Yun Kwon Kim

Yonsei University, Seoul, Seoul, South Korea

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Publications (6)7.16 Total impact

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    ABSTRACT: BACKGROUND: An adjunct to assist cardiopulmonary resuscitation (CPR) might improve the quality of CPR performance. STUDY OBJECTIVES: This study was conducted to evaluate whether a simple audio-visual prompt device improves CPR performance by emergency medical technicians (EMTs). METHODS: From June 2008 to October 2008, 55 EMTs (39 men, mean age 34.9±4.8 years) participated in this study. A simple audio-visual prompt device was developed. The device generates continuous metronomic sounds for chest compression at a rate of 100 beats/min with a distinct 30(th) sound followed by two respiration sounds, each for 1second. All EMTs were asked to perform a 2-min CPR series on a manikin without the device, and one 2-min CPR series with the device. RESULTS: The average rate of chest compressions was more accurate when the device was used than when the device was not used (101.4±12.7 vs. 109.0±17.4/min, respectively, p=0.012; 95% confidence interval [CI] 97.2-103.8 vs. 104.5-113.5/min, respectively), and hands-off time during CPR was shorter when the device was used than when the device was not used (5.4±0.9 vs. 9.2±3.9 s, respectively, p<0.001; 95% CI 5.2-5.7 vs. 8.3-10.3 s, respectively). The mean tidal volume during CPR with the device was lower than without the device, resulting in the prevention of hyperventilation (477.6±60.0 vs. 636.6±153.4mL, respectively, p<0.001; 95% CI 463.5-496.2 vs. 607.3-688.9mL, respectively). CONCLUSION: A simple audio-visual prompt device can improve CPR performance by emergency medical technicians.
    Journal of Emergency Medicine 05/2012; · 1.33 Impact Factor
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    ABSTRACT: With the development of information technology, real-time telemetry has been invented for checking patients' physiologic parameters during their transport, via an Emergency Medical Service (EMS) system. We developed a Real-Time Telemetry System (RTS), which sends physiologic parameters including electrocardiogram (ECG), vital signs, and pulse asymmetry in real-time from the ambulance to a hospital through the Emergency Medical Information Center, a kind of central control unit. Therefore, we asked whether the RTS monitoring affects the use of medical direction in EMS system. Of six ambulance stations covering EMS transport with RTS monitor, 941 patients who were classified as emergency patients by an Emergency Medical Technician were retrospectively enrolled in this study. We divided them into two groups: group 1 (the patients using RTS monitoring) and group 2 (control group). The mean age was 53.5 ± 22.8 years, and 494 patients were men. RTS monitoring was used in 118 (20%) patients. Medical direction for treatments in group 1 was much more than that of group 2 (8.0% vs. 0.3%; p <0.001). Ambulance diversion to proper hospitals in group 1 was much more than that of group 2 (14.4% vs. 0.1%; p <0.001). The mean treatment time at the scene in group 1 also decreased more significantly than that of group 2 (4.4 ± 3.5 min vs. 6.3 ± 5.9 min; p <0.001). The results showed that intermediate medical direction in the cases using the RTS was conducted more than in the conventional method-ambulance to the hospital. These results suggest that the RTS monitoring enhances the quality in developing EMS system.
    Telemedicine and e-Health 05/2011; 17(4):247-53. · 1.40 Impact Factor
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    ABSTRACT: We investigated the factors that affected the use of a realtime telemetry system (RTS) in emergency ambulances. During the study, a total of 7144 patients were transported to a hospital in the city of Wonju via ambulance. In 466 of these cases (7%), the Emergency Medical Technician (EMT) used the RTS. Based on the Elaboration Likelihood Model, we extracted variables from the run records, such as the qualifications of the EMT, level of the patient's consciousness and the transport time. The results indicated that EMTs with higher levels of expertise were more likely to use the RTS when the level of patient consciousness was low, regardless of transport time. Conversely, EMTs with low levels of expertise were more likely to use the RTS when the transport time from scene to hospital was long and were less likely to use the RTS when the transport time was short. There appear to be several ways of improving RTS usage in the pre-hospital situation.
    Journal of telemedicine and telecare 01/2011; 17(8):441-5. · 0.92 Impact Factor
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    ABSTRACT: Reexpansion pulmonary edema (REPE) is a rare yet sometimes fatal complication associated with the treatment of lung diseases such as pleural effusion, pneumothorax, and hemothorax. The current study summarizes our experience with REPE for a 3-year period. We prospectively collected demographic and clinical data on consecutive patients presenting to an academic university-based emergency department with spontaneous pneumothorax that was treated with closed thoracostomy for a 3-year period. Eighty-four study patients were enrolled between December 2002 and September 2005. Reexpansion pulmonary edema developed in 25 of 84 (29.8% [95% confidence interval, 21.0-40.2]) patients. Many cases of REPE were small and asymptomatic and only diagnosed on computed tomography of the chest. There was only one death (1.2% [95% confidence interval, A to B]). Reexpansion pulmonary edema was associated with patients with larger pneumothoraces without fibrotic changes and with patients with hypoxia and fibrotic changes. Classic REPE as seen on chest radiograph was 16 (19.0%) in 84 patients. Diffuse REPE as seen only on computed tomography and involved more than 1 lobe was 1 (1.2%) in 84 patients. Isolated REPE as seen only on computed tomography and limited to lesser than 1 lobe was 8 (9.5%) in 84 patients. The rate of REPE after tube thoracostomy of spontaneous pneumothorax is greater than previously reported and often asymptomatic. The risk of developing REPE is greater with larger pneumothorax, especially in patients without fibrotic lung changes, and with hypoxia in patients with fibrotic changes.
    The American journal of emergency medicine 10/2009; 27(8):961-7. · 1.54 Impact Factor
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    ABSTRACT: Medullary thyroid carcinoma accounts for 3% of all thyroid gland malignancies. It commonly metastasizes to liver, lung, and bone. It rarely metastasizes to skin, and only a few such cases have been documented. Cutaneous metastasis suggests a poor prognosis, with a mean survival of 7.5-19 months. The most effective treatment for skin metastasis is complete surgical removal of all local and regional lesions. The response to systemic chemotherapy is typically poor. We report a case of medullary thyroid carcinoma with cutaneous metastases, which responded to chemotherapy.
    Cancer Research and Treatment 01/2009; 40(4):202-6. · 1.96 Impact Factor
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    Tuberculosis and Respiratory Diseases 01/2008; 64(6).