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"Ik Joon Jo"

Original Articles

Critical Care

Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
Da Seul Kim, Jong Eun Park, Sung Yeon Hwang, Daun Jeong, Gun Tak Lee, Taerim Kim, Se Uk Lee, Hee Yoon, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Tae Gun Shin
Clin Exp Emerg Med 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324

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Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
Clin Exp Emerg Med. 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324
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Prediction of vasopressor requirement among hypotensive patients with suspected infection: usefulness of diastolic shock index and lactate
Clin Exp Emerg Med. 2022;9(3):176-186.   Published online September 30, 2022
DOI: https://doi.org/10.15441/ceem.22.324
Close
Objective
We evaluated the performance of diastolic shock index (DSI) and lactate in predicting vasopressor requirement among hypotensive patients with suspected infection in an emergency department.
Methods
This was a single-center, retrospective observational study for adult patients with suspected infection and hypotension in the emergency department from 2018 to 2019. The study population was split into derivation and validation cohorts (70/30). We derived a simple risk score to predict vasopressor requirement using DSI and lactate cutoff values determined by Youden index. We tested the score by the area under the receiver operating characteristic curve (AUC). We performed a multivariable regression analysis to evaluate the association between the timing of vasopressor treatment and 28-day mortality.
Results
A total of 1,917 patients were included. We developed a score, assigning 1 point each for the high DSI (≥2.0) and high lactate (≥2.5 mmol/L) criteria. The AUCs of the score were 0.741 (95% confidence interval [CI], 0.715–0.768) at hypotension and 0.736 (95% CI, 0.708–0.763) after initial fluid challenge in the derivation cohort and 0.676 (95% CI, 0.631–0.719) at hypotension and 0.688 (95% CI, 0.642–0.733) after initial fluid challenge in the validation cohort, respectively. In patients with scores of 2 points, early vasopressor therapy initiation was significantly associated with decreased 28-day mortality (adjusted odds ratio, 0.37; 95% CI, 0.14–0.94).
Conclusion
A prediction model with DSI and lactate levels might be useful to identify patients who are more likely to need vasopressor administration among hypotensive patients with suspected infection.

