• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.41-45
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• 2012

Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

• Nuclear Engineering and Technology
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• v.38 no.3
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• pp.231-238
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• 2006

Whole-body exposure to high-dose radiation causes injury involving multiple organs that depends on their sensitivity to radiation. This acute radiation syndrome (ARS) is caused by a brief exposure of a major part of the body to radiation at a relatively high dose rate. ARS is characterized by an initial prodromal stage, a latent symptom-free period, a critical or manifestation phase that usually takes one of four forms (three forms): hematologic, gastrointestinal, or cardiovascular and neurological (neurovascular), depending upon the exposure dose, and a recovery phase or death. One of the most important factors in treating victims exposed to radiation is the estimation of the exposure dose. When high-dose exposure is considered, initial dose estimation must be performed in order to make strategy decisions for treatment as soon as possible. Dose estimation can be based on onset and severity of prodromal symptoms, decline in absolute lymphocyte count post exposure, and chromosomal analysis of peripheral blood lymphocytes. Moreover, dose assessment on the basis of calculation from reconstruction of the radiation event may be required. Experience of a criticality accident occurring in 1999 at Tokai-mura, Japan, showed that ARS led to multiple organ failure (MOF). This article will review ARS and discuss the possible mechanisms of MOF developing from ARS.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.211-218
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• 2018

Objective This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors. Methods This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups. Results No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043). Conclusion A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.109-115
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• 2022

During emergencies, the time from symptom onset to definitive treatment determines the final outcome. Therefore, the emergency medical service (EMS) system in Korea, aims to transfer patients requiring emergency care to appropriate medical facilities within 30 minutes. This is in an attempt to improve the chances of survival and reduce sequelae. We attempted to locate areas vulnerable to prehospital transportation and identify hot spots with high demand for emergency medical helicopters in Jeju, by using a grid-based geospatial analysis. This retrospective cross-sectional observational study employed EMS data of 119 ambulance run sheets spanning from January 1, 2010 to September 30, 2018 in Jeju. The location data of emergency patients was superimposed on the spatial analysis frame using the geographic information system (GIS). Subsequently, the locations of long-distance transfer and delayed transfers to the hospital were analyzed, to identify hot spots where the demand for helicopter emergency services would be high. Of the total analysis targets, 42.2% (20,288 people) took more than 30 minutes from reporting to 119 dispatchers to hospital transfer. As the transfer time interval increased, the patient occurrence time increased in the city of Jeju, increased in Seogwipo, and the ratio of patients/guardians to select a transfer hospital rose with significant differences. This study identified the characteristics related to time delays in prehospital transfer of emergency patients in Jeju, and the areas vulnerable to prehospital emergency care were derived and visualized through spatial analysis using the GIS.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.94-100
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• 2005

Background: Although trauma has been the major cause of death in korea, there are few reports describing the epidemiologic characteristics of trauma victims according to age-group. Thus, this study aimed to describe the epidemiologic characteristics of trauma victims visiting an urban emergency medical center in Korea. Method: This study was conducted with all trauma victims who visited the emergency departments of Asan Medical Center from April 11, 2005 to May 10, 2005. After the subjects were divided into three groups such as child (${\leq}14$ years old), adult(15-64 years old) and elderly(${\geq}65$ years old), the prehospital courses, injury mechanisms, injury severities and clinical results were compared. Result: Among total 5,927 patients who visited the emergency medical center, 896(15.1%) patients were trauma victims. Although child under the age of 15 comprised 28.7% of the total trauma victims, less severe injuries(injury severity score < 9) accounted for 97.7% of the cases. The hospitalization rate for injury among child was 21.5%. however, although elderly aged 65 comprised only 5.9% of the total trauma victims, more severe injuries(injury severity score ${\geq}9$) accounted for 30.2% of the cases. The hospitalization rate for injury among elderly was 56.4%. Conclusion: Patterns of injury and clinical results by age-group were considerably different. less severe and non-hospitalized injuries were more common in child than other age-groups. while severe and hospitalized injuries were common in elderly.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.72-76
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• 2007

Purpose: The purpose of this clinical trial was to evaluate the fixation method for treating alveolar fractures in an emergency department. Methods: The efficiency of using the fixation method was judged on the basis of clinical criteria. Stability, occlusion state, bleeding amount after fixation, operation time, and difficulties during procedural operation were recorded. Results: Eight patients were enrolled in this study. In all instances, the fixation method was effective in bleeding control. Each patient had a noticeable decrement in bleeding. A wire was used for four of the eight patients, and nylon strings was used for the others. The average operation time was 6.3 minutes for the wire patients and 2.8 minutes for the Nylon string patients. No specific problem was identified during the procedural operation. However, the difference in the fixation material influenced the effectiveness of the procedure, the operation time, and the satisfaction of the doctor. Conclusion: In the emergency department, the fixation method using wire or nylon string in the treatment of alveolar fractures is effective in bleeding control

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.2
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• pp.86-90
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• 2012

Purpose: Although Pokeweed intoxication is relatively less severe, there is little data on the clinical presentation of Pokeweed intoxication in Korea. This study examined the clinical aspects to provide basic data for evaluating Pokeweed intoxication. Methods: A retrospective study by a chart review was performed on 19 patients who ingested Pokeweed and presented to an academic emergency department with an annual census of 40,000 between March 2012 and May 2012. Results: Nineteen patients were identified. All patients were intoxicated unintentionally. The most common symptoms were vomiting with diarrhea and abdominal pain. The onset time varied, but occurs 30 minutes to 5 hours post ingestion of Pokeweed. All patients were discharged without fatal complications. Conclusion: Compared to previous reports, most pokeweed poisoning patients complain of gastrointestinal symptoms. Supportive care is the mainstay of the management of pokeweed intoxication. All symptoms were resolved over a 24 to 48 hour period.

• Journal of The Korean Society of Clinical Toxicology
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• v.7 no.2
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• pp.180-182
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• 2009

It is well known that Rhododendron sclippenbashii contains the toxic material grayanotoxin. So, Koreans do not eat it, but they do eat azalea although it contains grayanotoxin. That is why there have been no reports about Rhododendron sclippenbashii intoxication after ingesting it intentionally, not accidentally. In this case, the patient was admitted to the emergency room with several toxic symptoms after intentionally consuming 50 blossoms of Rhododendron sclippenbashii to get rid of thirst. Treatment with saline infusion and atropine was successful and the outcome was favorable enough in this case to produce a complete cure without any sequelae at discharge. But toxic symptoms were seen for 24 hours, although the symptoms usually fade in 9 hours. Therefore, we should carefully treat and observe, for over 24 hours, the patient who intentionally ingests about 50 blossoms of Rhododendron sclippenbashii.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.22-31
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• 2023

Purpose: Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI. Methods: The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study. Results: On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center. Conclusions: The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.