BACKGROUND: While point-of-care testing is being used increasingly as a basis for making decisions about erythrocyte transfusion, no valid standards or guidelines have been developed concerning the accuracy of measuring hemoglobin concentration. METHODS: To compare results from blood gas and auto blood cell count analyzers with respect to hemoglobin, 40 patient blood residual samples which had been withdrawn into 4 mL sodium heparin and EDTA tubes, were analyzed twice by each devices. RESULTS: Passing-Bablok comparisons for hemoglobin (g/dL) with the Nova CCX (y) and Advia 2120 (x) were y=0.877x+2.471 (r=0.985). Additionally, hemoglobin levels from the blood gas analyzer were out of the calculated range at the clinical decision point. CONCLUSION: Blood gas analyzers as point-of care testing exhibited a slightly higher hemoglobin level than auto blood cell count analyzers. Some also produced values of hemoglobin out of the expected range at the clinical decision point. Therefore, the use of blood gas analyzers for hemoglobin levels is limited and it is recommended that the assessment of hemoglobin for transfusion should be determined using auto blood cell count analyzers.
Blood Cell Count ; Blood Cells ; Edetic Acid ; Erythrocyte Transfusion ; Hemoglobins ; Heparin ; Humans

OBJECTIVE: Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. METHODS: This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application. RESULTS: The mean inter-incisor distance significantly decreased from 4.3 to 2.6 cm (P < 0.001). Fifty-seven participants classified as I and II were newly classified as III and IV according to the modified Mallampati classification after cervical collar application (16% to 91%). The angles of neck extension significantly decreased from 44° to 22° after cervical collar application (P < 0.001). Before cervical collar application, our simulations predicted that 14 of 76 participants (18%) would have a difficult airway, whereas after cervical collar application, 76 of 76 (100%) were predicted to have a difficult airway. CONCLUSION: All values for the LEMON criteria (mouth opening, modified Mallampati classification, and neck extension) worsened significantly after cervical collar application. Additionally, a difficult airway was predicted in all participants after cervical collar application.
Airway Management ; Classification ; Head ; Healthy Volunteers ; Humans ; Intubation, Intratracheal ; Mouth ; Neck ; Neck Injuries

Background: According to the recent coronavirus disease 2019 (COVID-19) pandemic experience, many emergency departments experience difficulties in responding to emerging infectious diseases and this has led to a public health crisis. Our emergency department (ED) is designed to respond to mass outbreaks of infection. Three major preparations were taken to respond to infectious disease; first, to improve the emergency department facilities;second, to created programs to respond to each phase of an epidemic of COVID-19; lastly, to implemented education and training to promote the safety of medical staff. We would like to share the actual responses and statistics of patients visiting emergency department during COVID-19 periods of pandemic. Materials and Methods: This research was conducted through a retrospective chart analysis provided by a public medical center with 502 beds since the first report of a COVID-19 confirmed case on January 19, 2020 to June 15, 2020 in Seoul, the capital of Korea. Our emergency department was designed based on Korean Regional Emergency Center Facility Standards, and modified throughout each phases of COVID-19 outbreak. Patients suspected to be infectious are screened in the triage, separating them from general patients, and then receive isolation treatment in isolated wards. Results: A total of 4,352 patients visited the ED. 3,202 screenings were conducted with 5 confirmed cases. Another 1,150 patients were treated with general emergent symptoms.There were no problems such as closure of the emergency department or isolation of medical staff while managing COVID-19 confirmed patients. Conclusion Improving emergency department facilities, create an operational program to respond to each phase of COVID-19 outbreak and implement educational programs enabled large number of screening tests and hospitalization for COVID-19 suspected patients while maintaining general medical services. Research in emergency department designs and operational programs should increase to combine research data with better ideas to respond not only during regular periods but also during periods of pandemic.

Background: According to the recent coronavirus disease 2019 (COVID-19) pandemic experience, many emergency departments experience difficulties in responding to emerging infectious diseases and this has led to a public health crisis. Our emergency department (ED) is designed to respond to mass outbreaks of infection. Three major preparations were taken to respond to infectious disease; first, to improve the emergency department facilities;second, to created programs to respond to each phase of an epidemic of COVID-19; lastly, to implemented education and training to promote the safety of medical staff. We would like to share the actual responses and statistics of patients visiting emergency department during COVID-19 periods of pandemic. Materials and Methods: This research was conducted through a retrospective chart analysis provided by a public medical center with 502 beds since the first report of a COVID-19 confirmed case on January 19, 2020 to June 15, 2020 in Seoul, the capital of Korea. Our emergency department was designed based on Korean Regional Emergency Center Facility Standards, and modified throughout each phases of COVID-19 outbreak. Patients suspected to be infectious are screened in the triage, separating them from general patients, and then receive isolation treatment in isolated wards. Results: A total of 4,352 patients visited the ED. 3,202 screenings were conducted with 5 confirmed cases. Another 1,150 patients were treated with general emergent symptoms.There were no problems such as closure of the emergency department or isolation of medical staff while managing COVID-19 confirmed patients. Conclusion Improving emergency department facilities, create an operational program to respond to each phase of COVID-19 outbreak and implement educational programs enabled large number of screening tests and hospitalization for COVID-19 suspected patients while maintaining general medical services. Research in emergency department designs and operational programs should increase to combine research data with better ideas to respond not only during regular periods but also during periods of pandemic.