Citations

Citations to this article as recorded by  Crossref logo
  • Utility of Shock Index and Pediatric Age-Adjusted Shock Index in Predicting Severe Sepsis and Septic Shock
    Raziye Merve Yaradilmiş, Aytaç Göktuğ, İlknur Bodur, Betül Öztürk, Orkun Aydin, Muhammed M. Güneylioğlu, Bilge Akkaya, Fatma Şule Erdem, Ahmet S. Özcan, Ali Güngör, Can Demir Karacan, Nilden Tuygun
    Pediatric Emergency Care.2026; 42(1): e1.     CrossRef
  • Predicting Cardiovascular Collapse in Critically Ill Patients During Intubation Induction: A Prospective Observational Study
    Ömer Emgin, Gamze Taşkan, Aytuğ Yıldız, İmren Taşkıran, Engin Haftacı, Adnan Ata, Mehmet Yılmaz
    Medicina.2026; 62(1): 177.     CrossRef
  • Effect of norepinephrine initiation timing on mortality in septic shock: a multicenter cohort study
    Jung Won Choi, Tae Gun Shin, Seung Jin Maeng, Sung Yeon Hwang, Sang-Min Kim, Won Young Kim, Kyuseok Kim, Sung-Joon Park, Sung-Hyuk Choi, Sejoong Ahn, Woon Yong Kwon, Taeyoung Kong, Sung Phil Chung, Byuk Sung Ko, Tae Ho Lim
    BMC Anesthesiology.2026;[Epub]     CrossRef
  • The Application of Scoring Systems in Pediatric Intensive Care Unit for Onco-Hematological Patients Who Have Not Undergone Stem Cell Transplantation: A Cross-Sectional Study
    Shereen Abdelmonem Mohamed Mohamed, Hanaa Ibrahim Abdel Fattah Rady, Eman Hany Ahmed Elsebaie, Rana Saber Bastawy Mahmoud
    Indian Journal of Medical and Paediatric Oncology.2026;[Epub]     CrossRef
  • Beyond the Mean: The Dynamic Fingerprint of Vasoplegia in Septic Shock
    Abhishek P Singh, Deepak Govil
    Indian Journal of Critical Care Medicine.2026; 30(2): 85.     CrossRef
  • Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and Its Correlation with Clinical Outcomes in an Indian Setting: A Prospective Observational Study
    Soumya Sarkar, Ashish K Sharma, Afzal Azim, Jitendra S Chahar, Sangam Yadav, PV Sai Saran, Prabhakar Mishra, Mohan Gurjar, Banani Poddar
    Indian Journal of Critical Care Medicine.2026; 30(2): 99.     CrossRef
  • The clinical utility of shock index in hospitalised patients requiring activation of the rapid response team
    Hasan M. Al-Dorzi, Yasser A. AlRumih, Mohammed Alqahtani, Mutaz H. Althobaiti, Thamer T. Alanazi, Kenana Owaidah, Saud N. Alotaibi, Monirah Alnasser, Abdulaziz M. Abdulaal, Turki Z. Al Harbi, Ahmad O. AlBalbisi, Saad Al-Qahtani, Yaseen M. Arabi
    Australian Critical Care.2025; 38(3): 101150.     CrossRef
  • Diastolic shock index: Its importance and application in critically ill patients: A narrative review
    Natthida Owattanapanich, Natyada Boonchana
    Clinical Critical Care.2025;[Epub]     CrossRef
  • Assessment of the Ability of Shock Index to Predict Early Hemodynamic Collapse in Hypotensive Sepsis Patient in Emergency Department
    Aiesha Baloch, Waqas Farooq Ali, Rafia Shoukat, Dania Asghar, Aqsa Baloch, Mars Christian Aragon Sta Ines
    Indus Journal of Bioscience Research.2025; 3(3): 696.     CrossRef
  • Temporal Analysis of Diastolic Shock Index in Patients with Septic Shock and its Correlation with Clinical Outcomes in Indian Setting – A Prospective Observational Study
    Banani Poddar, Mohan Gurjar, Afzal Azim, Prabhakar Mishra, Jitendra Chahar, Soumya Sarkar
    Indian Journal of Critical Care Medicine.2025; 29(S1): S194.     CrossRef
  • A Novel Approach to Early Personalized Hemodynamic Resuscitation: Non‐Invasive Peripheral Photoplethysmography for Identifying Predominant Vasodilatory Shock in Sepsis
    Sanne Ter Horst, Anna D. Schoonhoven, Raymond J. van Wijk, Rick Weitering, Sanne W. van Loon, Jan C. ter Maaten, Hjalmar R. Bouma
    Acta Anaesthesiologica Scandinavica.2025;[Epub]     CrossRef
  • The usefulness of lactate/albumin ratio, C-reactive protein/albumin ratio, procalcitonin/albumin ratio, SOFA, and qSOFA in predicting the prognosis of patients with sepsis who presented to EDs
    Kyung Hun Yoo, Sung-Hyuk Choi, Gil Joon Suh, Sung Phil Chung, Han Sung Choi, Yoo Seok Park, You Hwan Jo, Tae Gun Shin, Tae Ho Lim, Won Young Kim, Juncheol Lee
    The American Journal of Emergency Medicine.2024; 78: 1.     CrossRef
  • Predicting septic shock in patients with sepsis at emergency department triage using systolic and diastolic shock index
    Yumin Jeon, Sungjin Kim, Sejoong Ahn, Jong-Hak Park, Hanjin Cho, Sungwoo Moon, Sukyo Lee
    The American Journal of Emergency Medicine.2024; 78: 196.     CrossRef
  • Comparison of Early and Late Norepinephrine Administration in Patients With Septic Shock
    Chiwon Ahn, Gina Yu, Tae Gun Shin, Youngsuk Cho, Sunghoon Park, Gee Young Suh
    CHEST.2024; 166(6): 1417.     CrossRef
  • Early management of adult sepsis and septic shock: Korean clinical practice guidelines
    Chul Park, Nam Su Ku, Dae Won Park, Joo Hyun Park, Tae Sun Ha, Do Wan Kim, So Young Park, Youjin Chang, Kwang Wook Jo, Moon Seong Baek, Yijun Seo, Tae Gun Shin, Gina Yu, Jongmin Lee, Yong Jun Choi, Ji Young Jang, Yun Tae Jung, Inseok Jeong, Hwa Jin Cho, A
    Acute and Critical Care.2024; 39(4): 445.     CrossRef
  • Which haemodynamic monitoring should we chose for critically ill patients with acute circulatory failure?
    Xavier Monnet, Christopher Lai
    Current Opinion in Critical Care.2023; 29(3): 275.     CrossRef
  • DEVELOPMENT OF SCORE SYSTEM BASED ON POINT-OF-CARE ULTRASOUND TO PREDICT VASOPRESSOR REQUIREMENT FOR EMERGENCY PATIENTS WITH CARDIOPULMONARY SYMPTOMS
    Hayoung Kim, Ki Hong Kim, Yun Seong Park, Jin Hee Kim, Yun Ang Choi, Joong Wan Park, Yong Hee Lee, Jae Yun Jung
    Shock.2023; 60(1): 34.     CrossRef
  • Development and derivation of bacteremia prediction model in patients with hepatobiliary infection
    Jung Won Choi, Sung-Bin Chon, Sung Yeon Hwang, Tae Gun Shin, Jong Eun Park, Kyuseok Kim
    The American Journal of Emergency Medicine.2023; 73: 102.     CrossRef
  • Hemodynamic management of septic shock: beyond the Surviving Sepsis Campaign guidelines
    Gil Joon Suh, Tae Gun shin, Woon Yong Kwon, Kyuseok Kim, You Hwan Jo, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim
    Clinical and Experimental Emergency Medicine.2023; 10(3): 255.     CrossRef
  • Prognostic accuracy of initial and 24-h maximum SOFA scores of septic shock patients in the emergency department
    Tae Han Kim, Daun Jeong, Jong Eun Park, Sung Yeon Hwang, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Gun Tak Lee, Tae Gun Shin
    Heliyon.2023; 9(9): e19480.     CrossRef
  • Modified Cardiovascular Sequential Organ Failure Assessment Score in Sepsis: External Validation in Intensive Care Unit Patients
    Byuk Sung Ko, Seung Mok Ryoo, Eunah Han, Hyunglan Chang, Chang June Yune, Hui Jai Lee, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Tae Ho Lim, Won Young Kim, Jang Won Sohn, Mi Ae Jeong, Sung Yeon Hwang, Tae Gun Shin, Kyuseok Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • A Simple Bacteremia Score for Predicting Bacteremia in Patients with Suspected Infection in the Emergency Department: A Cohort Study
    Hyelin Han, Da Seul Kim, Minha Kim, Sejin Heo, Hansol Chang, Gun Tak Lee, Se Uk Lee, Taerim Kim, Hee Yoon, Sung Yeon Hwang, Won Chul Cha, Min Sub Sim, Ik Joon Jo, Jong Eun Park, Tae Gun Shin
    Journal of Personalized Medicine.2023; 14(1): 57.     CrossRef
  • Using the diastolic shock index to determine when to promptly administer vasopressors in patients with septic shock
    Gustavo A. Ospina-Tascón, Gustavo García-Gallardo, Nicolás Orozco
    Clinical and Experimental Emergency Medicine.2022; 9(4): 367.     CrossRef
  • 11,335 View
  • 480 Download
  • 23 Web of Science
  • 23 Crossref

COVID-19

Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Dohyung Kim, Weon Jung, Jae Yong Yu, Hansol Chang, Se Uk Lee, Taerim Kim, Sung Yeon Hwang, Hee Yoon, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Won Chul Cha
Clin Exp Emerg Med 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105

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Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Clin Exp Emerg Med. 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105
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Effect of fever or respiratory symptoms on leaving without being seen during the COVID-19 pandemic in South Korea
Clin Exp Emerg Med. 2022;9(1):1-9.   Published online March 31, 2022
DOI: https://doi.org/10.15441/ceem.21.105
Close
Objective
Coronavirus disease 2019 (COVID-19) has notably altered the emergency department isolation protocol, imposing stricter requirements on probable infectious disease patients that enter the department. This has caused adverse effects, such as an increased rate of leave without being seen (LWBS). This study describes the effect of fever/respiratory symptoms as the main cause of isolation regarding LWBS after the COVID-19 pandemic.
Methods
We retrospectively analyzed emergency department visits before (March to July 2019) and after (March to July 2020) the COVID-19 pandemic. Patients were grouped based on existing fever or respiratory symptoms, with the LWBS rate as the primary outcome. Logistic regression analysis was used to identify the risk factors of LWBS. Logistic regression was performed using interaction terminology (fever/respiratory symptom patient [FRP]×post–COVID-19) to determine the interaction between patients with FRPs and the COVID-19 pandemic period.
Results
A total of 60,290 patients were included (34,492 in the pre–COVID-19, and 25,298 in the post–COVID-19 group). The proportion of FRPs decreased significantly after the pandemic (P<0.001), while the LWBS rate in FRPs significantly increased from 2.8% to 19.2% (P<0.001). Both FRPs (odds ratio, 1.76; 95% confidence interval, 1.59–1.84 (P<0.001) and the COVID-19 period (odds ratio, 2.29; 95% confidence interval, 2.15–2.44; P<0.001) were significantly associated with increased LWBS. Additionally, there was a significant interaction between the incidence of LWBS in FRPs and the COVID-19 pandemic period (P<0.001).
Conclusion
The LWBS rate has increased in FRPs after the COVID-19 pandemic; additionally, the effect observed was disproportionate compared with that of nonfever/respiratory symptom patients.

