• Title/Summary/Keyword: non-emergency case

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Resuscitative Endovascular Balloon Occlusion of the Aorta for an Iliac Artery Aneurysm: Case Report

  • Chang, Sung Wook;Chun, Sangwook;Lee, Gyeongho;Seo, Pil Won
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.429-432
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    • 2021
  • Isolated iliac artery aneurysm (IAA) is rare, but can be fatal. Emergency surgery is performed in cases of hemorrhagic shock due to a suddenly ruptured IAA, which may have a high mortality rate because of massive non-compressible torso hemorrhage (NCTH). Recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an alternative to aortic cross-clamping via open thoracotomy to achieve hemostasis in trauma patients with profound shock due to NCTH and is considered an emerging bridging therapy for damage control. However, there is limited information on the use of REBOA in non-trauma patients with shock. Herein, we describe a patient with impending cardiac arrest due to isolated ruptured IAA, in whom perioperative bleeding was successfully controlled by REBOA.

A Case Report of Echocardiography of Non-rheumaic Giant Left Atrium (비-류마티스성 거대 좌심방의 심장 초음파 검사 증례 보고)

  • Ji, Myeong-Hoon;Seoung, Youl-Hun
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.443-451
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    • 2022
  • In this case, non-rheumatic GLA was observed and it was intended to report a case of ultrasound examination. The case patient, a 60-year-old male, visited the emergency room for dyspnea and palpitations. For radiology examination, chest X-ray examination and CT examination were performed, and a giant left atrium was confirmed. Echocardiography was performed to find the cause of the giant left atrium. Echocardiography The size and volume of the left atrium were evaluated by Simpson's method, and the giant left atrium with LVEDVI 6 times larger than that of the general giant left atrium could be evaluated. Also, a giant left atrium in a patient without rheumatic heart disease is evaluated as a very rare case. Since non-rheumatic giant left atrium could be caused by functional mitral regurgitation, diastolic dysfunction. It was confirmed that ultrasonography, which allowed both morphological and hemodynamic examinations, could be a useful case.

Results Analysis of CPR in Emergency Center by In-Hospital Utstein Style (In-Hospital Utstein Style에 의한 응급의료센터의 심폐소생술 결과 분석 - 심정지 상태로 내원한 환자를 대상으로 -)

  • Roh, Sang-Gyun;Park, Jin-Ok
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.1
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    • pp.79-87
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    • 2005
  • Purpose: Investigates the results of CPR operation in visited patients with arrest state, and element to affect the results, and it is checks a problem, and it is made to promote. Methods: As for this study, analysis studied the results that operation CPR with the object arrest patients of 69 visited Jecheon Seoul hospital emergency center for during the period from January 2002 to February 2005. It was played writing partly changed In-hospital Utstein Style, and to stick a record in it. Paramedic which participated in CPR directly did the record of a variable, As for the data processing, use SPSS Version 12.0 for Windows. Results: It was male 68.1% female 31.9% for 69 people, and the sex ratio didn't affect return of spontaneous circulation, with female 8 people to male 16 people for ROSC(Return of spontaneous circulation) 24 people. with female 14 people to male 31 people for NROSC(Non-return of spontaneous circulation) 45 people(p>0.05). The initial EKG rhythm was asystole 34.8%, VF 31.9%, The case that initial EKG was VF compared it to a patient of asystole, and a survivor had a lot of VF and there were a lot of survivors(p<0.05). The wasn't relativity between VF and PEA(p>0.05), The CPR lead time was short in ROSC with NROSC $25.0{\pm}15.0$ minutes, ROSC $11.9{\pm}10.7$ minutes(p<0.01). Epinephrine administer time was NROSC $3.0{\pm}4.1$ minutes, ROSC $2.1{\pm}1.9$ minutes(p>0.05). It was survivor 18 people(21.1%) than 24 hours and the PAM Index affected in ROSC. with $9.0{\pm}1.2$ points NROSC, with $1.6{\pm}1.7$ points ROSC(p<0.01). A correlation was high between a CPR lead time and PAM Index(p<0.02), a correlation was examined by being high between ROSC and a CPR lead time, PAM Index(p<0.01).

