• Title/Summary/Keyword: Injured Patient

Search Result 248, Processing Time 0.029 seconds

Application of Percutaneous Cardiopulmonary Support for Cardiac Tamponade Following Blunt Chest Trauma: Two Case Reports

  • Kim, Seon Hee;Song, Seunghwan;Kim, Yeong Dae;Cho, Jeong Su;Lee, Chung Won;Lee, Jong Geun
    • Journal of Chest Surgery
    • /
    • v.45 no.5
    • /
    • pp.334-337
    • /
    • 2012
  • Since the advent of percutaneous cardiopulmonary support (PCPS), its application has been extended to massively injured patient. Cardiac injury following blunt chest trauma brings out high mortality and morbidity. In our cases, patients had high injury severity score by blunt trauma and presented sudden hemodynamic collapse in emergency room. We quickly detected cardiac tamponade by focused assessment with sonography for trauma and implemented PCPS. As PCPS established, their vital sign restored and then, they were transferred to the operation room (OR) securely. After all injured lesion repaired, PCPS weaned successfully in OR. They were discharged without complication on day 26 and 55, retrospectively.

Factors Influencing Posttraumatic Stress Disorder Symptoms in Burn Injured Patients : Embitterment, Depression and Meaning in Life (화상환자의 외상후 스트레스 장애 증상에 대한 영향 요인 : 울분, 우울, 삶의 의미)

  • Hwang, Jihyun;Lee, Boung Chul;Chae, Jeong-Ho
    • Anxiety and mood
    • /
    • v.15 no.1
    • /
    • pp.29-34
    • /
    • 2019
  • Objective : To determine predictors of posttraumatic stress disorder (PTSD) symptoms in burn injured patients and evaluate factors for identifying high risk group of PTSD. Methods : This study examined sixty one patients aged in the range of 19-65 years with burn injuries. All subjects completed self-assessment inventories about PTSD (The PTSD Check List for DSM-5. PCL-5), depression (Patient Health Questionnaire-9, PHQ-9), embitterment (Posttraumatic embitterment disorder self-rating scale, PTED scale) and meaning of life (Meaning in Life Questionnaire, MLQ). Stepwise multiple regression and ROC curve analysis were the tools used for analysis. Results : The results revealed higher depression, embitterment and lower presence of meaning in life predicted severe PTSD symptoms. ROC analysis indicated PTED scale and PHQ-9 were useful for discriminating high risk group of PTSD. Conclusion : The present study established that the need to consider embitterment, depression and meaning of life for alleviation and prevention of PTSD symptoms in burn patients.

Rehabilitation of an Amur Leopard Cat (Prionailurus bengalensis) with Complex Injury by a Road Accident

  • Sungryong Kim;Sungin Lee;Ok-Joo Lim;Ki-Jeong Na;Dong-Hyuk Jeong
    • Journal of Veterinary Clinics
    • /
    • v.39 no.6
    • /
    • pp.411-416
    • /
    • 2022
  • A 2.2 kg adult female Amur leopard cat (Prionailurus bengalensis) injured in a road accident was rescued. Severe abrasions on the left chin were washed daily with an antiseptic and silver sulfadiazine ointment was applied. Corneal edema of the oculus sinister (OS) was treated with ofloxacin and 5% sodium chloride eye drops. The skin wounds gradually improved, but the eye condition did not improve and the lens was also found to be detached. In addition, on the 6th day of hospitalization, melena was observed. On radiographic examination, foreign bodies in the stomach and a fracture of the sternum were confirmed. Subsequently, endoscopic removal of foreign bodies and enucleation of the OS using an electrothermal vessel sealer were performed sequentially over several days. However, corrective surgery of the fractured sternum was not carried out because a natural union of the fracture had occurred, which was found to be fairly stable. The patient completely recovered on the 83rd day and was successfully released into the wild on the 97th day, after two weeks of adaptation training in a natural environment. This report describes the rehabilitation of a wild Amur leopard cat injured in a road accident through a series of diagnostic and treatment steps until its eventual return to the wild and highlights some improvements needed in the process.

Temporary Abdominal Coverage with Malex Mesh Prosthesis in Cases of Severely Injured Abdominal Trauma Patients (중증 외상환자에서 mesh를 이용한 일시적 수술창 봉합의 경험)