Citations

Citations to this article as recorded by  Crossref logo
  • Nationwide Age-Specific Changes in EMS-Transported Emergency Department Visits in Korea During the Pre-COVID-19 and Post-COVID-19 Periods
    Min-Jung Kim, Jae-Hyun Kwon, Soo Hyun Park, Young-Hoon Byun, Ho-Young Song, Jin Hee Kim, Sung-Ha Kim, So-Hyun Paek
    Journal of Clinical Medicine.2026; 15(7): 2552.     CrossRef
  • Impact of the Early COVID-19 Pandemic on Emergency Department Visits of Adult Cancer Patients With Fever or Respiratory Symptoms: A Korean Nationwide Population-Based Study, 2016–2020
    Kyung Shin Lee, Ho Kyung Sung, Youn Young Choi, Changwoo Han, Hye Sook Min
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Impact of COVID-19 outbreak on acute gallbladder disease in the emergency department
    Dal Sakong, Michael Sung Pil Choe, Woo Young Nho, Chang Won Park
    Clinical and Experimental Emergency Medicine.2023; 10(1): 84.     CrossRef
  • The impact of the COVID-19 pandemic on in-hospital mortality in patients admitted through the emergency department
    Changgyun Kim, Juncheol Lee, Yongil Cho, Jaehoon Oh, Hyunggoo Kang, Tae Ho Lim, Byuk Sung Ko
    Clinical and Experimental Emergency Medicine.2023; 10(1): 92.     CrossRef
  • Patient Anxiety and Communication Experience in the Emergency Department: A Mobile, Web-Based, Mixed-Methods Study on Patient Isolation During the COVID-19 Pandemic
    Sumin Kim, Hansol Chang, Taerim Kim, Won Chul Cha
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Epidemiologic trends of patients who visited nationwide emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Hyun Ho Yoo, Young Sun Ro, Eunsil Ko, Jin-Hee Lee, So-hyun Han, Taerim Kim, Tae Gun Shin, Seongjung Kim, Hansol Chang
    Clinical and Experimental Emergency Medicine.2023; 10(S): S1.     CrossRef
  • Characteristics of pediatric emergency department visits before and during the COVID-19 pandemic: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Jin Hyuck Hong, So Hyun Paek, Taerim Kim, Seongjung Kim, Eunsil Ko, Young Sun Ro, Jungeon Kim, Jae Hyun Kwon
    Clinical and Experimental Emergency Medicine.2023; 10(S): S13.     CrossRef
  • The effect of COVID-19 pandemic on the length of stay and outcomes in the emergency department
    Soh Yeon Chun, Ho Jung Kim, Han Bit Kim
    Clinical and Experimental Emergency Medicine.2022; 9(2): 128.     CrossRef
  • Emergency Transport Refusal during the Early Stages of the COVID-19 Pandemic in Gyeonggi Province, South Korea
    Min Young Ryu, Hang A. Park, Sangsoo Han, Hye Ji Park, Choung Ah Lee
    International Journal of Environmental Research and Public Health.2022; 19(14): 8444.     CrossRef
  • The impact of COVID-19 on cancer care in a tertiary hospital in Korea: possible collateral damage to emergency care
    Shin Hye Yoo, Jin-Ah Sim, Jeongmi Shin, Bhumsuk Keam, Jun-Bean Park, Aesun Shin
    Epidemiology and Health.2022; 44: e2022044.     CrossRef
  • Optimal diagnostic fever thresholds using non-contact infrared thermometers under COVID-19
    Fan Lai, Xin Li, Tianjiao Liu, Xin Wang, Qi Wang, Shan Chen, Sumei Wei, Ying Xiong, Qiannan Hou, Xiaoyan Zeng, Yang Yang, Yalan Li, Yonghong Lin, Xiao Yang
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
    Jinwook Bahk, Kyunghee Jung-Choi
    Epidemiology and Health.2022; 44: e2022110.     CrossRef
  • 8,470 View
  • 252 Download
  • 12 Web of Science
  • 12 Crossref

Emergency Medical Services

The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Hanzo Choi, Won Chul Cha, Ik Joon Jo, Jin-Ho Choi, Min Seob Sim, Taegun Shin
Clin Exp Emerg Med 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083

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The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Clin Exp Emerg Med. 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083
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The individual and neighborhood factors associated with the use of emergency medical services in patients with ST-elevation myocardial infarction
Clin Exp Emerg Med. 2020;7(4):302-309.   Published online December 31, 2020
DOI: https://doi.org/10.15441/ceem.19.083
Close
Objective
The utilization of emergency medical services (EMS) varies widely among communities. In this study, we aimed to evaluate the relationship between the use of EMS by patients with ST-elevation myocardial infarction (STEMI) and the individual and neighborhood characteristics of these patients.
Methods
We performed a secondary analysis of data from the Cardiovascular Disease Surveillance project, which included patients diagnosed with STEMI at 29 emergency centers in South Korea. Our analysis included only patients living in Seoul, and the primary outcome measured was the use of EMS. While the clinical variables of the patients were collected from the Cardiovascular Disease Surveillance registry, the 2010 National Census data was used to identify neighborhood variables such as population density, income, age, and residence type. We used a 3-level hierarchical logistic regression to estimate the effects of neighborhood-level factors on EMS use by individual patients.
Results
We evaluated 1,634 patients with STEMI from 2007 to 2012. The neighborhoods were grouped into 25 counties. The regional rates of EMS use varied from 18.3% to 46.5%. The final adjusted logistic model revealed that the use of EMS was significantly associated with the average number of households (neighborhood level factor) and symptoms of syncope, cardiac arrest, and history of cardiovascular disease (individual level factors).
Conclusion
The individual levels factors had a greater influence on the use of EMS compared to the neighborhood-level factors.

