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Clinical and Experimental Emergency Medicine

Cliff Reid, Toby Fogg, Geoff Healy
No abstract text is available yet for this article.
September 2018: Clinical and Experimental Emergency Medicine
Laura T Director, David C Mackenzie
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...
September 2018: Clinical and Experimental Emergency Medicine
Changwoo Kang, Dong Hoon Kim, Taeyun Kim, Soo Hoon Lee, Jin Hee Jeong, Sang Bong Lee, Jin Hyun Kim, Myeong Hee Jung, Kyung-Woo Lee, In Sung Park
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...
September 2018: Clinical and Experimental Emergency Medicine
Hyukhoon Kim, Sangchun Choi, Eunjung Park, Eunhui Yoon, Younggi Min, Samsun Lampotang
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...
September 2018: Clinical and Experimental Emergency Medicine
Ho Chul Kwon, Yong Sung Cha, Gyo Jin An, Yoonsuk Lee, Hyun Kim
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...
September 2018: Clinical and Experimental Emergency Medicine
Joo Yeong Kim, Sung Oh Hwang, Sang Do Shin, Hyuk Jun Yang, Sung Phil Chung, Sung Woo Lee, Kyung Jun Song, Seung Sik Hwang, Gyu Chong Cho, Sung Woo Moon, Kyuseok Kim, Won Young Kim, Seil Oh, Young Ho Kwak
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...
September 2018: Clinical and Experimental Emergency Medicine
Kyeong Jae Lee, Min Joung Kim, Joon Min Park, Kyung Hwan Kim, Junseok Park, Dong Wun Shin, Hoon Kim, Woochan Jeon, Hyunjong Kim
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...
September 2018: Clinical and Experimental Emergency Medicine
Kyung Hune Cho, Jong-Hak Park, Sung Woo Moon, Seong-Keun Yun, Jin-Young Kim
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...
September 2018: Clinical and Experimental Emergency Medicine
Cliff Reid, Peter Brindley, Chris Hicks, Simon Carley, Clare Richmond, Michael Lauria, Scott Weingart
The primary survey assessment is a cornerstone of resuscitation processes. The name itself implies that it is the first step in resuscitation. In this article, we argue that in an organized resuscitation the primary survey must be preceded by a series of steps to optimize safety and performance and set the stage for the execution of expert team behavior. Even in the most time critical situations, an effective team will optimize the environment, perform self-assessments of personal readiness and participate in a preemptive team brief...
September 2018: Clinical and Experimental Emergency Medicine
Daesung Kim, Soo Hyun Kim, Kyu Nam Park, Sang Hoon Oh, Young Min Kim, Chun Song Youn
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 quantified 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...
September 2018: Clinical and Experimental Emergency Medicine
Kyoung Min Ryu, Sung Wook Chang
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...
September 2018: Clinical and Experimental Emergency Medicine
Takaaki Mori, Takateru Ihara, Yusuke Hagiwara
A previously healthy 1-year-old boy suddenly began coughing while eating a dried sweet potato. Because he continued gagging after vomiting a piece of the dried sweet potato, his mother brought him to our emergency room. Upon arrival, despite normal pulmonary findings, he was drooling and gagging. Ultrasonography was performed because food impaction at the upper esophagus was suspected based on his medical history and physical examination, and results showed that a linear hyperechoic lesion was obstructing the posterior esophageal wall...
June 2018: Clinical and Experimental Emergency Medicine
Jae Hee Lee, Kyoung Ae Kong, Duk Hee Lee, Yoon Hee Choi, Koo Young Jung
Objective: Several abbreviated versions of the Alcohol Use Disorder Identification Test (AUDIT) have been developed and are widely used in clinical settings. In this study, we provide evidence supporting the use of abbreviated versions of AUDIT by comparing the utility of various abbreviated versions and determining cut-off values for the population of South Korea. Methods: Data were obtained from the 4th to 6th Korean National Health and Nutrition Examination Surveys...
June 2018: Clinical and Experimental Emergency Medicine
Duk Ho Kim, Yoon Hee Choi, Seong Jong Yun, Sun Hwa Lee
Objective: Most patients with head trauma require brain computed tomography (CT) in the emergency department. However, the requirement for facial CT remains controversial. The aim of this study was to evaluate the diagnostic value of brain CT alone for detection of facial fractures and its ability to determine the requirement for additional facial CT. Methods: This retrospective multicenter study was conducted in two tertiary hospitals in Seoul, Republic of Korea, between January 2014 and December 2015...
