Objective : The aim of this study was to investigate risk factor, precaution and treatment of aspirated foreign body during dental procedure. Material and Methods : Twenty cases of accidental aspiration of the foreign body, which removed by bronchoscopy at the Asan Medical Center between 2008 and 2012, were analyzed retrospectively. Results : Ten cases of accidental aspiration were occurred during dental procedure. Symtoms include cough(65%), dyspnea(50%), sputum(25%) and wheezing(25%). The most common location of foreign body was right bronchial tree(50%), left bronchial tree(45%) and carina(5%). Patients risk factors were chronic obstructive pulmonary disease, lung cancer, pulmonary tuberculosis, esophageal cancer and vegetative state. Conclusion : Accidental aspiration or swallowing of dental instrument or material is not uncommon accidents in dental practice. Most foreign bodies enter into gastrointestinal tract spontaneously. But aspiration into broncho-trachea can be more serious events and must be treated as an emergency situation. Prompt emergency treatment and removal of the foreign body is necessary to avoid complication. Dentists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental procedures.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.27
no.2
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pp.122-125
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2016
Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.
The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.
Purpose: This study was to understand actual state of supportive behavior of parents and nurses during invasive procedure for children who visit emergency medical center. Method: The object group was children's parents who have from 0 to 7 aged children takes invasive procedure except neonates and nurses who take part in the invasive procedure. Among them, 80 children's parents and 31 nurses were selected. For data analysis, SPSS for Window 8.0 was used and especially content analysis was performed for concrete supportive behavior of parents and nurses by survey. Results: Supportive behavior of parents and nurses during children's invasive procedure gave negative influences to the children, because most parents supplied poor supportive behavior without preparation, nurses performed work-oriented and treatment-oriented nursing due to speciality and busy business in emergency medical center. Conclusion: To lead positive and affirmative supportive behavior of parents and nurses during children's invasive procedure, for parents, positive supportive behavior ability must be strengthen through the overall education about children's invasive procedure when they visit emergency medical center or go to hospital: for nurses, hospital must provide successive instruction and policy to make nurses perform not work-oriented but patient-oriented nursing and positive supportive behavior.
Proceedings of the Korean Society for Rock Mechanics Conference
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2008.10a
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pp.33-41
/
2008
The longest tunnel has been halted at Daekwanryung by the failure of the host country of the Winter Olympiad in 2014, but modern High-Power TBM will come to Korea to excavate these long tunnels to establish the better horizontal connection between the western and eastern countries to improve the strong powerful logistic strategy of Korean peninsula. Train operation provides a key function of air movements in a long underground tunnel, and heat generation from transit vehicles may account of the most heat release to the ventilation and emergency systems. This paper indicates the optimal fire suppress services and safety provision for the long railway tunnel which is designed twin tunnel with length 22km in Gangwon province of Korea. The design of the fire-fighting systems and emergency were prepared by the operation of the famous long-railway tunnels as well as the severe lessons from the real fires in domestic and overseas experiences. Designers should concentrate the optimal solution for passenger's safety at the emergency state when tunnel fires, train crush accidents, derailment, and etc. The optimal fire-extinguishing facilities for long railway tunnels are presented for better safety of the comfortable operation in this hard rock tunnel of eastern mountains side of Korea. Since year 1900, hard rock tunnel construction has been launched for railway tunnels in Korea, tunnels have been built for various purposes not only for infrastructure tunnels including roadway, railway, subway, and but also for water and power supply, for deposit food, waste, and oils etc. Most favorable railway tunnel system was discussed in details; twin tunnels, distance of cross passage, ventilation systems, for the comfortable train operations in the future.
A simulation-based approach is proposed to study the protective actions taken by residents during nuclear emergencies using cognitive findings. Human perception-based behaviors are not heavily incorporated in the evacuation study for nuclear emergencies despite their known importance. This study proposes a generic framework of perception-based behavior simulation, in accordance with the ecological concept of affordance theory and a formal representation of affordance-based finite state automata. Based on the generic framework, a simulation model is developed to allow an evacuee to perceive available actions and execute one of them according to Newton's laws of motion. The case of a shadow evacuation under nuclear emergency is utilized to demonstrate the applicability of the proposed framework. The illustrated planning algorithm enables residents to compute not only prior knowledge of the environmental map, but also the perception of dynamic surroundings, using widely observed heuristics. The simulation results show that the temporal and spatial dynamics of the evacuation behaviors can be analyzed based on individual perception of circumstances, while utilizing the findings in cognitive science under unavoidable data restriction of nuclear emergencies. The perception-based analysis of the proposed framework is expected to enhance nuclear safety technology by complementing macroscopic analyses for advanced protective measures.
