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1.
Laboratory Animal Research ; : 229-238, 2020.
Article | WPRIM | ID: wpr-836905

ABSTRACT

Obesity has been known as an independent risk factor for stroke. Effects of high-fat diet (HFD)-induced obesity on neuronal damage in the somatosensory cortex of animal models of cerebral ischemia have not been studied yet. In this study, HFD-induced obesity was used to study the impact of obesity on neuronal damage/loss and microgliosis in the somatosensory cortex of a gerbil model of 5-min transient forebrain ischemia. We used gerbils fed normal diet (ND) and HFD and chronologically examined microgliosis (microglial cell activation) by ionized calcium-binding adapter molecule 1 (Iba-1) immunohistochemistry. In addition, we examined neuronal damage or death by using neuronal nuclear protein (NeuN, a neuronal marker) immunohistochemistry and Fluoro-Jade B (F-J B, a marker for neuronal degeneration) histofluorescence staining. We found that ischemia-induced microgliosis in ND-fed gerbils was increased from 2 days post-ischemia; however, ischemia-mediated microgliosis in HFD-fed gerbils increased from 1 day post-ischemia and more accelerated with time than that in the ND-fed gerbils. Ischemia-induced neuronal death/loss in the somatosensory cortex in the ND-fed gerbils was apparently found at 5 days post-ischemia. However, in the HFD-fed gerbils, neuronal death/loss was shown from 2 days post-ischemia and progressively exacerbated at 5 days post-ischemia. Our findings indicate that HFD can evoke earlier microgliosis and more detrimental neuronal death/loss in the somatosensory cortex after transient ischemia than ND evokes.

2.
Article | WPRIM | ID: wpr-834914

ABSTRACT

Objective@#This study examined the characteristics of the patients taking poison intentionally at the pre-hospital stage to prevent it at the community level. @*Methods@#We retrospectively reviewed the data that had been reported to fire stations from January 2017 to December 2018. This data included sex, age, occupation, the season of the year, time, place, methods, alcohol ingestion, transferred to the hospital or not, and we examined how taking poison had an effect on the suicide success rate. @*Results@#The subjects were a total of 1,356 patients who had been reported to fire stations due to intentionally taking poison. Forty-five point five percent of them were male, and 54.5% were female. The most common method of intentional taking poison was sedatives (58.3%), followed by pesticides (24.6%), antidepressants (19.0%), and other methods (12.6%). The home place was preferred more than any other places. The suicide success rate was 2.1% in males and 1.4% in females. For the age groups, those patients 40-64 years old tried taking poison much more than the other age groups. In the aspect of the season of the year, summer was the highest season for taking poison, at 30.3%. The daytime was more preferred than the night time. @*Conclusion@#In this study, we analyzed the characteristics of the pre-hospital intentional poisoning cases according to gender, age, occupation, season of the year, time, and between the transferred and the untransferred groups. Efforts should be made in cooperation with the community to prevent suicide attempts by intentionally taking poison.

3.
Article | WPRIM | ID: wpr-834910

ABSTRACT

Objective@#This study analyzed the characteristics of people who attempted suicide that resulted in deaths as compared to that of the suicide survivors. @*Methods@#This study included 799 suicide attempts that occurred from March 1, 2015, to March 31, 2019 at the emergency department of the university hospital in a city of around 300,000 people. Suicide attempts were classified into the survivor and death groups, and the characteristics of each group were compared. The suicide deaths due to re-attempts were also analyzed. @*Results@#There were more males than females in the death groups. There was a high proportion of people aged 50 or older in the death groups. Hanging, carbon monoxide poisoning, and jumping from great heights were the most commonly used methods of suicide in the death groups. In the selected death group, psychiatric symptom, physical illness, and economic problem among the suicidal causes and depressive disorder among the psychiatric diagnoses were factors that increase the risk of suicide death. Sixty-three point four percent of the survival groups and 52.5% of the selected deaths had not received psychiatric care. On the analysis of suicide deaths due to re-attempts, the average number of suicide attempts was 2.45±0.9. The time from the first suicide attempt to the last suicide attempt was 13.8±10.4 months. @*Conclusion@#If it is necessary to make a treatment decision for a suicide attempt in a limited time, such as the case of treating a suicide attempter who visits an emergency department, it is necessary to consider the characteristic factors of the death attempts of suicidal people.

