• Title/Summary/Keyword: Rescue

Search Result 1,287, Processing Time 0.029 seconds

The analgesic efficacy of the continuous adductor canal block compared to continuous intravenous fentanyl infusion with a single-shot adductor canal block in total knee arthroplasty: a randomized controlled trial

  • Kim, Min Kyoung;Moon, Hyoung Yong;Ryu, Choon Gun;Kang, Hyun;Lee, Han Jun;Shin, Hwa Yong
    • The Korean Journal of Pain
    • /
    • v.32 no.1
    • /
    • pp.30-38
    • /
    • 2019
  • Background: The adductor canal block (ACB) is an effective intervention for postoperative analgesia following total knee arthroplasty (TKA). However, the ideal ACB regimen has not yet been established. We compared the analgesic effects between a continuous ACB group and fentanyl-based intravenous patient-controlled analgesia (IV-PCA) with a single-shot ACB group. Methods: Patients who underwent TKA were randomly allocated to either a continuous ACB group (Group CACB) or IV-PCA with a single-shot ACB group (Group IVACB). Before the surgery, ultrasound guided ACB with 0.5% ropivacaine 20 cc was provided to all patients. Before skin incision, the infusion system (0.2% ropivacaine through an adductor canal catheter in group CACB vs. intravenous fentanyl in group IVACB) was connected. The postoperative pain severity; the side effects of local anesthetics and opioids; administration of rescue analgesics and anti-emetics; and sensorimotor deficits were measured. Results: Postoperative pain severity was significantly higher in the IVACB group at 30 min, 4 h, 24 h, and 48 h after surgery. The averages and standard deviations (SD) of the NRS score of postoperative pain were $0.14{\pm}0.37$, $4.57{\pm}2.37$, $6.00{\pm}1.63$, and $4.28{\pm}1.49$, respectively in the IVACB group. Rescue analgesic requirements and quadriceps muscle strength were not statistically different between the groups throughout the postoperative period. Moreover, rescue antiemetic requirements were higher in group IVACB than group CACB. Conclusions: In this study, the continuous ACB provided superior analgesia and fewer side effects without any significant motor deficit than the IV-PCA with a single-shot ACB.

Pre-emptive analgesic efficacy of injected ketorolac in comparison to other agents for third molar surgical removal: a systematic review

  • Tirupathi, Sunnypriyatham;Rajasekhar, Srinitya;Maloth, Sardhar Singh;Arya, Aishwarya;Tummalakomma, Pushpalatha;Lanke, Rama Brahman
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.21 no.1
    • /
    • pp.1-14
    • /
    • 2021
  • This study aimed to evaluate and compare the pre-emptive analgesic efficacy of injected ketorolac to that of other agents for impacted third molar surgical removal in a healthy population. PubMed, Ovid SP, Cochrane databases were filtered from 1980 to July 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria independently by reviewers. Studies that compared pre-emptive intramuscular or intravenous administration of ketorolac to other agents were evaluated. The outcomes sought were self-reported postoperative pain (patient-perceived pain), median duration for rescue analgesic medication, total number of analgesics consumed in the recovery period, and global assessment (overall patient satisfaction) after the recovery period. Six studies were included in the final evaluation. The outcome of pain perception and the number of analgesics taken were significantly lower in the ketorolac group (intramuscular or intravenous) in most of the studies (n=5) than in the group of other drugs. The mean time for rescue analgesia intake was higher for the ketorolac group, and global assessment scores were also better in the ketorolac group. Although the included studies show significantly better outcomes such as postoperative pain, median time taken for rescue medication, total number of analgesics taken, and overall patient satisfaction with injected ketorolac group in comparison to injected diclofenac, dexamethasone, and tramadol, definitive conclusions cannot be made regarding the superiority of injected Ketorolac as a pre-emptive agent. A greater number of randomized control trials with a proper protocol are needed to make definitive conclusions.