  • Kim, Yeon Woo;Jung, Yong Sik;Kim, Wook Hwan;Min, Young Gi;Kim, Ki Woon;Lee, Kug Jong
    • Journal of Trauma and Injury
    • /
    • v.18 no.1
    • /
    • pp.70-79
    • /
    • 2005
  • Background: Abdominal compartment syndrome has multiple etiologies that are not only related to trauma but also any problem condition in the absence of abdominal injury. To determine whether prevention of the abdominal compartment syndrome after celiotomy for trauma victims justifies the use of temporary abdominal coverage with monofilament knitted polypropylene mesh (Malex mesh) in severely injured patients. Method: Medical records at the Ajou University Medical Center were reviewed for a 32-month period from May 1st, 2002 to December 31st, 2004. Twenty-nine consecutive patients requiring celiotomy who were survived until at the end of celiotomy received temporary abdominal coverage and staged abdominal repairs with Malex mesh. One of them was dissecting aortic aneurysm patient and the others were all trauma victims. Malex mesh prosthesis coverage was used in cases of abdominal compartment syndrome due to excessive fascial tension, severe bowel edema and retroperitoneal hemorrhage or edema followed by staged abdominal repairs. Result: Eighteen of twenty-nine patients were survived. Demographic characteristics, injury severity number of abdominal-pelvic bone injuries, mortality rate, complications, number of operations for permanent closure, required time for permanent closure showed no difference between man and women or child and adult. Except one dissecting aortic aneurysm patient, trauma cases showed $3.24{\pm}0.98$ injury sites. All cases that received temporary abdominal coverage and staged abdominal repairs did not show abdominal compartment syndrome. $10.08{\pm}5.85$ days and $2.27{\pm}0.82$ times of operation required making permanent abdominal closure after temporary abdominal coverage followed by staged abdominal repairs. Most of surviving patients have shown antibiotic-resistant organism and fungus infection. Patients who received permanent closure recovered from infectious problem completely. Conclusion: The use of Malex mesh for temporary abdominal coverage in severely injured patients undergoing celiotomy was effective treatment method.

Comparisons of Fracture Types and Pelvic Angiographic Findings in Hemodynamically Unstable Pelvic Bone Fracture (혈역학적으로 불안정한 골반골 골절 환자에서 골반골 골절 소견과 혈관조영술 소견의 비교)

  • Lee, Kwon Il;Lee, Kang Hyun;Kang, Sung Chan;Park, Sung Min;Jang, Yong Su;Shin, Tae Yong;Hwang, Sung Oh;Kim, Hyun
    • Journal of Trauma and Injury
    • /
    • v.20 no.1
    • /
    • pp.26-32
    • /
    • 2007
  • Purpose: Hemorrhagic shock is the leading cause of death in patients with pelvic bone fractures. The majority of blood loss is due to injured pelvic arteries and retroperitoneal veins and to bleeding from the fracture site itself. Pelvic angiography and embolization of injured vessels is an effective way to control continuous bleeding. However, identifying the bleeding focus in hemodynamically unstable patients before diagnostic intervention is difficult. The purpose of this study was to determine the correlation between fracture patterns in hemodynamically unstable patients with pelvic fractures and later pelvic angiography findings. Methods: We performed a retrospective study of 21 hemodynamically unstable patients with pelvic fractures admitted to our emergency department between April 2001 to April 2006. All 21 patients underwent pelvic angiography. Pelvic fractures were assessed according to the Tile's classification and the degree of injury was assessed using the Injury Severity Score (ISS) and Revised Trauma Score (RTS). The hemodynamic status of the patients was defined using vital signs, base excess, and blood lactate. Fracture patterns were compared with hemodynamic status and angiography findings. Results: In the 5year study period, 21 hemodynamically unstable pelvic bone fracture patients were admitted; ten were men (47.6%), and 11 were women (52.4%). The mean age was 41.1 years (range: ${\pm}20.1$). Of the 21 embolization was performed in 6 patient (28.6%): 1 patient of the 5 unstable pelvic bone fracture patients (20%), and 5 patients of 16 the stable pelvic bone fracture patients (31.3%). There were no significant differences between the RTS (p=0.587) and embolization rate (p=0.774) for either the stable patients or the unstable patients. Patients with arterial injury on angiography had a lower RTS compared with patients without arterial injury but there was no significant difference in ISS between the two groups. The angiographic injured sites were five internal femoral arteries and one external femoral artery. Conclusion: The findings in this study suggest that the pelvic fracture pattern in hemodynamically unstable patients with pelvic fractures does not correlate with pelvic angiography findings.

Hematoma in Neck following Stellate Ganglion Block -A case report- (성상신경절 차단후 발생한 경부혈종 -증례 보고-)

  • Eun, Hyun-Hee;Hwang, Ho-Yong;Ryu, Hong-Hyun;Lee, Yong-Woo
    • The Korean Journal of Pain
    • /
    • v.10 no.1
    • /
    • pp.124-126
    • /
    • 1997
  • Stellate ganglion block is the most widely practiced procedure in the pain clinics due to its wide range of indications. We experienced a rare case who exhibited severe hematoma in neck following stellate ganglion block. A 58-year-old female patient injured by a traffic accident was admitted to the department of negro surgery for the treatment of cerebral contusion, cervical and lumbar sprain and left arm paresis. Because left sensory neural hearing loss occurred, the patient was referred to the pain clinic for treatment with stellate ganglion block due to her left sensory neural hearing loss. The next day stellate ganglion block was done with a negative aspiration for blood. Three hours later, hematoma in neck was found and the patient complained of pain in the neck and dyspnea. The symptoms and signs of respiratory difficulty were progressively aggravated. The hematoma was removed and ruptured muscular branch of vertebral artery was ligated under surgical exploration. In this case, the needle was apparently in the branch of vertebral artery during or after injection in spite of the negative aspiration for blood. Authors recommend that compression of the injected site over 5 minutes should be necessary to prevent a hematoma formation despite of a negative aspiration for blood.