4.
Anatomy & Cell Biology ; : 128-135, 2018.
Article in English | WPRIM | ID: wpr-715223

ABSTRACT

Cardiac arrest (CA) is sudden loss of heart function and abrupt stop in effective blood flow to the body. The patients who initially achieve return of spontaneous circulation (RoSC) after CA have low survival rate. It has been known that multiorgan dysfunctions after RoSC are associated with high morbidity and mortality. Most previous studies have focused on the heart and brain in RoSC after CA. Therefore, the aim of this research was to perform serological, physiological, and histopathology study in the lung and to determine whether or how pulmonary dysfunction is associated with low survival rate after CA. Experimental animals were divided into sham-operated group (n=14 at each point in time), which was not subjected to CA operation, and CA-operated group (n=14 at each point in time), which was subjected to CA. The rats in each group were sacrificed at 6 hours, 12 hours, 24 hours, and 2 days, respectively, after RoSC. Then, pathological changes of the lungs were analyzed by hematoxylin and eosin staining, Western blot and immunohistochemistry for tumor necrosis factor α (TNF-α). The survival rate after CA was decreased with time past. We found that histopathological score and TNF-α immunoreactivity were significantly increased in the lung after CA. These results indicate that inflammation triggered by ischemia-reperfusion damage after CA leads to pulmonary injury/dysfunctions and contributes to low survival rate. In addition, the finding of increase in TNF-α via inflammation in the lung after CA would be able to utilize therapeutic or diagnostic measures in the future.


Subject(s)
Animals , Blotting, Western , Brain , Eosine Yellowish-(YS) , Heart , Heart Arrest , Hematoxylin , Humans , Immunohistochemistry , Inflammation , Lung , Models, Animal , Mortality , Rats , Survival Rate , Tumor Necrosis Factor-alpha
5.
Article in Korean | WPRIM | ID: wpr-719085

ABSTRACT

OBJECTIVE: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. METHODS: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. RESULTS: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. CONCLUSION: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.


Subject(s)
Emergency Medical Services , Emergency Service, Hospital , Female , Fires , Humans , Male , Methods , Mortality , Seasons , Suicide , Treatment Refusal
6.
Article in English | WPRIM | ID: wpr-646633

ABSTRACT

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.


Subject(s)
Animals , Heart Arrest , Heart , Humans , Male , Necrosis , Rats , Rats, Sprague-Dawley , Resuscitation , Survival Rate
7.
Article in English | WPRIM | ID: wpr-180938

ABSTRACT

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.


Subject(s)
Animals , Heart Arrest , Heart , Humans , Male , Necrosis , Rats , Rats, Sprague-Dawley , Resuscitation , Survival Rate , Tumor Necrosis Factor-alpha
8.
Singapore medical journal ; : 618-622, 2017.
Article in English | WPRIM | ID: wpr-304099

ABSTRACT

<p><b>INTRODUCTION</b>We performed this study to find clinical features and laboratory parameters that could facilitate the process of selecting patients who should receive lumbar punctures from among those who present with headache and fever.</p><p><b>METHODS</b>We selected patients aged ≥ 16 years who presented to and received lumbar puncture in the emergency department of Kangwon National University Hospital, South Korea, between 2011 and 2013. Patients who received lumbar punctures were divided into two groups - those who were diagnosed with viral meningitis and those who were not. We compared the clinical features and laboratory data between the two groups. Key indices were then used to develop a scoring system to diagnose viral meningitis in patients and identify those who should receive lumbar punctures.</p><p><b>RESULTS</b>Among the patients who were included in the study, 42 had viral meningitis and 96 did not. The variables of C-reactive protein level ≤ 1.291 mg/dL, neck stiffness and vomiting were assigned 3 points, 2 points and 1 point, respectively, in the scoring system. Overall scores ≥ 4 yielded a positive likelihood ratio of 7.79 (sensitivity 0.600, specificity 0.923), while negative likelihood ratio decreased to less than 0.1 (0.072) for overall scores < 3.</p><p><b>CONCLUSION</b>Using the proposed scoring system, we were able to determine the likelihood of viral meningitis in patients presenting with fever and headache, and to successfully identify those who should receive lumbar punctures.</p>