Preliminary Experience of Neuroform Atlas Stenting as a Rescue Treatment after Failure of Mechanical Thrombectomy Caused by Residual Intracranial Atherosclerotic Stenosis

  • Yi, Ho Jun;Sung, Jae Hoon;Lee, Dong Hoon
    • Journal of Korean Neurosurgical Society
    • /
    • v.64 no.2
    • /
    • pp.198-206
    • /
    • 2021
  • Objective : The low-profile Neuroform Atlas stent can be deployed directly without an exchange maneuver by navigating into the Gateway balloon. This retrospective study assessed the safety and efficacy of Neuroform Atlas stenting as a rescue treatment after failure of mechanical thrombetomy (MT) for large artery occlusion. Methods : Between June 2018 and December 2019, a total of 31 patients underwent Neuroform Atlas stenting with prior Gateway balloon angioplasty after failure of conventional MT caused by residual intracranial atherosclerotic stenosis (ICAS). Primary outcomes were successful recanalization and patency of the vessel 24 hours after intervention. Secondary outcomes were vessel patency after 14 days and 3-month modified Rankin Scale. Peri-procedural complications, intracerebral hemorrhage (ICH), and 3-month mortality were reviewed. Results : With a 100% of successful recanalization, median value of stenosis was reduced from 79.0% to 23.5%. Twenty-eight patients (90.3%) showed tolerable vessel patency after 14 days. New infarctions occurred in three patients (9.7%) over a period of 14 days; two patient (6.5%) underwent stent occlusion at 24 hours, and the other patient (3.2%) with delayed stent occlusion had a non-symptomatic dot infarct. There were no peri-procedural complications. Two patients (6.5%) developed an ICH immediately after the procedure with one of them is symptomatic. Conclusion : Neuroform Atlas stenting seems to be an effective and safe rescue treatment modality for failed MT with residual ICAS, by its high successful recanalization rate with tolerable patency, and low peri-procedural complication rate. Further multicenter and randomized controlled trials are needed to confirm our findings.

Internet of Things-Based Command Center to Improve Emergency Response in Underground Mines

  • Jha, Ankit;Verburg, Alex;Tukkaraja, Purushotham
    • Safety and Health at Work
    • /
    • v.13 no.1
    • /
    • pp.40-50
    • /
    • 2022
  • Background: Underground mines have several hazards that could lead to serious consequences if they come into effect. Acquiring, evaluating, and using the real-time data from the atmospheric monitoring system and miner's positional information is crucial in deciding the best course of action. Methods: A graphical user interface-based software is developed that uses an AutoCAD-based mine map, real-time atmospheric monitoring system, and miners' positional information to guide on the shortest route to mine exit and other locations within the mine, including the refuge chamber. Several algorithms are implemented to enhance the visualization of the program and guide the miners through the shortest routes. The information relayed by the sensors and communicated by other personnel are collected, evaluated, and used by the program in proposing the best course of action. Results: The program was evaluated using two case studies involving rescue relating to elevated carbon monoxide levels and increased temperature simulating fire scenarios. The program proposed the shortest path from the miner's current location to the exit of the mine, nearest refuge chamber, and the phone location. The real-time sensor information relayed by all the sensors was collected in a comma-separated value file. Conclusion: This program presents an important tool that aggregates information relayed by sensors to propose the best rescue strategy. The visualization capability of the program allows the operator to observe all the information on a screen and monitor the rescue in real time. This program permits the incorporation of additional sensors and algorithms to further customize the tool.

