PURPOSE: Despite significant concern on elevating the rate of return of spontaneous circulation (ROSC) of prehospital cardiac arrest patients, the rate in Korea is still low compared to other advanced countries. The purpose of this study is to investigate prehospital factors that can influence the use of an automated external defibrillator (AED). METHODS: We retrospectively analyzed 94 non-cardiogenic prehospital cardiac arrest patients who arrived at one hospital from June 20, 2010 to August 10, 2012. RESULTS: AED was attached to 37(39.4%) patients. Age (p=0.024), witnessed arrest (p=0.023), rate of AED attachment (p<0.001), and time interval call to emergency medical service (EMS) arrival at a scene (p=0.004) influenced the detection of ventricular tachycardia (VT) or ventricular fibrillation (VF). Bystander cardiopulmonary resuscitation (CPR) was performed in 6.4% of total patients. We assumed that assessment of patients' status, including age and underlying disease, might influence the decision of AED attachment. CONCLUSION: In cardiac arrest patients, early CPR and rapid defibrillation should be performed. Results of our study showed a low bystander CPR rate and low AED attachment rate. Further investigations should be conducted in order to find determine the factors that affect decisions of EMS personnel regarding attachment of AED.
Cardiopulmonary Resuscitation ; Defibrillators* ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

PURPOSE: Despite significant concern on elevating the rate of return of spontaneous circulation (ROSC) of prehospital cardiac arrest patients, the rate in Korea is still low compared to other advanced countries. The purpose of this study is to investigate prehospital factors that can influence the use of an automated external defibrillator (AED). METHODS: We retrospectively analyzed 94 non-cardiogenic prehospital cardiac arrest patients who arrived at one hospital from June 20, 2010 to August 10, 2012. RESULTS: AED was attached to 37(39.4%) patients. Age (p=0.024), witnessed arrest (p=0.023), rate of AED attachment (p<0.001), and time interval call to emergency medical service (EMS) arrival at a scene (p=0.004) influenced the detection of ventricular tachycardia (VT) or ventricular fibrillation (VF). Bystander cardiopulmonary resuscitation (CPR) was performed in 6.4% of total patients. We assumed that assessment of patients' status, including age and underlying disease, might influence the decision of AED attachment. CONCLUSION: In cardiac arrest patients, early CPR and rapid defibrillation should be performed. Results of our study showed a low bystander CPR rate and low AED attachment rate. Further investigations should be conducted in order to find determine the factors that affect decisions of EMS personnel regarding attachment of AED.
Cardiopulmonary Resuscitation ; Defibrillators* ; Emergency Medical Services ; Heart Arrest* ; Humans ; Korea ; Retrospective Studies ; Tachycardia, Ventricular ; Ventricular Fibrillation

Due to increasing participation in outdoor activities, many people visit the emergency room for various symptoms after mistaking poisonous plants for medicinal herbs. The toxicity of Arisaematis rhizome is due to its content of calcium oxalate, which causes painful oropharyngeal edema, hypersalivation, aphonia, oral ulceration, esophageal erosion, and hypocalcemia. We report a case of accidental poisoning after chewing and spitting of the root of A. rhizome, resulting in focal symptoms-such as oral pain, swelling and drooling-that required only conservative management. A 54-year-old male and his 58-year-old wife developed oral pain, swelling and drooling after accidentally chewing and spitting the root of the A. rhizome plant as a medicinal herb. Their symptoms started immediately after chewing on and spitting out the root of A. rhizome, and they were unable to speak due to oral pain, swelling, and hypersalivation on arrival at the emergency department. They were treated with antihistamines and corticosteroids and painkillers. A few hours after treatment, they had improved and were discharged from the hospital.
Adrenal Cortex Hormones ; Aphonia ; Calcium Oxalate ; Edema ; Emergency Service, Hospital ; Histamine Antagonists ; Humans ; Hypocalcemia ; Male ; Mastication ; Middle Aged ; Oral Ulcer ; Plants ; Plants, Medicinal ; Plants, Toxic ; Poisoning* ; Rhizome ; Sialorrhea ; Spouses

