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1.
Notas enferm. (Córdoba) ; 20(36): 31-45, nov.2020.
Article in Spanish | LILACS, BDENF, BINACIS, UNISALUD | ID: biblio-1140721

ABSTRACT

Todo quirófano debe adecuar el plan de evacuación según sus riesgos más probables y sus posibilidades operativas en forma realista y creativa. En el presente se tomó el incendio como el factor con mayor posibilidad que pueda producir una situación de desastre y/o emergencia. Objetivo: Diseñar, disponer e implementar un Plan de Evacuación que permita hacer frente a una situación peligrosa (un incendio, una inundación, un derrumbe del edificio, etc.) y ayude a que las personas y los bienes sufran el menor daño posible, en el servicio de quirófano del Sanatorio Allende sede Nueva Córdoba, en diciembre del año 2019. Es un proyecto de intervención, que se comenzó en mayo del mismo año y fue planificado para que se ejecute en el año 2020. El plan debe ser responsabilidad de todo el equipo quirúrgico. Conclusión: Contar con un plan de evacuación implica tener un equipo interdisciplinario capacitado permanentemente en condiciones de dar respuestas a amenaza de orden natural o generada por el hombre. Para ello es necesario la formación de brigadas en donde quedarán explícitos los roles y las acciones que cumple cada integrante ante un evento adverso. La seguridad no se improvisa, todos son responsables[AU]


Every operating room must adapt their evacuation plan according to its most probable risks and its operational possibilities in a realistic and creative way. In the following, the fire was taken as the most likely factor that could produce a disaster and/ or emergency situation. Objective: Design, arrange and implement an Evacuation Plan that allows to deal with a dangerous situation (a fire, a flood, a collapsing building, etc.) and help people and property suffer the least possible damage, in the operating room service of the Sanatorio Allende, Nueva Córdoba headquarters, in December of 2019. It is an intervention project, which began in May of the same year and was planned to be executed in 2020. The plan must be the responsibility of the entire surgical team. Conclusion: Having an evacuation plan implies having an interdisciplinary team permanently trained in a position to respond to natural or man-made threats. This requires the formation of brigades where roles and actions that each member must fulfill in case of an adverse event, will be explicit. Security is not improvised, everyone is responsible[AU]


Toda sala de operações deve adaptar seu plano de evacuação de acordo com suas riscos mais prováveis e suas possibilidades operacionais de maneira realista e criativa. A seguir, o incêndio foi considerado o fator mais provável que poderia causar um desastre e / ou situação de emergência. Objetivo: projetar, organizar e implementar um plano de evacuação que permita lidar com uma situação perigosa (incêndio, inundação, prédio em colapso etc.) e ajude pessoas e propriedades a sofrerem o menor dano possível no serviço da sala de operações do hospital. Sanatório Allende, sede de Nueva Córdoba, em dezembro de 2019. Trata-se de um projeto de intervenção, iniciado em maio do mesmo ano e previsto para ser executado em 2020. O plano deve ser de responsabilidade de toda a equipe cirúrgica. Conclusão: Ter um plano de evacuação implica uma equipe interdisciplinar permanentemente treinada em uma posição para responder a ameaças naturais ou provocadas pelo homem. Isso requer a formação de brigadas onde serão explicitados os papéis e ações que cada membro deve cumprir em caso de evento adverso. A segurança não é improvisada, todos são responsáveis[AU]


Subject(s)
Operating Rooms , Security Measures , Evacuation , Fires , Fires/prevention & control
2.
Rev. bras. ortop ; 55(5): 625-628, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1144203

ABSTRACT

Abstract Objective To investigate the incidence of infection in patients with gunshot-related fractures, and to correlate this finding with the occurrence of surgical debridement in the emergency room. Methods A retrospective, observational, descriptive study that included all cases of fractures caused by firearms between January 2010 and December 2014; 245 fractures in 223 patients were included. Results There was surgical-site infection in 8.5% of the fractures, and the mean number of debridements required to control the infectious process was of 1.273 ± 0.608. A correlation was identified between the surgical treatment chosen and the affected body segment (p< 0.001). The surgical treatment in the emergency room had a correlation with the occurrence of infection (p< 0.001; Chi-squared test). Conclusion Patients with gunshot injuries treated non-operatively presented less severe and stable lesions; thus, the incidence of complications in this group was found to be lower. On the other hand, those patients with complex lesions underwent debridement and external fixation. Therefore, a greater number of infectious complications in patients submitted to external fixation was found, as expected.


