• Title/Summary/Keyword: injury characteristics

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The Choice of Management in Patients with Splenic Blunt Trauma : A Single Center Study (외상성 비장 손상 환자의 치료방법의 선택: 단일 기관 연구)

  • Jang, Ji Young;Lee, Seung Hwan;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.280-285
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    • 2013
  • Purpose: Nowadays, non-operative management increases in patients with blunt splenic injury due to development of diagnostic and interventional technique. The purpose of this study is to evaluate the management in patients with blunt splenic injury and effect of clinical state such as shock on the choice of management. Methods: From April 2007 to July 2013, we retrospectively reviewed the medical charts of fifty patients who had splenic injury after blunt trauma. The demographic characteristics, American Association for the Surgery of Trauma (AAST) grade of splenic injury, management method (emergency operation, angiographic embolization or observation) and clinical outcome were analyzed. Results: The mean age was $41.5{\pm}21.4$ years and male was 44(88%). Twenty patients(40%) were in shock condition initially and five patients(10%) underwent emergency operation due to hemodynamic instability. Emergency angiographic embolization was performed in 20 patients(40%) and 25 patients were managed conservatively. When patients were divided into shock group (SG) and non-shock group (NSG), Patients in SG had significantly higher serum lactate level and base deficit than NSG (lactate; $4.5{\pm}3.4$ mmol/L, base deficit; $5.8{\pm}4.4$ mmol/L vs $1.9{\pm}1.4$ mmol/L, $2.8{\pm}2.5$ mmol/L, p=0.007, p=0.013). There was no significant difference of AAST grade and contrast blush rate in abdomen CT between two groups. Among 45 patients with non-operative management, four patients(8.9%) got delayed angiographic embolization and 3 patient died from companied organ injury. Conclusion: Non-operative management can be acceptable management option in patients with splenic blunt trauma under intensive hemodynamic monitoring.

Dental trauma patients visiting the emergency room in H hospital (H 병원 치과응급실에 내원한 치아 외상 환자에 대한 임상적 고찰)

  • An, So-Youn;Kim, Ah-Hyeon;Shim, Youn-Soo
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.5
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    • pp.819-826
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    • 2013
  • Objectives : The purpose of this study was to analyze the types of dental emergencies. This study was carried out for dental trauma patients visiting the emergency room in H hospital from 2005 to 2006. Methods : Subjects were 252 patients. Demographic characteristics consisted of age, gender, dentition, and dental related injury. Results : Male patients had 1.65 times higher tooth injury than female. Teenagers had higher prevalence of tooth injury. Main cause of dental injury was falling down. Young children accounted for 41.7% of the injuries. Late evening was the highest outbreak time of injury. The most commonly affected teeth were central incisor and lateral incisor. The damage of oral soft tissue was more common than the that of alveolar bone. Main area of primary tooth loss was gingiva(10.7%), tongue or soft palate(7.5%), and frenulum(6.0%). Subluxation(28.6%) and luxation(28.6%) were main cause for the primary teeth. Tooth fracture(50.0%) were the most common injury. Conclusions : Thus, to understand the incidence, causes and patterns of dental trauma is to help preserving natural teeth. The results of this study could provide the clinical guidelines on the treatment of dental emergency patients.

A Strategy for Exposure Assessment of Humidifier Disinfectant Associated to Health Effects (가습기 살균제 건강 피해 조사에서 노출 평가 방법 고찰)

  • Park, Dong-Uk
    • Journal of Environmental Health Sciences
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    • v.44 no.2
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    • pp.107-114
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    • 2018
  • Objectives: The objectives of this study are to describe strategy for exposure assessment of humidifier disinfectant (HD) used in the national program to associate the use of HD with lung injury. Methods: Strategy and method employed to evaluate HD use characteristics were developed to associate health effects including HD associated with lung injury (HDLI). We developed HD-specific questionnaire to assess potential HD exposure, which was consistently used in the national program. Trained environmental health scientists visited the residences of registered subjects and investigated HD use characteristics. Results: Major HD exposure related variables were type of HD brand/s used; HD volume added to the humidifier, frequency of HD addition, and time spent in room/s with the humidifier; duration of HD use in the household in average months/year, weeks/month, and days/week; average sleeping hours in a room with an operating humidifier containing a disinfectant; number of HD brands used and type of HD; average distance of the bed from the humidifier in meters. Conclusions: We concluded that estimated airborne HD concentration was significantly associated with the risk of HDLI.

