논문 상세보기

대한응급의학회> 대한응급의학회지> Is the immediate blood pressure control using parenteral antihypertensive drug needed for patients with severe high blood pressure with epistaxis in the emergency department?

KCI등재

Is the immediate blood pressure control using parenteral antihypertensive drug needed for patients with severe high blood pressure with epistaxis in the emergency department?

Kyunghoon Shin , Kyunghoon Park , Heekyung Lee , Changsun Kim , Laurie Seiwon Kim , Ji Won Yoo
  • : 대한응급의학회
  • : 대한응급의학회지 33권5호
  • : 연속간행물
  • : 2022년 10월
  • : 471-479(9pages)
대한응급의학회지

DOI


목차

INTRODUCTION
METHODS
RESULTS
DISCUSSION
ORCID
CONFLICT OF INTEREST
REFERENCES

키워드 보기


초록 보기

Objective: This study aimed to assess whether the conventional treatments administered in the emergency department (ED) for hypertensive urgencies (observed or peroral [PO]-controlled) in severe high blood pressure (BP) patients with epistaxis increase the incidence of epistaxis recurrence and the mortality rate as compared to immediate BP control using intravenous (IV) antihypertensive medication
Methods: A retrospective study over 7 years was conducted at the ED of a tertiary university hospital. Among adult patients with spontaneous epistaxis, subjects with severe high BP (systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg) were included in the study. Participants were divided into three groups determined by the methods used to control BP: non-controlled, PO-controlled, and IV-controlled groups. The incidence of epistaxis recurrence and mortality rate within 6 months were compared.
Results: Among the 380 patients enrolled, 238 were discharged from the ED without any pharmacological antihypertensive treatment (non-controlled group), 83 received PO antihypertensive medication (PO-controlled group), and 59 received IV antihypertensive medication (IV-controlled group). Of these, 29 (12.2%), nine (10.8%), and seven (11.9%) patients from the non-controlled, PO-controlled, and IV-controlled groups, respectively, experienced epistaxis recurrence within 24 hours, which was statistically not different among the three groups (P=0.948). The 6-month mortality rates were determined to be 0.8%, 2.4%, and 3.4% in the non-controlled, PO-controlled, and IV-controlled groups, respectively. The difference was also not significant among the groups (P=0.294).
Conclusion: The conventional treatments of hypertensive urgencies (observed or PO-controlled) in patients with severe high BP with epistaxis in the ED did not increase the incidence of epistaxis recurrence and short-term mortality rate when compared to immediate BP control using IV antihypertensive medication.

UCI(KEPA)

간행물정보

  • : 의약학분야  > 외과학
  • : KCI등재
  • :
  • : 격월
  • : 1226-4334
  • : 2384-048x
  • : 학술지
  • : 연속간행물
  • : 1990-2022
  • : 2760


저작권 안내

한국학술정보㈜의 모든 학술 자료는 각 학회 및 기관과 저작권 계약을 통해 제공하고 있습니다.

이에 본 자료를 상업적 이용, 무단 배포 등 불법적으로 이용할 시에는 저작권법 및 관계법령에 따른 책임을 질 수 있습니다.

33권6호(2022년 12월) 수록논문
최근 권호 논문
| | | |

KCI등재

1진달래 꽃에서 liquid chromatography-tandem mass spectrometry를 이용한 grayanotoxin의 검출

저자 : 김선춘 ( Sun Cheun Kim ) , 김희중 ( Heejung Kim ) , 심주현 ( Juhyun Sim ) , 장혜진 ( Hye Jin Chang ) , 장문희 ( Moonhee Jang ) , 권은채 ( Eunchae Kwon ) , 정종민 ( Chong Min Choung ) , 정성필 ( Sung Phil Chung )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 521-523 (3 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

2비외상성 병원 밖 심정지 환자에서 COVID-19 대유행 전후의 심정지 종결 사유 분석

저자 : 목동엽 ( Dongyeob Mok ) , 조규종 ( Gyu Chong Cho ) , 조영석 ( Youngsuk Cho )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 524-531 (8 pages)

다운로드

(기관인증 필요)