9.
Article in English | WPRIM | ID: wpr-124954

ABSTRACT

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.


Subject(s)
Aged, 80 and over , Aortic Aneurysm , Diagnosis , Emergencies , Esophageal Fistula , Fistula , Gastrointestinal Hemorrhage , Hematemesis , Hemorrhage , Humans , Syncope
10.
Article in Korean | WPRIM | ID: wpr-71032

ABSTRACT

PURPOSE: A combination of β1-adrenergic receptor (β₁-AR) blockade and β₂-AR activation might potentially be the novel therapy for treating heart failure. However, the use of β-AR agonists and/or antagonists in the clinical setting is controversial due to the lack of information on cardiac inotropic or chronotropic regulation by AR signaling. METHODS: In this study, we performed a hemodynamic evaluation by examining the force frequency response (FFR), Frank-Starling relationship, and response to non-selective β-AR agonist (isoproterenol) in the hearts isolated from 6-month-old transgenic (TG) mice overexpressing β₁- and β₂-ARs (β₁- and β₂-AR TG mice, respectively). RESULTS: Cardiac physiologic consequences of β₁- and β₂-AR overexpression resulted in a similar maximal response to that of isoproterenol and faster temporary decline of positive inotropic response in β₂-AR TG mice. β₁-AR TG mice showed a pronounced negative limb of FFR, whereas β2-AR TG mice showed high stimulation frequencies with low contractile depression during FFR. Contrastingly, Frank-Starling relationship was equally enhanced in both β₁- and β₂-AR TG mice. CONCLUSION: Hemodynamic evaluation performed in the present study showed a difference between β₁- and β₂-AR signaling, which may be due to a difference in the desensitization of β₁- and β₂-ARs.


Subject(s)
Animals , Depression , Extremities , Heart , Heart Failure , Hemodynamics , Humans , Infant , Isoproterenol , Mice , Mice, Transgenic , Receptors, Adrenergic
11.
Article in Korean | WPRIM | ID: wpr-56980

ABSTRACT

Percutaneous needle aspiration biopsy is a relatively simple and safe procedure for the diagnosis of lung and mediastinal lesions. Systemic air embolism during and after percutaneous needle aspiration biopsy of the lung is very rare; however, it is still a complication that can cause fatal outcomes, such as cerebral infarction and myocardial infarction. Here, we report a 72-year-old woman who suffered a change in consciousness immediately after receiving a percutaneous needle aspiration biopsy for the pathologic examination of pulmonary nodules found during a routine health medical examination. She had left side weakness and ST segment elevation on an electrocardiogram. After a high concentration of oxygen, she recovered from neurological symptoms and electrocardiographic abnormalities. The authors report a case of air embolism occurring simultaneously in the brain and coronary arteries after percutaneous needle aspiration biopsy.


