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Objectives Continuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA). Methods All patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups. Results The mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from – 15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland-Altman limits of agreement (bias±1.96 SD) ranged from –19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients. Conclusions PtcCO2 monitoring showed wider limits of agreement with PaCO2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to determine the plausibility of forecasting the outbreak of diseases based on the weather by analysing the impact of atmospheric temperature and humidity on the occurrence of different diseases. Methods: The subjects of the present study were the 30 434 patients who visited the ED in 1 year from 1 February 2005 to 3 February 2006. The present study analysed the correlation between the daily number of patients who suffered from 22 types of traumatic and non-traumatic diseases and the data on atmospheric temperature and humidity provided by the Korea Meteorological Administration. Results: With traumatic disease, the occurrence tended to increase in proportion to the rise in temperature and humidity; whereas with non-traumatic disease, the occurrence tended to increase according to the rise in temperature, irrespective of humidity changes. The research on the impact of atmospheric temperature and humidity on different diseases revealed a high level of distribution of most diseases in an environment with high temperature and humidity. However, in the case of pulmonary diseases and trauma to multiple body regions, the occurrence increased in environments with low temperature and high humidity for pulmonary diseases, and with low temperature and low humidity for trauma to multiple body regions. Conclusion: Most diseases tend to increase in proportion to the rise in atmospheric temperature whereas being less affected by humidity. However, an increase in humidity in an optimum range of atmospheric temperature (12°C or higher) triggers an increase in the occurrence of diseases. [ABSTRACT FROM AUTHOR]

This study compared the trauma outcome between urban and suburban hospitals. The medical records of patients admitted to the intensive care unit (ICU) following trauma, obtained from 1994 to 1995 and 2002 to 2003, were examined. One was a tertiary university teaching hospital with regional emergency medical center (EMC), and the other was a small general hospital in a suburban area. Since 1999, the suburban hospital has enlarged its capacities to include EMC. In this study, the standardizing W (Ws), 95% confidence interval (CI) of Ws, and the predicted survival rate (Ps) were calculated using the Trauma and Injury Severity Score (TRISS) method. From 1994 to 1995, 225 and 121 records of the urban and suburban hospital were reviewed, respectively. The performance of trauma care in the urban hospital was more accurate than that in the suburban (95% CI of the Ws in urban and small suburban hospital: –2.30 to 2.73 and –11.40 to –5.90, respectively). The actual survival rate of the suburban hospital was significantly lower than the predicted survival rate at all revised trauma score (RTS). From 2002 to 2003, 315 and 268 medical records of urban and suburban hospital were reviewed, respectively. The 95% CI of the Ws in urban and suburban hospital was –3.56 to 0.24 and –3.73 to 0.26, respectively. In addition, there were no differences in the distribution of actual survival rate that was compared with the predicted survival rate according to injury severity score (ISS) and RTS in each hospital. After increasing the capacity of the suburban hospital, the trauma care performance was more accurate, and the ability of the physiologic support had improved. In addition, a larger suburban hospital could manage more severely injured patients without the need for transfer (mean ISS from 1994–1995 to 2002–2003: 21.0 vs. 24.3, p = 0.059, mean RTS: 7.0 and 6.2, p = 0.003; transfer:admission ratio = 0.182:0.056, respectively, p = 0.01). In conclusion, under the well-constructed emergency medical service system, the enlargement of the capacities of emergency and intensive care should improve the performance of trauma care in suburban hospital. [ABSTRACT FROM AUTHOR]

Presents a study which investigated the electron temperature and plasma density at the lateral distance of 125 µm from the center of sustaining electrode gap. Problems associated with the use of alternating current plasma display panels; Location of the bus electrode; Setup made for a sustaining electrode pair; Way that the plasma propagation speed on the cathode.

Presents a study which examined the characteristics of diode perveance and vircator output under various anode-cathode gap distances. Experimental configurations; Description of a cylindrical carbon cathode; Analysis of the results of microwave frequency measurement.

