• Journal of Trauma and Injury
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• v.18 no.2
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• pp.161-171
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• 2005

Background: The management of hepatic injuries has changed dramatically during the past two decade after the technologic breakthroughs in radiologic imaging techniques. Recently, the non-operative management of blunt hepatic trauma has become the standard of care in hemodynamically stable patients. We reviewed our experience of the non-operative management of blunt hepatic trauma. And the purpose of this study was to examine the prognostic factors and indicators affecting the decision for treatment modality of emergent hepatic trauma. Methods: The medical records of 84 patients who were treated for blunt hepatic injury at Masan Samsung Hospital from January 2002 to December 2003. The patients were divided two groups, non-operative(Non-OP) and operative(OP), according to the treatment modality. The two groups were compares for age, sex, mechanism of injury, grade of liver injury scale, combined injury, systolic blood pressure, pulse rate, hemoglobin, hematocrit, WBC count, S-GOT, S-GPT, ALP, transfusion amount during initial 24 hours, amount of infused crystalloid fluid, length of ICU stay, length of ward care, morbidity and mortality. The grade of the liver injury were determined by using the organ injury scale(OSI). Results: Among the 84 patients, 46 cases(54.8%) were managed non-surgically, and 3 cases of Non-OP group were treated by transarterial embolization. Between the two groups, there were significant difference in age, injury grade, combined injury, hemoglobin, hematocrit, initial systolic blood pressure, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, and length of ICU care, morbidity and mortality.(p<0.05) The overall mortality rate was 8.3%, but 2.2% mortality in the non-operative group. Conclusion: Non-operative management may be considered as a first choice in hemodynamic stable patients with blunt liver trauma. The reliable indicators affecting the treatment modality of blunt hepatic trauma were systolic BP, Hb, Hct, amount of infused crystalloid fluid, amount of transfusion during the first 24 hours, liver injury grade and combined injury. Strict selection of treatment madality and aggresive monitoring with intensive care unit were more important.

• Proceedings of the Korea Contents Association Conference
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• 2012.05a
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• pp.177-178
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• 2012

응급실을 내원한 중증외상 환자로 등록된 환자 중 중등도 분석의 객관상과 진단을 위한 영상의학검사을 시행 받은 환자를 대상으로 생존군과 사망군을 비교하여 생존의 영향을 미치는 인자에 대하여 알아보고자 하며 진단적 영상의학 검사의 유용성과 적절한 영상의학 검사의 시행시점을 알아보기 위한 것이다.

• Archives of Plastic Surgery
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• v.50 no.2
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• pp.213-215
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• 2023

• Korean Journal of Radiology
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• v.24 no.8
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• pp.752-760
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• 2023

Radiologists and trauma surgeons should monitor for early killers among patients with thoracic trauma, such as tension pneumothorax, tracheobronchial injuries, flail chest, aortic injury, mediastinal hematomas, and severe pulmonary parenchymal injury. With the advent of cutting-edge technology, rapid volumetric computed tomography of the chest has become the most definitive diagnostic tool for establishing or excluding thoracic trauma. With the notion of "time is life" at emergency settings, radiologists must find ways to shorten the turnaround time of reports. One way to interpret chest findings is to use a systemic approach, as advocated in this study. Our interpretation of chest findings for thoracic trauma follows the acronym "ABC-Please" in which "A" stands for abnormal air, "B" stands for abnormal bones, "C" stands for abnormal cardiovascular system, and "P" in "Please" stands for abnormal pulmonary parenchyma and vessels. In the future, utilizing an artificial intelligence software can be an alternative, which can highlight significant findings as "warm zones" on the heatmap and can re-prioritize important examinations at the top of the reading list for radiologists to expedite the final reports.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.1-5
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• 2018

