• Title/Summary/Keyword: Emergency medical

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Development of Analytical Method for Fipronil and Fipronil-Sulfone in Animal Serum by LC-MS/MS (LC-MS/MS에 의한 동물 혈청 내 피프로닐 및 피프로닐 설폰 분석법 개발)

  • Lee, Jeongsun;Park, Na-Youn;Jung, Woong;Kho, Younglim
    • Journal of the Korean Chemical Society
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    • v.63 no.6
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    • pp.415-419
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    • 2019
  • Fipronil is an insecticide that belongs to the N-phenylpytazole and has been used mainly for an insect pest control. However, it is known that acute poisoning of the human body causes various symptoms such as dizziness, muscle weakness, dyspnea, skin irritation, and increased heart rate. Lately, eggs containing fipronil have been distributed and toxic problems are spreading around the world. In this study, we tried to develop analytical methods to evaluate the exposure of fipronil and fipronil sulfone in animal serum samples. The differences according to mobile phase and the results of liquid - liquid extraction and solid phase extraction pretreatment method were compared. Distilled water (A) and acetonitrile (B) were selected for the mobile phase, and the pretreatment method was determined by solid phase extraction. As a result of the method validation, the intra-day / inter-day accuracies were 82.2~114.1% and the precisions were less than 20%. The detection limit was 0.027 ng/ml for fipronil and 0.087 ng/ml for fipronil sulfone. The linearity obtained was satisfying, with a coefficient of determination (r2) higher than 0.99. The concentrations in some animal sera were determined using the methods of analysis for fipronil and fipronil sulfone in animal sera developed in this study. Using the method developed in this study, it could be used as an analytical method for human bio-monitoring of fipronil and fipronil sulfone as well as animal serum.

Development and Effectiveness of Occupation Based Grocery Shopping Skill Training Program For The Person with Developmental Disability (거주시설 발달장애인을 위한 작업 기반 마트장보기 훈련 프로그램의 개발 및 효과)

  • Ju, Yu-mi;Kim, Dea-Yoon;Mo, Young-Ho;Son, Sung-Min
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.3
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    • pp.43-58
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    • 2017
  • Objectives : The Purpose of this study was to develop the occupation based grocery shopping skill training program for group of person with developmental disability and to test its effect. Methods : We set the grocery shopping task for the theme of the program and we applied this program for 9 sessions. There were initial, final, and follow-up evaluation and training sessions were provided 6 times. In the every session, group training program for grocery shopping skills was conducted. The performance of grocery shopping skills was evaluated by Test of Grocery Shopping Skills(TOGSS). Results : At the final assessment of grocery shopping skill, there were increased performance skills especially in item collection and size comparison. Among 3 subjects, two showed in improved navigation skills in order to search for target items. However, there was no improvement in comparing the optical price of items. For the last, it was significant that the total time to spend for shopping were commonly decreased. The performance of grocery shopping were maintained in 2 subjects and another subject was unable to perform it at the 5 month later follow-up evaluation. Conclusion : The occupation based grocery shopping skill training group program which was developed in this study is useful guide-line for occupational therapists who seek for the community based program. All 3 subjects showed the improved performance on shopping skill through this program.

The Effect of Trauma Team Approach on the Management of Hemodynamically Unstable Pelvic Bone Fracture: Retrospective Comparative study

