Loma Linda University

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Tae Eung Kim, MD
Associate Professor, Emergency Medicine
School of Medicine
Publications    Scholarly Journals--Published
  • Kim TE, Smith DD. "Thoracic aortic dissection in an 18 year-old female with no risk factors.." . (): -. (*)
    Spontaneous aortic dissection is a rare, life-threatening cause of chest pain, and has a higher pre-test probability when traditional risks, such as age, hypertension, dyslipidemia, or connective tissue disorders are present. However, even in the absence of risk factors non-traumatic rupture of an aortic dissection may occur. Most are found in patients over 40 years of age. Younger victims of this disease invariably also suffer from other conditions such as cystic medial necrosis, connective tissue disorders such as Marfan?s syndrome, or vasculitis. We present the youngest reported incident of spontaneous, non-traumatic rupture of an aortic dissection in a patient without any risk factors, history, or discoverable cause on necropsy, and review other reported cases in the literature of aortic dissection in the people under 40.
  • Dinh V A, Ko H S, Rao R, Bansal R C, Smith D D, Kim T E, & Nguyen H B. (2012). Measuring cardiac index with a focused cardiac ultrasound examination in the ED. American Journal of Emergency Medicine, 30(9), 1845-1851. ( 11/2012 - Present ) Link...
    Objectives: Noninvasive technology may assist the emergency department (ED) physician in determining the hemodynamic status in critically ill patients. The objective of our study was to show that ED physicians can accurately measure cardiac index (CI) by performing a bedside focused cardiac ultrasound examination. Methods: A convenience sample of adult subjects were prospectively enrolled. Cardiac index, left ventricular outflow tract (LVOT) diameter, velocity time integral (VTI), stroke volume index, and heart rate were obtained by trained ED physicians and a certified cardiac sonographer. The primary outcome was percent of optimal LVOT diameter and VTI measurements as verified by an expert cardiologist. Results: One hundred patients were enrolled, with obtainable CI measurements in 97 patients. Cardiac index, LVOT diameter, VTI, stroke volume index, and heart rate measurements by ED physician were 2.42 +/- 0.70 L min(-1) m(-2), 2.07 +/- 0.22 cm, 18.30 +/- 3.71 cm, 32.34 +/- 7.92 mL beat(-1) m(-2), and 75.32 +/- 13.45 beats/min, respectively. Measurements of LVOT diameter by ED physicians and sonographer were optimal in 90.0% (95% confidence interval, 82.6%-94.5) and 91.3% (73.2%-97.6%) of patients, respectively. Optimal VTI measurements were obtained in 78.4% (69.2%-85.4%) and 78.3% (58.1%-90.3%) of patients, respectively. In 23 patients, the correlation (r) for CI between ED physician and sonographer was 0.82 (0.60-0.92), with bias and limits of agreement of -0.11 (-1.06 to 0.83) L min(-1) m(-2) and percent difference of 12.4% +/- 10.1%. Conclusions: Emergency department ED physicians can accurately measure CI using standard bedside ultrasound. A focused ultrasound cardiac examination to derive CI has potential use in the management of critical ill patients in the ED. (C) 2012 Elsevier Inc. All rights reserved.
  • Kim T E, Reibling E T, & Denmark K T. (2012). Student perception of high fidelity medical simulation for an international trauma life support course. Prehosp Disaster Med, 27(1), 27-30. ( 2/2012 - Present ) Link...
    BACKGROUND: High fidelity medical simulators (HFMS) are accepted tools for health care instruction. The use of HFMS was incorporated into an International Trauma Life Support course, and course participants were surveyed regarding attitudes toward HFMS. METHODS: Course participants, including physicians, nurses, and prehospital personnel, were given pre- and post-course questionnaires measuring their confidence in knowledge and treatment of trauma resuscitation, as well as their attitudes towards the utility and realism of immersive simulation. The participants were randomly assigned to take a course examination either before or after their simulator session. RESULTS: Thirteen course participants of varying backgrounds and degrees of clinical experience were surveyed and tested. All surveyed areas improved following simulator training, including comfort level with simulation as a training method (17%), perception of the realism of HFMS (15%), and reported self-confidence in knowledge, experience and training in trauma care (27%). Test scores were improved in the post-simulation group as opposed to the pre-simulation group (86% pass rate in the post-simulation test group versus 50% pass rate in the pre-simulation test group). CONCLUSIONS: High fidelity medical simulation was accepted by medical professionals of different backgrounds and experience. Attitudes towards simulation and self-confidence improved after simulator sessions, as did test scores, suggesting improved comprehension and retention of course materials. Further testing is required to validate the findings of this small, observational study.
  • Kim T E, & Smith D D. (2010). Thoracic aortic dissection in an 18-year-old woman with no risk factors. J Emerg Med, 38(5), e41-4. ( 6/2010 - Present ) Link...
    Spontaneous aortic dissection is a rare, life-threatening cause of chest pain, and has a higher prevalence when traditional risks such as age, hypertension, dyslipidemia, or connective tissue disorders are present. However, even in the absence of risk factors, non-traumatic rupture of an aortic dissection may occur. Most are found in patients over 40 years of age. Younger victims of this disease often also suffer from other conditions such as cystic medial necrosis, connective tissue disorders such as Marfan's syndrome, or vasculitis. We present the case of an 18-year-old, previously healthy woman who was country line dancing when she began to complain of severe, cramping chest and back pain. She was hemodynamically stable on initial presentation but experienced two seizures while in the emergency department and was intubated. Subsequently, her blood pressure dropped and she developed cardiac arrest, and despite vigorous resuscitation that included blood products and emergency department thoracotomy, she was refractory to all attempts. At autopsy she was found to have a spontaneous, non-traumatic rupture of an aortic dissection. This patient had no discernable risk factors for aortic dissection or discoverable cause on necropsy. We present this case to raise awareness among physicians and review other reported cases in the literature of aortic dissection in patients under age 40 years.
  Non-Scholarly Journals
  • Klanduch F, Kim TE"Case of the Month: Inferior Vena Caval Thrombosis After Prolonged Travel.." Lifeline : 7 - 8 (*)