June 2018: Clinical and Experimental Emergency Medicine
Simona Susanu, Marco Angelillis, Cristina Giannini, Rossella Binella, Anna Matteoni, Rita Bellucci, Sandro Balestri, Nicola Ferrara, Federico Falchi, Giuliano Micheletti, Anna Sonia Petronio
Objective: The aim of this study was to investigate (1) whether the learning curve of new catheterization laboratory operators increases the incidence of complications of transradial access during percutaneous coronary interventions and (2) whether manual compression with a two-step approach is safe and efficient for radial access hemostasis. Methods: We performed a prospective study with all consecutive patients who underwent a coronary diagnostic or intervention procedure with radial access...
June 2018: Clinical and Experimental Emergency Medicine
Ajung Kim, Hyunjong Song, Namsoo Park, Sangchun Choi, Joonpil Cho
Objective: The injury-related disease burden in South Korea is relatively high compared to that in other nations. This study was conducted to identify the scale and causes of injury by severity, using an injury pyramid and analyzing the sex and age-dependent differences and the basic demographic characteristics. Methods: Unintentional injury was estimated for each group after classifying injury-related deaths, hospitalizations, and outpatient department (OPD) visits based on their severity...
June 2018: Clinical and Experimental Emergency Medicine
Yong Sung Cha, Kang Hyun Lee, Seok Jeong Lee, Ho Chul Kwon, Jong Wook Lee, Hyung Il Kim, Oh Hyun Kim, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang
Objective: Clinically, consumptive coagulopathy, such as disseminated intravascular coagulopathy (DIC), is the most important among the common venomous snakebite complications owing to the serious hemorrhage risk associated with this condition. We evaluated the predictive value of the delta neutrophil index (DNI)-a new indicator for immature granulocytes-for DIC diagnosis. Methods: This retrospective observational study consecutively assessed adult patients with venomous snakebites for over 51 months...
June 2018: Clinical and Experimental Emergency Medicine
Yong In Kim, Ji Ho Ryu, Mun Ki Min, Maeng Real Park, Soon Chang Park, Seok Ran Yeom, Sang Kyoon Han, Sung Wook Park, Seong Hwa Lee
Objective: To assess whether ultrasonographic examination compared to chest radiography (CXR) is effective for evaluating complications after central venous catheterization. Methods: We performed a prospective observational study. Immediately after central venous catheter insertion, we asked the radiologic department to perform a portable CXR scan. A junior and senior medical resident each performed ultrasonographic evaluation of the position of the catheter tip and complications such as pneumothorax and pleural effusion (hemothorax)...
June 2018: Clinical and Experimental Emergency Medicine
Patrick J Coppler, Benjamin S Abella, Clifton W Callaway, Minjung Kathy Chae, Seung Pill Choi, Jonathan Elmer, Won Young Kim, Young-Min Kim, Michael Kurz, Joo Suk Oh, Joshua C Reynolds, Jon C Rittenberger, Kelly N Sawyer, Chun Song Youn, Byung Kook Lee, David F Gaieski
Objective: A growing interest in extracorporeal cardiopulmonary resuscitation (ECPR) as a rescue strategy for refractory adult out-of-hospital cardiac arrest (OHCA) currently exists. This study aims to determine current standards of care and practice variation for ECPR patients in the USA and Korea. Methods: In December 2015, we surveyed centers from the Korean Hypothermia Network (KORHN) Investigators and the US National Post-Arrest Research Consortium (NPARC) on current targeted temperature management and ECPR practices...
June 2018: Clinical and Experimental Emergency Medicine
Byunghyun Kim, Kyung Su Kim
Atazanavir is a protease inhibitor approved for use in combination with other antiretroviral drugs for the treatment of human immunodeficiency virus infection. Atazanavir and other protease inhibitors can sometimes induce corrected QT prolongation and ventricular arrhythmia. A 40-year-old man with no comorbidities, except human immunodeficiency virus 1 infection, presented with palpitations 3 days after an overdose of 150 caps of atazanavir, with suicidal intent. His initial electrocardiogram showed monomorphic ventricular tachycardia, and hyperbilirubinemia was observed in his initial blood test...
June 2018: Clinical and Experimental Emergency Medicine
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