  • Cho, Won-Tae;Cho, Jae-Woo;Kim, Jinil;Kim, Jin-Kak;Oh, Jong-Keon;Kim, Hak Jun;Kim, Namryeol;Cho, Jun-Min
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.139-145
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    • 2016
  • Purpose: The major pelvic trauma results in high mortality with associated fatal other injuries. During early stage of resuscitation, multidisciplinary approach is essential to improve the survival and outcomes. This study aims to report the effect and positive outcome of the trauma team approach on the management of hemodynamically unstable pelvic bone fracture. Methods: This retrospective review included all patients with hemodynamically unstable pelvic bone fracture admitted between March 2007 and December 2015. Patients were divided into group A, which comprised those admitted before the trauma team approach was started, and group B, which comprised those admitted after the approach was started. The advanced trauma life support protocol was followed for all patient. The comparisons between the two groups were based on medical records. Study variables included demographics, initial vital sign, injury severity score, fracture type, and injury mechanism. We analyzed the outcomes in each group with respect to the time interval for doctors' arrival, total length of stay in the emergency department (ED), time interval for computed tomography evaluation, 24-hour mortality, time interval for definitive fixation, and definitive fixation in the time-window of opportunity. Results: Fifty-three patients met the inclusion criteria. No statistically significant differences in demographic data existed between the two groups. The time interval for doctors' arrival (min, $63.09{\pm}50.48$ vs $21.48{\pm}17.75$; p=0.038) and total length of stay in the ED (min, $269.33{\pm}105.96$ vs $115.49{\pm}56.24$; p=0.023) were significantly improved. The 24-hour mortality was not significantly different between the two groups.(%, 14.3 vs 12.0; p=1.000) However, the time interval for definitive fixation and definitive fixation in the time-window of opportunity showed better results. Conclusion: The trauma team approach has positive effects, which include initial resuscitation through multidisciplinary approach and shortening the time interval to definitive fixation, on the management of hemodynamically unstable pelvic bone fracture.

Concise Bedside Surgical Management of Profound Reperfusion Injury after Vascular Reconstruction in Severe Trauma Patient: Case Report

  • Chung, Hoe Jeong;Kim, Seong-yup;Byun, Chun Sung;Kwon, Ki-Youn;Jung, Pil Young
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.204-208
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    • 2016
  • For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

Perception of Good Death and Attitudes toward Death between ER Nurses and Coroners (검시관과 응급실 간호사의 좋은 죽음에 대한 인식과 죽음에 대한 태도)

  • Han, Ji-Young
    • Journal of Hospice and Palliative Care
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    • v.18 no.1
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    • pp.16-24
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    • 2015
  • Purpose: This study was conducted to describe and compare how emergency room (ER) nurses and coroners perceive good death and their attitudes toward death. Methods: A survey was performed with 51 ER nurses in P city and 44 coroners nationwide. Data were collected from October 1, 2010 through February 28, 2011. Data were analyzed with descriptive statistics, t-test, ANCOVA, Scheffe's test using the IBM SPSS statistics 21.0 program. Results: For the perception of good death and attitudes toward death, coroners scored higher ($3.01{\pm}0.43$ and $2.87{\pm}0.35$, respectively) than ER nurses group ($2.95{\pm}0.40$ and $2.61{\pm}0.33$, respectively), but the differences were not significant. The results of perception of good death and attitudes toward death were not statistically significant between ER nurses and coroners. Conclusion: The study showed no difference between ER nurses' perception of good death and attitudes toward death and those held by coroners. The findings of the study show that it is necessary to offer steady education on death to nurses and coroners to help them build a proper understanding of good death and grow positive attitudes toward death.

Convergence and Integration Review of Fire fighter Image through Disaster Movies (재난 영화를 통해 본 소방관 이미지에 대한 융·복합적 고찰)

  • Lee, In-Seob;Kim, Jee-Hee;Kim, Yun-Jeong
    • Journal of the Korea Convergence Society
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    • v.8 no.2
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    • pp.91-97
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    • 2017
  • The purpose of the study was to investigate the fire fighter image through disaster movies in Korea and other countries. From September 1 to 7, 2016, the movie search methods were carried out using movie title and key words via Wikipedia and various internet web sites from 1903 to 2016. The results included that the fire fighters had been considered as the precious person of volunteer activity regarding fire suppression, investigators, and self-sacrifice. Through the convergence and integration review of the disaster movie, this research suggested that the national based establishment of the welfare and safety system for the posttraumatic stress disorder(PTSD) and critical incident stress management(CISM) education program. This study will provide the basic data for the development of welfare and safety management for the fire fighters and let the people know the sacrifice of the fire fighters including the motto, "First in and the last out".