Resumo Objetivo Investigar a incidência de infecção em pacientes com fraturas por arma de fogo, e correlacionar esse achado com a ocorrência de desbridamento cirúrgico na sala de emergência. Métodos Estudo retrospectivo, observacional e descritivo, que incluiu todos os casos de fraturas causadas por armas de fogo entre janeiro de 2010 e dezembro de 2014; foram incluídas 245 fraturas em 223 pacientes. Resultados Houve infecção do local cirúrgico em 8,5% das fraturas, e a média de desbridamentos necessários para controlar o processo infeccioso foi de 1,273 ± 0,608. Foi identificada correlação entre o tratamento cirúrgico escolhido e o segmento corporal afetado (p< 0,001). O tratamento cirúrgico na sala de emergência teve correlação com a ocorrência de infecção (p< 0,001; teste do qui-quadrado). Conclusão Pacientes com ferimentos à bala tratados de forma não operatória apresentaram lesões menos graves e estáveis; portanto, a incidência de complicações nesse grupo foi menor. Por outro lado, os pacientes com lesões complexas foram aqueles submetidos a desbridamento e fixação externa. Portanto, como esperado, foi encontrado um maior número de complicações infecciosas em pacientes submetidos à fixação externa.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Wound Infection/epidemiology , Wounds and Injuries , Wounds, Gunshot/epidemiology , Firearms , Debridement , Emergency Service, Hospital , Fractures, Bone , Control , Fires , Hand , Infections
4.
Yonsei Medical Journal ; : 235-242, 2020.
Article in English | WPRIM | ID: wpr-811472

ABSTRACT

PURPOSE: To characterize associated reactions (ARs) in the contralateral arm across multiple muscles during unimanual tasks and to identify factors related to ARs in children with cerebral palsy (CP).MATERIALS AND METHODS: This was a prospective, cross-sectional study of 35 children with CP. The extent of ARs of the contra-lateral, non-task hand was assessed while performing three unimanual tasks (opening and clenching the fist, a finger opposition task, and tapping fingers). The occurrence of ARs in each trial was evaluated separately for each task using a four-point scale (total scores ranged from 0 to 12). Surface electromyography (SEMG) was used to measure the firing activity of the muscles of the opposite arm during the task. The Manual Ability Classification System and Melbourne Assessment 2 (MA-2) were used to evaluate upper limb function.RESULTS: AR scores were higher in the more-affected limb than in the less-affected limb. SEMG data on the non-task hand showed motor overflow up to the elbow muscles in the more-affected limb. Root mean square ratios of EMG signals were significantly higher in children with ARs than in children without ARs. Multiple regression analysis showed both age and MA-2 to be significant factors related to ARs in the more-affected limb.CONCLUSION: Children with visible ARs showed motor overflow in the non-task limb during unimanual hand tasks. Age and upper limb function were significantly related to the extent of ARs in the more-affected limb of children with CP.


Subject(s)
Arm , Cerebral Palsy , Child , Classification , Cross-Sectional Studies , Elbow , Electromyography , Extremities , Fingers , Fires , Hand , Humans , Muscles , Prospective Studies , Upper Extremity
5.
Article in English | WPRIM | ID: wpr-811435

ABSTRACT

PURPOSE: The aim of this study was to investigate the effect of different numbers of heat treatments applied to superstructure porcelain on optical, thermal, and phase formation properties of zirconia.MATERIALS AND METHODS: Forty zirconia specimens were prepared in the form of rectangular prism. Specimens were divided into four groups (n = 10) according to the number of firing at heating values of porcelain. Color differences and translucency parameter were measured, and X-ray diffraction (XRD) analysis and differential scanning calorimetry (DSC) were performed. Data were analyzed with analysis of variance (ANOVA).RESULTS: There were no statistically significant differences in ΔE, TP, L, a, and b value changes of the zirconia specimens as a result of repetitive firing processes (P>.05).CONCLUSION: Although additional firing processes up to 4 increase peak density in thermal analysis, additional firing processes up to 4 times can be applied safely as they do not result in a change in color and phase character of zircon frameworks.


