• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.2
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• pp.119-121
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• 2005

Sodium bromate or potassium bromate has been used as hair cold neutralizer. Sodium bromate intoxications occurred in children incidentally early days of marketing, but recently in adult suicidally. This chemical intoxication result in renal failure, ototoxicity, neurotoxicity, hemolytic anemia and so on. We experienced a 39-year-old woman of hairdresser with non-oliguric acute renal failure after ingestion hair neutralizer 500 ml. She received hemodialysis 3 times and discharged without complication on 8th admission days.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.100-106
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• 2015

Objectives : The purpose of this study was to find out the clinical and sociodemographic characteristics of elderly suicide attempters visiting emergency room, compared to non-elderly adult suicide attempters. Methods : We enrolled suicidal attempters who were treated in the emergency room of the Inje University Ilsan Paik Hospital between June 2013 and July 2015. We conducted a retrospective chart review of 336 suicidal attempters, and compared sociodemographic and clinical characteristics between elderly and non-elderly adult suicide attempters. Results : During the study period, 336 patients visited the emergency room of the medical center after suicide attempts. Among these, there were 71 elderly(21.2%) and 265 non-elderly adult(79.8%) suicide attempters. The suicidal methods among elderly were poisoning(73.3%), hanging(19.7%), cutting(5.6%), and jumping(1.4%). Those in non-elderly were poisoning(73.2%), cutting(17.0%), hanging(6.8%), and jumping(3.0%). The elderly suicide attempters had the tendency to choose more dangerous methods and showed higher lethality compared to adult suicide attempters(20.6% vs. 1.9%, ${\chi}^2=34.565$, p<0.05). On the other hand, premorbid psychiatric disorders had been more commonly diagnosed in non-elderly adults than elderly suicide attempters(49.8% vs. 26.8%, ${\chi}^2=12.024$, p<0.05). Conclusions : The results provide evidence of different sociodemographic and clinical characteristics of elderly suicide attempters compared to non-elderly ones visiting the emergency room. Through this study, it can be seen that the suicide attempt in the elderly tends to be severer than in the non-elderly, but only a small portion of them seek for help from psychiatric intervention. Further study is required to provide effective suicide prevention programs for elderly population.

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.39-50
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• 2017

Purpose: This study measured awareness of automated external defibrillators (AED) among students majoring in health-related versus non-health-related fields. Methods: A total of 577 students filled out a questionnaire on awareness of AEDs between June 12 and June 28, 2017. Using SPSS 23.0, data were analyzed using descriptive statistics, chi-square tests, and t-tests. Results: In response to a question about awareness of AED, 25.0% of students majoring in a health-related and 38.6% of those majoring in a non-health-related field answered on "I have seen or heard" and "I have no idea". In response to a question on perception on AED use, 82.4% of students majoring in a health-related field and 88.1% of those in a non-health-related field reported that they thought perception of AED use was not universal. In terms of experience with education on the use of AED, 30.2% of health-related majors and 49.7% of non-health-related majors had not received any training on the use of AED. The average overall score regarding knowledge about AED was 8.69 for health-related majors, compared to 7.79 for non-health-related majors. Conclusion: In order to improve awareness regarding AED use, education on importance and necessity of AED should be emphasized and implemented consistently by the mass media.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.1
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• pp.23-27
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• 2013

Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.77-84
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• 2014