초록보기

Objective: The coronavirus disease 2019 (COVID-19) pandemic saw rising cases of out-of-hospital cardiac arrests. In addition, there was an increase in the number of cardiac arrest terminations. This study analyzes the 3-year status (2018 to 2020) of out-of-hospital cardiac arrest resuscitation terminations.
Methods: This study is a retrospective observational study based on the diary of 119 first aid activities in the Seoul area. Factors analyzed included patient demographics, history, location of occurrence, witness status, cause of cardiac arrest, electrocardiogram rhythm, reasons for cardiac arrest termination, and hospital transfer. Data obtained from the periods January 1, 2018, to December 31, 2019 (defined as the pre_COVID-19 period) and from January 1, 2020, to December 31, 2020 (defined as the COVID-19 period) were compared and analyzed.
Results: There was an increase in the number of terminated resuscitation cases during the study period. Most cases were elderly men with chronic disease who underwent asystole arrest at home. The reasons for the termination of resuscitation were obvious evidence of death, refusal of cardiopulmonary resuscitation (CPR) by the guardian, medical guidance, and cessation of prior life-sustaining treatment. During the COVID-19 pandemic, clear evidence of death and refusal of CPR by caregivers were statistically and significantly increased.
Conclusion: The results of this study indicate a rise in the number of cases subjected to termination of resuscitation during the COVID-19 period. It is, therefore, necessary to find a way to improve this situation.

KCI등재

3Multidetector computed tomography-based evaluation of gastric volumes in patients with out-of-hospital cardiac arrest

저자 : Jung-ju Lee , Hyun-jeong Park , Gyeong-gyu Yu , Young-min Kim , Sang-chul Kim , Jee-han Lee , Hyun-seok Chai , Gwan-jin Park , Suk-woo Lee , Hoon Kim

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 532-542 (11 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Resuscitation-related gastric inflation is associated with inadequate ventilation and the risk of gastric regurgitation in out-of-hospital cardiac arrest (OHCA) patients. This study aims to estimate resuscitation-related gastric inflation values by using multi-detector computed tomography (MDCT) scanning.
Methods: MDCT imaging data were obtained from OHCA patients undergoing resuscitation from January 2014 to December 2020. Thirty age- and sex-matched healthy controls that underwent an MDCT scan were included. Gastric air volume (GAV), total gastric volume (TGV), and GAV/gastric content volume (GCV) ratio values were estimated.
Results: In healthy controls (n=30), GAV and TGV values were in the range 5.0-35.0 mL, and 202.0-1,002.0 mL, respectively. The mean GAV and TGV values of OHCA patients (n=97) were 251.0 mL (range, 55.5-896.0) and 878.0 mL (range, 430.5-1,696.0), respectively. Significant between-group differences were determined in the mean GCV, GAV, and GAV/GCV ratio values. In OHCA patients, the cut-off value for abnormal GAV was defined as 56.5 mL (mean value plus two times standard deviation). Patients with abnormal GAV findings on MDCT scans had a longer duration from arrest to the return of spontaneous circulation, low body mass index, and increased rates of lactic acidosis.
Conclusion: Our results indicate an association between gastric air accumulation after resuscitation with longer recovery from arrest to return of spontaneous circulation, low body mass index, and increased lactic acidosis.

KCI등재

4Comparison of early warning scores for predicting deterioration in patients with respiratory distress in alert mentality presenting to the emergency department

저자 : Jae Hwa Kwon , Yo Sep Shin , Se Hyun Oh , Hui Dong Kang , Sang Ku Jung , You Jin Lee

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 543-551 (9 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Early identification of patients at risk for deterioration is crucial to reduce in-hospital mortality. Various early warning scores have been widely applied in the emergency department (ED) of hospitals. This study evaluates and compares the effectiveness of three early warning scores_Modified Early Warning Score, Rapid Acute Physiology Score (RAPS), Worthing Physiological Scoring System (WPS), and Rapid Emergency Medicine Score. These scores help predict the need for critical care and 24- and 72-hour mortalities among alert patients presenting to the ED with dyspnea.
Methods: This retrospective cohort study used data from electronic medical records of patients admitted between 2018 and 2020 and included all consecutive alert patients who presented with dyspnea in the ED. The primary outcome was to evaluate the performance of early warning scores regarding the need for critical care. The secondary outcomes were the prediction of 24- and 72-hour in-hospital mortalities.
Results: Among 4,322 patients evaluated, 255 received critical care, and 17 and 84 died within 24 and 72 hours, respectively. The WPS had the overall highest performance for predicting the need for critical care (area under the curve [AUC], 0.781; 95% confidence interval [CI], 0.751-0.810) and 24-hour (AUC, 0.816; 95% CI, 0.738-0.894) and 72-hour mortalities (AUC, 0.794; 95% CI, 0.750-0.838), but differed significantly only from the RAPS.
Conclusion: The WPS might better predict the need for critical care and short-term mortality in alert patients with dyspnea in the ED. However, owing to a lack of its superiority in statistics, further studies are warranted to conclude the optimal tools applicable for these patients.

