• Title/Summary/Keyword: unconscious patient

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Emergency Cesarean Section Rescue of a Fetus from Maternal Severe Drug Intoxication (심각한 약물중독으로 내원한 38주 산모에게 실시된 응급제왕절개술 1례)

  • Park, Jung-Geun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.1
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    • pp.44-46
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    • 2009
  • Herein, we report a case of emergency cesarean section after severe maternal drug intoxication in late pregnancy. At a 38-week-gestation, a 32-year-old woman with a 10-year history of bipolar disorder took olanzapine (200 mg), diazepam (20 mg), and zolpidem (200 mg) as part of a suicidal attempt. Given her unconscious state and the evident concern regarding the toxic effects of the drugs on the fetus, a cesarean section was performed immediately. The patient gave birth to a male baby with Apgar scores of 5 at 1 and 8 at 5 minutes. The baby showed dyspnea and decreased activity directly after birth. After supportive care, the condition of both mother and baby improved and both were discharged.

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Clinical Analysis of the Laryngo-Tracheal Stenosis (후두 및 기관협착증의 임상적 고찰)

  • 김영호;최은창;최재영;홍원표
    • Korean Journal of Bronchoesophagology
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    • v.3 no.2
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    • pp.261-269
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    • 1997
  • When performing an endotracheal intubation or tracheotomy to an unconscious patient in emergent situations, one should consider the possibility of later complication of laryngo-tracheal stenosis which can result in difficulties in decannulation. Laryngo-tracheal stenosis is a bothersome problem developing as a complication of treatment by tracheotomy with a cuffed tube and long-term endotracheal intubation with assisted ventilation. One hundred twenty-three cases of laryngo-tracheal stenosis patients during the four yew period from May 1992 to April 1996 were restrospectively reviewed according to several parameters such as the duration of intubation, site of stenosis, treatment modality and, site of tracheostoma. The present report is an analysis of these materials to search for the possible etiologic factors and its proper preventive methods. It was desirable that the endotracheal intubation should be limited within 20 days at most. Tracheotomy performed by non-otolaryngologists has a tendency to be on a higher level of trachea. Technical precautions should be taken into consideration when doing a tracheotomy. The success rate of decannulation of tracheal T-tube was 78.8% and it required average 11 months.

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Signal Analysis for Detecting Abnormal Breathing (비정상 호흡 감지를 위한 신호 분석)

  • Kim, Hyeonjin;Kim, Jinhyun
    • Journal of Sensor Science and Technology
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    • v.29 no.4
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    • pp.249-254
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    • 2020
  • It is difficult to control children who exhibit negative behavior in dental clinics. Various methods are used for preventing pediatric dental patients from being afraid and for eliminating the factors that cause psychological anxiety. However, when it is difficult to apply this routine behavioral control technique, sedation therapy is used to provide quality treatment. When the sleep anesthesia treatment is performed at the dentist's clinic, it is challenging to identify emergencies using the current breath detection method. When a dentist treats a patient that is under the influence of an anesthetic, the patient is unconscious and cannot immediately respond, even if the airway is blocked, which can cause unstable breathing or even death in severe cases. During emergencies, respiratory instability is not easily detected with first aid using conventional methods owing to time lag or noise from medical devices. Therefore, abnormal breathing needs to be evaluated in real-time using an intuitive method. In this paper, we propose a method for identifying abnormal breathing in real-time using an intuitive method. Respiration signals were measured using a 3M Littman electronic stethoscope when the patient's posture was supine. The characteristics of the signals were analyzed by applying the signal processing theory to distinguish abnormal breathing from normal breathing. By applying a short-time Fourier transform to the respiratory signals, the frequency range for each patient was found to be different, and the frequency of abnormal breathing was distributed across a broader range than that of normal breathing. From the wavelet transform, time-frequency information could be identified simultaneously, and the change in the amplitude with the time could also be determined. When the difference between the amplitude of normal breathing and abnormal breathing in the time domain was very large, abnormal breathing could be identified.

A Study on Lawsuit Cases and Measures of Emergency Medical Service (응급의료서비스 중 발생되는 소송사례와 대책 연구)

  • Kwon, Hay-Ran
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.77-90
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    • 2009
  • Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

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A Comparative Study between Five Minds Mutual Restriction Therapy and Short-Term Dynamic Psychotherapy (STDP) (오지상승요법과 단기역동 정신치료에 대한 비교 연구)

  • Jeong, Seon-Yeong;Kim, Jae-Yeong;Cho, Myoung-Ui;Kho, Young-Tak
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.2
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    • pp.57-65
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    • 2016
  • Objectives The aim of this study was to develop a new Korean psychotherapeutic model in terms of emotion.Methods We compared the five minds mutual restriction therapy with short-term dynamic psychotherapy (STDP). We summarized 4 similarities and 4 differences of these two models of psychotherapy.Results 1. Short-term dynamic psychotherapy (STDP) needs active intervention of the therapist, with a restricted therapeutic focus and session. It blends with the present state of oriental neuropsychiatric clinics, and is suitable for Korean medical psychiatrists to apply short-term dynamic psychotherapy (STDP) to their clinical settings. 2. Short-term dynamic psychotherapy (STDP) and five minds mutual restriction therapy are similar, in that they both mainly use the emotions, needing restricted therapeutic focus and sessions, and active intervention of the therapist. 3. Short-term dynamic psychotherapy (STDP) and five minds mutual restriction therapy are different in their methods of arousing therapeutic emotion, the necessity of the patient being unconscious, the standard of patient selection, and the importance of follow up.Conclusions It is necessary to develop a new Korean psychotherapeutic model, which amalgamates the advantages of both methods of psychotherapy, and considers the present state of clinic. It is necessary that the Korean medical psychiatrists introspect themselves, since they are not merely therapists but also a role model for the patient.