Purpose: Carbamate insecticides are potent cholinesterase inhibitors capable of causing severe cholinergic toxicity. Use of carbamate rather than organophosphate insecticides has been increasing. Compared with organophosphate poisoning, relatively few studies have investigated carbamate-associated acute pancreatitis. We investigated general characteristics and pancreatitis of carbamate poisoning and the predictors, among those readily assessed in the emergency department. Methods: We performed a retrospective review of consecutive patients, aged over 18 years, who were admitted between January 2008 and April 2012 to an emergency department (ED) of an academic tertiary care center for treatment of carbamate poisoning. Patients who exhibited poisoning by any other material, except alcohol, were excluded. After application of exclusion criteria, patients were divided according to carbamate-induced pancreatitis and non-pancreatitis groups. Results: A total of 41 patients were included in this study. Among these 41 patients, the prevalence of acute pancreatitis was 36.6% (15 patients). Initial blood chemistry tests showed a statistically higher glucose level in the pancreatitis group, compared with the non-pancreatitis group (222, IQR 189-284 vs. 137, IQR 122-175 mg/dL, P<0.05). Regarding clinical courses and outcomes, a significantly higher proportion of patients developed pneumonia [10 (66.7%) vs. 6 (23.1%), P<0.05] and had a longer hospital stay (7 days, IQR 6-12 vs. 5 days, IQR 2-11, P<0.05), but no difference in mortality, in the pancreatitis group vs. the non-pancreatitis group. In multivariate analysis, the initial glucose was showing significant association with the presentation of carbamate-induced acute pancreatitis (odds ratio 1.018, 95% confidence interval 1.001-1.035, P<0.05). Conclusion: Carbamate-induced acute pancreatitis is common, but not fatal. Initial serum glucose level is associated with acute pancreatitis.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.22-27
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• 2008

Purpose: Treatment and prognosis in patients with pelvic bone fracture depend on the characteristics of the fracture and the stability of the pelvic ring. The purpose of this study is to analyze the characteristics of and the relationships between fracture patterns, injury mechanisms, clinical courses, and prognoses according to the hemodynamic pattern. Methods: Between January 2004 and September 2006, 89 patients under diagnosis of pelvic bone fracture were retrospectively analyzed on the basis of medical records and radiologic examinations. Patients with confirmed hemorragic shock with a systolic pressure of less than 90 mmHg were defined as the shock group. Young's classification was used to characterize fracture patterns. Factors relating to the clinical manifestation and to treatments such as transfusion and surgery were analytically compared. Results: The mean age of the patients was $48.8{\pm}18.7$, among which 49 (55.1%) were male. The numbers of shock and non-shock patients were 35 (39.3%) and 54 (60.7%) respectively. Eighteen (51.4%) of the shock patient had injuries resulting from pedestrian accidents (p=0.008). According to Young's classification, lateral impact fractures amounted to 20 and 33, front-rear impact fractures to 9 and 20, and multiple fractures to 6 and 1 among the shock and non-shock patients, respectively (p=0.027). Thirty-nine (39) cases in non-shock injuries were conservatively managed while 18 cases in shock injuries were surgically treated. In the shock group, the liver and the kidney were often damaged, as well. Among the shock patients, the average admission period was $7.5{\pm}8.7days$ in intensive care and $55.1{\pm}47.9days$ in total, which were longer than the corresponding numbers of days for the non-shock patients (p<0.05). No deaths occurred in the non-shock group while 5 deaths (14.2%) occurred in the shock group (p=0.007). Conclusion: The factors affecting hemodynamic instability in patients with pelvic bone fracture are injury mechanism, classification of fracture, and associated injuries.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.81-86
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• 2005

Background: Cardiac troponin I (cTnI) is a sensitive cardiac marker of myocardial injury. In normal coronary angiogram, positive cTnI values may be detected in various events such as sepsis, stroke, trauma and so on. To investigate characteristics of cTnI positive group in trauma patients, we designed this study between cTnI positive group and cTnI negative group. Method: Trauma patients who visited emergency room within 24 hours after accidents were included. Patients who had renal failure, acute coronary syndrome, sepsis, spontaneous SAH were excluded. Retrospective study of 97 trauma patients was done. We investgated ISS (injury severity score), positive cTnI, EKG abnormality, shock class, ICU admission rate and mortality. Result: In comparing with non chest trauma group, chest trauma group, whose chest AIS (Abbreviated Injury Score) is more than 3 point, had significant values in ISS, positive cTnI, EKG abnormality, shock class and ICU admission rate. Also, in non chest trauma group, we found several patients whose cTnI level was positive. When non chest trauma group was divided into two subgroups, the mortality and shock class of positive cTnI group were higher than that of negative cTnI group. When all trauma patients were divided into two groups, a positive cTnI group had higher values in ISS, shock class, ICU admission rate and mortality than that in a negative cTnI group. Conclusion: We found that cTnI were positive in patients of cardiac contusion but also in various trauma cases. In non chest trauma patients, we assumed that hypotension caused cTnI elevating. The cTnI could play a role in predicting prognosis in trauma patients.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.500-508
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• 2018

