PURPOSE: As the lay public indirectly acquires medical knowledge through the mass media, it is desirable to show medically correct care in movies or TV dramas. We evaluated whether the emergency care depicted in Korean boxoffice movies is appropriate and medically sound. METHODS: We selected Korean movies which more than 100,000 peoples had seen in Seoul from 1996 to 2001. We excluded fantasy or historical movies from the list. After searching the emergency situations in videos, including cardiopulmonary arrest, loss of consciousness, injuries, and medical emergencies, we evaluated whether the needed care was provided and properly done and whether the result was medically sound. RESULTS: During the 6-year period, we found 46 emergency situations in 80 movies (0.6 per movie). Loss of consciousness was the most common emergency situation (34.8%), followed by cardiopulmonary arrest (15.7%). Emergency care was provided in 24 situations (52.2%), but was appropriate in only 8 among those 24 situations. Regardless of care, 50% improved and another 36.4% improved without any interventions. There was total of 106 necessary actions in the 46 situations: for instance, EMS system activation, airway maintenance, breathing and circulation support, spinal cord protection, and hemostasis. Only 21 among the 106 necessary actions (19.8%) were done. Hemostasis by external compression was the most common action done (44.4%), and airway maintenance was the least (3.6%). CONCLUSION: We found that emergency care and its result were not properly depicted in Korean box-office movies. Emergency physicians and the medical community should pay attention to this problem and serve as medical advisors to guarantee a medically sound portrayal.
Drama ; Emergencies* ; Emergency Medical Services* ; Emergency Treatment ; Fantasy ; Heart Arrest ; Hemostasis ; Mass Media ; Respiration ; Seoul ; Spinal Cord ; Unconsciousness

PURPOSE: This study was conducted to evaluate the clinical efficacy of pharmacologic treatment of amatoxin poisoning patients. METHODS: Literature was accessed through PubMed, EMBASE, Cochrane library, KoreaMed, KISS and KMBASE. Studies relevant to human use of pharmacologic therapy including silymarin, penicillin and N-acetylcysteine (NAC) for amanita poisoning were included. Case reports, letters, editorials and papers with insufficient information were excluded. Comparison of clinical outcomes (especially mortality and liver transplantation rate) in each study was analyzed. RESULTS: The final analysis included 13 retrospective studies. None of these studies showed direct comparisons of individual agents. Among 12 studies comparing silymarin vs penicillin, eight showed clinical superiority of silymarin. Among eight studies comparing silymarin with NAC, six showed clinical superiority of silymarin. Among seven studies of NAC vs penicillin, five showed clinical superiority of NAC. CONCLUSION: This systematic review suggested that clinical superiority of various pharmacological agents used to treat amatoxin poisoning is debatable. Nevertheless, the available evidence suggests it is reasonable to consider combinations of multiple agents for patients with amanita poisoning. Further studies are required to establish a treatment regimen for amanita poisoning.
Acetylcysteine* ; Amanita ; Humans ; Liver Transplantation ; Mortality ; Penicillins* ; Poisoning* ; Retrospective Studies ; Silymarin* ; Treatment Outcome

PURPOSE: The purpose of this study is to find differences in the demographics of toxic exposed patients and substance between call based poison information data and hospital based poison information data. METHODS: Seoul 1339 call-response data were used as call based poison data and toxic related injury surveillance data of the Korean center for disease control and prevention (KCDC) were used as hospital based poison data. Age, sex, the kind of exposed substance, reasons for exposure, and exposure routes were compared between two data sets. We analyzed the presence or not of documentation on the name and amount of exposed substance, symptoms after exposure in call based poison data. RESULTS: Seoul1339 poison data included a total of 2260 information related to toxic exposure and KCDC poison data included 5650 poison cases. There was no difference in sexual distribution. Pediatric exposure and accidental exposure were more common in call based poison data. The most common exposed substances were household products in call based poison data and medicines in hospital based poison data, respectively. Documents regarding amount and time of toxic exposure and symptoms after toxic exposure were not recorded exactly in call based poison data. CONCLUSION: There were significant differences in age, reasons for toxic exposure, and the kinds of exposed substances. Poison information data from both pre-hospital and hospital must be considered.
Centers for Disease Control and Prevention (U.S.) ; Dataset ; Demography ; Emergency Service, Hospital* ; Hazardous Substances ; Household Products ; Humans ; Poisoning ; Seoul ; Telephone*

PURPOSE: The purpose of this study is to find differences in the demographics of toxic exposed patients and substance between call based poison information data and hospital based poison information data. METHODS: Seoul 1339 call-response data were used as call based poison data and toxic related injury surveillance data of the Korean center for disease control and prevention (KCDC) were used as hospital based poison data. Age, sex, the kind of exposed substance, reasons for exposure, and exposure routes were compared between two data sets. We analyzed the presence or not of documentation on the name and amount of exposed substance, symptoms after exposure in call based poison data. RESULTS: Seoul1339 poison data included a total of 2260 information related to toxic exposure and KCDC poison data included 5650 poison cases. There was no difference in sexual distribution. Pediatric exposure and accidental exposure were more common in call based poison data. The most common exposed substances were household products in call based poison data and medicines in hospital based poison data, respectively. Documents regarding amount and time of toxic exposure and symptoms after toxic exposure were not recorded exactly in call based poison data. CONCLUSION: There were significant differences in age, reasons for toxic exposure, and the kinds of exposed substances. Poison information data from both pre-hospital and hospital must be considered.
Centers for Disease Control and Prevention (U.S.) ; Dataset ; Demography ; Emergency Service, Hospital* ; Hazardous Substances ; Household Products ; Humans ; Poisoning ; Seoul ; Telephone*