Hazardous Factors and Accident Severity of Cabling Work in Telecommunications Industry

  • Kim, Yang Rae;Park, Myoung Hwan;Jeong, Byung Yong
    • Journal of the Ergonomics Society of Korea
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    • v.35 no.3
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    • pp.155-163
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    • 2016
  • Objective: This study aims to draw the characteristics of occupational accidents occurred in cabling work, and assess accident severity based on occupational injury data. Background: Accident factors and accident risk are different by the place of work in cabling work. Field managers require information on accident prevention that can be easily understood by workers. However, there has been a lack of studies that focus on cabling work in Korea. Method: This study classifies 450 injured persons caused in cabling work by process, and analyzes the characteristics of occupational injuries from the aspects of age, work experience and accident type. This study also analyzes accident frequency and severity of injury. Results: Results show that preparing/finishing (33.3%) was the most common type of cabling process in injuries, followed by maintenance (28.4%), routing/income (23.1%) and wiring/installation (15.1%) process. The critical incidents in the level of risk management were falls from height in the routing/incoming process, and falls from height in the maintenance process. And, incidents ranked as 'High' level of risk management were slips and trips, fall from height and vehicle incident in the preparing/finishing process, and fall from height in the wiring/installation process. Conclusion and Application: The relative frequency of accident and its severity by working process serve as important information for accident prevention, and are critical for determining priorities in preventive measures.

Biomechanics of stabbing knife attack for trauma surgeons in Korea: a narrative review

  • Kun Hwang;Chan Yong Park
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.1-5
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    • 2024
  • The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

Intervention of Nonsuicidal Self-Injury in School Counseling (비자살성 자해(NSSI)에 대한 학교상담에서의 개입)

  • Ryu, Shinhye;Bae, Seung Min;Jun, Jin Yong;Im, Woo-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.1
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    • pp.1-6
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    • 2022
  • Recently, nonsuicidal self-injury (NSSI) has been increasing considerably in school counseling. According to the Youth Counseling and Welfare Development Institute, the number of counseling support for NSSI adolescent in 2018 was more than three times higher than the previous year, and the average time when NSSI behavior first appeared was 12.43 years old. As such, adolesnect NSSI continues to increase in recent years, and the age is also gradually decreasing. Nevertheless, research on the motives and characteristics of NSSI among domestic adolescents is still insufficient. This may be attributed to the difficulty of conducting research because self-injury behavior is secretly performed. However, it is also true that this reality has another limitation in the school field, which urgently requires counseling intervention and prevention of students' mental health problems. In addition, counseling for self-injury in the school scene is the biggest cause of exhaustion for counselors because they are under very great stress to cope with repeated self-harm in the dual role of counselors and teachers in school situations. Therefore, this study examines the causes and characteristics of involuntary self-injury through previous research analysis, and examines various difficulties experienced as a school counselor, as well as the effective intervention method of non suicidal self-injury in school counseling.

Clinical Analysis of Patients with Abdomen or Neck-penetrating Trauma (복부와 경부 관통상 환자에 대한 임상적 고찰)