Subject(s)
Calorimetry, Differential Scanning , Dental Porcelain , Fires , Heating , Hot Temperature , X-Ray Diffraction
7.
Ciênc. Saúde Colet ; 24(11): 4133-4140, nov. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1039528

ABSTRACT

Resumo O objetivo deste artigo é avaliar o impacto das emissões da queima da cana-de-açúcar sobre o número de internações hospitalares por doenças respiratórias em uma região canavieira. Registros de internações hospitalares por doenças respiratórias foram adquiridas a partir da base de dados referentes ao sistema de informações hospitalares do sistema único de saúde (SIH-SUS), no período de 28 de março de 2011 a 28 de dezembro de 2012. Níveis de MP10, NO2, O3, temperatura e umidade relativa foram registradas. Modelos de regressão logística foram construídos para analisar a associação entre o número total de internações, poluentes atmosféricos e variáveis meteorológicas. Foram registradas 1.179 internações, dentre elas a pneumonia mostrou aumento significativo no período de queima (p = 0,005). Neste mesmo período observou-se que o cluster MP10 e NO2 influenciou 67,9% (IC95%: 11,111-2,537), seguido do cluster MP10, NO2, O3 e temperatura que influenciou 91,1% (IC95%: 1,116; 3,271) no número total de internações. Durante o período de queima houve maior número de internações por doenças respiratórias, principalmente de pneumonia, quando foi observada a influência dos poluentes e temperatura no processo de adoecimento da população.


Abstract The scope of this article is to evaluate the impact of emissions from sugarcane burning on hospital admission numbers for respiratory diseases in a sugarcane region. Hospital admission records for respiratory diseases were acquired from the database of the Hospital Information System of the Unified Health System (SIH-SUS) in the period from March 28, 2011 to December 28, 2012. Levels of PM10, NO2, O3, Temperature and Relative Humidity were recorded. Logistic regression models were created to analyze the association between the total number of hospitalizations, atmospheric pollutants and meteorological variables. A total of 1,179 hospitalization admissions were recorded, with a significant increase in cases of pneumonia in the burning period (p = 0.005). Likewise, it was observed that the cluster of PM10 and NO2 was influenced 67.9% (95% CI: 11.111-2.537) followed by cluster PM10, NO2, O3 and Temperature that influenced 91.1% (95% CI: 1.116; 3.271) in the total number of hospitalization admissions. During the sugarcane burning period there were more hospitalization admissions due to respiratory tract diseases, mainly pneumonia, where the influence of air pollutants and temperature in the process of illness in the population was detected.


Subject(s)
Humans , Pneumonia/epidemiology , Respiratory Tract Diseases/epidemiology , Saccharum , Environmental Exposure/adverse effects , Temperature , Brazil , Databases, Factual , Air Pollutants/toxicity , Particulate Matter/toxicity , Fires , Hospitalization/statistics & numerical data , Humidity , National Health Programs
8.
Article in Korean | WPRIM | ID: wpr-786031

ABSTRACT

PURPOSE: The purpose of this study was to identify the relationships among occupational identity, social support, posttraumatic growth, and health-related quality of life regarding firefighters.METHODS: The study was conducted with 149 firefighters working at two fire stations in South Gyeongsang Province. Data were collected between August and September 2018. There were four research instruments in the structured survey, including the occupational identity scale, social support scale, Korea Posttraumatic Growth Inventory and World Health Organization Quality of Life Assessment Instrument.RESULTS: As a result, the quality of life of firefighters was positively correlated with social support, occupational identity, and posttraumatic growth. The factors associated with the quality of life of firefighters were social support (β=.36, p < .001), and occupational identity (β=.31, p < .001). The total explanatory power of these variables was 53.1%.CONCLUSION: To improve the health-related quality of life of firefighters based on the results of this study, it is necessary to develop support programs to strengthen social support and occupational identity.


