No abstract available.
Disasters* ; Emergencies* ; Emergency Medical Services* ; Korea*

BACKGROUND: Assessing and securing airway is the beginning of the treatment for emergency patients. Rapid Sequence Intubation is a technique that uses sedatives and neuromuscular blockers to perform endotracheal intubation. This is a basic technique that all emergency physicians must master. Therefore, we investigated the recent circumstance of Rapid Sequence Intubation in patients at the emergency department. METHODS: Ten-item surveys were mailed to the board certified emergency physicians in the emergency department of 45 hospitals. Among the 45 surveys, 37 surveys were returned. The rate of reply was 82.2%. RESULTS: Throughout the hospital, 35/37 of the endotracheal intubation was performed in the emergency department. Anesthesiologists were not called for endotracheal intubation in 34/37 emergency department, and anesthesiologists were not called for the use of neuromuscular blockers in 36/37 emergency departments. 35 emergency departments used sedatives. The sedatives used were as follows : midazolam(48.6%), diazepam(25.7%), thiopental sodium(22.9%), and ketamine(2.9%). 30 emergency departments used neuromuscular blockers. The neuromuscular blockers used were as fallows : succinylcholine(46.7%), vecuronium(43.3%), and pancuronium(10.0%). The rate of Rapid Sequence Intubation was 33.8%. Various monitoring devices were used during Rapid Sequence Intubation ; cardiac monitors 90.5%, pulse oximeters 80.4%, noninvasive blood pressure monitors 64.9% and ETCO2/ 12.8%. Only 6 of 37 hospitals had the assessment program far endotracheal intubations and 60% was the assessment rate in these hospitals, however, there was no proctocol for the quality assurance assessment. CONCLUSION: Emergency endotracheal intubation was performed independently by the physician of the emergency department. The Rapid Sequence Intubation was effective and had low adverse effect. We recommended that Rapid Sequence Intubation should be used more aggressively in patients. Also, applying these assessment proctocol in patients, we could improve the quality of assurance assessment.
Blood Pressure Monitors ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Hypnotics and Sedatives ; Intubation* ; Intubation, Intratracheal ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Postal Service ; Thiopental

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

No abstract available.
Ambulances* ; Emergencies* ; Gangwon-do*

No abstract available.
Cardiopulmonary Resuscitation* ; Telephone*

No abstract available.
Disasters*

No abstract available.
Emergencies* ; Humans