  • PDF

Factors for Predicting the Need for an Emergency Blood Transfusion to a Multiple Trauma Patient Using Emergency Room Transfusion Score (ETS) (다발성 외상 환자에서 Emergency Room Transfusion Score (ETS)를 이용한 응급수혈의 예측인자)

  • Jo, Hyeon Kyu;Park, Yong Jin;Kim, Sun Pyo;Kim, Seong Jung;Cho, Soo Hyung;Cho, Nam Soo
    • Journal of Trauma and Injury
    • /
    • v.28 no.1
    • /
    • pp.1-8
    • /
    • 2015
  • Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas received an emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture.

  • PDF

Implementaion of Home Healthcare System for a Patient using SAW Tag (SAW 태그를 이용한 재택환자 종합관리시스템 구현)

  • Song, Jai-Chul
    • The Journal of the Institute of Internet, Broadcasting and Communication
    • /
    • v.17 no.3
    • /
    • pp.183-188
    • /
    • 2017
  • This paper is for the a study on home healthcare system for a patient using SAW Tag. This system is useful when there's a patient in home. Many patients are wounded in restroom. But restroom is very private place and nobody want to be disturbed here. The place where the patient is most injured in the house is the toilet, and it is the point where the privacy of the individual should be kept and the patient's condition should be checked and cope with in case of emergency. And using saw tag, we can calculate position and ID through reflected rf signal. Therefore we propose a general home healthcare system. The management system utilized a seat bed system to monitor at-home patients. The system mounts a bio-signal measuring unit on a toilet seat, measures a bio-signal from the bio-signal measuring unit, and the measured bio-signal is transmitted to the main server through the user's smart phone. With proposed system, we can expand operation area to silver town where many patients are cared. In this paper we developed sensor system and saw tag positioning system and showed the result.

Splenic Arterial Embolization in Salvage of the Injured Spleen in Children (소아의 비장 손상시 비장 보존을 위한 비장동맥색전술)

  • Hong, Soon-Hoon;Yoo, Soo-Young;Park, Jin-Su;Kim, Young-Ju
    • Advances in pediatric surgery
    • /
    • v.5 no.1
    • /
    • pp.15-25
    • /
    • 1999
  • Injured spleens have been successfully managed without operation in a number of children; however, splenectomy or splenic-conserving surgery may not be avoided because of exsanguinating hemorrhage. This study was performed to evaluate the efficacy of splenic arterial embolization (SAE) to control hemorrhage from injured spleens in children. We compared the outcomes of two groups of children with splenic injury. The first group (G1) consisted of eighteen children who were managed with conventional selective nonoperative treatment between 1993 and 1994. The second group (G2) consisted of 23 children prospectively studied from 1996 to 1997 after SAE was added in the management protocol of splenic injury. The criteria for SAE were grade III or IV injury, extravasation of contrast material revealed by CT, or unstable vital signs without evidence of associated injuries. Laparotomy was performed in 6 patients of G1 (33.3 %), 2 of whom had associated injuries. Five underwent splenectomy and the overall salvage rate in G1 was 72.2 % (13/18). In G2, eight patients (34.8 %) had SAE, which stopped bleeding successfully in all patients. Two of G2 (8.7 %) had laparotomy because of associated injuries. Only one patient underwent splenectomy and the salvage rate was 95.6 % (22/23). No patients required transfusion after SAE. In conclusion, the SAE effectively controlled hemorrhage from injured spleens. More spleens were salvaged with a reduced laparotomy rate after application of SAE in splenic injury.

  • PDF

LESCH-NYHAN SYNDROME: A CASE REPORT (Lesch-Nyhan syndrome: 증례보고)

  • Kim, Myoung-Gook;Yang, Kyu-Ho;Choi, Nam-Ki;Kim, Seon-Mi
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.38 no.3
    • /
    • pp.284-289
    • /
    • 2011
  • Lesch-Nyhan syndrome is a disease caused by metabolic disorder of purine. General muscle stiffness and hyposomia are shown from infancy and symptoms can include involuntary or irregular movements of arms and legs, mental retardation, and compulsive self-mutilating behaviors. Self-mutilating behaviors begin at approximately the first year or sometimes at late teens. The patients bite their lips, especially lower lip, tongue, buccal mucosa, hands and fingers. Tongue and lips can be injured or mutilated in severe cases. As the patient gets older, self-mutilating behaviors become more serious and extensive and secondary infection of injured areas is possible. Periodic soft tissue damage due to self-mutilating may evolve to cancer. Medical treatment, appliance treatment, extraction of tooth and surgical operation was attempted to control self-mutilaing behaviors. We hereby report the case of child Lesch-Nyhan syndrome patient who has self-inflicted labial damage as chief complaint. When patient was treated with conservate therapy, such as removable or fixed appliance, the frequency of labial damage could be subdued and yielded favorable results.