The First Study to Define School Type Emergency Kit of Korea with Analysing Main Diseases of Schools in Bucheon

PURPOSE: The objective of this study was to assess through the analysis of school accidents over several years in Bucheon, the preparedness of schools to respond to school emergencies including those involving students with special needs and to deal with potential mass disasters. METHODS: A two-part questionnaire was mailed to school nurses in Bucheon by the staff of the Bucheon school nurse association. The second part was a question soliciting participation in our study. Schools answering "yes", were enrolled in the study and were mailed portpolio for recording accidents and severe symptoms occurring in their schools between 1 March 2005 and 30 July 2006. We analyzed these results for compliance with proper treatments outlined by the emergency textbook and procedure book. Also, we suggested the sample medical kit for school to prepare for prehospital treatments. RESULTS: Of the 81 questionnaires returned, 72 were eligible for analysis. The most commonly reported difficulty in pre-hospital treatment of school medical emergencies was a shortage of proper instrumentation (22 of 72, 95% confidence interval [CI]: 28~34%). Next most common was clinical knowledge deficit on the part of the school nurse (20 of 72, 95% CI: 25~31%). In injury analysis, the most common injury in both elementary school (310 of 645, 95% CI: 44~52%) and middle school (255 of 481, 95% CI: 50~56%) was contusion. This was slightly less at fourty six percent (95% CI: 43~49%) in high school. Among severe conditions, concussion was most common, followed by dyspnea and hemodynamic instability in all school. In high school, just thirteen percent (95% CI: 11~15%) were administered pre-hospital treatment by a school nurse and sixty four percent (95% CI: 60~68%) were transferred to a hospital by EMTs without pre-hospital treatment. CONCLUSION: Efforts should be made to increase the education of school nurses in the assessment and management of life-threatening emergencies with which they have less experience and confidence than with more routine medical needs. In addition, there needs to be increased emphasis on maintaining proper medical kit in schools.

Comparison of ECG Findings between Hypertrophic Obstructive Cardiomyopathy and Hypertension with Disproportionate Septal Thickening

Electrocardiographic findings in 18 cases of hypertrophic obstructive cardiomyopathy(HOCM) were compared with those in 20 hypertensives with disproportinate septal hypertrophy(DSH) and in 20 normal controls. In conventional 12 leads electrocardiograms, abmormal Q waves were seen only in 6 cases of HOCM and none in the remadinder. The R waves were tallest in leads V4 in 6 cases(33%) of HOCM, 3(15%) hypertensives with DSH, and 4(20%) of the controls. The correlations of the QRS voltages with echocardiographically measured left ventricular dimension, interventricular septal thickness and left ventricular mass were significant in the hypertensives with DST and normal controls, but insignificant in patients with HOCM. We conclude that these electrocardiographic differences in patients with HOCM from the others would be caused by uneven distribution of hypertrophied muscle mass in the left ventricule and/or by the altered depolarization in hypertrophied cardiac muscles.