• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.185-187
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• 1997

Acquired tracheal dilatation is a state of abnormal tracheal dilatation developing from various causes. Tracheomalacia and tracheal dilatation can develop in respiratory distress patients with prolonged endotracheal intubation with assisted positive-pressure ventilation due to positive airway pressure and high cuff pressure. The authors have recently experienced one case of respiratory failure, cardiac arrest, and whole body emphysema after tracheostomy and portex tube insertion were performed to patient with the endotracheal intubation with assisted positive-pressure ventilation for two weeks in the septic shock resulted from colon perforation, who developed tracheal dilatation. We summarize diagnostic and therapeutic strategies of acquired tracheal dilatation for the prevention of emergency status and the management for that patients.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.1
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• pp.20-26
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• 2016

Sympathetic reaction to grotesque facial injuries with oral bleeding can trigger confusion and generate inefficiency among emergency room personnel. Regardless of the extent of the injury, or of the sympathy elicated, the victim must be evaluated and treated as a whole patient with multiple trauma. There must be no confusion as to order of importance in the steps of evaluation : 1. airway 2. hemorrhage 3. shock 4. associated injuries 5. local injury 6. triage of facial injuries. The most dangerous aspect of oral hemorrhage is the possibility of its obstructing the upper airway. Swallowing large amounts of blood will usually cause gastric irritation and lead to vomiting, thus further complicating the management of the patient. Once a clear airway is assured and hemorrhage have been controlled, consideration is given to possible associated injuries before undertaking treatment of the facial injuries themselves. Status of the cardiopulmonary, gastrointestinal and neuromuscular systems all have a bearing on decisions concerning facial injury treatment. In this light, treatment priority becomes exceeding important. On the other hand, the importance of facial injuries should never be minimized, especially in a mentally retarded patient with oral hemorrhage. This is a case report about oral hemorrhage control as treatment priority in a mentally retarded patient.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.2
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• pp.63-71
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• 2018

Prosthetic restorations through implants were popularized, and they became routine treatments. Small accessories used in the implant prosthodontic procedure are more likely to slip or fall off the dentist's hands. If the dental appliance or material passes into the upper gastrointestinal tract, there is a high possibility of excretion to the outside of the body without complications, but serious complications may occur depending on the type of foreign body. If the foreign body is passed to the airway, it is an emergency situation, and if it is not done properly, it can be fatal. The purpose of this review report is to investigate the process of foreign body ingestion or aspiration during dental treatment, and the method of prevention and treatment.

• Journal of The Korea Institute of Healthcare Architecture
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• v.26 no.3
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• pp.7-16
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• 2020

Purpose: As communicable disease, COVID-19, pandemic strikes over the world, it is critically bewared that air travel possibly be a major pass way to deliver the infectious disease virus. Especially the airplane could be an unique environment to cultivate the virus spreaders. In order to keep the continuous safe airway as well as the industry, related international associations and organizations have been published the guidelines for the prevention and control the infectious disease through the all aspects of aviation. By reviewing the guidelines, focusing on the in-flight infection prevention and control, this study would not only inform a summary of the international guidelines but also provide an essential and general consideration for related research or guideline study. Methods: Guidelines of 5 major countries are reviewed, which has been seriously influenced by COVID-19 : U.S., Canada, E.U., Australia and China. The items of the guidelines are re-categorized as its similarity and structure by applicable cases. Results: The result of this study shows that each guideline seems to share a major structure and issue such as identifying sick traveler, sick passenger care, and cleaning even though that of China has a different since it used to consider the flight conditions based on 3 levels of infection risk. For sick passenger care, the guidelines includes crew safety, service level, sick passenger isolation, and cleaning. Implications: A published guideline as a public manual could be to prevent and control the in-flight infection efficiently and promptly. It also could provide a confidence of knowledge and educate for all users to prepare the in-flight emergency as well.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Journal of Industrial Convergence
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• v.17 no.4
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• pp.77-86
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• 2019

