• 한국응급구조학회지
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• 제24권3호
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• pp.161-169
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• 2020

Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.212-216
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• 2003

자연성 종격동 기종은 젊은 연령에서 주로 직접적인 이유가 없이 발생되는 흔치 않은 질환으로 응급실에서 급성 흉통의 원인으로 감별해야할 질환중의 하나이다. 간혹 응급상황이 발생하여 응급 처치를 받을 수 있다고 하지만 대부분에서 보존적인 치료로 호전이 되는 양호한 질환이기도 하다. 저자들은 15세 남자에게 특별한 유발 요인이 없이 발생하였고 입원치료 없이 응급의료 센터에서 바로 퇴원한 자연성 종격동 기종 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.201-205
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• 2006

Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.

• 대한임상독성학회지
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• 제2권2호
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• pp.77-82
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• 2004

Backgrounds: Deaths from pesticides poisoning has increased annually, but no studies have been reported. Especially paraquat is suspected to be a major material in pesticide poisoning deaths. In Korea, simple epidemiology of pesticides poisoning is not well known. So, there is no effective method to prevent pesticides poisoning. We tried to investigate the present status of pesticides poisoning with data from Korea National Statistical Office and suggest an effective counterplan. Methods: We analysed death cause data derived from Korean Statistical association, deaths causes being pesticides poisoning in the year 2002. Also, we investigated data from internet, mainly from Korea National Statistical Office home page. Results: Total 2,875 persons died after pesticides poisoning in 2002 year. Average age is 54.2 year, standard deviation being 17.7 year. Many victims (about $41\%$) died during the herbicides' non-necessary period (JanuaryMarch, October-December) Conclusion: Herbicides sale should be restricted only during herbicides' necessary period, and so called a pesticides safety supervisor system shall effectively prevent herbicides poisoning.

• 대한임상독성학회지
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• 제2권2호
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• pp.96-100
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• 2004

Purpose: This study was to investigate the effects of ethanol in ingested patients by analyzing data from a single institution's registry, Methods: We conducted a prospective study of 50 patients who has ingested drugs with/without ethanol came to emergency department from January 2004 to May 2004. Only patients over 18 years of age were included. Clinical characteristics, general and specific treatment, laboratory finding, complication, and clinical outcomes were obtained from protocol. Patients were divided into two groups: drug ingested with alcohol (ethanol group, n=18), and ingested without alcohol (non-ethanol group, n=32). Results: The age, the amout of ingestion, the time to treatment, the systolic blood pressure, the diastolic blood pressure and the shock duration were not different between two groups. The AST level with the ethanol group was higher than with the non-ethanol group ($230.94\pm518.88$ U/L vs $43.22\pm63.39$ U/L, p=0.002). The ALT level with the ethanol group was higher than with the non-ethanol group ($97.06\pm152.98$ U/L vs $32.75\pm43.10$ U/L, p=0.001). The lactic acid level with the ethanol group was higher than with the non-ethanol group ($7.40\pm6.33$ mmol/L vs $3.77\pm3.10$ mmol/L, p=0.001). The hospital stay duration and the admission rate were not different between two groups. Conlusions: The ethanol increased the levels of serum AST, ALT and lactic acid in intoxicated patients. But the ethanol dose not increase admission rate and duration of admission stay in intoxicated patients.

• 대한임상독성학회지
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• 제10권2호
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• pp.97-102
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• 2012

Purpose: Serious acetaminophen (AAP) poisoning causes hepatotoxicity. N-acetylcysteine (NAC) is the most effective therapy for AAP poisoning and can be administered orally and intravenously (IV). Several studies have compared the efficacy of these two routes of administration and the results have been controversial. The purpose of this study was to compare the efficacy of oral and IV NAC for the prevention of hepatic toxicity in Korean patients whose serum AAP levels were higher than normal. Methods: A retrospective before/after study was performed, in which the patients presented to the emergency department with an AAP overdose from February 1995 to March 2012. A 3-day oral NAC regimen was used in the beginning, and a 20-hr intravenous regimen was then used from 2007. This study assessed the complications of an AAP overdose, such as hepatotoxicity, hepatic failure and renal failure as well as the side effects of the treatment regimen. Results: A total of 41patients was enrolled in this study. The median ALT and AST were 63 (IU/L) and 57 (IU/L) for the oral NAC treated patients, and 14 (IU/L) and 20 (IU/L) for the IV NAC treated patients (p=0.004 and p=0.001, respectively). The incidence of complications was similar in the treatment groups (p=0.399). Among the patients, 7 patients developed hepatotoxicity and were treated successfully with oral or IV NAC. Conclusion: This study suggests that IV NAC and oral NAC can prevent and successfully treat hepatic toxicity in patients whose serum AAP levels are higher than normal.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.44-50
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• 2009