The article features the prehospital care and emergency department care in South Korea. According to the authors, prehospital care and emergency medicine (EM) have developed rapidly across the nation over the last two decades. The development was the result of inadequacies shown by several disasters in the 1990s and in response to the needs of hosting international sporting events. The Korea Emergency Medical Society was established in 1989 and EM was recognized as a specialty in 1996.

To evaluate the accuracy of presepsin levels in diagnosing sepsis and predicting mortality among organ failure patients with and without hypercreatinemia in the emergency department (ED). This retrospective study was conducted on patients with positive quick sequential organ failure assessment (qSOFA) score and increase in SOFA score of =2 points. Hypercreatinemia, indicated by a creatinine level of =1.2 mg/dL, was defined as points =1 on the renal component of the SOFA score. The patients were divided into group 1 (sepsis with hypercreatinemia), group 2 (sepsis without hypercreatinemia), group 3 (non-sepsis with hypercreatinemia), and group 4 (nonsepsis without hypercreatinemia), and their presepsin levels were compared. Receiver operating characteristic curve (ROC) analyses were performed to determine the accuracy of presepsin in diagnosing sepsis and predicting 30-day mortality. The optimal cutoff values were obtained to determine the presence of sepsis and predict the 30-day mortality. In all, 420 patients were eligible for this study. The presepsin levels in all pairwise comparisons between the groups were different (Group 1; 1311.5 (732.0-2179.5), Group 2; 566.5 (353.0-928.0), Group 3; 400.0 (291.0-579.0), Group 4; 231.0 (154.0-346.0)). Among patients with hypercreatinemia, the presepsin area under the ROC (AUROC) for diagnosing sepsis was 0.884 (optimal cutoff: 706 pg/mL). Among patients without hypercreatinemia, the presepsin AUROC for diagnosing sepsis was 0.854 (optimal cutoff: 352 pg/mL). The optimal cutoff values for predicting the patients' 30-day mortality with and without hypercreatinemia were 1077 pg/mL and 393 pg/mL, respectively. Different cutoff values of presepsin based on creatinine levels could effectively diagnose sepsis in ED patients with organ failure. Further, presepsin was found to be associated with 30-day mortality in ED patients with organ failure, regardless of hypercreatinemia. [ABSTRACT FROM AUTHOR]

The corona virus disease 2019 (COVID-19) outbreak may have delayed the treatment of patients with ST-segment elevated myocardial infarction (STEMI) in the emergency department (ED). This study aimed to determine the causes for treatment delay and evaluate the outcomes of such delays in STEMI patients undergoing primary percutaneous coronary intervention. This was a single-center retrospective observational study. Hospital records of STEMI patients who received primary percutaneous coronary intervention from 01 January 2019, to 31 December 2020, were assessed. The preCOVID-19 period was set before 01 January 2020, and the COVID-19 period was set after 01 January 2020, following which the data between these two periods were compared. During the COVID-19 period, there was a decrease in the reported incidence of STEMI patients compared with during the pre-COVID-19 period (incidence rate ratio, 0.74; 95% confidence interval, 0.55–0.99; p = 0.04). After arrival at ED, the time from door to balloon significantly differed between the pre-COVID-19 and COVID-19 period (78.0 min vs. 102.0 min, p < 0.001). Also, the time to alert a cardiologist (16 min vs. 9 min), puncture time after cardiologist arrival (57 min vs. 42 min), and puncture to balloon time (19 min vs. 14 min) were significantly longer during the COVID period. However, the time from alert to cardiologist arrival was similar. Compared to the pre-COVID 19 period, more patients suffered from major adverse cardiac events during the COVID-19 period (n = 20 (25.3%) vs. n = 12 (11.2%), p = 0.012). In both periods, the number of patients admitted to the intensive care unit and died (106 vs. 79, 9 vs. 10, respectively) and the number of days spent in the ICU were similar. Early recognition of critically ill patients and appropriate response in the ED can lower misdiagnosis rates and increase prompt and correct treatments, thereby improving patient prognosis. [ABSTRACT FROM AUTHOR]

