No abstract available.
Humans ; Ulsan*

BACKGROUND: The fire victims are affected not only by bum and trauma but also carbon monoxide(CO) and hypoxia. It may be useful to triage mass casualties of fire field that preestimate the victim's injury sevrrities by experiments of measuring the concentration of CO and oxygen according to time progression. METHOD: We prepared one house of apartment as like usual residental environment. The mesuring of concentrations of CO and oxygen was started from firing. RESULT: 3.8 Min. after firing: CO concentration(0.007%) was reached to the level that can give rise to spontaneous headache. 5 Min.: The concentration of CO was incerased. At this level(0.012%), the victims of fire may be suffered severe headache inspite of mild movement. 5.5 Min.: At this time,0.02% of CO concentration that the victims can't escape by themselves was checked. 6 Min.; 0.08% was measured, almost patients may be unconscious and the symptoms will be more severe at this CO concentration because of hypoxia.6.4 Min.: It was absolutly impossible to be survival at this time due to incresing of CO concentration(0.195%) and decreasing of O2 concentration(5%). CONCLUSION: It is within 5.5 Min. that the patient can escape by themselves, and impossible to be survival more than 6.5 Min. in fire field. Rescuers and EMTs must consider time factor as well as sysmtoms of patients.
Anoxia ; Carbon* ; Fires* ; Headache ; Humans ; Mass Casualty Incidents ; Oxygen ; Time Factors ; Triage ; United Nations

BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

Otitis externa and otitis media spreading to the temporomandibular joint (TMJ) is rare, and infection to the TMJ may result as well from direct spreading from the adjacent structures or from hematogenous spreading. But, apparent pathomechanism is not identified clearly and more specific studies are required. We experienced 2 cases of otits media and otitis externa which involved dehiscence of the bony canal wall that communicates with TMJ and the glenoid cavity. We report this cases with literature.
Ear Canal* ; Ear, Middle* ; Glenoid Cavity ; Otitis Externa ; Otitis Media ; Temporomandibular Joint*

BACKGROUND: induction of analgesia is frequently required during undergoing reduction of fractures or dislocation in the emergency department. METHODto induce analgesia should be easy, convenient, and safe because patients are not always in fasting state. Nitrous oxide inhalation has been known as a good method of analgesia in emergency patients. PURPOSE: This study was aimed to evaluate the efficacy and safety of nitrous oxide analgesia in the emergency department. METHOD: We prospectively studied 34 patients undergone reductions of fractures in the emergency department. Nitrous-oxide was the sole source of analgesia. The Visual Analogue Scale(VAS) was rated by the emergency physician before nitrous oxide inhalation,5 minutes after inhalation and reduction procedures. RESULTS: No complication such as vomiting, respiratory depression, or a change in oxygen saturation resulted from the use of nitrous-oxide. Ninety one percent of patients obtained an analgesic effect. However, 9% of patients did not experience any analgesic effect after inhalation of nitrous oxide. In subgroup analysis for analgesic effect of nitrous-oxide, nitrous oxide provided only partial analgesia for acute pain in open fracture group. VAS was significantly lower after inhalation than before inhalation of nitrous oxide in simple fracture group. However, VAS of simple fracture group was increased during closed reductions, which indicated incomplete relief of pain by nitrous oxide. Nitrous oxide inhalation foiled to relieve pain during reduction in patients with open fracture or dislocation. CONCLUSION: Administration of nitrous-oxide, when used as the sole source of analgesia, is not the ideal method of analgesia during reduction of fractures or dislocations.
Acute Pain ; Analgesia ; Dislocations ; Emergencies* ; Emergency Service, Hospital* ; Fasting ; Fractures, Open ; Humans ; Inhalation ; Nitrous Oxide* ; Oxygen ; Prospective Studies ; Respiratory Insufficiency ; Vomiting

Transcutaneous cardiac pacing(TCP) is a rapid, safe, noninvasive and easily utilized form of emergency cardiac pacing, with hemodynamically similar to transvenous cardiac pacing. This paper reports the result of transcutaneous pacing in a series of patients in emergency department.32 patients with bradyanhythmia were enrolled during the study period. TCP was successful in 29(91%) patients. No evidence of electrical capture was seen in two patients in asystole and a patient with ventricular escape rhythm. Mean capture threshold was 66 mA. Transvenous pacemaker was inserted in 18(56%) of the 32 patients during transcutaneous cardiac pacing. Twenty(61%) of the 32 patients survived and eventually discharged. Ten patients(31%) were died of uncorrectable underlying disease in spite of successful ECG capture and palpable pulse by TCP. In conclusion, TCP is a reliable, noninvasive method that offers the possibility to initiate pacing within seconds and can be used by any emergency medical staff. In our opinion, it should be considered as the first choice of emergency treatment of hemodynamically unstable bradyarrhythmia.
Bradycardia* ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Heart Arrest ; Humans ; Medical Staff ; United Nations

