To determine the incidence rate of school accidents and its associated factors, a cohort observation was carried out in a boys' high school of a total of 2,324 students for an academic year from March 1986 to February 1987. Data for accidents were collected by the author (school nurse) as students came to the school health station for treatment of accidental injury. Data for school activities were obtained from the diary of academic affairs. A total of 603 students made 1,126 visits to the station for accidental injury during the study period that gave an average 1.9 accidents per student. The average number of visits for accidental injury per day was 5.1 and the incidence rate of accidental injury was 2.2 per 1,000 student days. Each class had about 30 accidents on the average in a year. However there were two classes that had exceptionally high incidence rate of accidents; 54 accidents in one class where 10 athletes were assigned and 58 accidents in the other class where the teacher in charge was On vacation for two months. The highest incidence rate of accident was observed in June (3.4 per 1,000 student days) and the lowest rates were in December and February (1.5 and 0.7 per 1,000 student days, respectively) and there were no appreciable difference by day of week. Accidents were caused by mischief or carelessness of students in 62.2% and by the inappropriate tools and facilities of school in 18.6% . The accidents caused by tools and facilities were mainly due to the antiquated chairs and tables. Referral rate to hospital for severe injury was three times higher in cloudy days and five times higher in rainy days than in clear days. There was almost no accident during the examination period but increased after the examination. Based on these findings, following measures are recommended to prevent school accident: disperse the athletes throughout the classes: should the teacher in charge leave the class for a long period, replace with another teacher who is familiar with the class to keep order; replace or repair the inappropriate tools and facilities; and warn the students for the risk of accident or broadcast music or let the students have light physical exercise to relieve the tension in cloudy or rainy day and after examination.
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.
A 55-year-old man underwent emergent sternotomy due to cardiac tamponade occurring just after an accidental fall from a 10-m height. Tricuspid valve regurgitation was found on echocardiography while he was on mechanical ventilation after the operation. The patient was weaned successfully from mechanical ventilation after tricuspid valve repair under cardiopulmonary bypass. Traumatic tricuspid valve regurgitation is a rare blunt chest injury and its symptoms occur late. Tricuspid regurgitation should be considered as a reason for failure to wean from mechanical ventilation after blunt cardiac trauma.
Kim, Young-Sin;Choi, Se-Min;Kim, Hyung-Min;Youn, Chun-Song;Park, Kyu-Nam
Journal of The Korean Society of Clinical Toxicology
/
v.7
no.2
/
pp.113-120
/
2009
Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.
Background: The incidence and etiology of facial bone fracture differ widely according to time and geographic setting. Because of this, prevention and management of facial bone fracture requires ongoing research. This study examines the relationship between socioeconomic status and the incidence of facial bone fractures in patients who had been admitted for facial bone fractures. Methods: A retrospective study was performed for all patients admitted for facial bone fracture at the National Medical Center (Seoul, Korea) from 2010 to 2014. We sought correlations amongst age, gender, fracture type, injury mechanism, alcohol consumption, and type of medical insurance. Results: Out of the 303 patients meeting inclusion criteria, 214 (70.6%) patients were enrolled in National Health Insurance (NHI), 46 (15.2%) patients had Medical Aid, and 43 (14.2%) patients were homeless. The main causes of facial bone fractures were accidental trauma (51.4%), physical altercation (23.1%), and traffic accident (14.2%). On Pearson's chi-square test, alcohol consumption was correlated significantly with accidental trauma (p<0.05). And, the ratio of alcohol consumption leading to facial bone fractures differed significantly in the homeless group compared to the NHI group and the Medical Aid group (p<0.05). Conclusion: We found a significant inverse correlation between economic status and the incidence of facial bone fractures caused by alcohol consumption. Our findings indicate that more elaborate guidelines and prevention programs are needed for socioeconomically marginalized populations.