KCI등재

5The difference of the HEART score for predicting cardiovascular disease according to obesity index in emergency department

저자 : Songhyun Kim , Heajin Chung , Youngjoo Lee , Hye Young Jang , Young Shin Cho , Joon Bum Park , Sang-il Kim , Beom Sok Seo , Youngwha Sohn

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 552-564 (13 pages)

다운로드

(기관인증 필요)

초록보기

Objective: The HEART score is a fast and simple cardiovascular disease (CVD) prediction tool useful in the emergency department (ED). This study evaluates the predictive value of the HEART score when applying other obesity indices such as waist circumference (WC) or waist-to-height ratio (WHtR) instead of body mass index (BMI).
Methods: Data were prospectively collected from the pre-made registry of patients who had visited the ED with chest pain. Based on their final diagnoses and coronary imaging study results, patients were classified as acute coronary syndrome (ACS), non-ACS, significant coronary arterial stenosis (SCS), and non-SCS. We compared the HEART score for each group and modified it with variable obesity indices. Multivariable logistic regression and the area under the curve were calculated to determine the most suitable obesity index for the HEART score in predicting ACS or SCS. In addition, we compared the gender-dependent relationship between obesity and ACS or SCS.
Results: Of the total 689 patients examined, 281 were diagnosed with ACS. The odds ratio (OR) of the HEART score for ACS was 12.1. The ORs were 13.2 and 11.2 when the HEART score was modified with WC or WHtR, respectively. Obesity was determined as the meaningful factor to predict ACS (OR: BMI, 2.38; WC, 3.39) and SCS (OR: BMI, 3.07; WC, 4.03) in women but not men.
Conclusion: The HEART score showed good predictive value regardless of obesity index modification. Furthermore, obesity is associated with CVD in women with chest pain, but not in men.

KCI등재

6The association between the neutrophil-to-lymphocyte ratio and bacteremia in elderly patients admitted to the emergency department

저자 : Ji Sun Yu , Hwan Song , Chun Song Youn , Sang Hoon Oh , Jeeyong Lim , Soo Hyun Kim , Hyo Jin Bang , Hyo Joon Kim

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 565-572 (8 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Bacteremia is a common cause of increased morbidity and mortality in elderly patients, but early diagnosis and identification are complex. The neutrophil-to-lymphocyte count ratio (NLR) is suggested as a useful indicator for diagnosing bloodstream infections. This study evaluated whether the NLR at admission is associated with bloodstream infections in older patients admitted to the emergency department.
Methods: A retrospective, multicenter analysis was performed on patients admitted to the emergency department from November 2016 to February 2017. We included patients aged 65 years and older who visited the emergency department with medical problems. Baseline NLR values were measured upon admission to the emergency department. The primary outcome was a positive blood culture.
Results: A total of 1,815 patients were included in this study. The median age was 77.25±7.38 years, and bacteremia was identified in 290 older patients (15.9%). The NLR was significantly higher in the bacteremia group (15.95±22.03) than in the non-bacteremia group (8.76±8.74, P<0.001). In the multivariate logistic regression analysis, the NLR was associated with bacteremia after adjusting for confounding factors as continuous variables (odds ratio [OR], 1.033; 95% confidence interval [CI], 1.009-1.057) and categorical variables (NLR ≥10; OR, 2.018; 95% CI, 1.246-3.268). The area under the curve of the NLR was determined to be 0.667 (95% CI, 0.639-0.694).
Conclusion: These results indicate that the NLR at admission to the emergency department is associated with bloodstream infections. Early suspicion of bacteremia, by determining the initial NLR value, will help treat bacteremia in elderly patients.

KCI등재

7External validation of the STONE score and the modified STONE score for the patients with suspicious urinary stone in the emergency department

저자 : Chanyi Song , Jeeyong Lim , Sang Hoon Oh , Hyo Joon Kim

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 573-580 (8 pages)

다운로드

(기관인증 필요)

초록보기

Objective: We aimed to investigate diagnostic accuracy of the STONE score and the modified STONE score by external validation in a large-scale cohort.
Methods: We retrospectively reviewed the medical records of patients with suspected urinary stones who underwent computed tomography in the emergency center of a single tertiary hospital from 2014 to 2015. We compared and analyzed our cohort and two original studies with each other. Patients were categorized into three risk groups (low, moderate, and high) according to both scoring systems. The prevalence of urinary stones and alternative diagnoses was evaluated in each group. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with our data for each score performance.
Results: Eight hundred fifty-six patients out of a total of 1,013 were diagnosed with urinary stones. The prevalence of urinary stones in the high-risk group of the STONE and the modified STONE scores were 91.1% and 91.2%, respectively. The areas under the receiver operating characteristic curve of both scores were 0.71 and 0.73, respectively. The optimal cutoff value for predicting urinary stones using the STONE score was 9, with 87.9% sensitivity, 45.9% specificity, 89.8% PPV, and 40.9% NPV. In the case of the modified STONE score, the optimal cutoff value was 10, which was the same as that of the original study with 85.9% sensitivity, 54.8% specificity, 91.2% PPV, and 41.6% NPV.
Conclusion: The STONE and the modified STONE scores showed good diagnostic accuracy in high-risk groups of patients with suspected urinary stones. These scoring systems would be helpful to physicians in their diagnoses and in reducing radiation exposure.