Honey is produced by bees from nectar collected from nearby flowers. Sometimes, honey produced from the Rhododendron species is contaminated by Grayanotoxin (GTX) in Nepal and other countries. There have been reports of GTX intoxication, also known as 'mad honey disease', from honey produced in countries other than Korea. The importation of wild honey has been prohibited by the Korean Food and Drug Administration since 2005, yet it is still distributed within Korea by the occasional tourist. We report a case of GTX intoxication from contaminated honey which included the symptoms of nausea, vomiting, general weakness, dizziness, blurred vision, hypotension and sinus bradycardia. By means of infusion with normal saline and atropine sulfate, the patient's condition fully recovered within 8 hours of hospital admission, and she was discharged without any complications.
Atropine ; Bees ; Bradycardia ; Dizziness ; Flowers ; Honey ; Hypotension ; Korea ; Nausea ; Nepal ; Plant Nectar ; Rhododendron ; United States Food and Drug Administration ; Vision, Ocular ; Vomiting

Foreign body aspiration is most likely to occur in children and in adults aged above 60 years, causing a respiratory emergency, such as airway closure. It is diagnosed based on a history of aspiration, presenting symptoms, and radiographic findings. The treatment may include removal of the foreign body via bronchoscopy or surgery. Here, we report a rare case of bronchial aspiration of a foreign body, confirmed with clinical and radiographic examinations, in a 57-year-old patient. The patient was transferred for treatment; however, spontaneous passage of the foreign body to the gastrointestinal tract led to its removal from the bronchus.
Adult ; Bronchi ; Bronchoscopy ; Child ; Emergencies ; Foreign Bodies ; Gastrointestinal Tract ; Humans ; Middle Aged ; Respiratory Aspiration

BACKGROUND: To develop the guidelines and the education models for primary agents caring for victims of child abuse, and investigate victims of child abuse visited the department of emergency medicine, College of Medicine, Hallym University, Choon-chun Sacred Heart Hospital. METHODS: Survey assessed the age, sex, visiting time, offender tools of maltreatment, types of maltreatment, and types of injury of 47 victims under 18 years old visited the emergency center, between the Jul. 1996 and the Aug. 1998. The injury severiy of victims of child abuse was compared with control group of 197 general violence victims visited the same emergency center at the same duration. RESULTS: The age distribution was 12.8%(n=6) of the 0-1 year old, 17%(n=8) of the 1-3 years old, 8.5%(n=4) of the 4-6 years old, 12.8%(n=6) of the 7-12 years old, and 48.9%(n=23) of over the 13 years old. The sex distribution was 49%(n=23) of male and 51%(n=24) of female. The most common visiting time was 59.6%(n=28) of the 22-02 o'clock. The types of abuse were 46.6%(n=22) of the physical abuse, 27.7%(n=13) of the neglect, 17%(n=8) of the psychic abuse, and 8.5%(n=4) of the sexual abuse. The offender was 38%(n=18) of the parents, 26%(n=12) of the relatives, 4.3%(n=3) of the grandmothers, and 6.4%(n=3) of the nurses. The severity of injury was applied to the ISS(injury severity score). The severity of injury according to ISS was mean ISS=3.82+/- 2.2 in the case of child abuse and mean ISS=1.86+/-1.6 in the case of general violence(P=0.000). CONCLUSION: Most victims of child abuse still never come to the overt attention of physicians, social workers, or other professionals. Therefore the establishment of CAN(Child abuse and neglect) protocol and the organization of CAN team in the hospital consisted by department of emergency medicine, pediatrics, and psychiatrics is essential. Furthermore, the co-operation system with child welfare facilities and polices in community is needed.
Adolescent ; Age Distribution ; Child ; Child Abuse* ; Child Welfare ; Child* ; Criminals ; Education ; Emergencies ; Emergency Medicine ; Female ; Heart ; Humans ; Male ; Parents ; Pediatrics ; Sex Distribution ; Sex Offenses ; Social Workers ; Violence