  • Noh, Ha-Ny;Kim, Kwang-Min;Park, Joon-Beom;Ryu, Hoon;Bae, Keum-Seok;Kang, Seong-Joon
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.107-112
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    • 2010
  • Purpose: Recently, the change to a more complex social structure has led to an increased frequency of traumas due to violence, accident and so on. In addition, the severity of the traumas and the frequency of penetrating injuries have also increased. Traumas to cervical and abdominal areas, what are commonly seen by general surgeons, can have mild to fatal consequences because in these areas, various organs that are vital to sustaining life are located. The exact location and characteristics of the injury are vital to treating patients with the trauma to these areas. Thus, with this background in mind, we studied, compared, and analyzed clinical manifestations of patients who were admitted to Wonju Christian hospital for penetrating injuries inflicted by themselves or others. Methods: We selected and performed a retrospective study of 64 patients who had been admitted to Wonju Christian Hospital from January 2005 to December 2009 and who had cervical or abdominal penetrating injuries clearly inflicted by themselves or others. Results: There were 51 male (79.7%) and 13 female (20.3%) patients, and the number of male patients was more dominant in this study, having a sex ratio of 3.9 to 1. The range of ages was between 20 and 86 years, and mean age was 43.2 years. There were 5 self-inflicted cervical injuries, and 19 self-inflicted abdominal injuries, making the total number of self-inflicted injury 24. Cervical and abdominal injuries caused by others were found in 11 and 29 patients, respectively. The most common area involved in self-inflicted injuries to the abdomen was the epigastric area, nine cases, and the right-side zone II was the most commonly involved area. On the other hand, in injuries inflicted by others, the left upper quadrant of the abdomen was the most common site of the injury, 14 cases. In the neck, the left-side zone II was the most injured site. In cases of self-inflicted neck injury, jugular vein damage and cervical muscle damage without deep organ injury were observed in two cases each, making them the most common. In cases with abdominal injuries, seven cases had limited abdominal wall injury, making it the most common injury. The most common deep organ injury was small bowel wounds, five cases. In patients with injuries caused by others, six had cervical muscle damage, making it the most common injury found in that area. In the abdomen, small bowel injury was found to be the most common injury, being evidenced in 13 cases. In self-inflicted injuries, a statistical analysis discovered that the total duration of admission and the number of patients admitted to the intensive care unit were significantly shorter and smaller, retrospectively, than in the patient group that had injuries caused by others. No statistically significant difference was found when the injury sequels were compared between the self-inflicted-injury and the injury-inflicted-by-others groups. Conclusion: This study revealed that, in self-inflicted abdominal injuries, injuries limited to the abdominal wall were found to be the most common, and in injuries to the cervical area inflicted by others, injuries restricted to the cervical muscle were found to be the most common. As a whole, the total duration of admission and the ICU admission time were significantly shorter in cases of self-inflicted injury. Especially, in cases of self inflicted injuries, abdominal injuries generally had a limited degree of injury. Thus, in our consideration, accurate injury assessment and an ideal treatment plan are necessary to treat these patients, and minimally invasive equipment, such as laparoscope, should be used. Also, further studies that persistently utilize aggressive surgical observations, such as abdominal ultrasound and computed tomography, for patients with penetrating injuries are needed.

Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

Study on the Characteristics of Bus Traffic Accidents by Types Using the Decision Tree (의사결정나무를 활용한 업종별 버스 교통사고 특성 연구)

  • Park, Wonil;Kim, Kyung Hyun;Han, Eum;Park, Sangmin;Yun, Ilsoo
    • International Journal of Highway Engineering
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    • v.18 no.5
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    • pp.105-115
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    • 2016
  • PURPOSES : This study was initiated to analyze the characteristics of bus traffic accidents, by bus types, using the decision tree in order to establish customized safety alternatives by bus types, including the intra-city bus, rural area bus, and inter-city bus. METHODS : In this study, the major elements involved in bus traffic accidents were identified using decision trees and CHAID algorithm. The decision tree was used to identify the characteristics of major elements influencing bus traffic accidents. In addition, the CHAID algorithm was applied to branch the decision trees. RESULTS : The number of casualties and severe injuries are high in bus accidents involving pedestrians, bicycles, motorcycles, etc. In the case of light injury caused by bus accidents, different results are found. In the case of intra-city bus accidents, the probability of light injury is of 77.2% when boarding a non-owned car and breaching of duty to drive safely are involved. In the case of rural area bus accidents, the elements showing the highest probability of light injury are boarding an owned car, vehicle-to-vehicle accidents, and breaching of duty to drive safely. In the case of intra-city bus accidents, boarding owned car, streets, and vehicle-to-vehicle accidents work as the critical elements. CONCLUSIONS : In this study, the bus accident data were categorized by bus types, and then the influential elements were identified using decision trees. As a result, the characteristics of bus accidents were found to be different depending on bus types. The findings in this study are expected to be utilized in establishing effective alternatives to reduce bus accidents.