Purpose: The purpose of the study is to investigate the actual state of activity on domestic and foreign civil anti-disaster organizations, related suggestions, and development plans. Methods: This study used the documentary survey research method and the technical approach method. Civil anti-disaster organizations' information was derived from detailed scholarly monographs, specialty publications, and previous studies of master doctorate dissertation. Results: Volunteer Fire Department and voluntary crime prevention groups show problems related to budgetary deficits and volunteer deficiency. In order to resolve these issues, laws must be enacted to guarantee interest and support. In addition, the Citizen Corps Active in Disaster (CAIND) organization requires a dedicated salary system to address the investment of its workforce and the cost of heavy equipment. Moreover, deficiencies were revealed regarding the lack of systems in support of occupational education and training. In conclusion, several weak points require close attention. Conclusion: The results of this comparative analysis study about the domestic and foreign civil anti-disaster organizations provide insight into identity materialization and concept establishment.
Purpose : This study was to examine the secondary traumatic stress(STS) and related factors of emergency medical technicians. Methods : This study was conducted among 190 emergency medical technicians, over the age of 25, with the 1st or 2nd grade qualification, who serve at fire stations in U and P city of Korea. The collected data for this study was analyzed using SPSS 12.0. Result : The average character type of A-type personality technicians was 43.25 points and the average of B-type personality technicians was 37.82 points. It suggested that the former was higher than the latter. State anxiety did not show statistically significant difference between A-Type group and B-Type group with the score of 48.51 for A-Type and 47.91 for B-Type. Physical symptoms showed statistically significant difference between the two groups with the higher score of 28.45 for A-type group than that of 28.13 for B-Type group. The level of STS related to the volunteers' job characteristics was found to be low when the volunteers were satisfied with their job and didn't want to transfer to another division. Those on duty who had slept more than seven hours that day had the highest points. The number of points was highest when the frequency for the onset of trauma was between 20~30 times. Furthermore it was found that for most technicians, 71.05%, the period of symptoms lasted for a few weeks at most, and this was where the STS was the lowest, whereas on the other hand the highest STS occurred when the symptoms lasted for a period of up to six months. The findings showed significant correlations with a relation of r=.24 between STS and level of anxiety and r=.45 between STS and physical symptoms. However, no significant correlation was found between the level of anxiety and physical symptoms. Conclusion : The more emergency medical technicians are exposed to accidents, the more serious the STS are. Those with an A-type personality are especially prone to have higher STS. The higher the STS level is, the higher the level of physical states and anxiety is.
Lee, Dong Keon;Lee, Kang Hyun;Cha, Kyoung Chul;Park, Kyoung Hye;Choi, Han Joo;Kim, Hyun;Hwang, Sung Oh
Journal of Trauma and Injury
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v.22
no.1
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pp.71-76
/
2009
Purpose: The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group. Methods: All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29,2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study. Results: Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11${\pm}$11units, BeforeTT 16${\pm}$15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251${\pm}$223 minutes, BeforeTT 486${\pm}$460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11${\pm}$12 days, Before TT 15${\pm}$30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43${\pm}$37 days, BeforeTT 68${\pm}$70 days, p=0.032), but this difference was not statistically significant. Conclusion: Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS<9) are good indices for activating the trauma team.
Korean Journal of Construction Engineering and Management
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v.20
no.3
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pp.46-53
/
2019
Recently, the need for emergency medical facilities is increasing due to a large-scale disaster. The Ministry of the Interior and Safety has completed the development of Disaster Resource Sharing System (DRSS). In this system, only air tent and negative pressure tent, which are classified and managed as equipment are resources related to emergency medical facility at disaster site. However, the characteristics of resources for the facility such as the time of input, a period of stay, transportation, and installation methods were not reflected. So, The purpose of this study is to propose improvements of management of resources for emergency medical facility at disaster site, that classified to materials and equipment in DRSS. This study analyzed the state of resources for facilities and the attributes of resources based on literature and disaster medical consultation of mobile hospitals. The resources for emergency medical facility are required to be linked to medical support resources and reflected in the DRSS, since emergency medical facility resources at the disaster site should be managed through a combination of medical resources classified as equipment. And future research on installation of emergency medical facilities plan considering the cost of the disaster management resources should be carried out.
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