Severe SARS-CoV-2 Infection With Multiorgan Involvement Followed by MIS-C in an Adolescent

  • Bomi Lim;Su-Mi Shin;Mi Seon Han
    • Pediatric Infection and Vaccine
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    • v.29 no.3
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    • pp.155-160
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    • 2022
  • Children and adolescents with coronavirus disease 2019 (COVID-19) generally have mild symptoms. Severe infection due to severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) involving multiorgan dysfunction is rare in this population. Herein, we present an unusual case of severe SARS-CoV-2 infection with multiorgan involvement followed by multisystem inflammatory syndrome in children (MIS-C) in a vaccinated 16-year-old boy. The patient was unconscious on initial presentation, and had severe paralytic ileus. On laboratory examination, there was severe metabolic acidosis, lymphocytopenia, thrombocytopenia, elevated inflammatory markers, elevated liver enzymes, and evidence of acute kidney injury with proteinuria and hematuria. His symptoms improved with the administration of remdesivir and dexamethasone. The patient briefly experienced MIS-C 2 weeks after the diagnosis of COVID-19, but the patient was discharged without any complications.

A Study on Implementation of Mobile Emergency Medical System Using NFC (NFC를 이용한 모바일 응급 의료 시스템 구현에 관한 연구)

  • Park, Joo-Hee
    • Journal of Advanced Navigation Technology
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    • v.18 no.6
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    • pp.633-639
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    • 2014
  • Recently the study about a smart health care which is combined IT with BT to provide a variety of health care services are being actively investigated. In order to provide the best possible emergency medical services in a short period of time, it is necessary that the rapid emergency measures in the event of an emergency essential. In this paper, we propose an emergency medical service platform to take effective first aid to person who has a NFC tag or NFC-enabled mobile smart phones in an accident. Using NFC, it is possible to help without physical contact to the patient unconscious to emergency incidents such as falling down in everyday life. In this paper, we design and implement an mobile emergency medical system that can deliver first aid information ask for help in case of emergency.

A ECG Analysis with Activity Monitrong for Healthcare of Elderly Person (노인 헬스케어를 위한 ECG분석 및 활동량 모니터링 구현)

  • Bhardwaj, Sachin;Purwar, Amit;Lee, Dae-Seok;Chung, Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2007.06a
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    • pp.347-350
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    • 2007
  • An ECG analysis with activity monitoring for the home care of elderly persons or patients, using wireless sensors technology was design and implemented. The changes in heart rate occur before, during, or following behavior such as posture changes, walking and running. Therefore, it is often very important to record heart rate along with posture and behavior, for continuously monitoring a patient's cardiovascular regulatory system during their daily life activity. The ECG and accelerometer data are continuously recorded with a built-in automatic alarm detection system, for giving early alarm signals even if the patient is unconscious or unaware of cardiac arrhythmias. The hardware allows data to be transmitted wirelessly from on-body sensors to a base station attached to server PC using IEEE802.15.4. If any abnormality un at server then the alarm condition sends to the doctor' PDA (Personal Digital Assistant).

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Mechanical ventilation-associated pneumothorax presenting with paroxysmal supraventricular tachycardia in patients with acute respiratory failure

  • Eom, Jeong Ho;Lee, Myung Goo;Lee, Chang Youl;Kwak, Kyong Min;Shin, Won Jae;Lee, Jung Wook;Kim, Seong Hoon;Choi, Sang Hyeon;Park, So Young
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.106-110
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    • 2015
  • The prevalence of pneumothorax cases among Intensive Care Unit patients who require mechanical ventilation ranges from 4%-15%. A pneumothorax remains one of the most serious complications of positive pressure ventilation. It can be diagnosed in a critically ill patient through a physical examination or radiographic studies that include chest radiographs, ultrasonography, or computed tomography scanning. However, in a critically ill patient, the diagnosis of a pneumothorax is often complicated by other diseases and by difficulties in imaging sick and unconscious patients. Although electrocardiogram changes associated with a pneumothorax have been described for many years, there has been no report of such among patients who require mechanical ventilation. In this paper, we report 2 cases of a spontaneous pneumothorax with paroxysmal supraventricular tachycardia in patients who required invasive mechanical ventilation due to acute respiratory failure.

A study on Medical servicer satisfaction of Emergency Department patient (응급실 내원자의 의료서비스 만족에 관한 연구)

  • Kwon, Seon Suk;Yoo, In Soo;Jung, Ha Sook
    • The Korean Journal of Emergency Medical Services
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    • v.1 no.1
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    • pp.42-53
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    • 1997
  • To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

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