Subject(s)
Aged , Biopsy , Biopsy, Needle , Brain , Cerebral Infarction , Consciousness , Coronary Vessels , Diagnosis , Electrocardiography , Embolism , Embolism, Air , Fatal Outcome , Female , Humans , Intracranial Embolism , Lung , Myocardial Infarction , Needles , Oxygen
12.
Article in English | WPRIM | ID: wpr-644693

ABSTRACT

OBJECTIVE: Combination of β₁-adrenergic receptor (AR) blockade and β₂-AR activation might be a potential novel therapy for treating heart failure. However, use of β-AR agonists and/or antagonists in the clinical setting is controversial because of the lack of information on cardiac inotropic or chronotropic regulation by AR signaling. METHODS: In this study, we performed hemodynamic evaluation by examining force frequency response (FFR), Frank-Starling relationship, and response to a non-selective β-AR agonist (isoproterenol) in hearts isolated from 6-month-old transgenic (TG) mice overexpressing β₁- and β₂-ARs (β₁- and β₂-AR TG mice, respectively). RESULTS: Cardiac physiologic consequences of β₁- and β₂-AR overexpression resulted in similar maximal response to isoproterenol and faster temporary decline of positive inotropic response in β₂-AR TG mice. β₁-AR TG mice showed a pronounced negative limb of FFR, whereas β₂-AR TG mice showed high stimulation frequencies with low contractile depression during FFR. In contrast, Frank-Starling relationship was equally enhanced in both β₁- and β₂-AR TG mice. CONCLUSION: Hemodynamic evaluation performed in the present showed a difference in β₁- and β₂-AR signaling, which may be due to the difference in the desensitization of β₁- and β₂-ARs.


Subject(s)
Animals , Depression , Extremities , Heart , Heart Failure , Hemodynamics , Humans , Infant , Isoproterenol , Mice , Mice, Transgenic , Receptors, Adrenergic
13.
Article in English | WPRIM | ID: wpr-219102

ABSTRACT

PURPOSE: The aim of this study was to evaluate whether a simple verbal instruction regarding the rescuer gazing point can improve the depth of chest compressions (CCs) in the hands-only cardiopulmonary resuscitation (CPR). METHODS: Participants who took part in basic life support training courses for lay-rescuers were eligible for inclusion in this prospective, single-blinded, cluster randomized controlled study. After the training courses, both the control and the intervention groups performed the hands-only CPR for two minutes on a manikin placed on the ground. Immediately prior to CCs, instructors provided the intervention group with brief verbal instructions to look in the opposite direction of the adducted arm after placing the heel of the hand on the mid-sternum. RESULTS: One hundred and twenty-two participants (61 for each group) were enrolled in this study. The intervention group showed significantly deeper CCs than the control group (47.9±8.2 mm vs. 43±8.4 mm, p<0.01); however, there were no significant differences between the two groups in the quality of chest recoil, CC rate, or duty cycle of CCs. However, the frequency of incorrect hand position was higher in the intervention group when compared with the control group (10.3 [2.3-35.7] vs. 5.7 [0-33.0], p=0.036) CONCLUSION: Instructions to look in the opposite direction of the adducted arm during CCs improved the mean depth of CCs without significant adverse effects on the quality of recoil, CC rate, or duty cycle of CCs. However, the frequency of incorrect hand position was higher in the intervention group than the control group.


Subject(s)
Arm , Cardiopulmonary Resuscitation , Education , Hand , Heart Massage , Heel , Manikins , Prospective Studies , Thorax
14.
Article in Korean | WPRIM | ID: wpr-160728

ABSTRACT

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.


Subject(s)
Humans , Spinal Fractures , Spine , Spondylitis, Ankylosing
15.
Article in English | WPRIM | ID: wpr-223734

ABSTRACT

Lead aVR ST segment elevation in patients with clinically suspected acute coronary syndrome strongly suggests the possibility of occlusion of the left main coronary artery (LMCA), and stenosis or occlusion in this area can cause severe life-threatening left ventricular dysfunction or malignant arrhythmias. Thus, it could be a sign suggestive of a poor prognosis for patients. In this study, we report on the case of a 67-year-old male who presented to the emergency department with total occlusion of LMCA with ST-segment elevation in only lead aVR, and without ST-segment elevation in other leads.