Purpose: The purpose of this study was to evaluate the causes of blow-out fractures, the computed tomography findings, and the associated facial bone fractures in aged patients. Methods: This study was performed by conducting a chart review. From January 2004 to December 2007, the patients who visited the emergency room of Asan Medical Center and were diagnosed as having a blow-out fracture were included in the study population. Patients 60 years of age or older were grouped as the aged group while patients younger than 60 years of age were grouped as the control group. Results: Between the aged group and the control group, there was a difference in the causes of blow-out fractures. The most common cause of blow-out fracture was a slip down in the aged group and violence in the control group (p<0.05). There were no differences in associated symptoms. Extraocular muscle herniation was the only statistically different computed tomography findings. In associated facial bone fractures, the most common fractures were the zygoma in the aged group and the nasal bone in the control group (p<0.05). Conclusion: In patients 60 years of age or older, the most common cause of blow-out fracture was a slip down, and the most common associated facial bone fracture was a zygomatic fracture.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.139-144
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• 2014

Purpose: Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury. Methods: In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries. Results: The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980). Conclusion: Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.178-185
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• 2014

Purpose: The aim of this study was to assess the clinical efficacy of combined treatment with local anesthesia and ketamine procedural sedation for pediatric facial laceration repair in the Emergency Department (ED). Methods: Patients aged 1 to 5 years receiving ketamine for facial laceration repair were prospectively enrolled in a double-blind, randomized, and controlled study at an ED. All patients were to receive intravenous ketamine (2 mg/kg). The local anesthesia group (LA group) received a local anesthetic along with ketamine, whereas the no local anesthesia group (NLA group) received only ketamine. The total time of sedation, the patients' movements and groans, adverse events, and the satisfaction ratings of physicians, nurses, and parents were recorded. Results: A total of 186 patients were randomized (NLA group: 90, LA group: 96). The total time of sedation (30.5 minutes for the NLA group, 32.6 minutes for the LA group; p=0.660), patients' groans (26 (28.9%) versus 23 (24.0%); 0.446) and movements (27 (30%) versus 35 (36.5%); p=0.350) was not affected by the addition of local anesthesia. Other adverse events were similar between the two groups. Also, the satisfaction ratings of physicians (median 4 for the NLA group versus 4 for the LA group (p=0.796)), nurses (2 versus 2.5 (p=0.400)), and parents (4 versus 4 (p=0.199)) were equivalent between the two groups. Conclusion: In this study, we found that local anesthesia was not required along with ketamine sedation for pediatric facial laceration repair.

• 대한임상독성학회지
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• 제9권1호
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• pp.34-38
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• 2011

Vinegar is a very popular ingredient used in many cuisines. It is also known for its beneficial health, beauty and possible weight-loss properties. The authors report on a patient who presented to the emergency department with unstable vital signs complaining of generalized abdominal pain after ingestion of 450 ml of apple cider vinegar. We documented a case of corrosive gastrointestinal injury with persistent metabolic acidosis occurring after ingesting apple cider vinegar with an acetic acid concentration of 12~14%. Toxic damage to the liver and kidney were also observed, peaking on post-ingestion day 3. The patient received supportive care and hemoperfusion for three days without much clinical improvement and died in the seventh day of intensive care due to disseminated intravascular coagulation and multi organ failure. Edible vinegar, when taken in large amounts, is capable of inducing corrosive injuries of the GI tract as well as severe systemic toxicities, such as metabolic acidosis. Safety precautions regarding vinegar deserve more public attention and clinicians also should be astute enough to recognize the potential damage accompanying vinegar ingestion.