Subject(s)
Firefighters , Fires , Humans , Korea , Occupations , Quality of Life , Social Identification , World Health Organization
10.
Article in Korean | WPRIM | ID: wpr-739044

ABSTRACT

PURPOSE: The Iri station explosion that occurred in 1977 was a major social disaster in Korea, caused by a fire in a train equipped with explosives. The purpose of this study was to investigate the social disaster adaptation experiences of railroad workers. METHODS: This study was based on qualitative research using phenomenological methodology. Participants were six railroad workers who experienced the Iri station explosion. Data were collected through in-depth interviews with individual workers from March to June, 2018. The data analysis method was based on Colaizzi's approach. RESULTS: Experiences of railroad workers were categorized into 12 themes and the following 6 theme clusters: (1) Anxiety due to the extreme vibration and crash, (2) Terror regarding the horrible situation that one cannot face, (3) Anger about the cause of the explosion and a sense of relief about survival, (4) Confusion regarding different rumors, (5) Various efforts to return to daily life, and (6) Trauma that continues to exist. CONCLUSION: The findings of this study recommend that railroad organizations and managers should pay attention to enhance disaster preparedness and develop organizational disaster coping guidelines for members. The results of this study can help us to better understand the various aspects of the Iri station explosion of 1977.


Subject(s)
Anger , Anxiety , Disasters , Explosions , Explosive Agents , Fires , Korea , Methods , Qualitative Research , Railroads , Statistics as Topic , Vibration
11.
Experimental Neurobiology ; : 568-577, 2019.
Article in English | WPRIM | ID: wpr-763789

ABSTRACT

The thalamus is a brain structure known to modulate sensory information before relaying to the cortex. The unique ability of a thalamocortical (TC) neuron to switch between the high frequency burst firing and single spike tonic firing has been implicated to have a key role in sensory modulation including pain. Of the two firing modes, burst firing, especially maintaining certain burst firing properties, was suggested to be critical in controlling nociceptive behaviors. Therefore, understanding the factors that influence burst firing properties would offer important insight into understanding sensory modulation. Using computational modeling, we investigated how the balance of excitatory and inhibitory inputs into a TC neuron influence TC bursting properties. We found that intensity of inhibitory inputs and the timing of excitatory input delivery control the dynamics of bursting properties. Then, to reflect a more realistic model, excitatory inputs delivered at different dendritic locations—proximal, intermediate, or distal—of a TC neuron were also investigated. Interestingly, excitatory input delivered into a distal dendrite, despite the furthest distance, had the strongest influence in shaping burst firing properties, suggesting that not all inputs equally contribute to modulating TC bursting properties. Overall, the results provide computational insights in understanding the detailed mechanism of the factors influencing temporal pattern of thalamic bursts.


Subject(s)
Brain , Calcium Channels, T-Type , Computational Biology , Dendrites , Fires , Neurons , Sensory Gating , Thalamus
12.
Experimental Neurobiology ; : 578-592, 2019.
Article in English | WPRIM | ID: wpr-763788

ABSTRACT

Depending on the intracellular buffering of calcium by chelation, zinc has the following two apparent effects on neuronal excitability: enhancement or reduction. Zinc increased tonic activity in the depolarized state when neurons were intracellularly dialyzed with EGTA but attenuated the neuronal activity when BAPTA was used as an intracellular calcium buffer. This suggests that neuronal excitability can be modulated by zinc, depending on the internal calcium buffering capacity. In this study, we elucidated the mechanisms of zinc-mediated alterations in neuronal excitability and determined the effect of calcium-related channels on zinc-mediated alterations in excitability. The zinc-induced augmentation of firing activity was mediated via the inhibition of small-conductance calcium-activated potassium (SK) channels with not only the contribution of voltage-gated L-type calcium channels (VGCCs) and ryanodine receptors (RyRs), but also through the activation of VGCCs via melastatin-like transient receptor potential channels. We suggest that zinc modulates the dopaminergic neuronal activity by regulating not only SK channels as calcium sensors, but also VGCCs or RyRs as calcium sources. Our results suggest that the cytosolic calcium-buffering capacity can tightly regulate zinc-induced neuronal firing patterns and that local calcium-signaling domains can determine the physiological and pathological state of synaptic activity in the dopaminergic system.