KCI등재

8수술을 시행 받은 노인 고관절 골절 환자에서 합병증 발생의 예측인자

저자 : 장경덕 ( Kyoung Deok Jang ) , 이재백 ( Jae Baek Lee ) , 진영호 ( Young Ho Jin ) , 정태오 ( Tae Oh Jeong ) , 윤재철 ( Jae Chol Yoon ) , 오태환 ( Tae Hwan Oh ) , 김소은 ( So Eun Kim )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 581-588 (8 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Hip fractures in elderly populations are a major public concern worldwide. This study aims to demonstrate the emergency department (ED)-related factors associated with medical complications in older patients with hip fractures who underwent surgery.
Methods: This was a retrospective observational study of 150 elderly patients (≥65 years) presenting with hip fractures in 2020. The data collected were analyzed to investigate medical complications and determine the predictors of complications after a hip fracture surgery by comparing the complication and non-complication group patients. Logistic regression analysis was applied to determine the independent predictors of postoperative medical complications.
Results: The overall complication rate was determined to be 39.3%, and delirium (40.7%) was observed to be the most common affliction. Independent walking (adjusted odds ratio [AOR], 0.459; 95% confidence interval [CI], 0.214-0.985), pre-operative medical conditions (AOR, 4.823; 95% CI, 1.735-13.408), and estimated glomerular filtration rate (eGFR; 3rd quartile [AOR, 3.224; 95% CI, 1.086-9.576], 4th quartile [AOR, 5.584; 95% CI, 1.861-16.756]) were independently associated with the development of medical complications post-surgery.
Conclusion: The overall incidence of complications following hip fracture surgery is relatively high. Independent walking, preoperative medical condition, and decreased eGFR are independent predictors of postoperative complications that can be screened in the ED in elderly hip fracture patients.

KCI등재

9단일 고압산소치료센터에서의 감압병 환자에 대한 치료 경험

저자 : 이정현 ( Joyng Hyun Lee ) , 정상구 ( Sang Ku Jung ) , 이유진 ( You Jin Lee ) , 오세현 ( Se Hyun Oh ) , 강희동 ( Hui Dong Kang )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 589-598 (10 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Hyperbaric oxygen therapy (HBOT) is the most crucial treatment for decompression sickness (DCS), which needs to be administered as swiftly as possible. This study evaluates the therapeutic responses of DCS patients and analyzes the major factors for clinical outcomes.
Methods: This is a retrospective cohort single-center study on patients who arrived at our hospital's emergency department for diving-related symptoms and were diagnosed with DCS and administered HBOT.
Results: Totally, 337 patients were enrolled from June 2015 to May 2020. The proportion of SCUBA diving, rapid ascent, and inter-facility transport cases was higher in the recreational group, with a longer lag time from symptom onset to HBOT. The professional group had a higher proportion of cases with previous DCS history, total diving time, bottom time, in-water decompression, and repetitive diving. Examination of treatment outcomes revealed more type I cases and a shorter lag time from symptom onset to HBOT in the complete recovery group. Conversely, the incomplete recovery group had a higher proportion of type II cases and aggravation of symptoms before HBOT was administered.
Conclusion: DCS can occur regardless of professional or recreational divers. Both groups showed a similar level of severity. It is recommended that recreational divers should be cautious of accidents related to safety (such as rapid ascent) and receive swift treatment in case of the onset of symptoms. Occupational divers need more active efforts to get HBOT rather than just performing in-water recompression or home O2 therapy.

KCI등재

10Status of functional capacity of the emergency care system in Cambodia: a cross-sectional survey

저자 : Duk Hwan Ko , Kyung Hwan Kim , Junseok Park , Dong Wun Shin , Hyunjong Kim , Joon Min Park , Hoon Kim , Woochan Jeon , Jung Eon Kim

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 6호 발행 연도 : 2022 페이지 : pp. 599-615 (17 pages)

다운로드

(기관인증 필요)

초록보기

Objective: The establishment of a proper emergency care system can significantly decrease the number of deaths and disabilities. However, this is neglected in many low- and middle-income countries, including Cambodia. At present, many Cambodian hospitals lack designated emergency departments, formal triage systems, and staff trained in emergency medicine. This study sought to measure the functional capacity of the Cambodian emergency care system corresponding to each hospital level using the Emergency Care Assessment Tool (ECAT).
Methods: We conducted a survey from April 19, 2021, to April 27, 2021, by distributing survey sheets to a total of eight Cambodian medical staff who were invited to a hospital in South Korea for an educational program. The ECAT comprises items evaluating the capability of hospitals to perform signal functions for each of the six emergent sentinel conditions that could occur prior to death. We analyzed the data by categorizing the hospitals into basic, intermediate, and advanced levels.
Results: Basic-level hospitals had weaknesses in signal functions related to altered mental status and trauma care. The intermediate-level hospital showed weaknesses in signal functions related to respiratory failure, altered mental status, shock, and trauma care. Advanced-level hospitals had weaknesses in signal functions related to respiratory failure, trauma, and shock.
Conclusion: Our survey shows that most Cambodian hospitals lack the capability to perform the emergency signal functions expected at each level. We believe that this gap can be bridged with proper customized education targeting medical staff based on the level of their hospital and ensuring a proper supply of medical devices.

