• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.306-308
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• 2022

본 연구는 기관내삽관(Endotracheal intubation) 시 환자의 자세인 냄새맡는자세(Sniffing position)와 특별 제작된 기구를 사용하여 만든 수정된 경사면자세(Modified ramped position)을 비교·분석하여 전문기도술 수행을 향상시키는 데 목적이 있다. 연구대상은 전문심장소생술 및 전문기도관리학을 이수한 N대학교 응급구조학과 학생 30명을 대상으로 무작위 교차 방법(Randomized crossover study)으로 실험을 진행하였다. 연구결과 수정된 경사면자세에서 냄새맡는자세보다 더 나은 성문시야를 보였으며, 그에 따른 신속성에도 유의미한 차이를 보였다. 연구대상자의 주관적인 용이성, 자신감 그리고 선호도에서도 냄새맡는자세보다 수정된 경사면자세에서 더 향상된 결과를 나타냈다. 따라서 기관내삽관 시 환자를 수정된 경사면자세로 취할 경우 전문기도술 수행을 향상 시키는데 도움이 될 것 으로 사료된다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• 동의생리병리학회지
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• 제18권3호
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• pp.734-739
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• 2004

In the present study, the author intended to investigate whether two oriental medical prescriptions named socheongryong-tang(SCRT) and Kamichihyo-san(KCHS) significantly affect mucin release from cultured hamster tracheal surface epithelial(HTSE) cells. Confluent HTSE cells were metabolically radiolabeled with ³H-glucosamine for 24 hrs and chased for 30 min in the presence of SCRT or KCHS to assess the effect of each agent on ³H-mucin release. Possible cytotoxicities of each agent were assessed by measuring lactate dehydrogenase(LDH) release. Also, the effects of SCRT and KCHS on contractility of isolated tracheal smooth muscle were investigated. The results were as follows: (1) SCRT significantly inhibited mucin release from cultured HTSE cells, without cytotoxicity; (2) KCHS significantly increased mucin release without cytotoxicity; (3) SCRT and KCHS did not affect contractility of isolated tracheal smooth muscle. We suggest that the effects of SCRT and its components should be further investigated and it is of great value to find, from oriental medical prescriptions, novel agents which have the possible inhibitory effects on mucin release from the viewpoint of management of hypersecretion of airway mucus.

• 한국응급구조학회지
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• 제24권1호
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• pp.67-76
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• 2020

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider's essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.871-874
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• 2011

Purpose: In some patients with velopharyngeal insufficiency (VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure (CPAP) is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. Methods: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation, nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during follow-up of more than a year after CPAP therapy. Results: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. Conclusion: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy, but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.

• 대한두개안면성형외과학회지
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• 제17권4호
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• pp.202-205
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• 2016

Background: Packing after closed reduction of nasal fracture causes uncomfortable nasal obstruction in patients. We packed the superior meatus with synthetic polyurethane foam (SPF) to support the nasal bone, and packed the middle nasal meatus with a nasal airway splint (NAS) and SPF. The aim of this article is prospectively to compare the subjective patient discomfort of SPF (Nasopore Forte plus) packing alone and SPF with NAS. Methods: We compared the prospectively subjective patient discomfort of SPF packing alone (group A) and SPF with NAS (group B) via visual analog scale (VAS; 0, no symptom; 100, most severe symptom). Results: At first postoperative day group B showed significant lower scores in dry mouth, sleep disturbance, conversation difficulty. However at third postoperative day, VAS scores of each group had no statistically significant differences. Moreover at fifth postoperative day group A had statistically significant lower scores for nasal pain, dry mouth than the group B. Conclusion: Combination method of using NAS and SPF have some advantage on the patient comfort from first postoperative day to third postoperative day.

• 대한두경부종양학회지
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• 제34권1호
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• pp.45-47
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• 2018

Thyroid hematoma secondary to a blunt trauma is a rare problem. Despite the rarity, it can be a life-threatening condition with tracheal compression. Both surgical exploration and conservative management have been suggested for thyroid hematoma. However, there is still controversy on the optimal treatment. A 67-year old man who progressed severe dyspnea and neck swelling was transferred to the emergency department with a blunt anterior neck trauma after traffic accident. Contrast enhanced neck computed tomography scan showed huge hematoma within the right thyroid gland and slight tracheal deviation without prominent airway obstruction. One day later, anterior neck swelling was aggravated and the patient was intubated to prevent airway obstruction. After 3 days, hematoma resolution was revealed and extubation was done. We report this case with a review of literature.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권2호
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• pp.101-103
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• 2015

In oral and maxillofacial surgery, many complications associated with nasotracheal tube can be caused. In this case, we reported ballooning tube damage of nasotracheal tube during orthognathic double-jaw surgery and replacement of tube through cut down of tube and tube exchange using airway exchange catheter. The patient scheduled for high Le Fort I osteotomy and bilateral sagittal split osteotomy was intubated nasotracheally with nasal endotracheal tube. During maxilla osteotomy, air bubble was detected in the oral blood. In spite of our repeated ballooning, the results were the same so we changed damaged tube using airway exchange catheter aseptically. Tiny and superficial cutting site was detected in the middle of pilot tube. As we know in our case, tiny injury impeded a normal airway management and prevention is important.

• 한국응급구조학회지
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• 제2권1호
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• pp.26-35
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• 1998

This study was to exhibit the effective emergency care method for the drowning and non-drowning who are reached two-thousand peoples every year in our country. For investigate the effective emergency care, this study was discussed as follows ; Pathophysiology of the water submersion, Fresh-water & sea-water drowning, Factors affecting survival, and Prehospital management. The conclusions from this study were summarized as follows; 1. Remove the patient from the water. If you suspect neck or spinal injuries, Always support the head and neck level with the back and, begin rescue breathing. 2. Maintain the airway and support ventilation in the water use the jaw-thrust technique to avoid farther injury to the neck or spine. We might encounter more resistance to ventilations than you expect because of water in the airway. Once you have determined that there are no foreign objects in the airway, apply ventilations with more force; adjust ventilations until you see the patient's chest rise and fall but not until you see gastric distention. Do not attempt to remove water from the patient's lungs or stomach. 3. If there is no pulse, begin CPR. 4. Administer high-flow supplemental oxygen; suction as needed. 5. Once the patient is breathing and has a pulse, assess for hemorrhage; control any serious bleeding that you find. 6. Cover the patient to conserve body heat, Handle the patient very gently, and, Transport the patient as quickly as possible to Emergency Department, Continuing resuscitative measures during transport. If the patient have the hypothermia, follow hypothermia management.

• 한국컴퓨터정보학회논문지
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• 제24권10호
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• pp.167-174
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• 2019

본 연구는 기관 내 삽관 수행 시 성공률에 영향을 미치는 신체적 요인에 대해 알아보기 위한 비동등성 단일군 사후 유사 실험연구이다. 연구결과 기관 내 삽관을 성공적으로 수행한 시간과 신체적 요인은 상관관계가 있는 것으로 나타났다. 특히 기관 내 삽관 수행 시 수행자의 팔의 각도는 수행시간에 영향을 미쳤으며, 팔의 각도가 좁아질수록 수행시간이 짧아지는 결과를 보였다. 기관 내 삽관 수행 시 수행자의 팔의 각도를 줄일 수 있도록 노력한다면 성공적인 기관 내 삽관을 시행할 수 있을 것이다. 하지만 다양한 환경 및 직군에 대한 추가적인 후속 연구를 통해 임상적 활용의 가능성을 확인해야 할 것이다.