Subject(s)
Animals , Calcium , Calcium Channels, L-Type , Cytosol , Dopaminergic Neurons , Egtazic Acid , Electrophysiology , Fires , Neurons , Potassium , Rats , Ryanodine Receptor Calcium Release Channel , Transient Receptor Potential Channels , Zinc
13.
Article in English | WPRIM | ID: wpr-763316

ABSTRACT

OBJECTIVES: In the developing auditory cortex, maturation of electrophysiological properties and cell types before and after hearing onset has been reported previously. However, the exact timing of firing pattern change has not been reported. In this study, firing pattern change was investigated from postnatal day 3 (P3) to P12 in auditory cortical layer II/III neurons to investigate whether firing pattern changes dramatically after a specific point during development. METHODS: ICR mice pups aged from P3 to P12 were sacrificed to obtain 300-mm-thick brain slices containing the primary auditory cortex. From cortical layer II/III neurons, the patterns of action potential firing generated by current injection were examined using whole cell current clamp technique and the characteristics of Na⁺ currents involved in action potential firing were investigated using whole cell voltage clamp technique. RESULTS: From P3 to P6, most cells did not show action potential firing (29 of 46 cells), and some cells responding to current injection showed a single action potential at the initial depolarizing current step (17 of 46 cells). This firing pattern changes from P7. From P7 to P9, cells begin to show regular spiking to current injection. The spiking frequency increased after P10. In studying Na⁺ current with whole cell voltage clamp, Na⁺ current densities increased gradually (32.0±2.0 pA/pF [P3–P6, n=7], 51.2±2.0 pA/pF [P7–P9, n=13], and 69.5±3.7 pA/pF [P10–P12, n=13]) in low external [Na⁺] condition. Na⁺ current recovery was accelerated and inactivation curves shifted to hyperpolarization with age. CONCLUSION: As regular spiking cells were observed from P7 but never from P3 to P6, P7 might be regarded as an important milestone in the development of auditory cortical layer II/III neurons. This change might mainly result from the increase in Na⁺ current density.


Subject(s)
Action Potentials , Animals , Auditory Cortex , Brain , Fires , Hearing , Mice , Mice, Inbred ICR , Neurons
15.
Article in English | LILACS | ID: biblio-1140031

ABSTRACT

This article presents the mapping and analysis of fires with dead and wounded people in the Metropolitan Region of Recife (MRR) served by the Firefighters Department from 2013 to 2016. There was an average rate of 1 death per million inhabitants, similar to countries such as Singapore and Vietnam. The weighted number of fires per wounded or dead person results in rates of 0.5 and 1.7 per 100 recorded fires, respectively. These numbers are concerning, especially when compared to rates from other regions in the world. The victims of fires in MRR were shown to generally not be a perceivable problem in terms of common sense, yet they are real and require accurate analysis and effective measures.


Este artigo apresenta o mapeamento e a análise de incêndios com mortes e feridos na Região Metropolitana do Recife ­ RMR, atendidos pelo Corpo de Bombeiros, no período de 2013 a 2016. Verificou-se uma taxa média de 1 morte por milhão de habitantes, semelhante a países como Singapura e Vietnam. Quando se pondera a quantidade de incêndios para que haja um ferido ou morto, as taxas se apresentam respectivamente em 0,5 e 1,7 por 100 incêndios registrados ­ sendo estes números preocupantes, principalmente quando comparados com taxas de outras regiões no mundo. Conclui-se que as vítimas de incêndios na Região (RMR) são um problema silente ao senso comum, mas real e que exige análise acurada e providências efetivas.


Este artículo presenta la cartografía y análisis de incendios con muertes y heridos en la Zona Metropolitana de Recife (ZMR), atendidos por el Cuerpo de Bomberos, en el período de 2013 a 2016. Se ha verificado un promedio de 1 muerte por millón de habitantes, semejante a países como Singapur y Vietnam. Cuando se examina la cantidad de incendios para que haya un herido o muerto, los promedios se presentan respectivamente de 0,5 y 1,7 por 100 incendios registrados, lo cual es preocupante, principalmente en comparación con los promedios de otras regiones del mundo. Se concluye que las víctimas de incendios en la ZMR son un problema silencioso y real, lo que exige un análisis cuidadoso y diligencias efectivas.