12
권호별 보기
같은 권호 다른 논문
| | | | 다운로드

KCI등재

12020 대한민국 응급의학과 전문의 총조사

저자 : 김선구 , 조광현 , 김인병 , 이미진 , 윤유상 , 박경혜 , 박송이 , 김홍재 , 기동훈 , 서범석 , 주영민 , 지창근 , 최석재 , 여인환 , 강지훈 , 정우진 , 임대성 , 이의선 , 이형민 , 왕순주

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 1-1 (1 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

23차 병원 응급실을 빈번히 이용하는 소아 환자들의 특성

저자 : 채현석 ( Hyun-seok Chai ) , 박관진 ( Gwan Jin Park ) , 김영민 ( Young Min Kim ) , 김상철 ( Sang Chul Kim ) , 이지한 ( Ji Han Lee ) , 김김훈 ( Hoon Kim ) , 이석우 ( Seok-woo Lee )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 421-428 (8 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Frequent emergency department (ED) visit is a global public health problem that can delay proper management and reduce the quality of medical services. While many researches were done on adult frequent ED users, studies lack on pediatric patients. This study was designed to identify the characteristics of the frequent pediatric ED users and risk factors related to pediatric frequent ED visits.
Methods: This was a retrospective observational study using ED-based data derived from pediatric patients at a tertiary university hospital. The main exposure variable was frequent pediatric ED visits, which were defined as more than 4 visits within a year (January 1-December 31, 2019). Characteristics and risk factors for frequent pediatric ED users were evaluated using forward stepwise regression analysis.
Results: During the study period, 10,050 pediatric ED visits (8,313 patients) were identified. Of which, 550 (5.5%) were frequent ED visits (114 patients, 1.4%). The independent risk factors for frequent pediatric ED visits were age <1 year (adjusted odds ratio [AOR], 2.79; 95% confidence interval [CI], 1.32-5.93), visiting during spring and winter (AOR, 5.72; 95% CI, 3.36-9.75) and visiting due to medical problem (AOR, 1.66; 95% CI, 1.02-3.08). Primary diagnosis of unspecified convulsions, acute lower respiratory infection, other specified medical care, and arrhythmia were associated with frequent pediatric ED visits.
Conclusion: Age <1 year, visiting ED during spring and winter, visiting ED due to medical problem can increase the risk of frequent ED visit by pediatric patients.

KCI등재

3한국소아소생술테이프의 효용성 검증: 소아의 체중과 기관내관 크기 예측을 중심으로

저자 : 김보성 ( Boseong Kim ) , 장혜영 ( Hye Young Jang ) , 노노현 ( Hyun Noh ) , 박수연 ( Suyeon Park ) , 이영주 ( Youngjoo Lee ) , 조영신 ( Young Shin Cho ) , 박준범 ( Joonbum Park ) , 정혜진 ( Heajin Chung ) , 김상일 ( Sang-il Kim ) , 서범석 ( Beom Sok Seo ) , 손영화 ( Young Wha Sohn )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 429-435 (7 pages)

다운로드

(기관인증 필요)

초록보기

Objective: Various tools using the length-based method for weight estimation and decisions regarding equipment size have been used in pediatric resuscitation globally. The Korean Pediatric Resuscitation Tape (KPRT) is one such tool that has been developed recently. This study was performed to validate the use of KPRT in Korean children.
Methods: Data on the measured weights and the endotracheal tube (ETT) sizes used for children aged 12 years or less, who received general anesthesia, were collected by reviewing medical records from June 2018 to October 2020 at two hospitals in the urban areas of Korea. We compared the weight and ETT size estimated by the KPRT to the actually measured weight and ETT size used for the study population. We also calculated the weight and ETT size using an agebased formula and compared these values to the actual values of the patients. We then analyzed the agreement between these estimated values and the actual values of the children.
Results: A total of 1,237 children were included in this study. The intra-class correlation coefficient of agreement between the actual weight and estimated weight by the KPRT was 0.94 compared to 0.93 when estimated by the age-based formula. The weighted kappa coefficient of the agreement between the ETT size actually used, and the size estimated by the KPRT was 0.61 compared to 0.74 when estimated by the age-based formula. The estimated ETT sizes using the KPRT were smaller than the actual size used in children under three years old, whereas it was larger for children aged eight years or more.
Conclusion: Our study showed that the KPRT was a dependable tool for estimating the weight and ETT size of Korean children. Future studies would be needed to augment the reliability of the KPRT in pediatric resuscitation.

