Five hundred and thirty five cases of patients who were transferred to the Department of Emergency Medicine in Pusan University Hospital from Aug 1, 1997 to Aug 31, 1997 and from Oct 1, 1997 to Oct 31, 1997 were studied prospectively. The results were as follows: 1. Total 535 patients were transferred to the emergency department of PNUH(Pusan National University Hospital) for 2 months(average 8.2 a day). Male to female ratio was 1.58:1 and peak age group was 6th decade(17.0% of total). 2. In distribution about arrival time of transferred patients, 40.7% was from 08:00 to 16:00, 39.3% was from 16:00 to 24:00 and 20.0% was from 0:00 to 8:00. 3. Cases that were communicated with the emergency department of PNUH were 7.7%, cases that were communicated with other departments of PNUH were 10.1%, and 82.2% of total cases were transferred without any communication. 4. A 40.7% of patients was transferred by a hospital ambulance, 33.1% of patients used non-emergency vehicles such as taxis or buses, 25.3% of patients was transferred by an 119 or 129 rescue ambulance, and 0.9% was transferred by on foot or others. 5. Transferring hospital was divided into 3 groups: primary hospital, secondary hospital, and university hospital. The majority was secondary hospital(83.6%). 6. The cases that patients wanted to be treated in PNUH were the greatest in number as 55.5%, the cases transferred due to emergency surgery were 9.3%, the cases transferred without specialized department concerned were 28.6%, the cases transferred because of bed deficit were 1.7% and the cases transferred due to other cause were 4.9%. 7. Traumatic patients were 32.5%, and among them 9.9% was due to motor vehicle accident, among these 78.5% was mild patients. Non-traumatic patients were 67.5% and among them 74.2% was mild patients. 8. Among all transferred patients, 75.7% was admitted for general care, emergency operation, and ICU care. The percentage of discharge was 19.1%, the percentage of death was 2.4%, and the percentage of transfer to other hospital was 2.8%. Generally, because of bed deficit and of availability of operation room, patients were transferred to other hospital. 9. Among specialized departments, the proportion of the department of internal medicine, neurosurgery and pediatrics was 29.3%, 17.2% and 11.4% respectively. In conclusion, it is considered that proper patient transfer and effective medical service can be achieved through the well-organized EMSS, and cooperative interhospital communication.
Ambulances ; Busan* ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Foot ; Humans ; Internal Medicine ; Male ; Motor Vehicles ; Neurosurgery ; Patient Transfer ; Pediatrics ; Prospective Studies

No abstract available.
Colitis, Ulcerative* ; Ulcer*

No abstract available.
Drainage*

Complications of mitomycin C soaking method during pterygium surgery and its effect on recurrence rate were compared with postoperative use of topical mitomycin C. Sixty three patients(seventy three eyes) with primary pterygium received surgery with the bared sclera method. Thirty nine eyes randomly chosen were treated with cotton applicator soaked with 0.2mg/ml mitomycin C for 5 minutes after the excision of pterygium(soaking group). Thirty four eyes underwent the same surgical procedure and received topical 0.2mg/ml mitomycin C postoperatively, twice a day for five days(eye drop group). During the mean follow-up period of 13 months, recurrence rate was 15.4%(6 eyes) in soaking group and 20.6%(7 eyes) in eye drop group respectively. This difference was not statistically significant(p>0.5). There were no specific complications related to mitomycin C treatment in both groups during the follow-up periods. The soaking method of 0.2mg/ml mitomycin C was found as effective and safe as postoperative use of topical 0.2mg/ml mitomycin C for prevention of the recurrence of primary pterygium.
Follow-Up Studies ; Mitomycin* ; Pterygium* ; Recurrence ; Sclera

The author has reviewed 16 HIV infected individuals who visited emergency center. The results were as follows ; 1. In view of sex, age distribution, and clinical state, most of the patients managed in emergency room were known HIV infected patients, and they were in progressed state to AIDS. 2. The symptom, and sign were nonspecific in most of the patients. 3. In view of sex, age distribution, course of infection, clinical state, and other foreign report, patients who visit emergency room have proportionaly high incidence of HIV infection to general population. Therefore, systemized effort is needed to detect, and manage them.
Age Distribution ; Emergencies* ; Emergency Service, Hospital ; HIV Infections ; HIV* ; Humans ; Incidence

OBJECTIVES: Although ambulance-based telemedicine has been reported to be safe and feasible, its clinical usefulness has not been well documented, and different prehospital management systems would yield different results. The authors evaluated the feasibility and usefulness of telemedicine-assisted direct medical control in the Korean emergency medical service system. METHODS: Twenty ambulances in the Busan area were equipped with a telemedicine system. Three-lead electrocardiogram, blood pressure, and pulse oximetry data from the patient and audiovisual input from the scene were transferred to a server. Consulting physicians used desktop computers and the internet to connect to the server. Both requesting emergency medical service (EMS) providers and consulting physicians were asked to fill out report forms and submit them for analysis. RESULTS: In the 41 cases in which telemedicine equipment was used, cellular phones were concomitantly used in 28 cases (68.35%) to compensate for the poor audio quality provided by the equipment. The EMS providers rated the video transmission quality with a 4-point average score (interquartile range [IQR] 2-5) on a 5-point scale, and they rated the biosignal transmission quality as 4 (IQR 3-5). The consulting physicians rated the video quality as 4 (IQR 2.5-4) and the biosignal quality as 4 (IQR 3-4). The physicians' ratings for usefulness for making diagnosis or treatment decisions did not differ significantly in relation to the method of communication used. CONCLUSIONS: Our study did not find any significant advantage of implementing telemedicine over the use of voice calls in delivering on-line medical control. More user-friendly, smaller devices with clear advantages over voice communication would be required before telemedicine can be successfully implemented in prehospital patient care.
Ambulances ; Blood Pressure ; Busan ; Cellular Phone ; Diagnosis ; Electrocardiography ; Emergency Medical Services ; Humans ; Internet ; Oximetry ; Patient Care ; Remote Consultation ; Telemedicine* ; Telemetry ; Voice

