No abstract available.
Checklist* ; Fetus* ; Humans ; Mothers*

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity

PURPOSE: Trampoline-related injuries are steadily increasing. To our knowledge, there have been very few studies on trampoline injuries in Asia. The purpose of this study is to report the characteristics of pediatric trampoline injuries in Korea. MATERIALS AND METHODS: We conducted a nationwide retrospective cohort study. Data were collected from prospective nationwide databases (Emergency Department-based Injury In-depth Surveillance databases of the Korea Centers for Disease Control and Prevention) for patients who visited emergency departments (EDs) after injuries during 2011–2016. RESULTS: Of 263712 patients between 0 and 17 years of age, 2799 patients with trampoline injuries visited EDs. The median age of the patients was 5 years (interquartile range, 3–8 years), and 63% of the patients were under 6 years old. Of the patients, 1526 (54.2%) were male. Seventy-six percent of injuries occurred at trampoline parks. Trampoline injuries and trampoline park injuries have increased steadily, while ages at injury have gradually decreased year by year (p < 0.001). Injury locations included the lower extremity (47%), head and face (24%), and upper extremity (24%). A fracture was sustained by 886 (31.7%) patients. The distal humerus and proximal tibia were the most common fracture sites (34% and 23%, respectively). Fractures occurred more commonly in trampoline parks than in homes (33.7% vs. 21.1%, p < 0.001). CONCLUSION: In Korea, pediatric trampoline injuries and trampoline park injuries have tended to increase, while ages at injury have tended to decrease. Policies to prevent trampoline injuries are needed.
Asia ; Centers for Disease Control and Prevention (U.S.) ; Cohort Studies ; Emergency Service, Hospital ; Fractures, Bone ; Head ; Humans ; Humerus ; Korea* ; Lower Extremity ; Male ; Pediatrics ; Prospective Studies ; Retrospective Studies ; Tibia ; Upper Extremity ; Wounds and Injuries

No abstract available.
Antibodies* ; Fetus* ; Heart Block* ; Heart*

No abstract available.
Cervix Uteri* ; Female

Objective: When bike riding under the influence of alcohol, incidence of injury increases, although reports of highly severe injuries is rare. Therefore, this study aimed to determine how drinking alcohol affects bicycle injuries. Methods: This study included patients who visited the emergency departments at 23 hospitals. Participants were enrolled in the emergency department-based injury in-depth surveillance program of the Korea Centers for Disease Control and Prevention, were over 15-years-old, and were injured while riding a bike either with or without alcohol intake.Patients with important data missing or insufficient data such as Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS) were excluded from the analysis. Results: A total of 28,094 patients were analyzed. The alcohol-intake group numbered 1,946 (6.9%) while the non-alcohol-intake group numbered 26,148 (93.1%). The incidence of severe injury (EMR-ISS≥25) in the alcohol-intake group was 451 (23.2%), whereas that in the non-alcohol-intake group was 2,881 (11.0%), which was statistically different between the two groups (P<0.001). According to multivariate logistic regression, the odds ratio of severe injuries in the alcohol-intake group was 2.04 (95% confidence interval, 1.80-2.30) compared to the non-alcohol-intake group after adjusting for age, alcohol use, type of road, sex, injury time, and transportation. Conclusion Alcohol is associated with an increase in the incidence of severe injuries. Therefore, as part of preventive measures, it will be necessary to tighten regulations on post-drinking bike riding and improve awareness through public relations.

Objective: When mass casualty incidents occur in Korea, disaster medical assistance teams (DMATs) and public health disaster response teams (PHDRTs) treat casualties at the scene. However, the appropriateness of their on-site responses has not been assessed so far. In this study, we evaluated their response and the variations in their response according to the accessibility of medical care. Methods: We analyzed mass casualty incidents that were reported to the Disaster Emergency Medical Service Situation Room of the National Emergency Medical Center from July 2014 to December 2018. We divided the accident locations into medically underserved areas (MUAs) and adequately served areas (ASAs) and compared the responses of the two teams in each area. Results: Of the 61 incidents, 20 occurred in MUAs, and 41 occurred in ASAs. In MUAs compared to ASAs, time from DMATs' dispatch to arrival was longer (48 [40-58.5] vs. 23 [18-32], P<0.001) but the time taken by the PHDRTs did not vary between two areas (19 [14-35] vs. 15.5 [9-24.5], P=0.263). In MUAs, the time elapsed from the PHDRTs' dispatch to arrival was less than that of the DMATs (48 [40-58.5] vs. 20 [15-35], P<0.001). In MUAs, the distance of the PHDRTs from the scene was lower (31.4 [25-50.95] vs. 13.6 [5.3-19.7], P=0.001) and more members were dispatched to the scene than the DMAT (5 [4-6] vs. 9 [5-10.5], P=0.013). Conclusion Because of the low accessibility to the scene in MUAs, DMATs took a long time to initiate medical support . To provide adequate disaster medical support, the PHDRTs must be specialized and trained.