KCI등재

4Factors in early hospital arrival following suspected acute stroke symptoms

저자 : Dong Hyeob Han , Jonghwan Shin , Jin Hee Jung , Kyoung Jun Song , Hui Jai Lee , Kyoung Min You

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 436-447 (12 pages)

다운로드

(기관인증 필요)

초록보기

Objective: We investigated the factors that affect the time from the onset of acute stroke symptoms to arrival at the emergency department (ED).
Methods: Between July 2019 and February 2020, patients with acute stroke symptoms who visited a public hospital were evaluated by retrospective analysis using a prospective survey. The data for this study was gathered from baseline interviews with patients enrolled in stroke surveys. The primary outcome was time to arrival at the ED, evaluated as a binary variable with a value of 4.5 hours.
Results: Overall, 205 patients were included in the final analysis. Among them, 47% (n=96) of patients with acute stroke symptoms arrived at the ED later than 4.5 hours from the time of onset of acute stroke symptoms. After multivariable logistic regression analyses, it was found that patients with higher National Institutes of Health Stroke Scale (NIHSS) scores, patients who did not live with their family members, and patients who were found by a passerby were associated with early ED arrival post onset of acute stroke symptoms. Among patients diagnosed with acute stroke, those with higher NIHSS scores or underlying malignant diseases were found to present earlier at the ED.
Conclusion: Approximately half of the patients (47%) with acute stroke symptoms presented to the ED within 4.5 hours. Higher NIHSS scores and the presence of underlying malignancy were identified as the key factors that were associated with an early presentation at the ED from the time of onset of acute stroke.

KCI등재

5Effect of albumin on the outcomes in septic patients with hypoalbuminemia in the emergency department: a propensity score-matched retrospective cohort study

저자 : Ji Eun Hwang , Jae Hyuk Lee , Joonghee Kim , Inwon Park

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 448-459 (12 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

Objective: A low albumin concentration is known to be associated with poor prognosis in patients with sepsis, but the benefits of albumin administration in these patients are unclear. This study was performed to investigate the effect of albumin administration on the outcomes of patients suffering from sepsis or septic shock.
Methods: This was a retrospective, propensity score-matched cohort study of septic patients with an initial serum albumin level < 3.0 g/dL admitted to the emergency department (ED) of an urban tertiary university hospital. Patients who received 20% albumin within 24 hours of admission to the ED were compared with those who did not. We performed a 1:1 propensity score-matched analysis. The primary outcome was the 28-day mortality rate and the secondary outcomes were the Sequential Organ Failure Assessment (SOFA) score at 24, 48, and 72 hours, the need for mechanical ventilation and renal replacement therapy (RRT), and admission to the intensive care unit (ICU).
Results: A total of 1,284 patients were included in the study, and the overall mortality rate was 29.4%. After propensity score matching, 192 patients in the albumin group and 192 in the control group were included in the final analysis. There was no significant difference in the 28-day mortality rates. The SOFA scores at 24, 48, and 72 hours were higher in the albumin group than in the control group. The rates of RRT and admission to the ICU were also higher in the albumin group.
Conclusion: In patients with sepsis and hypoalbuminemia, albumin replacement was not associated with higher 28-day mortality, but was associated with the higher SOFA scores, higher rates of RRT application and admission to the ICU.

KCI등재

6패혈증 환자에서 혈장내 무세포 혈색소(plasma cell-free hemoglobin)와 사망률의 관계

저자 : 변궁도 ( Gungdo Byun ) , 황지은 ( Ji Eun Hwang ) , 이재혁 ( Jae Hyuk Lee ) , 김중희 ( Joonghee Kim ) , 박인원 ( Inwon Park )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 460-470 (11 pages)

다운로드

(기관인증 필요)