Citations

Citations to this article as recorded by  Crossref logo
  • Characteristics of consecutive versus non-consecutive frequent emergency medical services transport to a single emergency department
    Sun Hyu Kim, Hyeji Lee, Fadwa Alhalaiqa
    PLOS ONE.2024; 19(5): e0301337.     CrossRef
  • Association of Symptoms and Mode of Transportation to Emergency Department in Patients With Acute Coronary Syndrome
    Leslie L. Davis, Thomas P. McCoy, Barbara Riegel, Sharon McKinley, Lynn V. Doering, Debra K. Moser
    Dimensions of Critical Care Nursing.2023; 42(2): 95.     CrossRef
  • 6,934 View
  • 81 Download
  • 2 Web of Science
  • 2 Crossref

Pulmonary

Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Soo Yeon Kang, Won Chul Cha, Junsang Yoo, Taerim Kim, Joo Hyun Park, Hee Yoon, Sung Yeon Hwang, Min Seob Sim, Ik Joon Jo, Tae Gun Shin
Clin Exp Emerg Med 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052

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Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Clin Exp Emerg Med. 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052
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Predicting 30-day mortality of patients with pneumonia in an emergency department setting using machine-learning models
Clin Exp Emerg Med. 2020;7(3):197-205.   Published online September 30, 2020
DOI: https://doi.org/10.15441/ceem.19.052
Close
Objective
This study aimed to confirm the accuracy of a machine-learning-based model in predicting the 30-day mortality of patients with pneumonia and evaluating whether they were required to be admitted to the intensive care unit (ICU).
Methods
The study conducted a retrospective analysis of pneumonia patients at an emergency department (ED) in Seoul, Korea, from January 1, 2016 to December 31, 2017. Patients aged 18 years or older with a pneumonia registry designation on their electronic medical record were enrolled. We collected their demographic information, mental status, and laboratory findings. Three models were used: the pre-existing CURB-65 model, and the CURB-RF and Extensive CURB-RF models, which were machine-learning models that used a random forest algorithm. The primary outcomes were ICU admission from the ED or 30-day mortality. Receiver operating characteristic curves were constructed for the models, and the areas under these curves were compared.
Results
Out of the 1,974 pneumonia patients, 1,732 patients were eligible to be included in the study; from these, 473 patients died within 30 days or were initially admitted to the ICU from the ED. The area under receiver operating characteristic curves of CURB-65, CURB-RF, and extensive-CURB-RF were 0.615 (0.614–0.616), 0.701 (0.700–0.702), and 0.844 (0.843–0.845), respectively.
Conclusion
The proposed machine-learning models could predict the mortality of patients with pneumonia more accurately than the pre-existing CURB-65 model and can help decide whether the patient should be admitted to the ICU.

Citations

Citations to this article as recorded by  Crossref logo
  • Implementation of machine learning in emergency departments: A systematic review
    Banafshe Hosseini, Atushi Patel, Megan Landes, Samuel Vaillancourt, Muhammad Mamdani, Kevin Maruthananth, Neha Matharu, Zuha Pathan, Krishihan Sivapragasam, Onlak Ruangsomboon, Becky Skidmore, Andrew D Pinto
    DIGITAL HEALTH.2026;[Epub]     CrossRef
  • Multimodal AI-based 28-day mortality prediction of pneumonia patients at ED discharge: a multicenter study
    Sunjin Hwang, Sejin Heo, Sungjun Hong, Kyu-Hwan Jung, Won Chul Cha, Junsang Yoo
    Scientific Reports.2026;[Epub]     CrossRef
  • Artificial Intelligence Applications in Pneumonia: Diagnosis and Outcome Prediction
    Mengou Zhu, Melissa J. Bak, Catherine A. Gao
    Current Pulmonology Reports.2026;[Epub]     CrossRef
  • Comparison of Predictive Models for Keloid Recurrence Based on Machine Learning
    Yan Hao, Mengjie Shan, Hao Liu, Yijun Xia, Xinwen Kuang, Kexin Song, Youbin Wang
    Journal of Cosmetic Dermatology.2025;[Epub]     CrossRef
  • Machine learning-based model for predicting all-cause mortality in severe pneumonia
    Weichao Zhao, Xuyan Li, Lianjun Gao, Zhuang Ai, Yaping Lu, Jiachen Li, Dong Wang, Xinlou Li, Nan Song, Xuan Huang, Zhao-hui Tong
    BMJ Open Respiratory Research.2025; 12(1): e001983.     CrossRef
  • Enhanced super-resolution generative adversarial network augmented convolution neural network for pneumonia prognosis in India: promising health policy implications
    Tapan Kumar, R. L. Ujjwal
    International Journal of System Assurance Engineering and Management.2025; 16(4): 1438.     CrossRef
  • Inteligencia Artificial en la identificación de la Neumonía Pediátrica en Radiografías de Tórax
    Elizabeth Espinoza-Portilla, Milagro Henríquez-Suárez, Catia Cilloniz
    Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo.2025;[Epub]     CrossRef
  • Enhancing pneumonia prognosis in the emergency department: a novel machine learning approach using complete blood count and differential leukocyte count combined with CURB-65 score
    Yin-Ting Lin, Ko-Ming Lin, Kai-Hsiang Wu, Frank Lien
    BMC Medical Informatics and Decision Making.2024;[Epub]     CrossRef
  • Systematic Literature Review: The Role of Artificial Intelligence in Emergency Department Decision Making
    Sumaiya Amin Adrita
    medtigo Journal of Medicine.2024; 1(1): 1.     CrossRef
  • Machine-Learning Model for Mortality Prediction in Patients With Community-Acquired Pneumonia
    Catia Cilloniz, Logan Ward, Mads Lause Mogensen, Juan M. Pericàs, Raúl Méndez, Albert Gabarrús, Miquel Ferrer, Carolina Garcia-Vidal, Rosario Menendez, Antoni Torres
    CHEST.2023; 163(1): 77.     CrossRef
  • Haemogram indices are as reliable as CURB-65 to assess 30-day mortality in Covid-19 pneumonia
    OKAN BARDAKCI, MURAT DAS, GÖKHAN AKDUR, CANAN AKMAN, DUYGU SIDDIKOGLU, OKHAN AKDUR, YAVUZ BEYAZIT
    The National Medical Journal of India.2023; 35: 221.     CrossRef
  • Prediction of mortality in pneumonia patients with connective tissue disease treated with glucocorticoids or/and immunosuppressants by machine learning
    Dongdong Li, Liting Ding, Jiao Luo, Qiu-Gen Li
    Frontiers in Immunology.2023;[Epub]     CrossRef
  • Machine learning-based prediction of in-ICU mortality in pneumonia patients
    Eun-Tae Jeon, Hyo Jin Lee, Tae Yun Park, Kwang Nam Jin, Borim Ryu, Hyun Woo Lee, Dong Hyun Kim
    Scientific Reports.2023;[Epub]     CrossRef
  • Performance of Machine Learning Algorithms for Predicting Adverse Outcomes in Community-Acquired Pneumonia
    Zhixiao Xu, Kun Guo, Weiwei Chu, Jingwen Lou, Chengshui Chen
    Frontiers in Bioengineering and Biotechnology.2022;[Epub]     CrossRef
  • Pneumonia Update for Emergency Clinicians
    Boris Garber
    Current Emergency and Hospital Medicine Reports.2022; 10(3): 36.     CrossRef
  • Benchmarking emergency department prediction models with machine learning and public electronic health records
    Feng Xie, Jun Zhou, Jin Wee Lee, Mingrui Tan, Siqi Li, Logasan S/O Rajnthern, Marcel Lucas Chee, Bibhas Chakraborty, An-Kwok Ian Wong, Alon Dagan, Marcus Eng Hock Ong, Fei Gao, Nan Liu
    Scientific Data.2022;[Epub]     CrossRef
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    Teng Zhang, Yifeng Zeng, Runpei Lin, Mingshan Xue, Mingtao Liu, Yusi Li, Yingjie Zhen, Ning Li, Wenhan Cao, Sixiao Wu, Huiqing Zhu, Qi Zhao, Baoqing Sun
    Journal of Clinical Medicine.2022; 11(20): 6015.     CrossRef
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    Byuk Sung Ko, Sanghoon Jeon, Donghee Son, Sung-Hyuk Choi, Tae Gun Shin, You Hwan Jo, Seung Mok Ryoo, Youn-Jung Kim, Yoo Seok Park, Woon Yong Kwon, Gil Joon Suh, Tae Ho Lim, Won Young Kim
    Journal of Clinical Medicine.2022; 11(23): 7231.     CrossRef
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    Christine Giang, Jacob Calvert, Keyvan Rahmani, Gina Barnes, Anna Siefkas, Abigail Green-Saxena, Jana Hoffman, Qingqing Mao, Ritankar Das
    Medicine.2021; 100(23): e26246.     CrossRef
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    Syunsuke Yamanaka, Koji Morikawa, Hiroshi Morita, Ji Young Huh, Osamu Yamamura
    Frontiers in Medical Technology.2021;[Epub]     CrossRef
  • Evaluation and management of pleural sepsis
    Justin K. Lui, Ehab Billatos, Frank Schembri
    Respiratory Medicine.2021; 187: 106553.     CrossRef
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    You‐Ming Chen, Yuan Kao, Chien‐Chin Hsu, Chia‐Jung Chen, Yu‐Shan Ma, Yu‐Ting Shen, Tzu‐Lan Liu, Shu‐Lien Hsu, Hung‐Jung Lin, Jhi‐Joung Wang, Chien‐Cheng Huang, Chung‐Feng Liu
    Academic Emergency Medicine.2021; 28(11): 1277.     CrossRef
  • 8,719 View
  • 159 Download
  • 20 Web of Science
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Emergency Medical Services | Disaster

