Deformation of a humeral intraosseous catheter due to positioning for thoracostomy.
Clinical and Experimental Emergency Medicine.2018;5(3):208-209. doi:10.15441/ceem.17.243
Clinical and Experimental Emergency Medicine
2014 (1, 1) to Present ISSN: 2383-4625
Sort by
DISPLAY OPTIONS
Format:
Per page:
Clinical and Experimental Emergency Medicine.2018;5(3):204-207. doi:10.15441/ceem.17.252
Pulmonary contusion complicated with endobronchial hemorrhage is potentially life-threatening, particularly in patients with tracheobronchial tree disruption and severe airway bleeding after blunt trauma, and pose a high mortality risk. In such cases, extracorporeal membrane oxygenation (ECMO) can be used as a salvage treatment modality. However, the use of ECMO for moribund trauma patients with respiratory failure may be limited for several reasons, such as intractable bleeding. In this case report, we describe a patient with severe bilateral pulmonary contusions with tracheobronchial tree disruption that was successfully treated using heparin-free venovenous ECMO.
Bronchi ; Contusions* ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Heparin ; Humans ; Lung Injury ; Mortality ; Respiratory Insufficiency ; Salvage Therapy ; Trees
Bronchi ; Contusions* ; Extracorporeal Membrane Oxygenation* ; Hemorrhage ; Heparin ; Humans ; Lung Injury ; Mortality ; Respiratory Insufficiency ; Salvage Therapy ; Trees
Dural sinus thrombosis identified by point-of-care ultrasound.
Clinical and Experimental Emergency Medicine.2018;5(3):199-203. doi:10.15441/ceem.17.237
Dural sinus thrombosis (DST), or cerebral venous thrombosis, is an uncommon cause of stroke. It has a variable presentation, and the symptoms and signs can be non-specific. The diagnosis of DST can be difficult to make and is often delayed or missed. Computed tomography venography or magnetic resonance venography are the typical imaging modalities used to diagnose DST. However, computed tomography venography and magnetic resonance venography both have limitation for emergency department patients. In this article, we report the use of point-of-care ultrasound to facilitate the diagnosis of DST.
Diagnosis ; Diagnostic Imaging ; Emergencies ; Emergency Service, Hospital ; Humans ; Phlebography ; Point-of-Care Systems* ; Sinus Thrombosis, Intracranial* ; Stroke ; Thrombosis ; Ultrasonography* ; Venous Thrombosis
Diagnosis ; Diagnostic Imaging ; Emergencies ; Emergency Service, Hospital ; Humans ; Phlebography ; Point-of-Care Systems* ; Sinus Thrombosis, Intracranial* ; Stroke ; Thrombosis ; Ultrasonography* ; Venous Thrombosis
Therapeutic effect of ascorbic acid on dapsone-induced methemoglobinemia in rats.
Clinical and Experimental Emergency Medicine.2018;5(3):192-198. doi:10.15441/ceem.17.253
OBJECTIVE: Dapsone (diaminodiphenyl sulfone, DDS) is currently used to treat leprosy, malaria, dermatitis herpetiformis, and other diseases. It is also used to treat pneumocystis pneumonia and Toxoplasma gondii infection in HIV-positive patients. The most common adverse effect of DDS is methemoglobinemia from oxidative stress. Ascorbic acid is an antioxidant and reducing agent that scavenges the free radicals produced by oxidative stress. The present study aimed to investigate the effect of ascorbic acid in the treatment of DDS induced methemoglobinemia. METHODS: Male Sprague-Dawley rats were divided into three groups: an ascorbic acid group, a methylene blue (MB) group, and a control group. After DDS (40 mg/kg) treatment via oral gavage, ascorbic acid (15 mg/kg), MB (1 mg/kg), or normal saline were administered via tail vein injection. Depending on the duration of the DDS treatment, blood methemoglobin levels, as well as the nitric oxide levels and catalase activity, were measured at 60, 120, or 180 minutes after DDS administration. RESULTS: Methemoglobin concentrations in the ascorbic acid and MB groups were significantly lower compared to those in the control group across multiple time points. The plasma nitric oxide levels and catalase activity were not different among the groups or time points. CONCLUSION: Intravenous ascorbic acid administration is effective in treating DDS-induced methemoglobinemia in a murine model.