Study on 2.5D Map Building and Map Merging Method for Rescue Robot Navigation (재난 구조용 로봇의 자율주행을 위한 지도작성 및 2.5D 지도정합에 관한 연구)

  • Kim, Su Ho;Shim, Jae Hong
    • Journal of the Korean Society of Manufacturing Process Engineers
    • /
    • v.21 no.4
    • /
    • pp.114-130
    • /
    • 2022
  • The purpose of this study was to investigate the possibility of increasing the efficiency of disaster relief rescue operations through collaboration among multiple aerial and ground robots. The robots create 2.5D maps, which are merged into a 2.5D map. The 2.5D map can be handled by a low-specification controller of an aerial robot and is suitable for ground robot navigation. For localization of the aerial robot, a six-degree-of-freedom pose recognition method using VIO was applied. To build a 2.5D map, an image conversion technique was employed. In addition, to merge 2.5D maps, an image similarity calculation technique based on the features on a wall was used. Localization and navigation were performed using a ground robot to evaluate the reliability of the 2.5D map. As a result, it was possible to estimate the location with an average and standard error of less than 0.3 m for the place where the 2.5D map was normally built, and there were only four collisions for the obstacle with the smallest volume. Based on the 2.5D map building and map merging system for the aerial robot used in this study, it is expected that disaster response work efficiency can be improved by combining the advantages of heterogeneous robots.

Enhancing Design and Evaluating Mobility of Firefighting Chemical and Flame Protective Clothing for the National 119 Rescue Headquarters (중앙119구조본부 소방대원용 화학 보호복과 방열복의 동작적합성 평가 및 디자인 개선)

  • Syifa Salsabila;Do-Hee Kim;Joo-Young Lee
    • Fashion & Textile Research Journal
    • /
    • v.25 no.4
    • /
    • pp.520-533
    • /
    • 2023
  • The present study developed a test protocol for evaluating the mobility of firefighting chemical and flame personal protective equipment (PPE) for the National 119 Rescue Headquarters in Korea and suggested ergonomic design factors to improve their mobility and performance. Six types of PPE were employed, including three types for flame protective PPE (5 ~ 6 kg excluding the self-contained breathing apparatus), and three types for chemical and flame protective PPE (8 ~ 11 kg). These PPEs are used by the 119 Rescue firefighters. Three male firefighters (34.3 ± 1.2 y in age, 175 ± 8 cm in height, 81 ± 13 kg in body weight) participated in the mobility test and interview. A mobility test protocol consisting of 16 components (nine postures and seven motions including a dexterity test) along with a visibility test were developed based on pre-interviews and literature reviews. The findings indicated that the clothing microclimate humidity on the neck and chest exceeded 85%RH on average for all the six PPE conditions, with the chest area reaching as high as 98%RH. This high humidity caused fogging inside the visor and impaired visibility. The requirements for improving the PPE design in terms of mobility varied depending on whether it was the separated types or all-in-one types, particularly regarding the hood and gloves design. The findings of this study can be applied to improve the design of Level A_PPE for firefighters. The mobility test protocol and visibility test developed in this study can also be applied to other types of Level A impermeable PPE.

Ruminal impaction with an indigestible foreign body in long-tailed goral (Naemorhedus caudatus)

  • Sangjin Ahn;Woojin Shin;Yujin Han;Sohwon Bae;Chea-Un Cho;Sooyoung Choi;Yeonsu Oh;Jong-Taek Kim
    • Korean Journal of Veterinary Service
    • /
    • v.46 no.2
    • /
    • pp.161-165
    • /
    • 2023
  • A 6-year-old female long-tailed goral (Naemorhedus caudatus, goral) was admitted to the Gangwon wildlife medical rescue center due to severe starvation and hypothermia. The goral displayed clinical signs of severe weight loss, dehydration, lethargy, regurgitation, hypothermia, and bloating, with blood tests showing a decrease in albumin, calcium, glucose, and sodium. Supportive care was given through heating, oxygen supply, and fluid therapy, but the goral's condition worsened, and the goral died three days after admission. Radiographic and computed tomography scans revealed the presence of an indigestible foreign body (IFB) in the rumen, which was confirmed during the necropsy. The cause of goral's death was identified as chronic rumen impaction caused by the IFB (a ball of string), with other pathological findings including bloating, the presence of serous ascites, and congestion of digestive organs. Blood biochemical changes, clinical signs, and veterinary medical imaging diagnosis can be helpful in diagnosing ruminal impaction. This case report can provide valuable information for the diagnosis and treatment of ruminal impaction caused by IFB in endangered gorals, which may include rumenotomy or other surgical procedures.