Purpose: Although there has been substantial progress for the treatment of thoracic trauma, the mortality of the penetrating neck injury is still high, has been reported about 10-15%. However, there has not been a report which is reflecting Korean medical present. We retrospectively analyzed the penetrating neck injury patients based on the Korean Trauma Data Base. Methods: Between December 2013 and June 2017 at the trauma center of the Pusan National University Hospital, Busan, Korea, total of 36 patients with isolated low-velocity penetrating neck injuries were included. We analyzed the patients' age, gender, injury mechanism and causes by medical chart review. Results: Among total of 36 patients, 26 (72.2%) were male and 10 (27.8%) were female. Homicidal neck injuries were most common, followed by accidental and suicidal injuries (47% vs. 33% vs. 19%, respectively). All penetrating injuries in our study were low-velocity trauma such as following: knife (n=16, 44.4%); glass or glass bottle (n=11, 30.6%); scissors (n=4, 11.1%); grinder (n=2, 5.6%); and three (8.3%) of miscellaneous injuries. Twenty-seven (75.0%) patients underwent emergency surgery, and only one (2.8%) patient underwent elective surgery. Eleven (30.6) patients were diagnosed with superficial injuries, including six patients who had conservative treatment. Twelve (33.3%) patients had arterial injuries and 10 (27.8%) patients had venous injuries. The patients who had deep injuries showed significant difference against the patient with superficial injury (98.0 vs. 129.1, p=0.008). Conclusions: Low velocity penetrating injury confined to the neck is able to be successfully treated with prompt surgical management. Regardless of the conditions which are evaluated at emergency department, all penetrating neck injury patients should be regarded as urgent surgical candidates.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.13-20
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• 2021

Purpose: Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients. Methods: Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%. Results: Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127). Conclusions: The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

• Journal of Chest Surgery
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• v.52 no.5
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• pp.372-375
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• 2019

A 55-year-old man was admitted to the trauma center after a car accident. Cardiac tamponade, traumatic aortic injury, and hemoperitoneum were diagnosed by ultrasonography. The trauma surgeon, cardiac surgeon, and interventional radiologist discussed the prioritization of interventions. Multi-detector computed tomography was carried out first to determine the severity and extent of the injuries, followed by exploratory sternotomy to repair a left auricle rupture. A damage control laparotomy was then performed to control mesenteric bleeding. Lastly, a descending thoracic aorta injury was treated by endovascular stenting. These procedures were performed in the hybrid-angio room. The patient was discharged on postoperative day 135, without complications.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.123-128
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• 2015

Purpose: Establishment of the trauma system changed quality of trauma care in many countries. As one of the first designated level 1 trauma center in Korea, we analyzed trauma registration data in 2014. Methods: Data was extracted from Korean Trauma Data Base (KTDB) that was started from august 2013. Variables related to demographics and trauma was collected through the year 2014. Results: There were 3269 trauma patients who admitted to our hospital and registered to KTDB in 2014. Median age was 49 years, 64.4% were men, and 90% of patients were blunt in mechanism. Median injury severity score (ISS) was 5, mean revised trauma score (RTS) was 7.65. There were 138 (4.2%) deaths and 87 (2.7%) patients of them was death after admission. Conclusion: This is the first report using KTDB registration from our institution. Trauma volume is appropriate but it should be compared with other trauma centers in Korea. In future national analysis of KTDB is mandatory.

• Child Health Nursing Research
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• v.8 no.2
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• pp.174-182
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• 2002

The purpose of this study was to investigate the experiences of accident and visiting emergency center, and the experiences of education about emergency care for parents. The subjects of this study were 117 mothers whose children are attending 9 different nursery schools or kindergartens. The instrument used in this study was developed by researchers and validated by nursing professor, first aid doctor and the president of nursery school, and consisted of 'most important thing in child rearing' ,'experiences of accident and visiting emergency center', 'type of trauma' and 'need for parent education program' the result of this study were as followed ; 1.There were 70.09％ of the experience of visiting emergency center among the subjects. The cause of visiting emergency center were high fever and convulsion(42.86％), and trauma by accident(28.04％) 2. The most common type of the indoor accident were fall down and slipping(76.92％), the common type of trauma were contusion (76.92％), abrasion(47.01％), laceration(29.06％), dislocation or fracture(12.82％), burn(10.26％), piercing(8.55％). 3.47.01％ of subjects had the experience of education about emergency care for parents. They were educated by child rearing journals (32.72％), small books which were published by hospitals or community health center (25.45％), mass media(21.8％), parent seminar (12.72％), nursery school or kindergarten (5.45％). In conclusion, the need of emergency care for children was strongly found. Therefore, on the basis of above results, the parent education program which fits their cognitive level and their health care needs So, it must be directed on the further study of parents' knowledge about emergency care for children. To enhance the effectiveness of program and accomplish the children's health promotion, advanced instructional media and demonstration must be included.

• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.3
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• pp.81-90
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• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.