OBJECTIVES: We have not only examined telemedicine scenario but also applied IPSec(AH, ESP) algorithms under VPN(Virtual Private Network) for performance evaluation of telemedicine system's security and transmission. METHODS: In this study, we applied IPSec(AH, ESP) algorithms under VPN(Virtual Private Network) protocol when transmit healthcare data through Satellite Network. At that time, we evaluated performance of telemedicine system through RTT(Round Trip Time), Jitter, Bandwidth that indicate to QoS(Quality Of Service). RESULTS: It is possible to transfer remote healthcare data over Satellite Network under provided image of 15 frame and bio-signal of 10 kbps and RTT(Round Trip Time) of 774.53ms, Jitter of 25.2ms. But applying IPsec(AH, ESP) under VPN(Virtual Private Network), it is frequently happened distortion of image data affected SHA-1 and 3DES algorithm. CONCLUSION: In this study, it is possible to use telemedicine system for Secure Satellite Network, but demand to be based QoS(Quality Of Service) limited. We expected that it is possible to use the designed system in the disaster area.
Delivery of Health Care ; Disasters ; Telemedicine

PURPOSE: Geographic problems can make it difficult for rescue teams to access emergency patients in the mountains. We developed the aeromedical relief program in conjunction with fire department helicopter EMS teams. This study describes the clinical experience of patients transported from the mountains in this program. METHODS: We reviewed the employed protocols and the medical records of patients transported to our hospital from the mountains by the aeromedical transport system from June 2006 to June 2007. RESULTS: Thirty-one patients were transported by helicopter during the study period, most of them (84%) from Mt. Bukhan. The time interval from call for help to hospital arrival was 80+/-56 min, and rescue time alone was 30+/-24 min. Eleven patients (36%) were pronounced dead on arrival, and 11 patients were admitted for management. The number of trauma patients were 24 (77%), who had an average RTS score (excluding the 11 patients who expired before arrival) of 11.7+/-0.6. When the ground team and the aeromedical team were dispatched at the same time, the total transport time was 54.0+/-22.8 min, compared to 133.0 +/-75.7 min when the aeromedical team was dispatched only upon the request of the ground team, a large and statistically significant difference. CONCLUSION: This study suggests that the helicopter transport system can be successfully employed to achieve early access to patients in the mountains. To optimize the current program, cooperation between hospital and the regional helicopter EMS is required.
Aircraft* ; Emergencies ; Emergency Medical Services ; Fires ; Humans ; Medical Records ; Mountaineering ; Seoul*

The occurrences of subcutaneous emphysema or pneumomediastinum after a dental procedure are rare, but they are potentially life-threatening complications. These complications are reported to occur mainly in patients after dental procedures on the third molar, in particular during mandibular extractions and treatment on the right side. A 22-yearold woman visited the emergency department with neck swelling and chest pain after a right lower third molar extraction. She had a subcutaneous emphysema on the face and neck. Her chest x-ray and computed tomography of the chest showed a pneumomediastinum. She was discharged 6 days later without serious complications. Many cases of subcutaneous emphysema are of limited severity, resulting in minor, localized swelling, and require nothing more than observation and reassurance. However, early recognition of these problems is essential in preventing lifethreatening complications such as airway obstruction, mediastinitis, deep neck infection, and cardiac failure. We review the pathophysiology and clinical course of this disease.
Airway Obstruction ; Chest Pain ; Emergency Service, Hospital ; Female ; Heart Failure ; Humans ; Mediastinal Emphysema* ; Mediastinitis ; Molar, Third ; Neck ; Subcutaneous Emphysema* ; Thorax

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review.The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

PURPOSE: The purpose of this study is to evaluate the effectiveness of vitamin B12 treatment in subacute combined degeneration (SCD) caused by nitrous oxide (Nâ‚‚O) abuse. METHODS: Relevant literature was accessed through PubMed, EMBASE, Scopus, and KoreaMed. All the literature that was relevant to human use of vitamin B12 treatment for SCD caused by Nâ‚‚O abuse was included. Case reports were excluded if the treatment regimens were not precisely described. The literature search was conducted by two investigators during September 2019 for the final publication period. The languages of the publications were restricted to English and Korean. RESULTS: Twenty-three published articles that contained 24 cases were included. Sixteen cases among them were treated with intramuscular vitamin B12 of 1 mg/day and the rest received different doses or routes. Although most cases described significant clinical improvements, one case showed no beneficial effect due to the patient's noncooperation. Another case showed adverse events, including spinal myoclonus, following vitamin B12 therapy. CONCLUSION Vitamin B12 has been broadly used for the treatment of SCD caused by Nâ‚‚O abuse. However, most of the relevant studies were case reports that reported various regimens of vitamin B12 administration. Further studies are needed to establish a standard regimen of vitamin B12 because the incidence of Nâ‚‚O abuse may increase in South Korea.

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review.The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.