• Title/Summary/Keyword: Shock patient

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A Case of 'ALUM' Intoxication Leading to ARDS (급성 호흡 곤란 증후군을 유발한 백반 중독 중독 1예)

  • Kim, Won-Jang;Park, Youn-Hee;Kim, Eun-Kyung;Lim, Chae-Man;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.2
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    • pp.234-237
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    • 2002
  • A 77-year-old female was admitted 3 hours after intentionally ingesting 5g of aluminum ammonium sulfate ('Alum') powder dissolved in water. Gastric lavage with normal saline, activated charcoal chelation, and supportive therapies were performed. She showed a high anion gap metabolic acidosis, which rapidly progressed to multiple organ failure including ARDS. The patient subsequently progressed to a refractory shock which eventually led to death.

Comparison of visual blood loss estimates and subjective emergency according to clothing color : quasi-experimental study using bleeding simulation (의복의 색상에 따른 시각적 출혈량 추정값의 정확도와 주관적 응급도의 차이 비교 : 출혈모의환자를 이용한 유사실험연구)

  • Park, Si-Eun;Kwak, Yumi
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.111-121
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    • 2020
  • Purpose: The purpose of this study was to compare visual blood loss estimation and subjective emergency according to clothing color. Methods: This is a quasi-experimental study which involved the use of mock bleeding patients wearing different colors tops. Results: Differences in visual estimates according to clothing color were significant in both paramedic students (F=6.69, p=.002) and the general department students (F=20.92, p=.000). When looking specifically at the accuracy of visual estimates, the paramedic students group tended to underestimate (50% white, 62.5% black, 32.5% yellow) the actual blood volume in all experimental conditions. On the other hand, the general department group tended to overestimation (45% white, 40% black, 67.5% yellow). The subjective emergency was also found to differ between paramedic students (F=13.58, p=.000) and general department students (F=9.67, p=.000). Conclusion: Paramedics treating bleeding patients at pre-hospital stages need to pay attention to blood loss estimations depending on clothing color, a factor not to be neglected or underestimated.

A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

Atlantoaxial Joint Syndrome Misconceived as an Idiopathic Neuralgia -A case report- (특발성 신경통으로 오인된 환축추관절 증후군 -증례 보고-)

  • Hong, Seong Joon;Lee, Jeong Beom;Jung, Seung Won;Kim, II Seok;Lim, So Young;Shin, Keun Man
    • The Korean Journal of Pain
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    • v.18 no.1
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    • pp.48-51
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    • 2005
  • Although the atlantoaxial joint is the most common site of rheumatoid arthritis, our patient had no symptoms or signs suggestive of rheumatoid arthritis. The atlantoaxial joint is frequently involved in degenerative osteoarthritis, especially in elderly patients. An 81-year old man presented with severe intermittent electric shock like, lancinating pain from the occipital to the temporal and parietofrontal areas. He also had neck pain and a limited range of motion. After many examinations and laboratory tests, at the department of neurology and neurosurgery, he was diagnosed with idiopathic neuralgia. The diagnosis of atlantoaxial joint syndrome was confirmed, and treated successfully with atlantoaxial joint block.

A Clinical Evaluation of 402 Chest Traumas (흉부손상 401례에 대한 임상적 관찰)

  • Ahn, Byoung-Hee;Lee, Ho-Wan;Lee, Dong-Joon
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.311-318
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    • 1981
  • A clinical evaluation was performed on 402 cases of chest trauma those were admitted and treated at the department of chest surgery, Chonnam National University Hospital, during the past 13 years and 7 months from Jan. 1968 to July 1980. 1. The ratio of male to female was 5.5:1 in 1968 and 3.4:1 in 1980 with progressive increase of female patient and age from 20 to 59 years is 81.0%. 2. The most common cause of chest trauma was stab wound in penetrating trauma and traffic accidents in nonpenetrating trauma. 3. The most common injury from chest trauma was hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. 4. Hemothorax was observed in 76 cases [18.9%] of total cases and rib fracture was observed in 163 cases [40.5%] of total cases. 5. Rib fracture was prevalent from 4th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and with other organ injuries. 6. Open thoracotomy was performed in 72 cases [17.9%] and others were treated with conservative nonoperative treatment. 7. Overall mortality was 4.5% [19 cases], and common causes of the death were shock and respiratory insufficiency.

