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- 저자 : 조현규 ( Hyeon Kyu Jo ) (검색결과 2 건)
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다발성 외상 환자에서 Emergency Room Transfusion Score (ETS)를 이용한 응급수혈의 예측인자
조현규 ( Hyeon Kyu Jo ),박용진 ( Yong Jin Park ),김선표 ( Sun Pyo Kim ),김성중 ( Seong Jung Kim ),조수형 ( Soo Hyung Cho ),조남수 ( Nam Soo Cho ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.1
Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas receivedan emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture. [ J Trauma Inj 2015; 28: 1-8 ]
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제초제 중독으로 유발된 메트헤모글로빈혈증 환자에서 고용량 비타민 C 치료 1례
선경훈 ( Kyung Hoon Sun ),김준규 ( Jun Kew Kim ),류창연 ( Chang Yeon Ryu ),김서진 ( Seo Jin Kim ),조현규 ( Hyeon Kyu Jo ),유태호 ( Tae Ho Yoo ),박용진 ( Yong Jin Park ),김선표 ( Sun Pyo Kim ) 대한임상독성학회 2017 대한임상독성학회지 Vol.15 No.2
Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.
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