The Analysis of Medical Services during Summer Universiade

PURPOSE: The purpose of this study is to supply basic data for medical supports of the international games held in Korea and to design adequate plans for medical support systems in the international games. METHODS: We analyzed patients who visited the medical facilities during Summer Universiade Daegu 2003. A total of 3,363 individuals used the Athlete's Village Polyclinic during the Game, but a total of 1,079 cases were treated with traditional oriental medicine and were excluded. Standard charts were available for the 2,248 cases. Data were collected regarding patients' sex, age, participation role, chief complaint, diagnosis, visits of medical departments, management, and disposition. We classified patients according to acuity scoring criteria (a four-tier triage system), economies, and the data compared. Significant athlete injuries were triaged immediately by physicians stationed at the event scene. RESULTS: In the analysing, we used 2,248 cases, including some repeat visits. There were 987 visits by athletes, 937 visits by officials, 236 visits by staffs, and 88 visits by others. Musculoskeletal diseases were the primary chief complaint. Curiously, the lower income group visited the Polyclinic more often than the high income group. CONCLUSION: Most Polyclinic staffs were volunteers, providing encouragement and enthusiasm to patients. In this study, patient were contacted with emergency physicianbased medical service. For the future plans of the medical supports for similar events, effective medical plans should be finalized by considering multiple factors.

Clinical Characteristics and Prognosis of Heat Stroke

PURPOSE: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. METHODS: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. RESULTS: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower HCO3-level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. CONCLUSION: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, HCO3-, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.

Clinical Characteristics and Prognosis of Heat Stroke

PURPOSE: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. METHODS: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. RESULTS: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower HCO3-level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. CONCLUSION: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, HCO3-, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.

An Analysis of Disaster Recognition in Medical Personnel and 119 Rescuers after Daegu Subway Disaster

PURPOSE: Disaster is defined as hazards that impact on human lives, causing adverse physical, social, economic or even political effects that exceed abilitiesto rapidly and effectively respond. The purpose of this study, conducted in 2003 and in 2005, was to improve regional disaster plans through a disaster-recognition survey conducted among medical personnel and rescuers in Daegu, Korea. METHODS: This study was carried out using a questionnaire to gauge disaster awareness among medical personnel and 119 rescuers in the Daegu area. We compared responses obtained from medical personnel with those obtained from 119 rescuers. One way ANOVA was used for comparisons. Statistical significance attributed to a pvalue less than 0.05. RESULTS: Many medical personnel and 119 rescuers showed a poor understanding of the disaster response system with regard to activities and triage systems at disaster sites, communication between facilities emergency response exercises in mock disasters, and laws and regulations related to regional governments and facilities. This lack of understanding was especially evident among medical personnel. CONCLUSION: This study revealed that medical personnel and rescuers in Daegu had little understanding of and ability to cope with actual disaster conditions. In view of the close cooperation required in disaster situations between regional medical facilities, rescue workers and government agencies, disaster training and education are imperative. If these groups can work together well, any disaster can be dealt with rapidly and effectively.

A Clinical Review of Acute Mountain Sickness

PURPOSE: Rapid ascent from low to high altitude (above 2500 m) often causes acute mountain sickness (AMS), a symptom-complex characterized by headache and other systemic symptoms (gastrointestinal upset, weakness, dizziness, and difficulty sleeping). In this study, we observed the vital signs and AMS symptoms. 13 participants in a mountain climb in order to determine correlation between AMS and risk factors such as obesity, smoking, and a previous history of AMS. METHODS: We studied 13 participants who climbed Mt.Cholatse (6440 m), and measured their vital signs and symptoms during the trekking. Standard Lake Louise questionnaires were filled out at five times during the trek: at the sea level, 2700 m, 3440 m, 4040 m, and 4700 m. With AMS scores and severity grades, we evaluate the severity of symptoms and the physical status. RESULTS: The overall AMS score was 3.7+/-.5, and headache was the most frequent symptom. As the altitude increased, oxygen saturation decreased whereas other vital signs (blood pressure, respiratory rate, and pulse rate) increased. The average AMS scores and severity grades increased more rapidly for obese men than for non-obese men (p<0.001). Smoking and previous history of AMS were also associated with the development of AMS (p<0.001). CONCLUSION: Persons who are obese or have a history of a smoking or AMS, are more likely to develop AMS symptoms. Further understanding of the natural and evolution of AMS and of the risk factors associated with AMS will educate the general population and physicians and help in its prevention and treatment.