Types of emergency patient analyzed using the geographic information system

Objective@#Predicting the incidence of emergency patients can be very important for the efficient use of emergency medical resources and the deployment of 119 centers in a pre-hospital setting. The study was conducted to analyze the occurrence of emergency patients using geographic information systems in a pre-hospital setting in Korea. @*Methods@#The basic data used in this study were collected from the 119 centers in Chuncheon-si, Korea, under the firefighting headquarters in Gangwon-do from January 2012 to December 2016. @*Results@#The total number of patients transferred by 119 paramedics was 72,362. Of these, 9,904 (14.7%) were emergency patients; 519 (0.7%) had cardiovascular diseases; 383 (0.5%) had cerebrovascular diseases; 3,043 (4.2%) were trauma patients; 58,413 (80.7%) were non-emergency patients. The occurrence of emergency diseases was slightly lower in the Hyoja-dong area, and it was slightly higher in the area of the outskirts of the city. The incidence of heart disease was low in the Hyoja-dong and Nam-myeon areas, but the incidence of heart disease was highly observed in other areas. The number of trauma patients was 1,265 (41.6%) in the outskirts of the city, a suburban area, showing a relatively higher incidence than other emerging diseases. @*Conclusion@#The deployment of ambulances in Chuncheon-si should be carried out considering demographic characteristics and patient occurrence.

Changes in histopathology and tumor necrosis factor-α levels in the hearts of rats following asphyxial cardiac arrest

OBJECTIVE: Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have return of spontaneous circulation (ROSC) after CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during the post CA syndrome. METHODS: We induced asphyxial CA in male Sprague-Dawley rats and determined the survival rate of these rats during the post resuscitation phase. RESULTS: Survival of the rats decreased after CA: 66.7% at 6 hours, 36.7% at 1 day, and 6.7% at 2 days after ROSC following CA. The rats were sacrificed at 6 hours, 12 hours, 1 day, and 2 days after ROSC, and their heart tissues were examined. Histopathological scores increased at 12 hours post CA and afterwards, histopathological changes were not significant. In addition, levels of tumor necrosis factor-α immunoreactivity gradually increased after CA. CONCLUSION: The survival rate of rats 2 days post CA was very low, even though histopathological and inflammatory changes in the heart were not pronounced in the early stage following CA.

Changes in Histopathology and Tumor Necrosis Factor-αLevels in the Hearts of Rats Following Asphyxial Cardiac Arrest

PURPOSE: Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have a return of spontaneous circulation (ROSC) after the CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during post CA syndrome. METHODS: Asphyxial CA was induced in male Sprague-Dawley rats and the survival rate of the rats was determined during the post resuscitation phase. RESULTS: Survival of the rats decreased after CA: 66.7% at 6 hours, 36.7% at 1 day, and 6.7% at 2 days after the ROSC following CA. The rats were sacrificed at 6 hours, 12 hours, 1 day, and 2 days after the ROSC, and their heart tissues were examined. Histopathological scores increased at 12 hours post CA. Afterwards, the histopathological changes were not significant. In addition, the levels of tumor necrosis factor-αimmunoreactivity increased gradually after CA. CONCLUSION: The survival rate of the rats 2 days post CA was very low, even though the histopathological and inflammatory changes in the heart were not pronounced in the early stages following the CA.

Bursting Fracture of the Thoracic Spine in Ankylosing Spondylitis: No Visible in Standard Radiograph

Patients with ankylosing spondylitis (AS) are at high risk for spinal fracture even after a minor injury. Most spinal fractures with ankylosing spondylitis occur in the cervical spine, whereas spinal fractures in thoracic or lumbar spine are rare. These fractures are often difficult to detect on standard radiographs, because the normal anatomical landmarks are lacking and the abnormal spinal stiffness precludes optimal exposure of the spine. We report on a case of a 12th thoracic spine fracture in ankylosing spondylitis with bamboo spine after a minor injury. In this case, anteroposterior and lateral radiographs of the thoracolumbar spine showed a bamboo spine typical for ankylosing spondylitis with no evidence of fracture. However, computed tomography showed a 12th thoracic fracture with burst. Therefore, this fracture, in a patient with AS involved all three spinal columns, was considered unstable.

Comparison of Quality of Cardiopulmonary Resuscitation in Manikins with a Change in the Compression to Ventilation Ratio from 30:2 to 15:1

PURPOSE: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended changing the ratio of chest compression to ventilation ratio to 30:2. However, current studies have shown that the hands-off time was >10 seconds with that method. For this reason, we reasoned that a chest compression to ventilation ratio of 15:1 would be a more suitable way to reduce hands-off time because this ratio will not change the total compression and ventilation count. METHODS: The subjects were asked to perform CPR for 5 cycles with a compression to ventilation ratio of 30:2. The subjects rested for 5 minutes, then performed CPR with a compression to ventilation of 15:1. The skill performance was measured and analyzed using a statistical program. RESULTS: In the group which performed CPR with a chest compression to ventilation ratio of 30:2, the average number of compressions per minute was 76+/-9, while at a chest compression to ventilation ratio of 15:1, the average number of compressions per minute was 68+/-9. Between the compression to ventilation ratios of 30:2 and 15:1, the count gap was 8.3+/-3.2. When CPR was performed at a chest compression to ventilation ratio of 30:2, the average hands-off time was 9.3+/-1.9. When CPR was performed at a chest compression to ventilation ratio of 15:1, the average hands-off time was 6.7+/-1.3. Between chest compression to ventilation ratios of 30:2 and 15:1, the time gap of the average hands-off time was 2.7+/-1.2 seconds. CONCLUSION: When the chest compression to ventilation ratio was 15:1, the hands-off time was significantly reduced, but the compressions per minute were also reduced.