Abstract Background Nighttime hospital admission is often associated with increased mortality risk in various diseases. This study investigated compliance rates with the Surviving Sepsis Campaign (SSC) 3-h bundle for daytime and nighttime emergency department (ED) admissions and the clinical impact of compliance on mortality in patients with septic shock. Methods We conducted an observational study using data from a prospective, multicenter registry for septic shock provided by the Korean Shock Society from 11 institutions from November 2015 to December 2017. The outcome was the compliance rate with the SSC 3-h bundle according to the time of arrival in the ED. Results A total of 2049 patients were enrolled. Compared with daytime admission, nighttime admission was associated with higher compliance with the administration of antibiotics within 3 h (adjusted odds ratio (adjOR), 1.326; 95% confidence interval (95% CI), 1.088–1.617, p = 0.005) and with the complete SSC bundle (adjOR, 1.368; 95% CI, 1.115–1.678; p = 0.003), likely to result from the increased volume of all patients and sepsis patients admitted during daytime hours. The hazard ratios of the completion of SSC bundle for 28-day mortality and in-hospital mortality were 0.750 (95% CI 0.590–0.952, p = 0.018) and 0.714 (95% CI 0.564–0.904, p = 0.005), respectively. Conclusion Septic shock patients admitted to the ED during the daytime exhibited lower sepsis bundle compliance than those admitted at night. Both the higher number of admitted patients and the higher patients to medical staff ratio during daytime may be factors that are responsible for lowering the compliance.

The development of vision-based navigation algorithms using a camera is becoming more important. The vision-based navigation can be categorized into two types. The first is to use sequential camera images as relative navigation. The second is to estimate the absolute navigation solution using a camera image and database. In absolute navigation, the difference between the database and the camera image is a major obstacle to image registration. One of the factors that make a lot of difference is the shadow effect. This shadow increases the inconsistency between the two images and eventually degrades the localization accuracy. This means that shadows have a significant impact when measuring the similarity of the two templates. To mitigate this effect, we inherited and developed the Monte Carlo Localization (MCL) algorithm based on a new similarity cost function, which is a key contribution to this article. We have established the importance of information with information reallocation logic that considers shadow areas. The proposed algorithm allocates the importance of the information considering a portion of the shaded area in the camera image. First of all, we analyzed the effects of shadows on the camera. To compare the performance of the algorithm, we used not only the shadow restoration algorithm but also various template-based matching algorithms. The proposed algorithm is validated through various simulations and real flight experiments as well.

Purpose Visit to the emergency department of the pediatric patients has increased steadily every year. The number of pediatric patients visiting the emergency department has increased steadily each year. It is believed that through recurrent visits (re-visit), many of them are using the emergency room, understanding the characteristics of pediatric patients to re-visit to the emergency department and should help to improve the quality of emergency service. Due to this increase and the rise in recurrent visits by pediatric patients, it is important to understand the characteristics and needs of this group, as well as to improve the quality of emergency service. Methods Patients under the age of 6 years with 6 months of history visiting local emergency centers were included in this study. It was practically observed medical record. Medical records of these patients were observed. During the study period, there were 9,448 visitations including re-visits; a total of 7,480 visits were confirmed as re-visits via patient surveys. Results A total of 9,448 pediatric patients, under the age of 6 (32.4%), made visitations to an emergency medical center during a 6-month period, of which, 7,480 visits were attributed to revisits, and thus, overlapped. Among these with confirmed revisitations, patients with no more revisitation are 5,273, one-time revisitation are 1,428, two revisitations are 458, three revisitations are 199, and four or more revisitations are 122. The rate of revisitations is higher in in the younger age group. Conclusion In this study, we found the characteristics of pediatric patients with revisitations to the emergency department; young age correlated to higher revisits. The use of EMS system increases in the group of patients with many re-visits, medical illnesses, hospitalization rates, and allergies.

