• Title/Summary/Keyword: emergency response

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Clinical Analysis of Patients with Cardiotoxicity Caused by Himalayan Mad Honey (히말라야산 석청 복용 후 발생한 심장독성 환자들의 임상적 특성 분석)

  • Kim, Sung Ho;Seo, Dong Woo;Ryoo, Seung Mok;Kim, Won Young;Oh, Bum Jin;Lim, Kyoung Soo;Sohn, Chang Hwan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.2
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    • pp.119-126
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    • 2013
  • Purpose: The aim of this study was to evaluate the clinical characteristics and outcome of patients who presented to the emergency department (ED) with cardiotoxicity caused by ingestion of Himalayan mad honey. Methods: Medical records of 12 patients who presented to the ED from January 1, 2005 to December 31, 2012 with cardiotoxicity caused by ingestion of Himalayan mad honey were retrospectively reviewed. Results: The mean age of patients was 54.5 years and 58.3% were men. The median amount of mad honey ingested was 30.0 cc, and the mean time from ingestion to onset of symptoms was 39.4 minutes. All patients had hypotension and bradycardia upon arrival in the ED. The initial electrocardiogram showed sinus bradycardia in seven patients, junctional bradycardia in four patients, and atrial fibrillation with slow ventricular response in one patient. Four patients were treated with intravenous normal saline solution only. Eight patients were treated with intravenous normal saline solution and atropine sulfate in a dose ranging from 0.5 to 2.0 mg. Blood pressure and pulse rate returned to normal limits within 24 hours in all patients. Conclusion: Our study showed that all patients with cardiotoxicity caused by ingestion of Himalayan mad honey had severe hypotension, bradycardia, and bradyarrythmias, including sinus bradycardia and junctional bradycardia and all patients responded well to conservative treatment, including intravenous normal saline solution and intravenous atropine sulfate.

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Significance of Biomarkers as a Predictive Factor for Post-Traumatic Sepsis

  • Lee, Kyung-Wuk;Choi, Sung-Hyuk;Yoon, Young-Hoon;Kim, Jung-Youn;Cho, Young-Duck;Cho, Han-Jin;Park, Sung-Jun
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.166-173
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    • 2018
  • Purpose: Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients. Methods: This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient's blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week. Results: A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ${\geq}15$). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups. Conclusions: MIF may be considered as a predictive factor for sepsis in trauma patients.

The Prevalence of Post-traumatic Stress Disorder Among Emergency Room Workers and Factors Contributing to Its Occurrence (응급실 근무자의 외상 후 스트레스장애 유병률 및 발생 기여 요인)

  • Ko, Dong-Ryul;Kim, Gun-Bae;Lee, Ji-Hwan
    • Quality Improvement in Health Care
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    • v.27 no.1
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    • pp.10-19
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    • 2021
  • Purpose: This study was designed to investigate that the prevalence of Post-traumatic stress disorder (PTSD) and occupational environmental factors that contribute to the developing of PTSD in workers who worked in emergency room in Korea. Methods: This study is a multicenter cross-sectional study that was conducted in three emergency rooms. Data was collected by self-response method through questionnaire. The Impact Event Scale-Revised was used to screen the high-risk group of PTSD. Univariate and multivariate regression analysis was used to identify the factors associated with the developing of high-risk group of PTSD. Results: Total 211 subjects responded to the questionnaire. Of these, 170 subjects experienced psychological trauma event (PTE) in the working environment. And 60 subjects classified as high risk group of PTSD, so a prevalence of high risk group for PTSD was 28.4%. Factors related to the high risk group of PTSD were the frequency of psychological trauma events experienced over the past 1 year and the high score of QIDS-SR16. Conclusion: The prevalence of high risk group for PTSD among emergency room workers in Korea is very high. This may adversely affect the safety of patients, so early screening and intervention are necessary.

The present condition analysis of patients who transferred to the emergency room by 119 Rescue service at night - Focused on the Emergency Center of Chonnam National University Hospital - (119 구급대를 이용하여 야간에 응급실로 내원한 환자 현황 분석 - 전남대학교병원 응급의료센터를 중심으로 -)

  • Yoon, Jonggun;Kim, Gunnam;Kim, Kyungwan;Jeong, Yongtae
    • The Korean Journal of Emergency Medical Services
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    • v.8 no.1
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    • pp.117-126
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    • 2004
  • In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

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A Study on the necessity of development for the Curriculum related to Marine Transportation of Radioactive waste (방사성폐기물 해상운송과 관련된 교육과정 개발의 필요성에 대한 연구)

  • KIM, Jin-kwon;HONG, Jeong-Hyuk;KIM, Won-Wook;KIM, Jong-Kwan;LEE, Chang-Hee
    • Journal of Fisheries and Marine Sciences Education
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    • v.29 no.3
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    • pp.920-931
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    • 2017
  • Since the export of Korean-type APR 1400 in 2009 to the UAE, Korea has been achieved management performance, quality inspections, training, nuclear fuel exports for the nuclear power plant. Despite this apparent growth, there are lacking of the research on the marine transportation of radioactive waste. And the terrible accident at the Japan nuclear power plant in 2011 has caused another reconsideration such as emergency response training and plan, reinforcement of safety regulation. According to the Korean government aims to rebuild the appropriate regulation, training, education that is necessary in order to ensure the safety of marine transportation of radioactive waste. Therefore, this study analyzed the various problems identified by the team of experts for the radioactive waste and marine field, the investigation of relevant legal basis, the need for emergency response training for the person in charge of radioactive waste and suggested the simulation-based interactive curriculum during the process of safety verification related to the marine transport of mid- and low-level radioactive waste generated at the Yeon-ggwang nuclear power(Hanbit) plant in 2015.