Animals ; Ascorbic Acid* ; Catalase ; Dapsone ; Dermatitis Herpetiformis ; Free Radicals ; Humans ; Leprosy ; Malaria ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Nitric Oxide ; Oxidative Stress ; Plasma ; Pneumonia, Pneumocystis ; Rats* ; Rats, Sprague-Dawley ; Tail ; Toxoplasmosis ; Veins
Animals ; Ascorbic Acid* ; Catalase ; Dapsone ; Dermatitis Herpetiformis ; Free Radicals ; Humans ; Leprosy ; Malaria ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Nitric Oxide ; Oxidative Stress ; Plasma ; Pneumonia, Pneumocystis ; Rats* ; Rats, Sprague-Dawley ; Tail ; Toxoplasmosis ; Veins
Clinical and Experimental Emergency Medicine.2018;5(3):185-191. doi:10.15441/ceem.17.217
OBJECTIVE: Reliable biomarkers of delayed neuropsychological sequelae (DNS) after acute carbon monoxide (CO) poisoning are lacking. This study investigated the associations between potential serum markers and the development of DNS after acute CO poisoning. METHODS: Retrospective chart reviews were conducted for patients diagnosed with acute CO poisoning during a 28-month period. The patients were divided into two groups according to the presence or absence of having developed DNS. Multivariate analysis was performed to identify predictors of DNS after CO poisoning. RESULTS: Of a total of 102 patients, 10 (9.8%) developed DNS. The levels of serum osmolarity, S100B protein, and serum lactate, as well as serum anion gap, were statistically significant in univariate analysis. Multiple logistic regression analysis showed that anion gap (adjusted odds ratio [AOR], 1.36; 95% confidence interval [CI], 1.11 to 1.88), serum lactate level (AOR, 1.74; 95% CI, 1.26 to 2.75), and serum S100B protein level ([AOR, 7.02×10⁵; 95% CI, 4.56×10² to 9.00×10¹⁰] in model 1, [AOR, 3.69×10⁵; 95% CI, 2.49×10² to 2.71×10¹¹] in model 2) were independently associated with DNS development. CONCLUSION: Based on our preliminary results, serum lactate level, serum anion gap, and serum S100B protein level in the emergency department could be informative predictors of DNS development in patients with acute CO poisoning. These markers might have the potential to improve early recognition of DNS in patients with acute CO poisoning.
Acid-Base Equilibrium ; Biomarkers* ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Emergency Service, Hospital ; Humans ; Interleukin-6* ; Lactic Acid* ; Logistic Models ; Multivariate Analysis ; Neurotoxicity Syndromes ; Odds Ratio ; Osmolar Concentration* ; Poisoning ; Retrospective Studies
Acid-Base Equilibrium ; Biomarkers* ; Carbon Monoxide Poisoning* ; Carbon Monoxide* ; Carbon* ; Emergency Service, Hospital ; Humans ; Interleukin-6* ; Lactic Acid* ; Logistic Models ; Multivariate Analysis ; Neurotoxicity Syndromes ; Odds Ratio ; Osmolar Concentration* ; Poisoning ; Retrospective Studies
Clinical and Experimental Emergency Medicine.2018;5(3):177-184. doi:10.15441/ceem.17.238
OBJECTIVE: In severe organophosphate (OP) poisoning, administration of atropine via continuous intravenous infusion is typically considered. To date, there have been no studies on predicting successful atropine discontinuation through plasma cholinesterase (PChE) and serum lactate levels, which are monitored during critical care in severe acute OP poisoning. Therefore, we retrospectively evaluated the usefulness of serum lactate and PChE as predictors of successful discontinuation of atropine infusion. METHODS: This retrospective observational study was performed on consecutive adult patients treated for severe acute OP poisoning between March 2011 and December 2016. We sequentially evaluated serum lactate and PChE levels on emergency department arrival and before a discontinuation trial of atropine infusion. Discontinuation of atropine intravenous infusion was attempted in patients after clearance of respiratory secretions and cessation of bronchoconstriction. Discontinuation of atropine infusion attempts were divided into successful and failed trials. RESULTS: A total of 95 trials were conducted in 62 patients. Serum lactate levels before trials were significantly different between patients with successful and failed trials. The area under the curve for prediction of successful atropine discontinuation using serum lactate levels before trial discontinuation were 0.742 (95% confidence interval, 0.638 to 0.846). PChE level was not significantly different between two groups. CONCLUSION: Serum lactate levels before the discontinuation trial of atropine infusion served to predict successful discontinuation in severe acute OP poisoning.