Introduction. The rapid antigen test (RAT) plays an important role in the Emergency Room (ER). In this study, we investigated the effect of the RAT for influenza on clinical practice in an emergency department. Methods. A retrospective chart review was conducted considering two periods, namely before and after the 2009 influenza pandemic. The rate of antibiotic administration, the use of blood sample tests, the use of simple chest X-rays, the rate of antibiotic administration according to the result of the RAT, and the duration of ER stay in the case of influenzalike illnesses were investigated for the two study periods considered. Results. The use of the RAT increased from 23.9% to 39.8% in influenzalike pediatric patients (p<0.05) and from 4.9% to 67.6% in adult patients (p<0.001). After the 2009 influenza pandemic, the number of cases of antibiotic administration, blood sample test and simple chest X-ray decreased by 19.0%, 46.2%, and 27.4%, respectively, in pediatric patients with the use of RAT. Among RAT-positive patients, after the 2009 influenza pandemic, none of the pediatric patients and only 3 of the adult patients (17.6%) were administered antibiotics. The duration of ER stay was longer in patients who underwent RAT than in those who did not. Conclusion. The increased use of RAT for influenza has led to a decrease in antibiotic administration and a reduction in additional diagnostic tests in influenza-like illnesses. However, the use of RAT has not contributed to a decrease in the duration of ER stay. [ABSTRACT FROM AUTHOR]

BACKGROUND: A well-constructed and properly operating influenza surveillance scheme is essential for public health. This study was conducted to evaluate the distribution of respiratory viruses in patients with influenza-like illness (ILI) through the first teaching hospital-based surveillance scheme for ILI in South Korea. METHODS: Respiratory specimens were obtained from adult patients (≥18 years) who visited the emergency department (ED) with ILI from week 40, 2011 to week 22, 2012. Multiplex PCR was performed to detect respiratory viruses: influenza virus, adenovirus, coronavirus, respiratory syncytial virus, rhinovirus, human metapneumovirus, parainfluenza virus, bocavirus, and enterovirus. RESULTS: Among 1,983 patients who visited the ED with ILI, 811 (40.9%) were male. The median age of patients was 43 years. Influenza vaccination rate was 21.7% (430/1,983) during the 2011-2012 season. At least one comorbidity was found in 18% of patients. The positive rate of respiratory viruses was 52.1% (1,033/1,983) and the total number of detected viruses was 1,100. Influenza A virus was the dominant agent (677, 61.5%) in all age groups. The prevalence of human metapneumovirus was higher in patients more than 50 years old, while adenovirus was detected only in younger adults. In 58 (5.6%) cases, two or more respiratory viruses were detected. The co-incidence case was identified more frequently in patients with hematologic malignancy or organ transplantation recipients, however it was not related to clinical outcomes. CONCLUSION: This study is valuable as the first extensive laboratory surveillance of the epidemiology of respiratory viruses in ILI patients through a teaching hospital-based influenza surveillance system in South Korea.

BACKGROUND: During the 2011/2012 winter influenza season in the Republic of Korea, influenza A (H3N2) was the predominant virus in the first peak period of influenza activity during the second half of January 2012. On the other hand, influenza B was the predominant virus in the second peak period of influenza activity during the second half of March 2012. The objectives of this study were to compare the clinical and epidemiological characteristics of patients with laboratory-confirmed influenza A or influenza B. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed data from 2,129 adult patients with influenza-like illnesses who visited the emergency rooms of seven university hospitals in Korea from October 2011 to May 2012. Of 850 patients with laboratory-confirmed influenza, 656 (77.2%) had influenza A (H3N2), and 194 (22.8%) influenza B. Age, and the frequencies of cardiovascular disorders, diabetes, hypertension were significantly higher in patients with influenza A (H3N2) (P

Describes a planar microchip-based creatinine biosensor employing an oxidizing layer developed to facilitate the microfabrication of the sensor and to provide improved, reliable determination of creatinine in physiological samples. Feasibility of using hydrophilic polyurethanes in permselective barrier membranes for creatinine biosensors.