http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
서길준 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4
Background. Endotracheal intubation is one of the most important and challenging tasks that an emergency physician has to perform. Complications associated with this procedure range from local trauma of the airway to death caused by unrecognized misplacement of the endotracheal tube. This study was designed to investigate complications of intubation including rapid sequence intubation in the emergency department. Method. One hundred four consecutive patients requiring endotracheal intubation in the emergency department of the Stanford Medical Center over a 8-month period were studied prospectively. Result. The indications for intubation were acute respiratory failure(60.5%), airway protection(30.8%), and cardiopulmonary arrest(8.7%). 97(93.3%) intubations were inserted orally, remaining 7(6.7%) were intubated via the nasotracheal route. Of 97 orotracheal intubations, rapid sequence intubation was used in 71(73.2%) cases. Grouped by level of training, junior residents attempted 69(66.3%) intubations, senior residents 21(20.2%), and staff 13(12.5%). Of the 104 intubations, 92(88.5%) were successful on the first or second attempt. 12 procedures(11.5%) required more than two attempts at intubation. A total of 36(34.6%) complications occurred. Esophageal intubations occurred in 13 cases, right main stem intubation in 13, pulmonary aspiration in 4, and others in 6. Fourteen patients(13.5%) died after intubation. Conclusion. The complication rate of endotracheal intubation in the emergency department is high. In order to decrease the complication, detailed knowledge, skill, and equipments about endotracheal intubation are required. The good condition of a patient before intubation appears to be important for survival.
119구급대를 통한 서울지역 외상환자 진료체계에 대한 통계분석
서길준,이승한,조익준,권운용,송형곤,이중의,윤여규 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2
Backgroud: Despite continous efforts to improve the prehospital trauma care system in Korea, the preventable death rate has been reported to be high. The purpose of this study was to evaluate the prehospital trauma care system in Seoul by analyzing 119 rescue databases. Methods: The 119 rescue data bases of 22,275 trauma patients, who were transported to the secondary and tertiary hospital in Seoul by Seoul 119 rescue services from January 1, 2000 to December 31, 2000, were analyzed. Results: The response time(mean 3.7 min.) showed no time, weekly, and regional variations. However, the transport time from field to hospital showed was high in the morning rush hour(7:00 to 10:00 am), and was gradually decreased and the lowest between 10:00 pm and 7:00 am. There was also a regional variation in the transport time, which was short in the central area and long in the peripheral area of Seoul. Prehospital cares were given to the 10,999 trauma patients(49.4%). Of the 464 unresponsive patients(2%), only 236 patients were identified in transported hospitals. The outcomes of these unresponsive patients were DOA(54%), survival(19%), death in ER(14%), transfer to other hospitals(8%), and death after admission(5%) in order. Conclusion: We suggest that this study may be helpful to the establishment and improvement of the prehospital trauma care system as well as the determination of the adequate numbers and locations of trauma center in Seoul.
계유찬,서길준,권운용,김경수,유경민 대한응급의학회 2016 大韓應急醫學會誌 Vol.27 No.5
Purpose: To investigate the change in mitogen-activated protein kinase pathways in the brain tissue after therapeutic hypothermia in the swine cardiac arrest model. Methods: After the return of spontaneous circulation by cardiopulmonary resuscitation, following a 6 min of no-flow time induced by ventricular fibrillation, pigs (n=24) were randomly assigned to one of four groups (sham, normothermia, 24 hr of therapeutic hypothermia, 48 hr of therapeutic hypothermia). After 24 or 48 hr of therapeutic hypothermia (core temperature 32-34 C), the pigs were then rewarmed to 36℃ for a period of 8 hr. At 60 hr upon the return of spontaneous circulation, the pigs were sacrificed and brain tissues were harvested. Results: We measured the tissue levels of p38, JNK, and ERK pathway expressions from the hippocampus of the swine brain in all four groups. The phosphorylated p38-to-p38 ratio and phosphorylated JNK-to-JNK ratio were significantly increased in all of the intervention groups compared with the sham group. The phosphorylated ERK-to-ERK ratio was increased only in the therapeutic hypothermia groups (p-value=0.026 in the 24 hr of therapeutic hypothermia group and p-value=0.002 in the 48 hr of therapeutic hypothermia group, compared with the sham group). Conclusion: The p38 and JNK pathways were also activated during therapeutic hypothermia and normothermia. However, the ERK pathway was activated only in therapeutic hypothermia. Therapeutic hypothermia activated the ERK pathway in ischemia-reperfusion injury of the brain tissue after cardiac arrest, which seemed to be dependent on the duration of therapeutic hypothermia.