Adult ; Atropine* ; Bronchoconstriction ; Cholinesterases ; Critical Care ; Emergency Service, Hospital ; Humans ; Infusions, Intravenous ; Lactic Acid* ; Observational Study ; Organophosphate Poisoning* ; Plasma ; Poisoning ; Prognosis ; Retrospective Studies
Adult ; Atropine* ; Bronchoconstriction ; Cholinesterases ; Critical Care ; Emergency Service, Hospital ; Humans ; Infusions, Intravenous ; Lactic Acid* ; Observational Study ; Organophosphate Poisoning* ; Plasma ; Poisoning ; Prognosis ; Retrospective Studies
Korean Cardiac Arrest Research Consortium (KoCARC): rationale, development, and implementation.
Clinical and Experimental Emergency Medicine.2018;5(3):165-176. doi:10.15441/ceem.17.259
OBJECTIVE: This study aimed to describe the conceptualization, development, and implementation processes of the newly established Korean Cardiac Arrest Resuscitation Consortium (KoCARC) to improve out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: The KoCARC was established in 2014 by recruiting hospitals willing to participate voluntarily. To enhance professionalism in research, seven research committees, the Epidemiology and Preventive Research Committee, Community Resuscitation Research Committee, Emergency Medical System Resuscitation Research Committee, Hospital Resuscitation Research Committee, Hypothermia and Postresuscitation Care Research Committee, Cardiac Care Resuscitation Committee, and Pediatric Resuscitation Research Committee, were organized under a steering committee. The KoCARC registry was developed with variables incorporated in the currently existing regional OHCA registries and Utstein templates and were collected via a web-based electronic database system. The KoCARC study population comprises patients visiting the participating hospitals who had been treated by the emergency medical system for OHCA presumed to have a cardiac etiology. RESULTS: A total of 62 hospitals volunteered to participate in the KoCARC, which captures 33.0% of the study population in Korea. Web-based data collection started in October 2015, and to date (December 2016), there were 3,187 cases compiled in the registry collected from 32 hospitals. CONCLUSION: The KoCARC is a self-funded, voluntary, hospital-based collaborative research network providing high level evidence in the field of OHCA and resuscitation. This paper will serve as a reference for subsequent KoCARC manuscripts and for data elements collected in the study.
Cardiopulmonary Resuscitation ; Data Collection ; Emergencies ; Epidemiology ; Heart Arrest* ; Humans ; Hypothermia ; Korea ; Out-of-Hospital Cardiac Arrest ; Professionalism ; Registries ; Resuscitation
Cardiopulmonary Resuscitation ; Data Collection ; Emergencies ; Epidemiology ; Heart Arrest* ; Humans ; Hypothermia ; Korea ; Out-of-Hospital Cardiac Arrest ; Professionalism ; Registries ; Resuscitation
Clinical and Experimental Emergency Medicine.2018;5(3):156-164. doi:10.15441/ceem.17.254
OBJECTIVE: We aimed to investigate the factors related to satisfaction with the pediatric emergency department service in Korea. METHODS: This study examined data from the Korea Health Panel Data from 2010 to 2012. Pediatric patients who visited the emergency department at least once between 2010 and 2012 in Korea were included. Data were collected on patient satisfaction with the emergency department service, and factors related to the patient characteristics, emergency department service process, and medical institution. We compared the dissatisfied and satisfied groups, and calculated the odds ratios for satisfaction according to each variable. RESULTS: A total of 1,505 emergency department visits from 947 pediatric patients during the 3-year period were analyzed. We estimated that about 79.5% of patients in the population were satisfied. The odds of expressing satisfaction were higher among males than in females, and among patients who were hospitalized after emergency department treatment compared to those who were transferred to another hospital. Conversely, the odds of expressing satisfaction were lower among patients who had a chronic disease, a financial source other than National Health Insurance, experienced hospitalization within 1 year. CONCLUSION: Our study results might be helpful for establishing a satisfactory pediatric emergency medical service system. In the future, further prospective studies evaluating the causal relationships between the relevant factors and patient satisfaction are warranted.