Effect of typhoons on the Korean national emergency medical service system
Soo Hyun Park, Won Chul Cha, Giwoon Kim, Tae Rim Lee, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo
Clin Exp Emerg Med 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255

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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
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Effect of typhoons on the Korean national emergency medical service system
Clin Exp Emerg Med. 2018;5(4):272-277.   Published online December 31, 2018
DOI: https://doi.org/10.15441/ceem.17.255
Close
Objective
While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance.
Methods
The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively.
Results
During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39).
Conclusion
Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.
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Resuscitation

Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Jikyoung Shin, Eunsil Ko, Won Chul Cha, Tae Rim Lee, Hee Yoon, Sung Yeon Hwang, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong, Jin-Ho Choi
Clin Exp Emerg Med 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167

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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
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Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest
Clin Exp Emerg Med. 2017;4(2):65-72.   Published online June 30, 2017
DOI: https://doi.org/10.15441/ceem.16.167
Close
Objective
Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated.
Methods
The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed. Early CAG was defined as CAG performed within 24 hours of emergency department admission. The primary outcome was survival to discharge, with neurologically favorable status defined by cerebral performance category scores ≤2.
Results
Compared to patients without CAG (n=469), patients who underwent early CAG (n=138) were younger, more likely to be male, and more likely to have received bystander cardiopulmonary resuscitation, pre-hospital defibrillation, and revascularization (P<0.01 for all). Analysis of 115 propensity score-matched pairs showed that early CAG is associated with a 2.3-fold increase in survival to discharge with neurologically favorable status (P<0.001, all). Survival to discharge increased consistently according to the time interval between emergency department visit and CAG (P<0.05).
Conclusion
Early CAG of OHCA patients was associated with better survival and favorable neurologic outcomes at discharge. However, there was no clear time threshold for CAG that predicted survival to discharge.

Citations

Citations to this article as recorded by  Crossref logo
  • Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation on Electrocardiograms: A Comprehensive Review
    Sachin Kumar, Bahaa Abdelghaffar, Meghana Iyer, Ghaith Shamaileh, Raunak Nair, Weili Zheng, Beni Verma, Venu Menon, Samir R. Kapadia, Grant W. Reed
    Journal of the Society for Cardiovascular Angiography & Interventions.2023; 2(1): 100536.     CrossRef
  • Impact of emergent coronary angiography after out-of-the-hospital cardiac arrest without ST-segment elevation – A systematic review and meta-analysis
    Nuno Alves, Mauro Mota, Madalena Cunha, Joana Maria Ribeiro
    International Journal of Cardiology.2022; 364: 1.     CrossRef
  • ST-Elevation Myocardial Infarction Complicated by Out-of-Hospital Cardiac Arrest
    Marinos Kosmopoulos, Jason A. Bartos, Demetris Yannopoulos
    Interventional Cardiology Clinics.2021; 10(3): 359.     CrossRef
  • 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 5. Post-cardiac arrest care
    Young-Min Kim, Kyung Woon Jeung, Won Young Kim, Yoo Seok Park, Joo Suk Oh, Yeon Ho You, Dong Hoon Lee, Minjung Kathy Chae, Yoo Jin Jeong, Min Chul Kim, Eun Jin Ha, Kyoung Jin Hwang, Won-Seok Kim, Jae Myung Lee, Kyoung-Chul Cha, Sung Phil Chung, June Dong
    Clinical and Experimental Emergency Medicine.2021; 8(S): S41.     CrossRef
  • Post-cardiac arrest syndrome
    N.V. Bragina, T.G. Markova, V.I. Gorbachev
    Anesteziologiya i reanimatologiya.2021; (4): 140.     CrossRef
  • Gender difference in the clinical outcomes of patients with out-of-hospital cardiac arrest
    Gun Tak Lee, Sung Yeon Hwang, Ik Joon Jo, Tae Rim Kim, Hee Yoon, Won Chul Cha, Min Seob Sim, Sang Do Shin, Tae Gun Shin, Jin-Ho Choi
    Medicine.2021; 100(48): e27855.     CrossRef
  • Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation
    Beni R. Verma, Vikram Sharma, Shashank Shekhar, Manpreet Kaur, Shameer Khubber, Agam Bansal, Jarmanjeet Singh, Keerat Rai Ahuja, Salik Nazir, Michael Chetrit, Venu Menon, Grant Reed, Samir Kapadia
    JACC: Cardiovascular Interventions.2020; 13(19): 2193.     CrossRef
  • Management of post-cardiac arrest syndrome
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 173.     CrossRef
  • Selective Coronary Angiography Following Cardiac Arrest
    Jayasheel O. Eshcol, Adnan K. Chhatriwalla
    Cardiovascular Innovations and Applications.2019;[Epub]     CrossRef
  • Predictors of Obstructive Coronary Disease and Mortality in Adults Having Cardiac Arrest
    Jignesh K. Patel, Ganesh Thippeswamy, Abdo Kataya, Charles A. Loeb, Puja B. Parikh
    The American Journal of Cardiology.2018; 122(1): 12.     CrossRef
  • 14,914 View
  • 171 Download
  • 7 Web of Science
  • 10 Crossref

