- A Case Study of a Patient with Penetrating Neck Injuries caused by a Nail Gun
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Jong Soon Han, You Dong Sohn, Ji Yoon Ahn, Hee Cheol Ahn, Hyuk Sool Kwon, Gang Yeol Seo, Kwang Yun Cho, Seung Min Park
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J Korean Soc Traumatol. 2011;24(1):48-51.
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- Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.
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- A Case of Tension Viscerothorax: A Rare Complication of Diaphragmatic Rupture after Blunt Abdominal Trauma
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Maeng Real Park, Jae Ho Lee, Ji Yoon Ahn, Bum Jin Oh, Won Kim, Kyoung Soo Lim
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J Korean Soc Traumatol. 2006;19(2):201-205.
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- Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera.
A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.
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- Triage Score as a Predictor of need for Tertiary care Center Transport from Scene by Helicopter
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Song Won Song, Jae Chol Yoon, Boo Soo Lee, Woo Joo Kim, Ji Yoon Ahn, Bum Jin Oh, Kyung Su Lim
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J Korean Soc Traumatol. 2006;19(2):159-163.
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- PURPOSE
The number of patients transported by the Helicopter Emergency Medical Service (HEMS) has increased recently. In our review of the Korean HEMS, there was no established helicopter utilization criteria or triage tool on the scene, so many patients with minor injuries were transported to tertiary care centers. The aim of this study is to evaluate the percentage of patients with minor injuries and to propose a more appropriate triage tool for predicting the need for transport to a tertiary care center.
METHODS
The subjects of this study were 59 trauma patients transported to Asan Medical Center (AMC) from the scene by Seoul HEMS from January 2004 to December 2005. The Triage score (TS), Injury Severity Score (ISS), and modified Canadian Triage and Acuity Scale (mCTAS) were calculated as severity scales.
Patients with minor injuries were defined as those with TS=9, ISS< or =15, and mCTAS> or =3. We evaluated the association of TS, ISS, and mCTAS with the appropriateness of transport.
RESULTS
Many of the patients transported to tertiary medical centers were classified as having a minor injury: TS=9 group 35 cases (72.9%), ISS< or =15 group 30 cases (62.5%) and mCTAS> or =3 group 27 cases (56.2%).
However, 56.2% (27/59) of the patients were appropriately transported according to need for admission or an operation. The more severely injured patients classified by TS, ISS, and mCTAS were more appropriately transported to a tertiary center (p<0.05).
CONCLUSION
Many patients with minor injuries were transported to a tertiary center from the scene directly.
The TS can be easily calculated by an emergency medical technician at the scene. Thus, we propose the TS as a useful triage tool for determining the necessity of transport to a tertiary center by helicopter.
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