• Journal of Trauma and Injury
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• 제19권1호
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• pp.54-58
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• 2006

Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

• Journal of Trauma and Injury
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• 제28권4호
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• pp.248-255
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• 2015

Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.1-7
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• 2006

Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

• 한국안전학회지
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• 제35권4호
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• pp.23-31
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• 2020

In the construction sector, there were 99 fatalities from falls associated with steel tube and system scaffolds for three years from 2016 to 2018 and out of which 27.3 percent (27 workers) were found to have occurred during installing and dismantling procedure. To erect scaffolding which is installed for the work at height, the work platforms are generally installed first and the safety guardrails are installed and vice versa to dismantle. As a result, workers are exposed to the risk of falling because they erect and dismantle scaffolding without guardrails. To minimize the risk of falling, it is necessary to study a new construction method that can erect or dismantle scaffolding while guardrails are installed (called advanced guardrail system). This study analyzed advanced guardrail system in terms of safety regulation, workability and economic efficiency by investigating the domestic situation on the use of scaffolding, reviewing domestic and foreign standards for guardrails and conducting economic feasibility study. The results of this study is expected to greatly contribute to preventing falls in scaffolding installation and dismantlement procedure. As a follow-up study, empirical research is required including physical test of scaffolding with advanced guardrail system and effectiveness analysis after trial applications.

• The Journal of Korean Physical Therapy
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• 제21권3호
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• pp.75-80
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• 2009

Purpose: The purpose of this study was to examine the effect of an obstacle height on the balance control of older adults while stepping over an obstacle from a position of quiet stance. Methods: Fifteen community-dwelling healthy older adults (mean age, $74.4\pm4.27$ yrs; age range, 67-82 yrs) volunteered to participate in this study. The subjects performed gait initiation (GI) and they stepped over obstacles of two different heights (10 cm and 18 cm) at a self-paced speed from a position of quiet stance. Their performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Results: The M-L displacement of the COP significantly increased for an 18 cm obstacle height condition as compared to the GI and a 10 cm obstacle height condition (p<0.01). Furthermore, the M-L displacement of the COP for a 10 cm high obstacle was significantly greater for that for the GI (p<0.01). However, the mean of the A-P displacement of the COP was similar between the stepping conditions for the A-P displacement of the COP (p>0.05). Conclusion: This study suggests that the M-L COP displacement could be a better parameter to identify the dynamic balance control in older adults when negotiating obstacles.

• 천문학회보
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• 제37권2호
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• pp.110.2-110.2
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• 2012

We investigate a cool loop and a dark lane over a limb active region on 2007 March 14 by the Hinode/EUV Imaging Spectrometer (EIS). The cool loop is clearly seen in the EIS spectral lines formed at the transition region temperature (log T = 5.8). The dark lane is characterized by an elongated faint structure in coronal spectral lines (log T = 5.8 - 6.1) and rooted on a bright point. We examine their electron densities, Doppler velocities, and non-thermal velocities as a function of distance from the limb using the spectral lines formed at different temperatures (log T = 5.4 - 6.4). The electron densities of the cool loop and the dark lane are derived from the density sensitive line pairs of Mg VII, Fe XII, and Fe XIV spectra. Under the hydrostatic equilibrium and isothermal assumption, we determine their temperatures from the density scale height. Comparing the scale height temperatures to the peak formation temperatures of the spectral lines, we note that the scale height temperature of the cool loop is consistent with a peak formation temperature of the Mg VII (log T = 5.8) and the scale height temperature of the dark lane is close to a peak formation temperature of the Fe XII and Fe XIII (log T = 6.1 - 6.2). It is interesting to note that the structures of the cool loop and the dark lane are most visible in these temperature lines. While the non-thermal velocity in the cool loop slightly decreases (less than 7 km $s^{-1}$) along the loop, that in the dark lane sharply falls off with height. The variation of non-thermal velocity with height in the cool loop and the dark lane is contrast to that in off-limb polar coronal holes which are considered as source of the fast solar wind. Such a decrease in the non-thermal velocity may be explained by wave damping near the solar surface or turbulence due to magnetic reconnection near the bright point.

• 한국의료질향상학회지
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• 제15권2호
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• pp.107-120
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• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• 한국기계가공학회지
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• 제18권3호
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• pp.41-48
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• 2019

The industrial safety helmets are personal protective equipment (PPE), used to protect the head against falls from a height. This study indicated the necessity of wearing a safety helmet while working at heights below 4 m, through analysis of fall accidents occurring in the industrial field. The stress, displacement, and strain of the safety helmet shell structure have been analyzed using the finite element method with various thicknesses, engineering plastics, and designs. It was preferred that the safety helmet shell structure had a reinforcement frame of uniform thickness in terms of increased impact strength and strain energy absorption rate. The thickness can be reduced to lighten the total weight for workers wearing safety helmets.

• 한국운동역학회지
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• 제18권2호
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• pp.11-17
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• 2008

파킨슨 환자들이 장애물에 걸려서 넘어지는 것은 위험한데, 아직까지 이와 관련된 연구는 미비한 실정이다. 본 연구의 목적은 장애물 보행을 성공적으로 수행한 5명을 대상으로, 4가지 높이(0, 2.5, 5.2, 15.2cm)의 장애물을 넘을 때 나타나는 보행 특성의 차이를 밝히는 것이다. 연구결과, 파킨슨 환자들은 장애물 높이가 높아질수록 장애물에 더 천천히 접근하였으며, 장애물의 높이가 높을수록 발이 장애물에 걸리지 않도록 더 높이 발을 들어 넘었다. 또한, 파킨슨 환자들은 장애물의 높이가 높을수록 더 안정되게 넘기 위해서 좌.우발 사이의 거리를 넓게 해서 넘었다. 파킨슨 환자들은 각 장애물별로 넘는 속도를 일정하게 하고, 장애물을 넘기 전 왼발 앞꿈치와 장애물과의 수평거리 및 장애물과 장애물을 넘은 오른발 뒷꿈치와의 수평거리에서 차이가 없이 장애물을 넘었다. 이와 같은 특성이 파킨슨 환자들이 장애물을 넘는 일반적인 전략인 것으로 판단된다. 결론적으로 파킨슨 환자들은 장애물을 천천히, 조심스럽게, 그리고 비효율적으로 넘는 것으로 나타났다.