Subject(s)
Acute Coronary Syndrome , Aged , Arrhythmias, Cardiac , Constriction, Pathologic , Coronary Vessels , Electrocardiography , Emergency Service, Hospital , Humans , Male , Myocardial Infarction , Prognosis , Ventricular Dysfunction, Left
16.
Article in English | WPRIM | ID: wpr-38084

ABSTRACT

Waterproofing spray is used to ensure that clothing, including mountain wear, leather, and other surfaces are waterproof. Respiratory illnesses related to the use of waterproofing spray have been reported globally. The composition of waterproofing spray varies depending on the manufacturer. We treated a patient with chemical pneumonitis and alveolar hemorrhage due to exposure to waterproofing spray containing perfluoroalkyl acrylate copolymer. We diagnosed the patient with chemical pneumonitis and alveolar hemorrhage based on computed tomography (CT) and bronchoalveolar lavage (BAL) test performed within 24 h after symptom occurrence. We believe that further study regarding the exact mechanism of pulmonary toxicity for waterproofing agents is required.


Subject(s)
Bronchoalveolar Lavage , Clothing , Hemorrhage , Humans , Pneumonia
17.
Article in English | WPRIM | ID: wpr-44896

ABSTRACT

BACKGROUND: Obesity induced by high-fat diet (HFD) is one of the most widespread metabolic disorders in current society. However, there has been little research regarding the effects of HFD-induced obesity in the septa of animal models of cerebral ischemia. Therefore, in the present study, we investigated septal effects of HFD on neuronal damage and gliosis induced by transient cerebral ischemia. METHODS: Body weight, blood glucose levels and serum lipid profiles levels were measured both in the normal diet (ND) and HFD-group. We also investigated the effects of ND and HFD on neuronal damage and gliosis in the septum after transient cerebral ischemia using immunohistochemistry. RESULTS: The levels of blood glucose, serum triglyceride, and total cholesterol were significantly increased in the HFD-fed gerbils compared with the ND-fed gerbils, although body weight was not significantly changed after HFD feeding. In the ND-fed gerbils, ischemia-induced neuronal damage was found in the septohippocampal nucleus (SHN) of the septum 7 days after ischemia. In the HFD-fed gerbils, ischemia-induced neuronal damage in the SHN was much more severe compared with that of the ND-fed gerbils 4 and 7 days after ischemia. In addition, we found that ischemia-induced glial activation including astrocytes and microglia was accelerated and exacerbated in the HFD-fed gerbils compared with that in the ND-fed gerbils. CONCLUSION: These results indicate that HFD can lead to much more severe effects in ischemia-induced neuronal damage/death in the septum after ischemia-reperfusion, and that it may be associated with accelerated change in glial activation.


Subject(s)
Astrocytes , Blood Glucose , Body Weight , Brain Ischemia , Cholesterol , Diet , Diet, High-Fat , Dietary Fats , Gerbillinae , Gliosis , Immunohistochemistry , Ischemia , Ischemic Attack, Transient , Microglia , Models, Animal , Neurons , Obesity , Triglycerides
18.
Article in English | WPRIM | ID: wpr-124663

ABSTRACT

Defibrillation is no longer universally recommended as initial intervention for the reversal of ventricular fibrillation (VF) after a prolonged and untreated cardiac arrest. We sought to examine this issue in an animal model where a prolonged untreated VF was induced. The aim of this study was to investigate the potential mechanism of the detrimental effect of defibrillation prior to cardiopulmonary resuscitation (CPR) in prolonged cardiac arrest model. VF was electrically induced in 32 domestic male swine weighing 40+/-3 kg and remained untreated for 15 minutes. The animals were then randomly allocated to either the initial defibrillation group or the chest compression group. Mean aortic pressure, right atrial pressure and coronary perfusion pressure (CPP) were continuously measured during the performance. The dimensions of the left ventricle (LV) were assessed by echocardiographic methods. The CPP induced by CPR after defibrillation was significantly lower in the initial defibrillation group than in the chest compression group; 1 minute after defibrillation (9+/-3 mmHg vs. 14.8+/-7 mmHg (P<0.05)), and after 5 minutes 16+/-5 mmHg vs. 21.7+/-1 mmHg (P<0.05). The LV volumes were reduced from 18+/-2 mmHg to 14+/-1 mmHg after defibrillation (P<0.05). In brief, this study showed that the conducting defibrillation prior to chest compression may cause a contracture of the LV, resulting in lowering CPP, thus dropping the efficiency of chest compression in a prolonged cardiac arrest model.


