Clinical and Experimental Emergency Medicine

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OBJECTIVE: In South Korea, the National Fire Agency (NFA) conducted a pilot project on the advanced life support (ALS) protocol, including epinephrine administration, to improve the survival rate of out-of hospital cardiac arrest (OHCA). Therefore, this study aimed to evaluate the effect of the ALS protocol of NFA on prehospital return of spontaneous circulation (PROSC) in patients with OHCA. METHODS: This study was conducted on patients with adult-presumed cardiac arrest between January and December 2020...

Organophosphorus agents are easily absorbed via respiratory, gastrointestinal, and dermal routes, and inhibit the acetylcholine transferase enzyme (AChE), which is responsible for the majority of toxicity caused by organophosphates in the body. A comprehensive search was conducted across three prominent databases, namely Google Scholar, PubMed, and Science Direct, to identify relevant articles published. The search focused on the keywords "MgSO4" or "magnesium sulfate" in conjunction with "organophosphate" or "organophosphate poisoning...

BACKGROUND: This study investigated the status and evaluated factors associated with knowledge and attitudes regarding concussions among Korean parents of children aged 6-18 years. METHODS: A cross-sectional online survey was employed to collect data from a panel of parents in the Republic of Korea in 2023. To assess knowledge and attitudes regarding concussions, participants completed a validated questionnaire. The outcome variables of the total knowledge and total attitude scores, which ranged from 0 to 30 and 7 to 49, respectively, were categorized into three levels based on approximately 33% increments...

Abdominal pain is one of the most common presenting chief complaints in the emergency department (ED). Erector spinae plane block (ESPB) is an ultrasound-guided nerve block with proven effectiveness in treating visceral and somatic abdominal pain. Despite the increasing popularity of ESPB, its role in the management of non-surgical abdominal pain has not yet been characterized. Our scoping review aims to review the current literature on the safety and efficacy of ESPB in the management of patients experiencing intractable, non-surgical abdominal pain...

Airway management is a fundamental and intricate process that involves a sequence of integrated tasks. Situations requiring emergency airway management may occur in emergency department, intensive care units, and various other spaces. Emergency airway management can face a variety of challenges during preparation, intubation, and post-intubation, and may result in significant complications for the patients. Therefore, many countries are establishing step-by-step systemization and detailed guidelines, and updating the content based on the latest research...

This case concerns a 59-year-old male with a past medical history of hypertension, chronic renal insufficiency, and autoimmune pancreatitis secondary to IgG4-related disease, on chronic steroids. The patient experienced acute onset of lightheadedness, a tingling sensation to both hands, and jaw tightness while masturbating. He was found to have a Type A aortic dissection. This is the first case of its kind to document an atypical, painless aortic dissection presentation in a patient with IgG4-related disease...

Uncontrolled hemorrhage and trauma-induced coagulopathy (TIC) remain the two predominante causes of preventable death after trauma. Early control of bleeding sources along with rapid detection, characterization and management of TIC have been associated with improved outcomes. However, recent surveys confirm vast heterogeneity in the clinical diagnosis and management of acute trauma hemorrhage and TIC even in advanced trauma centers. In addition, conventional coagulation assays, although still used frequently during the early assessment of bleeding trauma patients, have their limitations...

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Hyperbaric Oxygen Therapy (HBOT) has garnered significant attention as a therapeutic principle with potential benefits across a variety spectrum of medical conditions, ranging from wound healing and ischemic conditions to neurologic disorders and radiation-induced tissue damage. HBOT involves the administration of 100% oxygen at higher atmospheric pressures, leading to increased oxygen dissolved in bodily fluids and tissues. The elevated oxygen levels are proposed to facilitate tissue repair, reduce inflammation, and promote angiogenesis...

INTRODUCTION: The optimal diagnosis strategy for pulmonary embolism (PE) in the emergency department (ED) remains complex. This review summarizes PE diagnosis with clinical presentation, decision rules and investigations for acute PE. METHODS: This review was performed using studies published between January 1, 2010, and September 1, 2023. RESULTS: PE should be considered in ED in patients with chest pain, shortness of breath, syncope or signs of deep veinous thrombosis...