초록보기

Objective: This study sought to investigate the association between plasma cell-free hemoglobin (pHb) and mortality in sepsis or septic shock.
Methods: We performed a retrospective analysis of the prospective collected data of patients with sepsis or septic shock. Patients were divided into 4 groups according to their pHb concentrations using a restricted cubic spline: group I (pHb ≤20 mg/dL), group II (20 < pHb ≤40 mg/dL), group III (40 < pHb ≤60 mg/dL), and group IV (pHb >60 mg/dL). The primary outcome was the 28-day mortality, and a multivariate Cox proportional hazard regression method was used for analysis.
Results: A total of 372 patients were included in the analysis and the overall 28-day mortality rate was 16.7%. The median pHb concentration of the patients was 24.8 mg/dL (reference range, 0-5). The mortality rate did not increase in proportion to the pHb concentrations and was the lowest in group II (20.3%, 11.0%, 16.3%, and 26.7% in groups I, II, III, and IV, respectively). In the Cox proportional hazard regression analysis, group I was independently associated with 28-day mortality compared with group II (hazard ratio, 2.19; 95% confidence interval, 1.18-4.07). Group IV had a higher mortality rate compared to group II, but it was not statistically significant (hazard ratio, 2.17; 95% confidence interval, 0.85-5.56).
Conclusion: A low concentration of pHb (pHb ≤20 mg/dL) was associated with 28-day mortality in patients with sepsis or septic shock.

KCI등재

7Is the immediate blood pressure control using parenteral antihypertensive drug needed for patients with severe high blood pressure with epistaxis in the emergency department?

저자 : Kyunghoon Shin , Kyunghoon Park , Heekyung Lee , Changsun Kim , Laurie Seiwon Kim , Ji Won Yoo

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 471-479 (9 pages)

다운로드

(기관인증 필요)

초록보기

Objective: This study aimed to assess whether the conventional treatments administered in the emergency department (ED) for hypertensive urgencies (observed or peroral [PO]-controlled) in severe high blood pressure (BP) patients with epistaxis increase the incidence of epistaxis recurrence and the mortality rate as compared to immediate BP control using intravenous (IV) antihypertensive medication
Methods: A retrospective study over 7 years was conducted at the ED of a tertiary university hospital. Among adult patients with spontaneous epistaxis, subjects with severe high BP (systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg) were included in the study. Participants were divided into three groups determined by the methods used to control BP: non-controlled, PO-controlled, and IV-controlled groups. The incidence of epistaxis recurrence and mortality rate within 6 months were compared.
Results: Among the 380 patients enrolled, 238 were discharged from the ED without any pharmacological antihypertensive treatment (non-controlled group), 83 received PO antihypertensive medication (PO-controlled group), and 59 received IV antihypertensive medication (IV-controlled group). Of these, 29 (12.2%), nine (10.8%), and seven (11.9%) patients from the non-controlled, PO-controlled, and IV-controlled groups, respectively, experienced epistaxis recurrence within 24 hours, which was statistically not different among the three groups (P=0.948). The 6-month mortality rates were determined to be 0.8%, 2.4%, and 3.4% in the non-controlled, PO-controlled, and IV-controlled groups, respectively. The difference was also not significant among the groups (P=0.294).
Conclusion: The conventional treatments of hypertensive urgencies (observed or PO-controlled) in patients with severe high BP with epistaxis in the ED did not increase the incidence of epistaxis recurrence and short-term mortality rate when compared to immediate BP control using IV antihypertensive medication.

KCI등재

8응급의료센터에서 진단된 급성 단순 방광염 환자의 항생제 내성률 및 적절한 항생제에 대한 고찰

저자 : 정수용 ( Soo Young Chung ) , 김영식 ( Youngsik Kim ) , 정루비 ( Rubi Jeong ) , 이규현 ( Kyoohyun Lee ) , 유우성 ( Woosung Yu ) , 윤영탁 ( Youngtak Yoon ) , 최승주 ( Seungju Choi )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 480-486 (7 pages)

다운로드

(기관인증 필요)

초록보기

Objective: This study analyzed the urine cultures of emergency department patients diagnosed with acute uncomplicated cystitis and determined the antimicrobial resistance and appropriate treatment for our region.
Methods: Results of urine analysis and urine culture of acute uncomplicated cystitis patients diagnosed in our emergency department between January 2019 and December 2020 were examined and analyzed.
Results: In our study, 256 out of 340 urine culture samples (75.3%) were positive for cystitis. The most common microorganism was reported to be Escherichia coli (93.0%). The resistance rates of E. coli to the following antimicrobial agents were as follows: amikacin (0.0%), ampicillin (63.5%), amoxicillin/clavulanate (15.6%), aztreonam (7.1%), ceftazidime (3.4%), cefotaxime (16.4%), cefoxitin (5.5%), cefazolin (19.9%), ciprofloxacin (29.4%), cefepime (1.7%), ertapenem (0.0%), gentamicin (18.1%), piperacillin/tazobactam (2.1%), trimethoprim/sulfamethoxazole (36.1%), and tigecycline (0.4%). The prevalence of extended-spectrum beta-lactamase producing E. coli strains was 17.8%.
Conclusion: To determine the proper empirical antimicrobial treatment for acute uncomplicated cystitis, it is essential to examine the antimicrobial resistance. For our region, fosfomycin, nitrofurantoin, and 2nd and 3rd generation cephalosporin should be considered the first-line empirical treatment for acute uncomplicated cystitis.