Subject(s)
Animals , Arterial Pressure , Atrial Pressure , Cardiopulmonary Resuscitation , Contracture , Echocardiography , Heart Arrest , Heart Ventricles , Humans , Male , Models, Animal , Perfusion , Swine , Thorax , Ventricular Fibrillation
19.
Article in Korean | WPRIM | ID: wpr-139395

ABSTRACT

PURPOSE: The aim of this study was to evaluate the reliability of the chief complaint addressing seizure in 119 run-sheets and to estimate the frequency of recommended administration of prehospital anti-convulsants. METHODS: A retrospective medical review of the period from 1 January, 2007 to 1 December, 2012 at one university hospital was conducted. Patients who were transported by 119 ambulance and whose chief complaint addressing seizure were enrolled. Medical records were independently reviewed by two emergency physicians. The reliability was analyzed according to the level of prehospital providers. prehospital providers. The operational definition of prehospital status epilepticus was cases with prolonged (lasting five minutes or more) or repetitive generalized convulsive seizures and seizure witnessed by 119 providers or persistent seizure at the time of arrival at the hospital. RESULTS: Among 239 medical records, 188(78.7%) cases with seizure were identified. The reliability was increased when level I emergency medical technicians were staffed(90.6% vs 74.3%). Psychiatric disorders(4.6%) and hyperventilation syndrome(3.8%) were frequently confused with seizure. Prehospital anti-convulsants were recommended in 15 cases(6.3%). CONCLUSION: Chief complaints addressing seizure by 119 prehospital providers were reliable. Not only rarity of prehospital status epilepticus but also other medical and legal barriers should be considered in regard to the possibility of prehospital anti-convulsant administration.


Subject(s)
Ambulances , Emergencies , Emergency Medical Services , Emergency Medical Technicians , Humans , Hyperventilation , Medical Records , Retrospective Studies , Seizures , Status Epilepticus
20.
Article in Korean | WPRIM | ID: wpr-139390

ABSTRACT

PURPOSE: The aim of this study was to evaluate the reliability of the chief complaint addressing seizure in 119 run-sheets and to estimate the frequency of recommended administration of prehospital anti-convulsants. METHODS: A retrospective medical review of the period from 1 January, 2007 to 1 December, 2012 at one university hospital was conducted. Patients who were transported by 119 ambulance and whose chief complaint addressing seizure were enrolled. Medical records were independently reviewed by two emergency physicians. The reliability was analyzed according to the level of prehospital providers. prehospital providers. The operational definition of prehospital status epilepticus was cases with prolonged (lasting five minutes or more) or repetitive generalized convulsive seizures and seizure witnessed by 119 providers or persistent seizure at the time of arrival at the hospital. RESULTS: Among 239 medical records, 188(78.7%) cases with seizure were identified. The reliability was increased when level I emergency medical technicians were staffed(90.6% vs 74.3%). Psychiatric disorders(4.6%) and hyperventilation syndrome(3.8%) were frequently confused with seizure. Prehospital anti-convulsants were recommended in 15 cases(6.3%). CONCLUSION: Chief complaints addressing seizure by 119 prehospital providers were reliable. Not only rarity of prehospital status epilepticus but also other medical and legal barriers should be considered in regard to the possibility of prehospital anti-convulsant administration.


Subject(s)
Ambulances , Emergencies , Emergency Medical Services , Emergency Medical Technicians , Humans , Hyperventilation , Medical Records , Retrospective Studies , Seizures , Status Epilepticus
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