Emergency Medical Services | Critical Care

Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
Clin Exp Emerg Med 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159

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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
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Emergency medical service personnel need to improve knowledge and attitude regarding prehospital sepsis care
Clin Exp Emerg Med. 2017;4(1):48-55.   Published online March 30, 2017
DOI: https://doi.org/10.15441/ceem.16.159
Close
Objective
We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel’s knowledge of sepsis and their intention to engage in prehospital sepsis management.
Methods
The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference. We classified subjects into active and passive groups based on intent to participate in prehospital sepsis care.
Results
A total of 271 questionnaires were distributed; 255 EMS personnel (94%) completed the survey, 126 (49%) of whom were first-degree emergency medical technicians (EMTs). Less than 75% of subjects provided clinically relevant responses to questions about the definitions of sepsis, tachycardia, tachypnea, hypotension, hypothermia, fluid resuscitation, and vasopressor. Only 15% of participants had suspected that a patient had sepsis, and 9% reported that they could identify patients with sepsis during transportation. Overall, first-degree EMTs showed higher levels of knowledge and a positive attitude to sepsis compared with non-first-degree EMTs. Sixty percent of the participants reported that they were actively involved in prehospital sepsis care. The active group showed significantly higher levels of knowledge and more positive responses to the clinical impact of prehospital sepsis care.
Conclusion
Our study showed that is a substantial portion of EMS personnel lacks appropriate level of knowledge on sepsis care. We also found that the intention to engage in sepsis management was associated with appropriate knowledge of sepsis.

Citations

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  • Barriers and facilitators to optimal sepsis care – a systematized review of healthcare professionals’ perspectives
    Lea Draeger, Carolin Fleischmann-Struzek, Sabine Gehrke-Beck, Christoph Heintze, Daniel O. Thomas-Rueddel, Konrad Schmidt
    BMC Health Services Research.2025;[Epub]     CrossRef
  • Prehospital fluid therapy in patients with suspected infection: a survey of ambulance personnel’s practice
    Marie Egebjerg Jensen, Arne Sylvester Jensen, Carsten Meilandt, Kristian Winther Jørgensen, Ulla Væggemose, Allan Bach, Hans Kirkegaard, Marie Kristine Jessen
    Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2022;[Epub]     CrossRef
  • Prehospital delay is an important risk factor for mortality in community-acquired bloodstream infection (CA-BSI): a matched case–control study
    Martin Holmbom, Maria Andersson, Sören Berg, Dan Eklund, Pernilla Sobczynski, Daniel Wilhelms, Anna Moberg, Mats Fredrikson, Åse Östholm Balkhed, Håkan Hanberger
    BMJ Open.2021; 11(11): e052582.     CrossRef
  • The Knowledge of Nursing Internship Program Students about Early Detection of Sepsis
    Stefani Stefani, Yanny Trisyani, Anita Setyawati
    Open Access Macedonian Journal of Medical Sciences.2021; 9(T6): 116.     CrossRef
  • Knowledge of sepsis risk and management among dental professionals in Wales: a service evaluation
    Stephen Woolley, Mick Allen, Renata Medeiros Mirra
    British Dental Journal.2020;[Epub]     CrossRef
  • Prehospital sepsis alert notification decreases time to initiation of CMS sepsis core measures
    Christopher L. Hunter, Salvatore Silvestri, Amanda Stone, Anne Shaughnessy, Stacie Miller, Alexa Rodriguez, Linda Papa
    The American Journal of Emergency Medicine.2019; 37(1): 114.     CrossRef
  • Emergency medical service providers' knowledge and perception of sepsis at Makkah Saudi Red Crescent Authority
    BassamHassan Basaffar, NasserSafar Aloitibi, RashedMohammad Alzahrani, OmarOsama Felimban, KhalidSafir Algethami, AbdullahHamdan Alshehri
    Saudi Critical Care Journal.2019; 3(2): 85.     CrossRef
  • 11,612 View
  • 156 Download
  • 7 Web of Science
  • 7 Crossref

Case Report

Toxicology

Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023

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Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Clin Exp Emerg Med. 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023
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Upper airway obstruction resulting from acute mucosal injury induced by direct ingestion of sodium picosulfate/magnesium citrate powder
Clin Exp Emerg Med. 2016;3(2):109-111.   Published online June 30, 2016
DOI: https://doi.org/10.15441/ceem.15.023
Close
A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved. The tracheostomy tube was successfully removed after confirming recovery, and he was discharged 3 weeks after admission.

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  • Esophageal Stricture Caused by the Ingestion of Undissolved Picosulfate Powder
    Daehyun Kim, Byungha Cho, Jong Wook Choi, Ki Bae Kim, Seon Mee Park
    Clinical Endoscopy.2021; 54(1): 122.     CrossRef
  • 15,734 View
  • 106 Download
  • 1 Web of Science
  • 1 Crossref

Original Article

Resuscitation

A survey-based study on the protocols for therapeutic hypothermia in cardiac arrest patients in Korea: focusing on the differences between level 1 and 2 centers
Tae Gwan Oh, Won Chul Cha, Ik Joon Jo, Mun Ju Kang, Dong Woo Lee
Clin Exp Emerg Med 2015;2(4):210-216.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.15.018

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A survey-based study on the protocols for therapeutic hypothermia in cardiac arrest patients in Korea: focusing on the differences between level 1 and 2 centers
Clin Exp Emerg Med. 2015;2(4):210-216.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.15.018
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A survey-based study on the protocols for therapeutic hypothermia in cardiac arrest patients in Korea: focusing on the differences between level 1 and 2 centers
Clin Exp Emerg Med. 2015;2(4):210-216.   Published online December 28, 2015
DOI: https://doi.org/10.15441/ceem.15.018
Close
Objective
We aimed to summarize the therapeutic hypothermia (TH) protocols used in emergency departments (EDs) in Korea and to investigate the differences between level 1 and 2 centers.
Methods
The chief residents from 56 EDs were given a structured survey containing questions on the indications for TH, methods for TH induction, maintaining, and finalizing TH treatments. The participants were divided into 2 groups based on their work place (level 1 vs. level 2 centers).
Results
We received 36 responses to the survey. The majority of the participants (94.4%) reported that they routinely used TH. An average of 5.9 (standard deviation, 3.4) and 3.3 (standard deviation, 2.9) TH procedures were performed monthly in level 1 and 2 centers, respectively (P=0.01). The majority of level 1 and 2 centers (80.0% and 73.1%, respectively) had written TH protocols. Rectal (50.0%) and esophageal probes (38.9%) were most commonly used to monitor the patients’ body temperatures. Midazolam (80.6%) and remifentanyl (47.2%) were the most commonly used sedatives. For TH induction, external cooling devices (77.8%) and cold saline infusion (66.1%) were predominant. Between level 1 and 2 centers, only the number of TH, the usage of remifentanyl, and application of external cooling device showed significant differences (P<0.05)
Conclusion
Our study summarizes the TH protocols used in 36 EDs. The majority of study participants performed TH using a written protocol. We observed small number of differences in TH induction and maintenance methods between level 1 and 2 centers.