The purpose of this study was to identify the effect of Home Health Nursing based Respiratory Management Program (HHNbRMP) on unmet healthcare need and healthcare resource utilizations of patients applying the home mechanical ventilator in the home with amyotrophic lateral sclerosis. The subjects of this study were 40 patients placed in an experimental group(n=19) and a control group(n=21), respectively. This HHNbRMP based on Cox's interaction model was consisted of cognitive assent (education, specialized medical care, case management), internal motivation (airway clearance, thoracic and air accumulated exercise) and psychological response (meditation & active listening). The intervention was applied to experimental group during 12 weeks. As variables was measured at baseline, twelve, twenty-four weeks and healthcare unmet need, resource utilizations (admission, out patient department, emergency room) was measured at 24 weeks. The data were analyzed by t-test, ANOVA and Repeated Measures ANCOVA. This intervention was not effective the unmet healthcare need. But the admission in to the hospital among the healthcare resource utilizations variables showed a significant difference at twenty-four weeks(t=4.17, p=.049). This results suggest that applying this program tailored to patients condition, utility of medical resource would be decreased, specially admission.

• Journal of Korea Entertainment Industry Association
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• v.14 no.7
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• pp.477-485
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• 2020

This study is a random allocation similar experimental study to compare and analyze the difference in BVM (Bag-Valve-Mask) ventilation volume according to the characteristics of the rescuer's hand and the type of mask using a standardized mannequin. To this end, the Basic Life Resuscitation Education Center of D University in gwangju. Recruiting 39 students who have completed the basic resuscitation course for emergency medical personnel and the Korean-style specialized cardiac rescue course, In addition to measuring the physical characteristics of the hand, the average amount of ventilation per minute using a bag-mask was measured and analyzed. As a result, the type of mask that was not most affected by the characteristics of the hand and provided adequate Minute Ventilation was the soft type (tube, silicone) mask. On the other hard (tube, silicone) masks were found to be unsuitable for general use as they were greatly affected by the characteristics of workers' hands. COVID-19 is currently increasing the risk of transmission to paramedics and patients. Considering this situation, the universal use of a semi-permanent hard-type mask, which is disadvantageous not only for preventing infection but also for proper ventilation, should be avoided. In addition to the ease of use, it should be actively utilized in the field by supplying a soft type mask that can provide stable ventilation even with 'predominance recognition' and proper ventilation.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.121-125
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• 2010

Background: Penetrating neck injuries are potentially dangerous and require emergency management because of the presence of vital structures in the neck. The risk of airway, vascular, neurological, and pharyngoesophageal injuries leads to many difficult diagnostic decisions. The purpose of this retrospective study is to evaluate our experience with management of penetrating neck injuries, and to assess treatment outcome. Material and Method: Forty-two consecutive patients were identified (26 patients from Korea university Ansan hospital, 16 patients from Guro hospital) as having penetrating neck injuries from 2003 to 2009. With review of medical records, variables were collected and evaluated including the location of injury, mechanism of injury, number of significant injuries, diagnostic modalities, duration of hospital stay and outcome. Results: The location of injury was zone I (lower neck) in 13 cases (31%), zone II (midportion of the neck) in 22 (52%), and zone III (upper neck) in 7 (17%). Injuries were caused by stab wounds in 23 patients, penetrating foreign bodies in 12. Among 35 patients who had deep injuries that violated the platysma, significant injuries, including major vascular (20), trachea (5) Pharyngoesophageal injuries (5) were identified in 24 patients. The mean hospital stay was 9.5 days. Conclusion: The penetrating trauma in the neck may show various degrees of severity. However, Cervical penetrating injury should not be underestimated in spite of the minimal width of the lesion.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.3
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• pp.171-176
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• 2021

Pneumomediastinum is a very rare and potentially catastrophic complication of dental procedures. Its common causes are tooth extraction, endodontic treatment, and subgingival curettage using handpieces and high-pressure air/water syringes. We present a case of massive pneumomediastinum with subcutaneous emphysema in a 61-year-old female who underwent bone grafting into the maxilla for pretreatment of dental implantation using a syringe. The patient suffered from abrupt severe odynophagia and loss of consciousness. The patient transferred to emergency department and images work-up revealed a pneumomediastinum and subcutaneous emphysema on the entire face and neck. We performed conservative treatments including prophylactic antibiotics, oxygen inhalation, and fasting meals, and then discharge after 7 days uneventfully. The patient's syncope might be resulting from hypotension and pain shock induced by pneumomediastinum with a sudden chest compression. The pneumomediastinum could be resulting from concurrent perforation and massive air infiltration into the maxillary sinus during bone grafting. We suggest that pneumomediastinum needs prompt diagnosis and management because of the risk of airway obstruction when a patient present syncope in the dental room.