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Comparative Analysis of COVID-19 Outbreak and Changes in Neurosurgical Emergency Patients

  • Lee, Min Ho;Jang, Seu-Ryang;Lee, Tae-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.65 no.1
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    • pp.130-137
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    • 2022
  • Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

Penetrating and Nonpenetrating Cardiac Injuries Combined with Cardiac Tamponade. - Report of seven cases and Clinical analysis - (심낭압진이 동반된 관통성 및 비관통성 심장외상 - 7례 보고 및 임상분-)

  • 이만복
    • Journal of Chest Surgery
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    • v.22 no.4
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    • pp.698-704
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    • 1989
  • We experienced the seven cases of penetrating and non-penetrating cardiac injuries combined with cardiac tamponade from June 1986 to June 1989 at Seoul and Chun-An Hospital of SOONCHUNHYANG medical college. The results were as follows. l. In sex distribution, 7 cases were male. In age distribution, The fourth decades occupied about 58 % of all cases. 2. In mode of injury, 4 cases were stab wounds, 1 case penetration by metallic fragment, 2 cases blunt chest trauma. 3. We routinely checked the CVP with subclavian vein catheterization in case of suspicious cardiac tamponade. Significant increments were showed in 4 cases. 4. Becks triad [low blood pressure, raised central venous pressure, distant heart sound] were recorded in 43 % of the cases with proven tamponades. 5. The sites of injury included RV in 4 cases, LV in 1 case, RA in 1 case and branch of RCA in 1 case. The RV injuries were the most common. 6. Coronary artery damage occurred in 2 cases. LADA was severed in 1 case combined with RV rupture and branch of RCA was torn 1 case. 7. Pericardiocentesis was performed 1 case at another hospital before referring to our hospital. We have never used the procedure because we think that it is potentially dangerous with no clear benefit. 8. Subxyphoid pericardial window was performed in 2 cases of severe cardiac tamponade. We have employed this method to stabilize the patients who had systolic hypotension. 9. Surgical approaches were performed with median sternotomy in 3 cases, thoracotomy in 4 cases. 10. We undertook the simple closure in 6 penetrating cardiac wounds. The removal of impacted metallic fragment was performed under the cardiopulmonary bypass. Simple ligation was performed in 2 cases of coronary artery severance 11. One patient with no sign of life was urgently intubated and undertaken an emergency room thoracotomy on the stretch car without antiseptic preparation. The cardiorrhaphy in 6 cases were performed in the operating theater 12. One patient undertaken emergency room thoracotomy did not survive due to refractory hypovolemic shock. But the remaining 6 patients recovered.

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A Case of Non-immune Hydrops Fetalis due to Congenital Syphilis (선천성 매독에 의한 비면역성 태아수종 1례)

  • Jung, Ji-Sun;Park, Sang-Woo;Kim, Chun-Soo;Lee, Sang-Lak;Kwon, Tae-Chan
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.207-211
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    • 2008
  • Congenital syphilis is a rare cause of non-immune hydrops fetalis. We cared for a neonate with hydrops fetalis who was delivered by emergency Cesarean section due to prolonged fetal bradycardia and ascites at 34 weeks of gestation. He had anemia, purpura, and hepatosplenomegaly, and the serologic tests revealed congenital syphilis (high titers of serum VDRL and TPHA, and a positive serum FTA-ABS IgM). He survived after aspiration of ascitic fluid, ventilator care, and intravenous penicillin therapy. We report a case of non-immune hydrops fetalis due to congenital syphilis with a brief review of literature.

An Empirical Study on the Effects of Non-Tariff Barriers on FTAs: Regarding Import Control Measures of the Target Country on Korea's FTA (자유무역협정에 대한 비관세장벽의 효과에 관한 실증연구: 한국의 자유무역협정과 체결 대상국의 수입규제조치에 대하여)