Objective: The aim of this study was to evaluate the clinical characteristics of heat stroke in a bath facility and investigate predictive factors of multiple major complications in heat stroke patients. Methods: This was a retrospective study on heat stroke patients who visited an urban emergency center from January 2010 to March 2018. We compared clinical characteristics, complication, and outcomes of heat stroke patients in bath and non-bath facilities. Multivariate logistic regression analysis were performed to identify independent predictors of multiple major complications in heat stroke patients. Results: A total of 67 heat stroke patients with heat stroke were enrolled, of which 42 (62.6%) were in a bath facility and 25 (37.3%) were in a non-bath facility. Patients with heat stroke in the bath facility were characterized by old age, past medical history of hypertension and diabetes mellitus, and high incidence of hypotension compared with those in the non-bath facility but also low incidence of acute renal failure, seizure, and multiple major complications. In the multivariate analysis, predictive factors of multiple major complications in heat stroke patients were non-bath facility (odds ratio [OR], 5.4; 95% confidence interval [CI], 1.2-29.9), Glasgow Coma Scale (GCS)${\leq}8$ (OR, 8.2; 95% CI, 1.3-49.4), and mean arterial pressure (MAP), body temperature above $40.5^{\circ}C$ (OR, 8.1; 95% CI, 1.1-58.8) <60 mmHg (OR, 14.8; 95% CI, 1.8-122.9). Conclusion: Heat stroke in the bath facility resulted in less major complications, and high body temperature, GCS ${\leq}8$, and MAP <60 mmHg were independent predictive factors of multiple major complications in heat stroke patients.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.79-88
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• 2020

Purpose: The study aimed to collect the first aid activity log data of patients who were retransferred through paramedics and to analyze the data in the hospital to improve the plan. Methods: We analyzed 434 retransferred patients, out of the 18,197 patients who visited the emergency medical center in the C area in G metropolitan city, from January 2017 through December 2018. The collected data were analyzed using the SPSS software. Results: The patients were retransferred for various reasons: 17.7% (77 cases) due to the absence of specialists, 15.0% (65 cases) required first aid, and 5.3% (23 cases) due to absence of medical department. In addition, the major medical department with the largest number of retransfer was the department of emergency medicine with 38.2% (166 cases). In the prehospital stage, 38.5% (167 cases) were classified as severe, but in the hospital stage, they were classified as mild. In addition, as a result of hospitalization and discharge, 60.4% (262 cases) were discharged. Conclusion: Most of the retransferred patients were non-emergency patients, and were discharged for mild conditions. The overcrowding in the emergency room of a tertiary hospital can be prevented by reducing the retransmission.

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.77-95
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• 2024

Purpose: This study aimed to analyze the counseling status of overseas Koreans using emergency medical counseling services, identify frequently occurring types of diseases, explore approaches to emergency treatment guidance, and protect overseas Koreans from medical blind spots, thereby enhancing the quality of emergency medical counseling services. Methods: This study was approved by the Institutional Review Board of Kongju National University (KNU_IRB_2023-31), and data were collected and analyzed from 10,951 cases of emergency medical counseling services utilized by overseas Koreans from the National Fire Agency from 2018 to 2022. Results: Emergency medical consultation services for overseas Koreans included a majority of non-trauma patients, with medical consultations being predominant. Terrestrial patients commonly seek advice for internal medical symptoms, whereas maritime patients frequently present with trauma-related symptoms, with a higher incidence of cardiac arrest and altered consciousness cases at sea. The development of self-diagnostic tests based on internal medicine symptoms is necessary for terrestrial patients, whereas stakeholder education is required for maritime patients. Conclusion: Due to the different types of diseases occurring in terrestrial and maritime patients, emergency medical consultation services for overseas Koreans should be implemented according to the specific characteristics of each patient. Therefore, it is necessary to develop and disseminate response manuals that are tailored to medical and trauma-related symptoms.