gross elevation of chest) as 97(65.98%). Accuracy of artificial respiration(%) was $28.60{\pm}16.88$ and that of chest compression(%) was $73.10{\pm}22.16$. 4) Performance ability of AED after instruction showed proper performance in power on by 141(95.91%) and attaching pad by 135(91.83%), hand-off for analyzing rhythm showed 'accuracy' in 115(78.23%) and 'non-performance' in 32(21.77%), delivery of shock and hand-off confirmation showed 'accuracy' in 109(74.14%) and 'inaccuracy' in 38(25.86%), and beginning chest compression immediately after AED was done by 105(71.42%).
Background: Potassium, the most common cation in the intracellular space, plays a critical role in our physiology. Potassium imbalance may cause life-threatening problems, ranging from general weakness to cardiac arrest due to ventricular fibrillation. For emergency physicians, detection of such derangement within a short period of time is of critical importance. In this study, we wanted to determine whether analysis of whole blood samples can be used as a screening tool for potassium imbalance by comparative analysis of whole blood and serum samples. Methods: Two samples were drawn from 227 patients. The whole blood sample was taken from the radial artery and contained in a commercially available arterial blood collection syringe with a lithium-heparin coating. The serum sample was contained in a commercially available vacuum bottle in a non-additive silicone coated tube and transported to the laboratory. The study population was divided into three groups, patients with normal whole blood potassium, patients with decreased whole blood potassium, and patients with elevated whole blood potassium. Potassium levels for each group were coupled with serum potassium levels and compared. Results: No significant difference in potassium values was observed between whole blood and serum samples (P<0.05). Strong associations were observed among the three groups (normal range, hypokalemia, and hyperkalemia group). Compared to the normal group (r=0.851), the hyperkalemia group showed a stronger association between variables (r=0.897), and the hypokalemia group showed a weaker association (r=0.760). Their correlation coefficients were highly significant (P<0.05). Conclusion: Our study illustrates that point-of-care testing using whole blood with whole blood can be a reliable screening tool when treating patients with suspicious potassium abnormality, especially in hyperkalemia patients.
Kim, Young-Min;Kim, Sang-Chul;Park, Kwan-Jin;Lee, Seok-Woo;Lee, Ji-Han;Kim, Hoon
Journal of The Korean Society of Clinical Toxicology
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v.17
no.2
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pp.102-107
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2019
Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.
Purpose - The purpose of this study is to analyze the effects of non-tariff barriers on the Free Trade Agreement. Currently, it has achieved significant export effects by signing free trade agreements with many countries in Korea. However, most countries have implemented non-tariff barriers to protect their industries. This study analyzes the effects of non-tariff barriers in counterpart countries that have signed a free trade agreement. Design/methodology/approach - For analysis, first, prior studies were summarized, and second, the current status of free trade agreements and non-tariff barriers were identified. And, based on the current situation, the relationship between non-tariff barriers and export volume was analyzed. The targets of analysis are the United States, China, and Vietnam, which are Korea's three largest exporters. As for non-tariff barriers, anti-dumping tariffs, countervailing tariffs, and emergency import restrictions were analyzed as import regulatory measures. Findings - In the case of the United States, it can be seen that the decline in textiles, steel and electronics sectors is even greater. In the case of China, it can be seen that exports declined after imposing non-tariff barriers in the steel sector. Finally, it can be seen that exports declined after Vietnam implemented a non-tariff barrier on the steel sector. It was found that non-tariff barriers offset the effects of the Free Trade Agreement. Research implications or Originality - Currently, Korea has free trade agreements with numerous countries. However, after the free trade agreement entered into force, the number of annual average import regulation investigations for Korean products is on the rise. In the end, the implementation of non-tariff barriers is offsetting the effects of free trade agreements. Therefore, when signing a free trade agreement, it is necessary to thoroughly prepare for import regulatory measures such as the insertion of provisions of non-tariff barriers.
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