Chronic Disease ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Hospitalization ; Humans ; Korea* ; Male ; National Health Programs ; Odds Ratio ; Parents ; Patient Satisfaction ; Pediatrics ; Prospective Studies
Chronic Disease ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Female ; Hospitalization ; Humans ; Korea* ; Male ; National Health Programs ; Odds Ratio ; Parents ; Patient Satisfaction ; Pediatrics ; Prospective Studies
Clinical and Experimental Emergency Medicine.2018;5(3):150-155. doi:10.15441/ceem.17.250
OBJECTIVE: The objective of this study was to test the hypothesis that hemoglobin concentration after return of spontaneous circulation (ROSC) is associated with neurologic outcome after cardiac arrest in patients treated with targeted temperature management. METHODS: We studied consecutive adult patients with out-of-hospital cardiac arrest treated with targeted temperature management between January 2009 and December 2015. We investigated the association between post ROSC hemoglobin concentrations and good neurologic outcome (defined as Cerebral Performance Category of 1 and 2) at hospital discharge using multivariate logistic regression analysis. RESULTS: A total of 246 subjects were ultimately included in this study. The mean age was 54 years (standard deviation, 17); 168 (68%) subjects were male. Eighty-seven (35%) subjects had a good neurologic outcome at hospital discharge. Hemoglobin concentrations were higher in the good outcome group than in the poor outcome group (14.4±2.0 vs. 12.8±2.5 g/dL, P < 0.001). Multivariate logistic regression analysis showed that hemoglobin concentrations were associated with good neurologic outcome at hospital discharge after adjusting for other confounding factors (adjusted odds ratio, 1.186; 95% confidence interval, 1.008 to 1.395). CONCLUSION: In post ROSC patients, hemoglobin concentrations after ROSC were associated with neurologic outcome at hospital discharge.
Adult ; Heart Arrest* ; Humans ; Hypothermia, Induced ; Logistic Models ; Male ; Odds Ratio ; Out-of-Hospital Cardiac Arrest
Adult ; Heart Arrest* ; Humans ; Hypothermia, Induced ; Logistic Models ; Male ; Odds Ratio ; Out-of-Hospital Cardiac Arrest
Clinical and Experimental Emergency Medicine.2018;5(3):144-149. doi:10.15441/ceem.17.242
OBJECTIVE: In South Korea, the Gyeonggi Fire Services introduced a multi-tiered dispatch system for out-of-hospital cardiac arrest (OHCA) cases in July 2015. In this study, we investigated whether the multi-tiered dispatch system improved the pre-hospital return of the spontaneous circulation (ROSC) rate. METHODS: All non-traumatic adult OHCAs treated and transported by the 119 emergency medical system from July 2015 to December 2015 were included in the study. Demographic and pre-hospital Utstein element-data were collected from the emergency medical system OHCA database. The primary outcome was pre-hospital ROSC as measured at the scene. RESULTS: Of the included OHCAs, 1,436 (89.0%) were categorized to the single-tiered dispatch group and 162 (10.1%) to the multi-tiered dispatch group. The rate of administration of advanced airway ventilation (61.1% vs. 48.0%, P=0.002) and intravenous access (18.5% vs. 12.5%, P=0.037) was higher in the multi-tiered group compared to that in the single-tiered group. The use of epinephrine was higher in the multi-tiered group (4.9% vs. 1.5%, P=0.002). The pre-hospital ROSC rates in the multi-tiered group were higher when compared with the single-tiered group, but the difference was not significant (10.5% vs. 7.5%, P=0.218). The adjusted odds ratio for pre-hospital ROSC rates in the multi-tiered group was 1.29 (95% confidence interval, 0.69 to 2.40). CONCLUSION: The multi-tiered dispatch system was not associated with a significant increase in the pre-hospital ROSC rate during the early phase of its implementation, even though advanced maneuvers were performed more frequently.
Adult ; Emergencies ; Emergency Medical Services ; Epinephrine ; Fires ; Gyeonggi-do* ; Humans ; Korea* ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Ventilation
Adult ; Emergencies ; Emergency Medical Services ; Epinephrine ; Fires ; Gyeonggi-do* ; Humans ; Korea* ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Ventilation
Country
Republic of Korea
Publisher
Korean Society of Emergency Medicine
ElectronicLinks
http://ceemjournal.org/Editor-in-chief
Adam J. Singer
office@ceemjournal.org
Abbreviation
Clin Exp Emerg Med
Vernacular Journal Title
ISSN
2383-4625
EISSN
2383-4625
Year Approved
2017
Current Indexing Status
Currently Indexed
Start Year
2014
Description
It launched in 2014, published quarterly on the last day of March, June, September, and December. This journal focuses on both basic and clinical research of emergency medicine including pathophysiology, epidemiology, diagnosis, prognosis, treatment, and simulation. It is the member journal of the Korean Society of Emergency Medicine.
Powered by IMICAMS(
备案号: 11010502037788, 京ICP备10218182号-8)