Citations

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  • Hypothermia Inhibits Endothelium-Independent Vascular Contractility via Rho-kinase Inhibition
    Yoon Hee Chung, Keon Woong Oh, Sung Tae Kim, Eon Sub Park, Hyun Dong Je, Hyuk-Jun Yoon, Uy Dong Sohn, Ji Hoon Jeong, Hyen-Oh La
    Biomolecules & Therapeutics.2018; 26(2): 139.     CrossRef
  • 22,717 View
  • 81 Download
  • 1 Web of Science
  • 1 Crossref

Case Report

Cardiovascular | Resuscitation

Successful fibrinolytic and therapeutic hypothermic management of cardiac arrest following massive pulmonary embolism
Eunsil Ko, Jeong Hoon Lee, Minjung Kathy Chae, Tae Rim Lee, Min Seob Sim, Tae Gun Shin, Won Chul Cha, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2015;2(3):193-196.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.021

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Successful fibrinolytic and therapeutic hypothermic management of cardiac arrest following massive pulmonary embolism
Clin Exp Emerg Med. 2015;2(3):193-196.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.021
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Successful fibrinolytic and therapeutic hypothermic management of cardiac arrest following massive pulmonary embolism
Clin Exp Emerg Med. 2015;2(3):193-196.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.021
Close
Massive pulmonary embolism (MPE) with hemodynamic instability is a clinical condition with a poor prognosis and high mortality rates. There are no definitive treatment options for cardiac arrest due to MPE. A 52-year-old female presented at our emergency department with cardiac arrest, and a 62-year-old female presented after achieving return of spontaneous circulation of cardiac arrest from a local hospital, respectively. In each case, computed tomographic pulmonary angiography after return of spontaneous circulation demonstrated heavy burdens of pulmonary embolism in the pulmonary arteries. We immediately started therapeutic hypothermia and fibrinolytic therapy. They were transferred to the thoracic surgery and cardiology departments respectively, and then discharged with a cerebral performance categories scale score of 1. In summary, we report two cases of out-of-hospital cardiac arrest due to MPE in which fibrinolytic therapy was successfully combined with therapeutic hypothermia.
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  • 93 Download
  • 1 Web of Science

Original Article

Procedures | Infectious Disease

Contamination during doffing of personal protective equipment by healthcare providers
Seong Mi Lim, Won Chul Cha, Minjung Kathy Chae, Ik Joon Jo
Clin Exp Emerg Med 2015;2(3):162-167.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.019

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Contamination during doffing of personal protective equipment by healthcare providers
Clin Exp Emerg Med. 2015;2(3):162-167.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.019
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Contamination during doffing of personal protective equipment by healthcare providers
Clin Exp Emerg Med. 2015;2(3):162-167.   Published online September 30, 2015
DOI: https://doi.org/10.15441/ceem.15.019
Close
Objective
In this study, we aimed to describe the processes of both the donning and the doffing of personal protective equipment for Ebola and evaluate contamination during the doffing process.
Methods
We recruited study participants among physicians and nurses of the emergency department of Samsung Medical Center in Seoul, Korea. Participants were asked to carry out doffing and donning procedures with a helper after a 50-minute brief training and demonstration based on the 2014 Centers for Disease Control and Prevention protocol. Two separate cameras with high-density capability were set up, and the donning and doffing processes were video-taped. A trained examiner inspected all video recordings and coded for intervals, errors, and contaminations defined as the outside of the equipment touching the clinician’s body surface.
Results
Overall, 29 participants were enrolled. Twenty (68.9%) were female, and the mean age was 29.2 years. For the donning process, the average interval until the end was 234.2 seconds (standard deviation [SD], 65.7), and the most frequent errors occurred when putting on the outer gloves (27.5%), respirator (20.6%), and hood (20.6%). For the doffing process, the average interval until the end was 183.7 seconds (SD, 38.4), and the most frequent errors occurred during disinfecting the feet (37.9%), discarding the scrubs (17.2%), and putting on gloves (13.7%), respectively. During the doffing process, 65 incidences of contamination occurred (2.2 incidents/person). The most vulnerable processes were removing respirators (79.2%), removing the shoe covers (65.5%), and removal of the hood (41.3%).
Conclusion
A significant number of contaminations occur during the doffing process of personal protective equipment.

Citations

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  • A pilot trial of internet-delivered mastery-based Ebola simulation education in Uganda
    Catherine D. Tobin, Lacey MenkinSmith, Dulaney A. Wilson, Kenneth Catchpole, J.G. Reves
    Healthcare in Low-resource Settings.2025;[Epub]     CrossRef
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    Yu Lv, Minhong Cai, Qian Xiang, Pingping Wang
    BMC Medical Education.2025;[Epub]     CrossRef
  • Removal of Contaminated Personal Protective Equipment With and Without Supervision. A Randomized Crossover Simulation-Based Study
    Mostafa Somri, Ohad Hochman, Lina Somri-Gannam, Luis Gaitini, Alona Paz, Tami Bumard, Manuel Á. Gómez-Ríos
    Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2024; 19(3): 137.     CrossRef
  • Perspectives on Preparedness for Chemical, Biological, Radiological, and Nuclear Threats in the Middle East and North Africa Region: Application of Artificial Intelligence Techniques
    Hassan Farhat, Guillaume Alinier, Mariana Helou, Ionnais Galatis, Nidaa Bajow, Denis Jose, Sarra Jouini, Sermet Sezigen, Samia Hafi, Sheena Mccabe, Naoufel Somrani, Kawther El Aifa, Henda Chebbi, Asma Ben Amor, Yosra Kerkeni, Ahmed M. Al-Wathinani, Nassem
    Health Security.2024; 22(3): 190.     CrossRef
  • Assessing efficacy of instructor based orientation to donning doffing protocols and modifications to doffing area infrastructure in reducing SARS-CoV-2 infection among Doctors assigned to COVID-19 patient care
    Sunil V. Furtado, Parichay J. Perikal, Monica Narayanaswamy, T.V. Ravikumar, Lissy John, K. Harish
    Infection Prevention in Practice.2023; 5(2): 100279.     CrossRef
  • A hood shield reduces postdoffing contamination during simulated COVID-19 airway management: an exploratory, simulation-based randomized study
    Felipe Muñoz-Leyva, Anahi Perlas, Ki Jinn Chin, Mehdi Soheili, Qixuan Li, Ella Huszti, Vincent Chan
    Canadian Journal of Anesthesia/Journal canadien d'anesthésie.2023; 70(5): 869.     CrossRef
  • Unfamiliar personal protective equipment: The role of routine practice and other factors affecting healthcare personnel doffing strategies
    Emily E. Chasco, Jaqueline Pereira da Silva, Kimberly Dukes, Jure Baloh, Melissa Ward, Hugh P. Salehi, Heather Schacht Reisinger, Priyadarshini R. Pennathur, Loreen Herwaldt
    Infection Control & Hospital Epidemiology.2023; 44(12): 1979.     CrossRef
  • Rebuilding for Tomorrow’s Outbreak: The State of Special Pathogen Preparedness in the USA in the Wake of COVID-19
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Case Report