Compensation of Error in Noninvasive Blood Pressure Measurement System Using Optical Sensor (광학 센서를 이용한 비관혈적 혈압 측정의 오차 보정)

  • Ko, J.I.;Jeong, I.C.;Lee, D.H.;Park, S.W.;Hwang, S.O.;Park, S.M.;Kim, G.Y.;Joo, H.S.;Yoon, H.R.
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.178-186
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    • 2007
  • This study is attempted to correct an error of electronic blood pressure meter with an optical sensor. In general, for a hospitalized patient, ECG, blood pressure, oxygen saturation, and respiration are basically measured to monitor the patient's condition. Opening of a blood vessel after it is occluded by pressurizing the cuff influences the blood flow of peripheral blood vessels as well as oscillation changes in the cuff. Blood vessels are occluded and peripheral blood flow disappears at cuff pressure above the examinee's blood pressure, while blood vessels are opened and peripheral blood flow appears again at cuff pressure under the examinee's blood pressure. Then Disappear-Appear Point Length(DAPL) of peripheral blood flow can be judged with the signal of peripheral blood flow, thus is available as a factor of error correction for electronic blood pressure meter. Also, systolic or diastolic blood pressure can be corrected with Appear-Point-Pressure(APP) of cuff pressure at a point where blood flow occurs and Appear-Maximum Pressure(AMP) of cuff pressure at the maximum amplitude point of peripheral blood flow after peripheral blood flow appears again. For verification, 27 examinees were selected, and their blood value was obtained through experimental procedure of 4 stages including induction of blood pressure change. The examinees were divided into two groups of experimental group and control group, regression analysis was conducted for experimental group, and correction of a blood pressure error was verified with optical signal by applying the regression equation calculated in experimental group to control group. As an experimental result, mean of the whole measurement errors was 5mmHg or more, which did not meet the standard fur blood pressure meter. As a result of correcting blood pressure measurements with data of DAPL, APP, and AMP as drawn out of PPG signal, systolic blood pressure, mean blood pressure, and diastolic blood pressure were $-0.6{\pm}4.4mmHg,\;-1.0{\pm}3.9mmHg$ and $-1.3{\pm}5.4mmHg$, respectively, indicating that mean of the whole measurement errors was greatly improved, and standard deviation was decreased.

POSTSEDATION EVENTS IN PEDIATRIC PATIENTS SEDATED FOR DENTAL TREATMENT (진정법을 이용한 치과 치료 시 소아 환자의 진정 후 반응에 대한 연구)

  • Koo, Jung-Eun;Baek, Kwang-Woo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.2
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    • pp.209-216
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    • 2009
  • The purpose of this retrospective study was to examine twenty four hour postsedation events after discharge in children sedated for dental treatment. The sedation sheets of 355 children were selected. Selection criteria excluded no midazolam or nasal route of midazolam, no ASA class I, absent or incomplete questionnaire. Children received orally chloral hydrate and hydroxyzine, nitrous oxide was maintained during the sedation. Midazolam was injected to buccal submucosa with titration. Parents were interviewed via telephone within twenty four hours after sedation. Questionnaire included sleeping response, sleeping time, sleeping behavior, vomiting response at home. Two hundred twenty four (67.8%) children slept and twenty one(6.3%) children had abnormal sleeping behavior. One hundred four(31.0%) children had abnormal behavior after sleep and ten(3.0%) children had vomiting response. In the children took the higher dose of midazolam, there were the great tendency to sleep after discharge (p<0.05), the more negative response to sleeping behavior(p = 0.055), the longer sleeping time(p=0.054). In this study many children slept after sedation and a few children showed negative response. However there were not any considerable emergency events. Further study is required to determine the postsedation safety for the use of submucosal midazolam combination with chloral hydrate and hydroxyzine.

