A booster dose can result in a similar reaction to the initial dose. Neuromuscular blocking agents (NMBAs) can produce a comparable reaction in the absence of specific pathophysiologic alterations. Case: An initial dose of rocuronium 40 mg was given to a male patient (50 years old, height 168 cm, weight 54 kg, body mass index 19.13 kg/m2 ) for anesthesia. The onset was usual, but the duration was brief. Two booster doses were administered at 20 min intervals, but recovery came quickly. So, acute tolerance was suspected. Muscle function was restored to greater than train-of-four ratio 0.75 while spontaneous aided breathing was maintained without the need of further NMBAs. Following the operation, sugammadex (1.85 mg/kg) was provided to prevent residual neuromuscular inhibition. Conclusions: Anesthetists must be able to suspect acute tolerance to NMBAs in patients with no unique medical history and have a plan to resolve it.

A booster dose can result in a similar reaction to the initial dose. Neuromuscular blocking agents (NMBAs) can produce a comparable reaction in the absence of specific pathophysiologic alterations. Case: An initial dose of rocuronium 40 mg was given to a male patient (50 years old, height 168 cm, weight 54 kg, body mass index 19.13 kg/m2 ) for anesthesia. The onset was usual, but the duration was brief. Two booster doses were administered at 20 min intervals, but recovery came quickly. So, acute tolerance was suspected. Muscle function was restored to greater than train-of-four ratio 0.75 while spontaneous aided breathing was maintained without the need of further NMBAs. Following the operation, sugammadex (1.85 mg/kg) was provided to prevent residual neuromuscular inhibition. Conclusions: Anesthetists must be able to suspect acute tolerance to NMBAs in patients with no unique medical history and have a plan to resolve it.

A booster dose can result in a similar reaction to the initial dose. Neuromuscular blocking agents (NMBAs) can produce a comparable reaction in the absence of specific pathophysiologic alterations. Case: An initial dose of rocuronium 40 mg was given to a male patient (50 years old, height 168 cm, weight 54 kg, body mass index 19.13 kg/m2 ) for anesthesia. The onset was usual, but the duration was brief. Two booster doses were administered at 20 min intervals, but recovery came quickly. So, acute tolerance was suspected. Muscle function was restored to greater than train-of-four ratio 0.75 while spontaneous aided breathing was maintained without the need of further NMBAs. Following the operation, sugammadex (1.85 mg/kg) was provided to prevent residual neuromuscular inhibition. Conclusions: Anesthetists must be able to suspect acute tolerance to NMBAs in patients with no unique medical history and have a plan to resolve it.

A booster dose can result in a similar reaction to the initial dose. Neuromuscular blocking agents (NMBAs) can produce a comparable reaction in the absence of specific pathophysiologic alterations. Case: An initial dose of rocuronium 40 mg was given to a male patient (50 years old, height 168 cm, weight 54 kg, body mass index 19.13 kg/m2 ) for anesthesia. The onset was usual, but the duration was brief. Two booster doses were administered at 20 min intervals, but recovery came quickly. So, acute tolerance was suspected. Muscle function was restored to greater than train-of-four ratio 0.75 while spontaneous aided breathing was maintained without the need of further NMBAs. Following the operation, sugammadex (1.85 mg/kg) was provided to prevent residual neuromuscular inhibition. Conclusions: Anesthetists must be able to suspect acute tolerance to NMBAs in patients with no unique medical history and have a plan to resolve it.

A booster dose can result in a similar reaction to the initial dose. Neuromuscular blocking agents (NMBAs) can produce a comparable reaction in the absence of specific pathophysiologic alterations. Case: An initial dose of rocuronium 40 mg was given to a male patient (50 years old, height 168 cm, weight 54 kg, body mass index 19.13 kg/m2 ) for anesthesia. The onset was usual, but the duration was brief. Two booster doses were administered at 20 min intervals, but recovery came quickly. So, acute tolerance was suspected. Muscle function was restored to greater than train-of-four ratio 0.75 while spontaneous aided breathing was maintained without the need of further NMBAs. Following the operation, sugammadex (1.85 mg/kg) was provided to prevent residual neuromuscular inhibition. Conclusions: Anesthetists must be able to suspect acute tolerance to NMBAs in patients with no unique medical history and have a plan to resolve it.