Objective: Many trauma centers use their own criteria for major trauma patients, and these criteria are organized according to physiological causes and their related mechanisms. Mechanism related criteria have high sensitivity but low specificity. We confirmed 20 feet as a single factor for trauma team activation criteria. Methods: This study was retrospectively conducted in the Pusan National University Hospital trauma center, which is a level 1 trauma center in Busan. Patients were grouped as group 1, a fall from less than 20 feet; and group 2, a fall from more than 20 feet. We compare the two groups of prognostic factors using logistic regression analysis. Results: The relationship between the height of the fall and the patient’s prognosis showed a positive relationship on the logistic regression analysis. Yet the cut-off value of a 20 foot height showed poor predictive power for the patient’s prognosis. Conclusion In conclusion, as trauma team activation criteria, a 20 foot height seems to be a reasonable aspect of patients’ clinical prognosis between above 20 feet and below 20 feet. Yet it seems to be controversial as a cut-off value. Thus, more studies will be needed to identify a specific height for trauma team activation.

Background: Automated hematology analyzers report various research parameters. Certain parameters may have clinical implications, whereas others are used to set flags in automated hematology analyzers. In this study, we established sex-specific reference intervals for one reticulocyte parameter and two platelet clump parameters in Korean adults and examined the necessity of separate reference intervals for each sex. Methods: A total of 264 healthy adults (157 men and 107 women) aged between 18 and 65 years who underwent regular health check-ups were enrolled. Complete blood cell count was measured using Advia2120i (Siemens, Germany) within 4 hours of phlebotomy. Reference intervals were established according to the Clinical and Laboratory Standards Institute EP28-A3 guideline, and the necessity of separate sex-specific reference intervals was examined according to the method outlined by Harris and Boyd. Results: The reference intervals for each parameter were as follows:reticulocyte hemoglobin (g/L), 132.8–172.0 (men), 96.7–162.8 (women); the number of platelet clumps (# platelet clumps), 10.8–61.0 (men), －22.5–64.4 (women); and %platelet clumps, 0.20–1.49 (men), －0.57–1.53 (women).Reticulocyte hemoglobin showed a significant difference between men and women, whereas # platelet clumps and %platelet clumps did not; however, all three parameters needed separate sex-specific reference intervals. Conclusions We established sex-specific reference intervals for a reticulocyte parameter and platelet clumps parameters in Korean adults for the first time.The results could provide helpful information in clinical decision-making and instrument setting.

We, herein, present a patient with no history of trauma who developed shoulder pain after undergoing low-voltage electric shock. According to the computed tomography, there was a multi-segmental fracture that extended into the glenoid cavity of the left scapula. A good outcome was obtained after open reduction and internal fixation. Emergency physicians should be aware of the possibility of scapular fracture extending into the glenoid cavity, especially in patients with shoulder pain after electrical injury.
Electric Injuries ; Emergencies ; Glenoid Cavity* ; Humans ; Scapula ; Shock* ; Shoulder Pain

BACKGROUND: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. METHODS: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. RESULTS: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77+/-12.42 vs. 74.59+/-6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75+/-422.65 vs. 667.06+/-1093.22, p<0.01). CONCLUSIONS: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
Biomarkers ; Cerebral Infarction ; Creatine ; Emergency Service, Hospital ; Humans ; Natriuretic Peptide, Brain ; Prognosis ; Stroke* ; Troponin I

BACKGROUND: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. METHODS: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. RESULTS: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77+/-12.42 vs. 74.59+/-6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75+/-422.65 vs. 667.06+/-1093.22, p<0.01). CONCLUSIONS: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
Biomarkers ; Cerebral Infarction ; Creatine ; Emergency Service, Hospital ; Humans ; Natriuretic Peptide, Brain ; Prognosis ; Stroke* ; Troponin I