Medical Emergencies | Procedures

Finger necrosis after accidental radial artery puncture
Jun Sik Kang, Tae Rim Lee, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2014;1(2):130-133.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.045

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Finger necrosis after accidental radial artery puncture
Clin Exp Emerg Med. 2014;1(2):130-133.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.045
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Finger necrosis after accidental radial artery puncture
Clin Exp Emerg Med. 2014;1(2):130-133.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.045
Close
Radial artery puncture, an invasive procedure, is frequently used for critical patients. Although considered safe, severe complications such as finger necrosis can occur. Herein, we review the clinical course of finger necrosis after accidental radial artery puncture. A 63-year-old woman visited the emergency department (ED) with left second and third finger pain after undergoing intravenous (IV) access in her wrist for procedural sedation. During the IV access, she experienced wrist pain, which increased during the 12 hours prior to her ED presentation. Emergency angiography revealed a pseudoaneurysm in her left radial artery and absence of blood flow to the proper palmar digital artery. Subsequent angiointervention and urokinase thrombolysis failed. The second finger was eventually amputated owing to gangrene. Radial artery puncture can occur accidentally during IV wrist access, resulting in severe morbidity. Providers should carefully examine the puncture site and collateral flow, followed by multiple examinations to ensure distal circulation.

Citations

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Original Articles

Resuscitation | Education & Simulation

Factors affecting the accuracy of chest compression depth estimation
Jung Hee Kang, Won Chul Cha, Minjung Kathy Chae, Hang A Park, Sung Yeon Hwang, Sang Chan Jin, Tae Rim Lee, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Clin Exp Emerg Med 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006

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Factors affecting the accuracy of chest compression depth estimation
Clin Exp Emerg Med. 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006
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Factors affecting the accuracy of chest compression depth estimation
Clin Exp Emerg Med. 2014;1(2):101-108.   Published online December 31, 2014
DOI: https://doi.org/10.15441/ceem.14.006
Close
Objective
We aimed to estimate the accuracy of visual estimation of chest compression depth and identify potential factors affecting accuracy.
Methods
This simulation study used a basic life support mannequin, the Ambu man. We recorded chest compression with 7 different depths from 1 to 7 cm. Each video clip was recorded for a cycle of compression. Three different viewpoints were used to record the video. After filming, 25 clips were randomly selected. Health care providers in an emergency department were asked to estimate the depth of compressions while watching the selected video clips. Examiner determinants such as experience and cardiopulmonary resuscitation training and environment determinants such as the location of the camera (examiner) were collected and analyzed. An estimated depth was considered correct if it was consistent with the one recorded. A multivariate analysis predicting the accuracy of compression depth estimation was performed.
Results
Overall, 103 subjects were enrolled in the study; 42 (40.8%) were physicians, 56 (54.4%) nurses, and 5 (4.8%) emergency medical technicians. The mean accuracy was 0.89 (standard deviation, 0.76). Among examiner determinants, only subjects’ occupation and clinical experience showed significant association with outcome (P=0.03 and P=0.08, respectively). All environmental determinants showed significant association with the outcome (all P<0.001). Multivariate analysis showed that accuracy rate was significantly associated with occupation, camera position, and compression depth.
Conclusions
The accuracy rate of chest compression depth estimation was 0.89 and was significantly related with examiner’s occupation, camera view position, and compression depth.
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Critical Care

Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Young Min Joo, Minjung Kathy Chae, Sung Yeon Hwang, Sang-Chan Jin, Tae Rim Lee, Won Chul Cha, Ik Joon Jo, Min Seob Sim, Keun Jeong Song, Yeon Kwon Jeong, Tae Gun Shin
Clin Exp Emerg Med 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012

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Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Clin Exp Emerg Med. 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012
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Impact of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock in the emergency department
Clin Exp Emerg Med. 2014;1(1):35-40.   Published online September 30, 2014
DOI: https://doi.org/10.15441/ceem.14.012
Close
Objective

We aimed to investigate the effect of timely antibiotic administration on outcomes in patients with severe sepsis and septic shock.

 Methods

We analyzed data from a sepsis registry that included adult patients who initially presented to the emergency department (ED) and met criteria for severe sepsis or septic shock. Timely antibiotic use was defined as administration of a broad-spectrum antibiotic within three hours from the time of ED arrival. Multivariable logistic and linear regression analyses were performed to assess associations between timely administration of antibiotics and outcomes, including hospital mortality, 48-hour change in Sequential Organ Failure Assessment (SOFA) score (delta SOFA), and hospital length of stay (LOS).

 Results

A total of 591 patients were included in the study. In-hospital mortality was 16.9% for patients receiving timely antibiotics (n=377) and 22.9% for patients receiving delayed antibiotics (n=214; P=0.04). The adjusted odds ratio for in-hospital survival was 0.54 (95% confidence interval [CI], 0.34 to 0.87; P=0.01) in patients who received timely antibiotics. Timely antibiotic administration was also significantly associated with higher delta SOFA (2 vs. 1) and shorter hospital LOS among survivors (11 days vs. 15 days). Multivariable linear regression analyses showed that timely antibiotic administration was significantly associated with increased delta SOFA and decreased hospital LOS.

 Conclusion

Antibiotic administration within three hours from the time of ED arrival was significantly associated with improved outcomes, including in-hospital survival, reversal of organ failure, and shorter hospital LOS, in patients with severe sepsis and septic shock.

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CEEM : Clinical and Experimental Emergency Medicine