Background: The most recent variant of concern, omicron (B.1.1.529), has caused numerous cases worldwide including the Republic of Korea due to its fast transmission and reduced vaccine effectiveness. Methods: A mathematical model considering age-structure, vaccine, antiviral drugs, and influx of the omicron variant was developed. We estimated transmission rates among age groups using maximum likelihood estimation for the age-structured model. The impact of non-pharmaceutical interventions (NPIs; in community and border), quantified by a parameter μ in the force of infection, and vaccination were examined through a multi-faceted analysis. A theory-based endemic equilibrium study was performed to find the manageable number of cases according to omicron- and healthcare-related factors. Results: By fitting the model to the available data, the estimated values of μ ranged from 0.31 to 0.73, representing the intensity of NPIs such as social distancing level. If μ < 0.55 and 300,000 booster shots were administered daily from February 3, 2022, the number of severe cases was forecasted to exceed the severe bed capacity. Moreover, the number of daily cases is reduced as the timing of screening measures is delayed. If screening measure was intensified as early as November 24, 2021 and the number of overseas entrant cases was contained to 1 case per 10 days, simulations showed that the daily incidence by February 3, 2022 could have been reduced by 87%. Furthermore, we found that the incidence number in mid-December 2021 exceeded the theory-driven manageable number of daily cases. Conclusion NPIs, vaccination, and antiviral drugs influence the spread of omicron and number of severe cases in the Republic of Korea. Intensive and early screening measures during the emergence of a new variant is key in controlling the epidemic size. Using the endemic equilibrium of the model, a formula for the manageable daily cases depending on the severity rate and average length of hospital stay was derived so that the number of severe cases does not surpass the severe bed capacity.

Objective: Bystander cardiopulmonary resuscitation is important for the survival of cardiac arrest patients. The rapid recognition of cardiac arrest by dispatchers leads to quicker initiation of bystander cardiopulmonary resuscitation. This study examines the use of video phone by dispatchers in recognizing cardiac arrest. Methods: Between June to October 2018, 227 participants were recruited (114 lay people and 113 dispatchers) for this study. Lay people participants answered prepared questionnaires after watching 6 scenario video clips of a collapsed virtual patient with unresponsiveness. Dispatchers were divided into two groups: audio call group and video call group. The audio call group judged for occurrence of a cardiac arrest in the 6 scenarios, referring only to questionnaires of the lay people. The video call group judged the same scenarios referring to questionnaires and scenario video clips. The score of correct answers of each scenario was subsequently analyzed. Results: Significant difference was obtained for the total score among the audio call group and the video call group (3.67 ±1.3 vs. 4.66±1.11, respectively; P<0.001). In 2 scenarios concerning cardiac arrest with gasping, the correct answer rate was higher in the video call group (63.9% vs. 85.2%, P<0.001; 59.5% vs. 74.8%, P=0.014). In 2 other scenarios showing non-cardiac arrest with normal breathing, the correct answer rate was also higher in the video call group (52.7% vs. 71.4, P=0.010; 38.2% vs. 63.6%, P<0.001). Conclusion This study determined that compared to the audio call group, dispatchers of the video call group were more accurate in recognizing cardiac arrest. This indicates that video phones are more helpful in determining gasping and in discerning cardiac arrest with syncope or seizure.

BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28–2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69–3.42), having a lower education level (OR = 2.29, 95% CI = 1.33–3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32–3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43–46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75–4.23), lowered appetite (OR = 3.27, 95% CI = 2.16–4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83–4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.
Aged* ; Appetite ; Deglutition Disorders* ; Eating ; Education ; Female ; Food Habits ; Gwangju ; Gyeonggi-do ; Humans ; Korea* ; Logistic Models ; Malnutrition ; Mastication ; Nutrition Assessment ; Nutritional Status ; Risk Assessment ; Seoul

We made a mistake in presenting ORCID of Chorong Kim.

PURPOSE: The purpose of this study was to investigate the effects of a simulation-based practice program on nursing students' self-efficacy, critical thinking disposition and problem solving process.METHOD: A quasi-experimental non-equivalent control group pre-post test, design was used. A total of 111 students, 53 students for the experimental group and 58 students for the control group. The experimental group participated in the program for 30 hours during 4 days. Data were analyzed using descriptive statistics, X2-test, Fisher's exact probability test, and t-test.RESULTS: The results showed that the simulation-based practice program significantly improved self - efficacy and critical thinking disposition of nursing students. However, there was no significant difference in the problem solving process.CONCLUSION: Therefore, to promote self-efficacy and critical thinking disposition in nursing students, it is necessary to actively use simulation-based practice program. To improve the problem solving process in the future, it is necessary to apply the simulation-based practice program to the nursing curriculum continuously and to use it considering sufficient education periods.
Curriculum ; Education ; Evaluation Studies as Topic ; Humans ; Methods ; Nursing ; Problem Solving ; Students, Nursing ; Thinking