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Thoracic Trauma: Analysis of 150 Cases (흉부손상 150례에 대한 임상적 관찰)

  • 김형묵;김인수
    • Journal of Chest Surgery
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    • v.5 no.2
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    • pp.113-124
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    • 1972
  • Clinical observations were performed on 150 cases of chest trauma, those were admitted and treated at the Department of Surgery, Korea University Woosok Hospital, during the past 8 years period from August 1965 to August 1972. 1. The ratio of male to female patient of chest trauma was 3.4:1 in male predominence and age from 20 to 50 occupied 62% of the total cases. 2. The most common cause of chest trauma was traffic accident in this series. Eighty-one cases[54%] were injured by traffic accident and total cases due to blunt trauma [non-penetrating injury] were 113 cases[75.4%]including the cases with traffic accident, and remaining 37 cases[24.6%] were due to penetrating injury including 25[16.6%] cases of stab wounds. 3. Hemopneumothorax were observed in 645/[96 cases] of the total cases, and etiologic distribution revealed 78.1% due to non-penetrating trauma and 20.8% due to penetrating injury. 4. Rib fracture was found in 50% of cases. Common injuries associated with rib fracture were lung, brain and liver. 5. Most common symptom was chest pain and respiratory difficulty, and common sign associated with chest injury was decreased respiratory sound and subcutaneous emphysema. 6. Conservative non-operative treatment was performed in 94 cases[62.6%] and 56 cases [37.4%] were treated with operative treatment including 31 cases[20.6%] with open thoracotomy. 7. Overall mortality was 9.3%[14 cases] and most common causes of death were due to brain edema,asphyxia and shock.

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Tracheoplasty with using the Costal Cartilage, Including the Perichondrium, for Treating a Tracheoinnominate Artery Fistula - Surgical experience of one case - (기관절개술 후 발생한 기관무명동맥루에서 연골막를 포함한 늑연골을 이용한 기관성형술 - 수술치험 1예 -)

  • Cho, Seong-Ho;Kae, Yoe-Kon;Kim, Jong-In;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.651-654
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    • 2007
  • Tracheoinnominate artery fistula (TIF) is a very rare complication that can happen after long standing tracheostomy or insertion of an endotracheal tube and its mortality is very high. This condition requires early diagnosis and urgent management because of the life threatening results from tracheal obstruction or hypovolemic shock that is caused by massive bleeding. We report here on a case of successful tracheoplasty with using the costal cartilage, including the perichondrium, in a patient with laryngeal stricture, and this was done to preserve the trachea for the following operation to relieve the laryngeal stricture.

Peripheral gangrene in patients with severe falciparum malaria: report of 3 cases

  • Thanachartwet, Vipa;Krudsood, Srivicha;Wilairatana, Polrat;Phumratanaprapin, Weerapong;Silachamroon, Udomsak;Looareesuwan, Sornchai
    • Parasites, Hosts and Diseases
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    • v.44 no.2 s.138
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    • pp.139-143
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    • 2006
  • Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with falciparum malaria. Patients with this complication have generally undergone early amputation of the affected areas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, with high grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness and shock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient had gangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patients were diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfully achieved by treatment with artesunate and conservative treatment in 2 of 3 cases.

Bowel Perforation Due to Immobilization after Resurfacing Thumb with Anterolateral Thigh Free Flap in an Elderly Diabetic Woman

  • Park, Seong Hoon;Kim, Joo Hyun;Suh, In Suck;Kim, Kwang Yong;Jeong, Hii Sun
    • Archives of Reconstructive Microsurgery
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    • v.26 no.1
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    • pp.18-22
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    • 2017
  • Inevitable immobilization after surgery on lower extremities can induce chronic constipation. Elderly diabetic women usually express ambiguous gastrointestinal symptoms and signs. We present here a case of panperitonitis developed from severe fecal impaction in an elderly diabetic woman after hand reconstruction using material harvested from the lower extremities. A 68-year-old diabetic female underwent anterolateral thigh free flap and wound revision twice on the left thumb. Three weeks after surgery, she complained about mild abdominal pain though she had daily defecation. Despite encouraging ambulation, her compliance was low. Resection of the sigmoid colon and colostomy were performed after diagnosis with bowel perforation. However, the patient went into septic shock and died with multiorgan failure after the guardians issued a DNR (do not resuscitate) order. For preventing bowel perforation, increased uptake of dietary fiber and early ambulation postoperatively should be encouraged, after even hand surgeries.

Acquired Tracheal Dilatation (후천성 기관확장증)

  • Choi, Jong-Ouck;Kim, Yong-Hoan;Kim, Hye-Jeong;Lee, Seung-Hoon;Choi, Geon
    • 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.

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