Subject(s)
Humans , Buildings , Disaster Victims , Death , Fires
16.
Article in English | WPRIM | ID: wpr-761815

ABSTRACT

Cordycepin exerts neuroprotective effects against excitotoxic neuronal death. However, its direct electrophysiological evidence in Alzheimer's disease (AD) remains unclear. This study aimed to explore the electrophysiological mechanisms underlying the protective effect of cordycepin against the excitotoxic neuronal insult in AD using whole-cell patch clamp techniques. β-Amyloid (Aβ) and ibotenic acid (IBO)-induced injury model in cultured hippocampal neurons was used for the purpose. The results revealed that cordycepin significantly delayed Aβ + IBO-induced excessive neuronal membrane depolarization. It increased the onset time/latency, extended the duration, and reduced the slope in both slow and rapid depolarization. Additionally, cordycepin reversed the neuronal hyperactivity in Aβ + IBO-induced evoked action potential (AP) firing, including increase in repetitive firing frequency, shortening of evoked AP latency, decrease in the amplitude of fast afterhyperpolarization, and increase in membrane depolarization. Further, the suppressive effect of cordycepin against Aβ + IBO-induced excessive neuronal membrane depolarization and neuronal hyperactivity was blocked by DPCPX (8-cyclopentyl-1,3-dipropylxanthine, an adenosine A₁ receptor-specific blocker). Collectively, these results revealed the suppressive effect of cordycepin against the Aβ + IBO-induced excitotoxic neuronal insult by attenuating excessive neuronal activity and membrane depolarization, and the mechanism through the activation of A₁R is strongly recommended, thus highlighting the therapeutic potential of cordycepin in AD.


Subject(s)
Action Potentials , Adenosine , Alzheimer Disease , Fires , Ibotenic Acid , Membranes , Neurons , Neuroprotection , Neuroprotective Agents , Patch-Clamp Techniques , Pyramidal Cells
17.
Article in English | WPRIM | ID: wpr-761792

ABSTRACT

Confirming the direct link between neural circuit activity and animal behavior has been a principal aim of neuroscience. The genetically encoded calcium indicator (GECI), which binds to calcium ions and emits fluorescence visualizing intracellular calcium concentration, enables detection of in vivo neuronal firing activity. Various GECIs have been developed and can be chosen for diverse purposes. These GECI-based signals can be acquired by several tools including two-photon microscopy and microendoscopy for precise or wide imaging at cellular to synaptic levels. In addition, the images from GECI signals can be analyzed with open source codes including constrained non-negative matrix factorization for endoscopy data (CNMF_E) and miniscope 1-photon-based calcium imaging signal extraction pipeline (MIN1PIPE), and considering parameters of the imaged brain regions (e.g., diameter or shape of soma or the resolution of recorded images), the real-time activity of each cell can be acquired and linked with animal behaviors. As a result, GECI signal analysis can be a powerful tool for revealing the functions of neuronal circuits related to specific behaviors.


Subject(s)
Animals , Behavior, Animal , Brain , Calcium Channels , Calcium , Carisoprodol , Endoscopy , Fires , Fluorescence , Ions , Microscopy , Neuronal Calcium-Sensor Proteins , Neurons , Neurosciences , Statistics as Topic
18.
Article in Korean | WPRIM | ID: wpr-761462

ABSTRACT

PURPOSE: To evaluate an effect of additional firing process after sintering of monolithic zirconia crown on marginal and internal fit through three-dimensional analysis. MATERIALS AND METHODS: Ten monolithic zirconia crowns were fabricated using titanium abutment model. Monolithic zirconia crowns were designed, milled, and sintered as a control group, and additional firing with coloring was performed as a test group. Three dimensional analysis were performed by using triple-scan protocol, and cross-section analysis on mesio-distal and disto-lingual section was evaluated to measure marginal and internal fitness. Then, three-dimensional surface difference on between two groups was evaluated (α=.05). RESULTS: There was statistically significant difference between the control group (32.0 ± 24.3 µm) and the test group (17.0 ± 10.8 µm) in the mesial axial wall (P < .02) and the control group (60.2 ± 24.3 µm) and the test group (71.8 ± 21.5 µm) in the distal axial wall (P < .01). There was no statistically significant difference at the remaining point. CONCLUSION: There was no statistical significance on the deviation of inner surface of crown according to firing number, and the results of both group were considered clinically acceptable.