Purpose: This study is aimed at life adaptation process of women with the spinal cord injury. Method: The subjects were 6 women in Kyeonggi and they had interview individually. The study was conducted during June to November in 2009 and developed substantial theory in women's life adaptation process by applying ground research methodology. Result: Motivation for such a change was their psychological pain, which is the central phenomenon. Social activities sustained them during such a process, while social support and experience of achievement acted as an intervention condition. During the initial period, they had a vague expectation that the condition of their accidental spinal cord injury would be improved. Then the expectation had failed, they experienced psychological pain, finding out the reality about the disabled and social difficulties awaiting them. Since then they began to love themselves, pursuing a changed life of hope, achievement and serving. Conclusion: Its result is expected to serve as a basic data for rehabilitation nursing, so that they may conduct independent lives, with a love toward themselves. Repetitive research would be necessary concerning the adaptation process of women in order for the criteria presented to become richer, and for the relations among the criteria to become more refined.
Jo, Jun Yeon;Kwon, Yong Sik;Lee, Jin Wook;Park, Jae Seok;Rho, Byung Hak;Choi, Won-Il
Tuberculosis and Respiratory Diseases
/
v.74
no.3
/
pp.120-123
/
2013
Inhalation of toxic gases can lead to pneumonitis. It has been known that methane gas intoxication causes loss of consciousness or asphyxia. There is, however, a paucity of information about acute pulmonary toxicity from methane gas inhalation. A 21-year-old man was presented with respiratory distress after an accidental exposure to methane gas for one minute. He came in with a drowsy mentality and hypoxemia. Mechanical ventilation was applied immediately. The patient's symptoms and chest radiographic findings were consistent with acute pneumonitis. He recovered spontaneously and was discharged after 5 days without other specific treatment. His pulmonary function test, 4 days after methane gas exposure, revealed a restrictive ventilatory defect. In conclusion, acute pulmonary injury can occur with a restrictive ventilator defect after a short exposure to methane gas. The lung injury was spontaneously resolved without any significant sequela.
A survey was conducted to investigate the power tiller accidents. Eight provinces were covered for this study, and 278 power tiller owners were selected randomly by computer random generator. The results are summarized as follows : A. Frequency of accident. (1) Each power tiller had an accident 0.98 times a year and once every 361 hours of use. Higher frequency of accident was found during the miscellaneous operations including the preparation for farming operation, and there was one accident for every 92 hours of use. (2) The power tiller, which are more than six years old, met an accident 1.19 times a year , or one every 311 hours of use. This value was the highest one compared with any other group. (3) Kerosene engine power tillers met an accident 0.97 times a year, or one every 389 hours of use. It was one tie a year, or once every 329 hours of use for diesel engine power tillers. (4) Among diesel-engine power tillers, 10 horse-power group showed a higher frequency tillers. B. Cause of accident (1) The accidents of power tiller were mainly of sefety , which occurred due to the lack of attention during the operation and 47.4% of the total accidents. The next was of accidental, which represented 26.3% of the total accidents. (2) High percentage of safety accidents occurred during the preparation for farming operation including adjustment. Most of the accidental accidents occurred during the transportation. (3) Lower frequency of accident was found in the power tiller group which were operated by the 21-40 years old operator in comparison with that of the power tiller which was operated by other age group. Power tillers which were operated by high school graduates experienced less accidents compared to other education levels. C. Damage by accident (1) Eighty seven pescents of the total accidents caused damage to the power tiller operator , and 13 % of the total accidents caused property damage only. (2) With regard to the damage to the power tiller operator, 73.8% of the total accidents caused light injury but 26.3% caused heavy injury. (3) Accidents which occurred during machine preparation , and farming operations caused minor injury to the operator, but the accidents during transportation caused heavy injury which cost more than 15 days for recovery. (4) Among the 39 accidents , which caused property damage 18 accidents were from the transportation . Among the total property damage accidents 53.8% were light one which cost only less than 1,000 won. (5) The property damage from each accident cost 1,017 won, on the average, with regard to the kinds of operation, the highest property damage occurred during transportation work, with the value of 2, 965won.
Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.
Dae Hyun Kim;Jae-Hyug Woo;Yang Bin Jeon;Jin-Seong Cho;Jae Ho Jang;Jea Yeon Choi;Woo Sung Choi
Journal of Trauma and Injury
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v.36
no.3
/
pp.187-195
/
2023
Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.
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