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The Relations of Social Support to the Health Behaviors and Health Status in the Elderly (노인들의 사회적 지지와 건강행태 및 건강수준과의 관련성)

  • Kim, Tae-Myon;Lee, Sok-Goo;Jeon, So-Youn
    • Korean Journal of Health Education and Promotion
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    • v.23 no.3
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    • pp.99-119
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    • 2006
  • Objectives: This study intends to understand the difference within group of social support level and the effect of social support to health behaviors and health status of the elderly by selecting the old of local society as target. Methods: Data were obtained from self-administered questionnaire of 8,688 persons, older than 65 years, living in a community. We measured the sociodemographic characteristics, social support(family support, other support, quality of support), physical health state(subjective health status, number of chronic disease), physical function state(activities of daily living; ADL, instrumental activities of daily living; IADL), cognition state(mini-mental state examination-Korean; MMSE-K) and depression state(short form of geriatric depression scale; SGDS), health behaviors(smoking, drinking, exercise, eating habit). Univariate, multinominal logistic regression and covariance structure analysis were employed to analyze factors affecting on the social support of the elderly. Results: When considering the degree of social support by the sociodemographic characteristics of the older adults, the family support, other support and quality of support is better when the old is male, young, high education and self-reported living status is good and it has significance statistically. When considering the relation between social support and health status, the family support, other support and quality of support is better when the old's subjective and objective physical health status is good. The family support, other support and quality of support is better when the old's subjective health status is better. The other support and quality of support is better when the old's ADL(activities of daily living) and IADL(instrumental activities of daily living) are good. The family support, other support and quality of support is better when the old's cognitive function and depression state is better. When considering the relation between social support and health behaviors, in case of smoking and drinking, the quality of support, family support and other support is better when the old smokes and drinks rather than the old does not. In case of exercise and eating habit, the family support, other support and quality of support is better when the old exercises and eats regularly rather than the old does not. It has significance statistically. From the result of performing covariance structure analysis by structural equation modeling(SEM) with two endogenous variable(health behaviors and health status) and one exogenous variable(social support), factor loading of health status is 0.74 and factor loading of health behaviors is 0.05. The social support explains health status of 55.4% and health behaviors of 2.9%. Conclusions: This study has the meaning that it finds the difference of social support generating from inside of the group for the old residing in city and country and specifies the effect that the difference of social support influences to health status and health behaviors. From now on, in the development of health improvement strategy of the olds, it is necessary to approach from inclusive aspect while considering psychosocial factor such as social support and social economical factor as well as health status.

A Study on Strengthening Consequence Management System Against CBRN Threats (CBRN 위협에 대비한 사후관리체계 강화방안)

  • Kwon, Hyuckshin;Kwak, Minsu;Kim, Kwanheon
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.40 no.4
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    • pp.429-435
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    • 2020
  • North Korea declared itself complete with nuclear force after its sixth nuclear test in 2017. Despite efforts at home and abroad to denuclearize the Korean Peninsula, the prospects for the denuclearization are not bright. Along with political and diplomatic efforts to deter NK's WMD threats, the government is required to strengthen its consequence management capabilities against 'catastrophic situations' expected in case of emergency. Accordingly, this study was conducted to present measures to strengthen follow-up management against CBRN threats. The research model was partially supplemented and utilized by the THIRA process adopted and utilized by the U.S. Department of Homeland Security among national-level disaster management plan development models. Korea's consequence management (CM) system encompasses risk and crisis management on disaster condition. The system has been carried out in the form of a civil, government and military integrated defense operations for the purpose of curbing the spread or use of CBRNs, responding to threats, and minimizing expected damages. The preventive stage call for the incorporation of CBRN concept and CM procedures into the national management system, supplementing the integrated alarm systems, preparation of evacuation facilities, and establishment of the integrated training systems. In the preparation phase, readjustment of relevant laws and manuals, maintenance of government organizations, developing performance procedures, establishing the on-site support systems, and regular training are essential. In the response phase, normal operations of the medical support system for first aid and relief, installation and operation of facilities for decontamination, and development of regional damage assessment and control guidelines are important. In the recovery phase, development of stabilization evaluation criteria and procedures, securing and operation of resources needed for damage recovery, and strengthening of regional damage recovery capabilities linked to local defense forces, reserve forces and civil defense committees are required.