PURPOSE: Interhospital transfers are necessary to meet the needs for emergency medical care with limited resources. 1339 emergency medical information centers are responsible for arranging interhospital transfers. We analyzed the requests for transfer received by an emergency medical information center to explore ways to improve the effectiveness and appropriateness of interhospital transfers. METHODS: We retrospectively analyzed 830 requests for interhospital transfers received by the Busan 1339 Emergency Medical Information Center from Aug 1, 2002, to Oct 31, 2002, by using record from the Center's computer system. RESULTS: Among the total 830 requests, 271 requests were due to trauma, 242 requests were due to acute diseases, 212 were due to chronic diseases, and 39 were due to intoxication. The center managed 647 requests (78.0%) successfully, but 183 requests (22.0%) were impossible to arrange. Transport from a tertiary care facility to a secondary care facility accounted for the majority of requests (305 requests: 36.7%). Over half of the requests were because of temporarily unavailable resources (483 requests: 58.2%). CONCLUSION: Interhospital transfers mediated by the Emergency Medical Information Center are helpful to alleviate emergency department overcrowding and to effectively utilize emergency medical resources.
Acute Disease ; Busan ; Chronic Disease ; Computer Systems ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital ; Information Centers* ; Retrospective Studies ; Secondary Care Centers ; Tertiary Healthcare

BACKGROUND: The prehospital care system in the Pusan area is primitive in organization, and the emergency medical system of every hospital needs to be developed. A analysis of patients who were treated in emergency rooms and who died is necessary in order to establish an emergency medical service system which is appropriate for the community. METHOD: The authors reviewed the records of 117 patients who died in the emergency room of Pusan National University Hospital from January 1998 to December 1998. RESULTS: 1) Among the 117 patients, 68 patients were male (58.1%) and 49 patients were female (41.9%). The incidence of patients over the age of 70 was very high (33 cases, 28.2%). 2) Among the 117 patients, 99 patients died due to disease (84.6%), 16 due to trauma, and 2 due to intoxication. The most prevalent disease was cardiovascular disease. 3) Among the 117 patients, 63 patients arrived voluntarily (53.8%); the remainder were transferred from other hospitals. Forty-eight patients were transported by 119 ambulance (41.0%), and 41 patients were transported by hospital ambulance. 4) As for consciousness level, 52 patients (44.4%) were alert upon arrival at the emergency room, but 42 patients (35.9%) were unresponsive. 5) In 53 patients, the intervals between arrival at the emergency room and the onset of cardiac arrest were from 2 to 24 hours (45.3%). 6) Cardiac arrest was most frequent between 10:00 pm and 8:00 am. 7) Cardiopulmonary resuscitation was done in 74 patients (63.2%), and the mean duration was from 30 minutes to 1 hour. 8) Sixty-six patients were patients of internal medicine, and their mean stay time was 17 hours 27 minutes. CONCLUSION: These results suggest that systematic education in advanced cardiopulmonary resuscitation, expansion of emergency physicians, an increase in the number of intensive care units are required.
Ambulances ; Busan ; Cardiopulmonary Resuscitation ; Cardiovascular Diseases ; Consciousness ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Heart Arrest ; Humans ; Incidence ; Intensive Care Units ; Internal Medicine ; Male

Fenfluramine is an amphetamine-derived substance first developed in the late 1960s for appetite control. Because of its known side effects at therapeutic doses, it is now controlled by the government and has been withdrawn from the market, but the underground market is still big. When over-dosed, it can produce a wide range of neurologic and cardiovascular symptoms, and even death, when a large amount is ingested. We report two cases of acute fenfluramine overdose: a fatal case with generalized seizure and pulseless electrical activity, and a case of relatively mild intoxication.
Appetite ; Fenfluramine* ; Seizures

PURPOSE: The purpose of this study was to use a review of the regional disaster that occurred on April 15, 2002, to improve the National Disaster Medical System and to operate the Disaster Medical Assistance Team and the Mobile Emergency Support Unit better. METHODS: We retrospectively analyzed 39 survivors among the 167 victims of the Air China aircraft crash, Kimhae, Korea, on April 15, 2002, by using reports of the on-site disaster medical assistance team members, recordings of notifications to the Busan and the Kyoungnam 1339 Emergency Information Centers from the scene of accident, and medical records of the victims transported to hospitals. RESULTS: On the date of accident, April 15, 2002, 27 of the 39 survivors were transported to 5 hospitals in Kimhae and 12 were transported to 8 hospitals in Busan. On the next day, April 16, two patients who had been transported to hospitals in Kimhae were transferred to medical centers in Busan. One of them expired, and the other was subsequently transferred to a medical center in Seoul and expired on May 2, 2002. CONCLUSION: Still now, our National Disaster Medical System contains many problems, especially lack of cooperation between related parts, and insufficient communications. This study shows that we should recheck our National Disaster Medical Dystem and construct a cooperative Police, Fire defense organization, 1339 Emergency Medical Information Center, and regional medical service system.
Aircraft* ; Airports* ; Busan ; China* ; Disasters* ; Emergencies ; Fires ; Gyeongsangnam-do* ; Humans ; Information Centers ; Korea ; Medical Assistance ; Medical Records ; Police ; Retrospective Studies ; Seoul ; Survivors