Subject(s)
Crowns , Fires , Titanium
19.
Article in Korean | WPRIM | ID: wpr-758452

ABSTRACT

OBJECTIVE: This study examined the clinical characteristics of suicide attempters who exposed their suicidal intension to suggest an active intervention strategy for suicide prevention based on the regional emergency medical service system. METHODS: A prospective database of suicide attempters who visited the emergency department of Chungbuk National University Hospital between October 2013 and December 2017 was used. All of the adult patients who provided consent for the initial assessment for suicidal attempters were eligible, excluding cases with unknown exposure of suicidal intension. The primary and secondary endpoints were the risk factors affecting exposure to the suicidal intension and characteristics of the exposure group. The adjusted odds ratios (AORs) of exposure to suicidal attempts after adjusting for potential confounders was calculated. RESULTS: Of a total 1,035 suicidal attempters enrolled, 332 (32.1%) were included in the exposure group. The exposure group was more likely to have an educational level above high school and no religion, and have suicidal characteristics at night time (18:00–08:00), under the influence of alcohol, suicidal plan before 1 week, and suicidal method involving asphyxia (P<0.05). The exposure group was more likely to have no guardian (AORs, 1.46; 95% confidence interval [CI], 1.00–2.12), use methods involving asphyxia (AORs, 2.07; 95% CI, 1.46–2.91), and attempt suicide at night (18:00 to 08:00) (AORs, 1.38; 95% CI, 1.05–1.83) compared to the no exposure group. CONCLUSION: Models need to be established, where regional mental health welfare center, local government, fire headquarter, and tele-communication companies can participate in the implementation of an active intervention strategy.


Subject(s)
Adult , Asphyxia , Emergency Medical Services , Emergency Service, Hospital , Fires , Humans , Local Government , Mental Health , Methods , Odds Ratio , Prospective Studies , Risk Factors , Suicidal Ideation , Suicide , Suicide, Attempted
20.
Article in English | WPRIM | ID: wpr-785603

ABSTRACT

OBJECTIVE: Assessing the severity of injury and predicting outcomes are essential in traumatic brain injury (TBI). However, the respiratory rate and Glasgow Coma Scale (GCS) of the Revised Trauma Score (RTS) are difficult to use in the prehospital setting. This investigation aimed to develop a new prehospital trauma score for TBI (NTS-TBI) to predict mortality and disability.METHODS: We used a nationwide trauma database on severe trauma cases transported by fire departments across Korea in 2013 and 2015. NTS-TBI model 1 used systolic blood pressure < 90 mmHg, peripheral capillary oxygen saturation < 90% measured via pulse oximeter, and motor component of GCS. Model 2 comprised variables of model 1 and age >65 years. We assessed discriminative power via area under the curve (AUC) value for in-hospital mortality and disability defined according to the Glasgow Outcome Scale with scores of 2 or 3. We then compared AUC values of NTS-TBI with those of RTS.RESULTS: In total, 3,642 patients were enrolled. AUC values of NTS-TBI models 1 and 2 for mortality were 0.833 (95% confidence interval [CI], 0.815 to 0.852) and 0.852 (95% CI, 0.835 to 0.869), respectively, while AUC values for disability were 0.772 (95% CI, 0.749 to 0.796) and 0.784 (95% CI, 0.761 to 0.807), respectively. AUC values of NTS-TBI model 2 for mortality and disability were higher than those of RTS (0.819 and 0.761, respectively) (P < 0.01).CONCLUSION: Our NTS-TBI model using systolic blood pressure, motor component of GCS, oxygen saturation, and age was feasible for prehospital care and showed outstanding discriminative power for mortality.


Subject(s)
Hypoxia , Area Under Curve , Blood Pressure , Brain Injuries , Capillaries , Fires , Glasgow Coma Scale , Glasgow Outcome Scale , Hospital Mortality , Humans , Hypotension , Korea , Mortality , Observational Study , Oxygen , Quality Improvement , Respiratory Rate
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