Effect of a Single Tetanus Toxoid in Korean Adults with Low Tetanus Antibody Titers

PURPOSE: The determination of tetanus prophylaxis according to patients' memories of past immunization is inaccurate. However, by using the Tetanos Quick Stick(R) test, it is possible to select Korean adults with low tetanus antibody titers and to perform tetanus prophylaxis in the emergency department. In 1996, Ha reported that tetanus toxoid injection into healthy Korean adults revealed significant differences between the tetanus antibody titers at the beginning and the tetanus antibody titers after 1 week. Our purpose is to determine the effect of a single tetanus toxoid in Korean adults with low tetanus antibody titers. METHODS: Blood samples were taken from 44 volunteers for a period of 6 weeks. All samples were analyzed using the Tetanus IgG ELISA (enzyme-linked immunosorbent assay) method. RESULTS: The results for tetanus antibody titers at the beginning and after 1 week, 2 weeks, 4 weeks, and 6 weeks were 0.04+/-0.05 IU/mL, 1.22+/-3.63 IU/mL, 4.99+/-7.3 6 IU/mL, 8.36+/-11.10 IU/mL and 6.59+/-9.21 IU/mL respectively. There was a statistically significant defference between the tetanus antibody titers at the beginning and the tetanus antibody titers after 2 weeks. There was no statistically significant defference between the tetanus antibody titers after 2 weeks and 6 weeks. After 4 weeks, all subjects' tetanus antibody titers were at the protective level. CONCLUSIONS: A single tetanus toxoid injection is effective in Korean adults with low tetanus antibody titers.

Prognosis of Patients Admitted to ICU after Cardiopulmonary Resuscitation in Emergency Room / 대한마취과학회지

BACKGROUND: The prognosis of patients admitted to intensive care unit (ICU) after cardiopulmonary resuscitation (CPR) is poor. Although the number of these patients is increasing as a consequence of emergency medical service improvements, we had no information conceiving the survival rates of patients admitted to ICU after CPR in Korea. The aim of this study was to determine the outcome of these patients. METHODS: We retrospectively evaluated all patients admitted to an ICU after CPR at an emergency room of a teaching hospital during the 24 month period from July, 2002 to July, 2004. The demographic and clinical information of each patient were recorded. These included primary diagnosis, total resuscitation time, APACHE II score (acute physiology and chronic health evaluation II score) at admission to ICU, ICU days, and hospital days. We analyzed all variables in the database and compared the data of patients who died in hospital with that of those who were discharged. RESULTS: Thirty-seven patients were admitted to the ICU after CPR in the emergency room, and 14 were discharged alive. APACHE II scores were significantly lower and Glasgow coma scales were significantly higher in survivors. CONCLUSIONS: 38% of patients who admitted to ICU after CPR in the emergency room were discharged from hospital alive. We evaluated that the severity scores of patients who receive CPR before ICU admission are important predictors of survival.