KCI등재

9응급 현장 초음파에서 측정된 승모판륜 수축 이동과 삼첨판륜 수축 이동의 유용성: 응급실에서 임상적으로 적용하기 위한 비대면 선행 실험연구

저자 : 조재열 ( Jae Youl Cho ) , 황정성 ( Jung Sung Hwang ) , 홍정석 ( Jung Seok Hong )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 487-496 (10 pages)

다운로드

(기관인증 필요)

초록보기

Objective: As a part of point-of-care ultrasound (POCUS), the rapid assessment of cardiac systolic function using tricuspid annular plane systolic excursion (TAPSE) and mitral annular plane systolic excursion (MAPSE) are thought to be valuable tools during a cardiac emergency. This article is an untact pilot experiment before the clinical application of these procedures in an emergency room.
Methods: Totally, 206 video samples from YouTube concerning echocardiograms of a normal heart, ischemic heart disease, congestive heart failure, cardiomyopathy, pulmonary hypertension, and pulmonary embolism were extracted and analyzed with free programs opened in internet services.
Results: The values of MAPSE, TAPSE, and TAPSE+MAPSE ranged between 13.3±2.3 mm, 23±2.8 mm, and 36± 4.5 mm, respectively, in the normal echocardiogram versus 7.8±2.5 mm, 16.5±5.0 mm, and 24.2±6.4 mm, respectively, in an abnormal echocardiogram (P<0.05). Positive correlations were obtained between MAPSE and TAPSE, MAPSE and TAPSE+MAPSE, and TAPSE and TAPSE+MAPSE (R2=0.346, R2=0.687, and R2=0.871, respectively). MAPSE ≤ 7.7 mm, TAPSE ≤18.5 mm, and TAPSE+MAPSE ≤27.7 mm show 100% sensitivity, and the specificities for an abnormal echocardiogram at these values are 51.8%, 63.3%, and 71.7%, respectively. At TAPSE ≤18.5 mm and TAPSE/ (TAPSE+MAPSE) ≤0.61, the sensitivity of pulmonary hypertension containing a pulmonary embolism is 81.2%, and the specificity is 81%. It is presumed that the lower these values, the higher the emergency.
Conclusion: In a cardiac emergency, differentiating left or right systolic heart failure is probably useful by checking not only MAPSE or TAPSE using POCUS, but also determining the ratios MAPSE/(MAPSE+TAPSE) or TAPSE/(MAPSE+TAPSE). However, further retrospective or prospective studies in an emergency room are required for a specific disease diagnosis.

KCI등재

10COVID-19 유행이 119 구급대의 중증 환자 이송 시간에 미친 영향

저자 : 박종은 ( Jong Eun Park ) , 최성혁 ( Sung-hyuk Choi ) , 윤영훈 ( Young-hoon Yoon ) , 김정윤 ( Jung-youn Kim ) , 조영덕 ( Young-duck Cho ) , 이지영 ( Ji Young Lee ) , 박성준 ( Sung Joon Park )

발행기관 : 대한응급의학회 간행물 : 대한응급의학회지 33권 5호 발행 연도 : 2022 페이지 : pp. 497-505 (9 pages)

다운로드

(기관인증 필요)

초록보기

Objective: As the coronavirus disease 2019 (COVID-19) pandemic continues, it is believed that COVID-19 may have affected the transportation time of 119 emergency medical services (EMS). However, there are only a few studies to support this claim. The current study was undertaken to investigate the altered pre-hospital transportation time according to the severity of the patient after the COVID-19 period.
Methods: This is a retrospective observational study conducted on patients aged 15 or older who visited three emergency medical centers from January 1, 2019, to December 31, 2020, using the 119 EMS. The primary outcome was total pre-hospital transportation time; secondary outcomes include activation time, response time, on-scene, and transportation time.
Results: Before COVID-19, the total pre-hospital transportation times for patients admitted to the intensive care unit and patients with out-of-cardiac arrest were 26.78±9.91 minutes and 27.92±8.38 minutes, respectively. Post-COVID-19, the time increased to 35.31±16.30 minutes and 32.46±14.69 minutes, respectively (P<0.001). Furthermore, the total prehospital transportation time before and after COVID-19 differed in the critical patient group with Korean Triage and Acuity Scale 1 and 2 (26.58±10.12 minutes vs. 33.93±15.78 minutes). In addition, an increase in the total pre-hospital transportation time was observed after COVID-19 in the emergency and non-emergency patient groups. An increased time interval was also determined for the activation time, response time, on-scene arrival, and transportation time for all patient groups after the COVID-19 pandemic (P<0.001).
Conclusion: COVID-19 has resulted in delays throughout the pre-hospital transportation time, greatly impacting critical patients.

12
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기