Airway foreign body removal is challenging. It is a time-limited and life-saving procedure. We report a successful case of life-saving by pushing a foreign body further into the distal airway to block one lung and save the other lung. A 12-month-old boy presented in the emergency department with choking. Upon arrival, his mental status was alert. However, respiratory failure rapidly progressed and arrest occurred. We tried to push the foreign body distal by pushing the endotracheal tube as deep as possible and inserting stylet further...

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OBJECTIVE: Preoxygenation during the peri-intubation period is now considered a critical aspect of rapid sequence intubation and an important skill for emergency medicine and critical care providers. Peri-intubation hypoxemia carries significant risk, including cardiac arrest, and care must be taken for appropriate management including through apnea and initiation of laryngoscopy. Appropriate selection of preoxygenation devices should depend on underlying physiology to optimize oxygenation prior to intubation attempts...

Symptomatic urolithiasis is a common cause of emergency department (ED) visits, with non-contrast computed tomography (NCCT) considered the imaging gold standard. According to current guidelines, POCUS is limited to the evaluation of hydronephrosis as a secondary sign of acute ureteral stones. However, the use of POCUS to detect ureteral stones may lead to decreased radiation to the patient and a more rapid diagnosis. This case series describes 10 patients with suspected symptomatic urolithiasis who were diagnosed accurately by emergency physicians using POCUS to detect obstructive ureteral stones...

BACKGROUND: Emergency department (ED) triage systems are used to classify the severity and urgency of emergency patients, and Korean medical institutions use the Korean Triage and Acuity Scale (KTAS). During the coronavirus disease 2019 (COVID-19) pandemic, appropriate treatment for emergency patients was delayed due to various circumstances, such as overcrowding of EDs, lack of medical workforce resources, and increased workload on medical staff. The purpose of this study was to evaluate the accuracy of the KTAS in predicting the urgency of emergency patients during the COVID-19 pandemic...

BACKGROUND: Musculoskeletal ultrasound is increasingly used as the modality of choice in diagnosing many medical situations. The present study aimed to compare the efficacy of point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to detect acute medial meniscus knee tears. MATERIALS AND METHODS: The prospective study was conducted on patients with a suspected medial meniscus knee tear in the emergency department (ED). In the absence of a knee fracture in the X-ray, POCUS on the knee was done...

INTRODUCTION: Pain control for hip fractures is often achieved via intravenous opioids. However, opioids can have dangerous adverse effects, including respiratory depression and delirium. Peripheral nerve blockade is an alternative option for pain control, which reduces the need for opioid analgesia. The purpose of this study was to compare the use of femoral nerve blocks versus standard pain control for patients with hip fractures. METHODS: This retrospective study included adult patients presenting to the emergency department (ED) with isolated hip fractures between April 2021 and September 2022...

OBJECTIVE: Pulmonary embolism (PE) a vascular disease. Computed tomography pulmonary angiography (CTPA) is the radiological imaging technique used to diagnose PE. In this study, we aimed to demonstrate the diagnostic accuracy of Hounsfield Unit (HU) value for PE based on the hypothesis that acute thrombosis causes an increase in HU value on computed tomography (CT). METHODS: This research was as a single-center, retrospective study. Patients presenting to the emergency department (ED) diagnosed with PE on CTPA were enrolled as the study group...

OBJECTIVE: Many studies have examined the July effect. However, little is known regarding the July effect in sepsis. We hypothesized that the July effect would result in worse outcomes in patients with sepsis. METHODS: Prospectively collected patients with sepsis between January 2018 and December 2021 were used. In Korea, the new academic year starts on March 1, so the "July effect" appears in March. The primary outcome was 30-day mortality. Secondary outcomes included adherence to the Surviving Sepsis Campaign bundle...