A Study on Strengthening of Maritime Search and Rescue by Improving the Mobile-phone Boarding Reporting System (모바일 승선신고시스템 개선을 통한 해양수색구조 강화방안 연구)

  • Hae-Sang Jeong;Jong-Hwui Yun;Seong-Chan Lee;Choong-Ki Kim
    • Journal of the Korean Society of Marine Environment & Safety
    • /
    • v.29 no.4
    • /
    • pp.316-324
    • /
    • 2023
  • During maritime distress, Korean Coast Guard investigates the current status of the distress, such as identifying search objects, to establish a search plan. The ship master is required to submit a report to the competent authority before departure, along with an identity list of the crew and passengers. As a list of the passengers on board is made manually, the waiting time becomes longer, and it is difficult to immediately identify these during maritime distress. The Ministry of Oceans and Fisheries has developed an app to make it easier to register for boarding, but it has been inactive for various reasons. Therefore, this study proposed a plan to improve it. By activating the mobile-phone boarding report system, it is possible to quickly secure the initial location and time of the person in water and provide mental relief to them by acknowledging the receipt of a distress report. In addition, using this information, it is possible to quickly rescue the affected person through public-private partnership.

Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases

  • Hayato Yamaguchi;Masakatsu Fukuzawa;Takashi Kawai;Takahiro Muramatsu;Taisuke Matsumoto;Kumiko Uchida;Yohei Koyama;Akir Madarame;Takashi Morise;Shin Kono;Sakik Naito;Naoyoshi Nagata;Mitsushige Sugimoto;Takao Itoi
    • Clinical Endoscopy
    • /
    • v.56 no.6
    • /
    • pp.778-789
    • /
    • 2023
  • Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is performed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing perforation. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of rescue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group (SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90-197] minutes) >C-ESD (90 [60-140] minutes) >SH-ESD (52 [29-80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dissection rate was significantly lower in the piecemeal resection group (25% [20%-30%]) than in the en bloc resection group (40% [20%-60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoiding surgery.

Safety and efficacy comparison of embolic agents for middle meningeal artery embolization for chronic subdural hematoma

  • Nathaniel R. Ellens;Derrek Schartz;Gurkirat Kohli;Redi Rahmani;Sajal Medha K. Akkipeddi;Thomas K. Mattingly;Tarun Bhalla;Matthew T. Bender
    • Journal of Cerebrovascular and Endovascular Neurosurgery
    • /
    • v.26 no.1
    • /
    • pp.11-22
    • /
    • 2024
  • Objective: To perform a systematic review and meta-analysis evaluating the efficacy of middle meningeal artery embolization in terms of both clinical and radiographic outcomes, when performed with different embolic agents. Methods: A systematic literature review and meta-analysis was performed to evaluate the impact of embolic agents on outcomes for middle meningeal artery (MMA) embolization. The use of polyvinyl alcohol (PVA) with or without (±) coils, N-butyl cyanoacrylate (n-BCA) ± coils, and Onyx alone were separately evaluated. Primary outcome measures were recurrence, the need for surgical rescue and in-hospital periprocedural complications. Results: Thirty-one studies were identified with a total of 1,134 patients, with 786 receiving PVA, 167 receiving n-BCA, and 181 patients receiving Onyx. There was no difference in the recurrence rate (5.5% for PVA, 4.5% for n-BCA, and 6.5% for Onyx, with P=0.71) or need for surgical rescue (5.0% for PVA, 4.0% for n-BCA, and 6.9% for Onyx, with P=0.89) based on the embolic agent. Procedural complications also did not differ between embolic agents (1.8% for PVA, 3.6% for n-BCA, and 1.6% for Onyx, with P=0.48). Conclusions: Rates of recurrence, need for surgical rescue, and periprocedural complication following MMA embolization are not impacted by the type of embolic agent utilized. Ongoing clinical trials may be used to further investigate these findings.