High-frequency Chest Wall Oscillation Therapy: Clinical Effectiveness in the Patients with Pulmonary Contusion / 대한구급학회지

BACKGROUND: Pulmonary contusion is the most common pulmonary parenchymal injury in blunt chest trauma and may constitute a life-threatening thoracic injury. In this study, we evaluated the usefulness of high-frequency chest wall oscillation (HFCWO) therapy in patients with pulmonary contusion. METHODS: Patients with lung contusion either received HFCWO therapy using the Vest system (Vest group; n = 18) or received conventional chest physiotherapy (non-Vest group; n = 23). The physiological parameters of the patients, length of stay in hospital and ICU, and the duration of mechanical ventilation were compared between the two groups. Variables, including pulmonary contusion score, percentage of patients receiving mechanical ventilation therapy, and PaO2/FiO2 ratio, were also analyzed. RESULTS: The pulmonary contusion score was higher in the Vest group (p < 0.01), and mechanical ventilation was used more frequently in the Vest group (p = 0.027). Improvement in the PaO2/FiO2 ratio over the first 48 h did not differ between the Vest and Non-Vest groups. No significant differences in the physiological parameters, hospital and ICU stays, and duration of mechanical ventilation were observed between the two groups. CONCLUSIONS: The therapeutic effect of the Vest system in patients with pulmonary contusion was similar to that of conventional chest physiotherapy. Therefore, the Vest system could be considered as an airway clearance technique in the management of patients with pulmonary contusion.

Analysis of Medical Care by Telemedicine / 항공우주의학회지

Telemedicine is a health care system that contains new-media techniques and medical special knowledge, using information techniques such as audio, moving picture, and communication provided to patients in distant areas with medical service such as diagnosis, consultation, education. Especially during medical transportation, it is possible that transferred patient can be rapidly taken care of by telemedicine. Our study reports 65 cases between a doctor in a hospital on ground and a patient during medical evacuation by telephone, e-mail and facsimile. Sixteen of 65 cases (25%) were immediately transferred to a hospital by sailing or helicopter. Other 49 cases were successfully taken care of by telemedicine.Telemedicine is economic and reasonable solving medical problems that may occur during medical evacuation where access to medical facilities is impossible.

Case Report of a Crushing Injury of Hand by Telemedicine

Crushing injury is a common in work place and require early judgment and assessment. However during shipping, it is impossible that patient is rapidly taken care in hospital. But in this case, crushed handed patient during shipping was early assessment and sutured by telemedicine. A healthy 28-year-old man had crushed hand during working. But this patient was on the sea, so could not use medical facilities. Using e-mailing and telephone by satellite, report-ed to the doctor that patient status. In order to doctor 's pre-scription, patient hand was sutured and prescribed medicines. So patient preserved good hand function and rapidly recovered. In the future, telemedicine will be useful and economic medical field in isolated areas to medical facilities or shipping.