Objective: When mass casualty incidents occur in Korea, disaster medical assistance teams (DMATs) and public health disaster response teams (PHDRTs) treat casualties at the scene. However, the appropriateness of their on-site responses has not been assessed so far. In this study, we evaluated their response and the variations in their response according to the accessibility of medical care. Methods: We analyzed mass casualty incidents that were reported to the Disaster Emergency Medical Service Situation Room of the National Emergency Medical Center from July 2014 to December 2018. We divided the accident locations into medically underserved areas (MUAs) and adequately served areas (ASAs) and compared the responses of the two teams in each area. Results: Of the 61 incidents, 20 occurred in MUAs, and 41 occurred in ASAs. In MUAs compared to ASAs, time from DMATs' dispatch to arrival was longer (48 [40-58.5] vs. 23 [18-32], P<0.001) but the time taken by the PHDRTs did not vary between two areas (19 [14-35] vs. 15.5 [9-24.5], P=0.263). In MUAs, the time elapsed from the PHDRTs' dispatch to arrival was less than that of the DMATs (48 [40-58.5] vs. 20 [15-35], P<0.001). In MUAs, the distance of the PHDRTs from the scene was lower (31.4 [25-50.95] vs. 13.6 [5.3-19.7], P=0.001) and more members were dispatched to the scene than the DMAT (5 [4-6] vs. 9 [5-10.5], P=0.013). Conclusion Because of the low accessibility to the scene in MUAs, DMATs took a long time to initiate medical support . To provide adequate disaster medical support, the PHDRTs must be specialized and trained.

OBJECTIVE: This prospective study was done to find out common symptoms and beneficial physical examinations, and to evaluate relations among symptom, pain severity, physical examination method and width of symphysis pubis of symptom-giving pelvic girdle relaxation (PGR) in pregnant women. METHODS: Four hundreds sixty-five pregnant women who complained pelvic pain were asked to fill out a questionnaire. Ninety-six pregnant women were diagnosed as PGR and were examined physically and took the sonogram. Statistical correlation was evaluated among symptoms, pain severity (visual analog scale: VAS), physical examination method and sonogram. RESULTS: The most common complain was difficulty of rolling in bed (100%). The most frequent positive diagnostic physical method was posterior pelvic pain provocative test (PPPT) (85.4%). There was correlation between VAS and symptoms (r= 0.340, P=0.001) but no correlations between VAS or symptoms and numbers of positive physical examination (P>0.05). CONCLUSION: It is suggested that PPPT was most beneficial diagnostic methods of PGR in pregnancy.
Female ; Humans ; Pelvic Pain ; Physical Examination* ; Pregnancy ; Pregnant Women* ; Prospective Studies ; Surveys and Questionnaire ; Relaxation*

PURPOSE: This study evaluated the efficacy and positive influences of a critical event monitoring system (CEMS), which is an automatic alerting system for patients with critical laboratory results. METHODS: We compared various patient data variables with hyperkalemia during the 1 year before and after CEMS, which was initiated in July 2007 (Before group: July 2006~June 2007, After group: July 2007~June 2008). RESULTS: A total of 2,417 patients had severe hyperkalemia (K+> or =6.5 mmol/L) during the period. Of the 2,417, 1680 were excluded, Leaving 389 patients to be enrolled in the 'before group' and 348 in the 'after group'. Baseline characteristics were similar between the two groups. Although the load of work for the medical staff increased during the period when CEMS was begun, the time interval from critical laboratory results to appropriate treatment decreased (72.68+/-94.03 vs. 70.07+/-92.28 minutes) as did the length of hospital stays (20.27+/-27.01 vs. 17.03+/-26.89 days). These decreases were not statistically significant. Decreases in time interval and hospital stay were more prominent for patients treated in the ICU and by emergency physicians during the day time. Mortality within 48 hours (19.5 vs. 19.5%) did not change after beginning CEMS. Mortality in the ICU (2.04 vs. 1.94%, p=0.046) decreased after beginning CEMS. CONCLUSION: Information technology strategies such as using CEMS may be an effective tool for improving the quality of medical care. But we must also consider other factors such as work load of the medical staff which also influence the quality of medical care.
Clinical Laboratory Information Systems ; Critical Care ; Emergencies ; Humans ; Hyperkalemia ; Length of Stay ; Medical Staff ; Quality of Health Care ; Sulfides