  • Oh, Dae-Hyuck
    • Asia-Pacific Journal of Business
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    • v.12 no.2
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    • pp.187-203
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    • 2021
  • Purpose - The purpose of this study is to analyze the effects of non-tariff barriers on the Free Trade Agreement. Currently, it has achieved significant export effects by signing free trade agreements with many countries in Korea. However, most countries have implemented non-tariff barriers to protect their industries. This study analyzes the effects of non-tariff barriers in counterpart countries that have signed a free trade agreement. Design/methodology/approach - For analysis, first, prior studies were summarized, and second, the current status of free trade agreements and non-tariff barriers were identified. And, based on the current situation, the relationship between non-tariff barriers and export volume was analyzed. The targets of analysis are the United States, China, and Vietnam, which are Korea's three largest exporters. As for non-tariff barriers, anti-dumping tariffs, countervailing tariffs, and emergency import restrictions were analyzed as import regulatory measures. Findings - In the case of the United States, it can be seen that the decline in textiles, steel and electronics sectors is even greater. In the case of China, it can be seen that exports declined after imposing non-tariff barriers in the steel sector. Finally, it can be seen that exports declined after Vietnam implemented a non-tariff barrier on the steel sector. It was found that non-tariff barriers offset the effects of the Free Trade Agreement. Research implications or Originality - Currently, Korea has free trade agreements with numerous countries. However, after the free trade agreement entered into force, the number of annual average import regulation investigations for Korean products is on the rise. In the end, the implementation of non-tariff barriers is offsetting the effects of free trade agreements. Therefore, when signing a free trade agreement, it is necessary to thoroughly prepare for import regulatory measures such as the insertion of provisions of non-tariff barriers.

An Analysis of Emergency Transport Proportional Population (인구비례 응급출동 현황 분석)

  • Kim, Chul-Tae
    • Journal of Digital Convergence
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    • v.12 no.12
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    • pp.449-456
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    • 2014
  • This study aimed to reveal the statistical correlation between the distribution of jurisdictional population and the incidence of mobilization, which consisted with cases of patient transfer and non-transfer to hospital. For this study, we collected and analysed the data for populational status, area, and cases of patient transfer and non-transfer to hospital from 5 fire stations in D city, from January 2010 to December 2012. Total numbers of mobilization were highest in J fire station and this supreme tendency were also seen in both cases (transfer and non-transfer). On the contrary, those of B fire station were lowest. In case of populational status of specific jurisdiction, S fire station was identified to possess the highest while D fire station showed the lowest. However, influences of jurisdictional population on occurrence of patient transfer and / or non-transfer to hospital were not seemed to be shown.

AC4E: An Access Control Model for Emergencies of Mission-Critical Cyber-Physical Systems

  • Chen, Dong;Chang, Guiran;Jia, Jie
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.6 no.9
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    • pp.2052-2072
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    • 2012
  • Access control is an essential security component in protecting sensitive data and services from unauthorized access to the resources in mission-critical Cyber-Physical Systems (CPSs). CPSs are different from conventional information processing systems in such that they involve interactions between the cyber world and the physical world. Therefore, existing access control models cannot be used directly and even become disabled in an emergency situation. This paper proposes an adaptive Access Control model for Emergences (AC4E) for mission-critical CPSs. The principal aim of AC4E is to control the criticalities in these systems by executing corresponding responsive actions. AC4E not only provides the ability to control access to data and services in normal situations, but also grants the correct set of access privileges, at the correct time, to the correct set of subjects in emergency situations. It can facilitate adaptively responsive actions altering the privileges to specific subjects in a proactive manner without the need for any explicit access requests. A semiformal validation of the AC4E model is presented, with respect to responsiveness, correctness, safety, non-repudiation and concurrency, respectively. Then a case study is given to demonstrate how the AC4E model detects, responds, and controls the emergency events for a typical CPS adaptively in a proactive manner. Eventually, a wide set of simulations and performance comparisons of the proposed AC4E model are presented.

A Bathroom, Stairway and Entrance Design preferred by the Elderly in Daejeon City (대전시 노인의 욕실 및 이동공간 디자인에 대한 선호)

  • Rhee, Ji-Sook
    • Proceeding of Spring/Autumn Annual Conference of KHA
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    • 2003.11a
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    • pp.133-136
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    • 2003
  • This study was purposed of finding housing characteristics, especially bathroom and preferred by the Elderly in Daejeon City. Collected By housing expenses and an administrative district, the Elderly over 65 were interviewed by well-trained investigators and 583 case was analyzed through SPSS PC 10.0. The results of this study were as follows ; They have a little emphasized emergency bell and convenience of a balustrade and have layed stress on non-slip floor in bathroom and stairways. Non-slip floor was considered more important thing for safety by the elderly.

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