Background: It is one factor of ambulance call that patients cannot judge themselves whether they should see a hospital. However, it has not been revealed how many cases of ambulance dispatch are present despite of judgement as “low  urgency” by telephone consultation.
Methods: We enrolled the patients who were judged as “low  urgency” and transported to hospital by ambulance from 2013 to 2015 in this study. We calculated the number of ambulance dispatch with low urgency per 1,000 judgement cases every 5 years old and assessed the trend by age group with Joinpoint analysis.
Results: There were 185 ambulance dispatch with low urgency and 23 cases in the 0-4 years old group. On the other hand, Joinpoint analysis showed the large increase since the age of 35-39.
Discussion: Especially in elderly people, they tended to request ambulance despite of judgement as “low  urgency”, it is necessary to establish an access method that can used for 24 hours instead of ambulance.

Bystander CPR (cardiopulmonary resuscitation) is very important factor for OHCPA patients (out-of-hospital cardiopulmonary arrest), but the age of implementation of CPR training differs in each country. We evaluated the effect of education and investigated the proper age of introduction of CPR training after we gave a lecture of CPR training to elementary students (age 10-12). We evaluated 37 students who participated in our kids rescue competition. Their median weight was 34 (30-39) kg. The median depth of chest compression was 30 (25-34) mm. The median rate of compression was 124 (113-132) /min. The median rate of proper recoil was 89 (74-100) %. About the degree of comprehension, they couldn't get reaching point of check the security and breathing. According to the questionnaire, all parents understood how to provide CPR and had interests of first aid. We conclude that elementary students (age 10-12) can understand CPR training. However we need consideration for their physical aspect. We suggest that elementary students (age 10-12) are the proper age of introduction of CPR training.

Press-through packages (PTPs) are widely used to enclose drugs. A number of studies have reported gastrointestinal foreign body and gastrointestinal perforation caused by accidental ingestion of PTPs. An 81-year-old woman presented to our emergency department with a complaint of abdominal pain. Her family was worried that she might have inadvertently swallowed tablets that were still in the PTP. Abdominal computed tomography (CT) revealed intraabdominal free air and detected a high-density object in the small intestine; this suggested the presence of a tablet. Moreover, CT revealed a high-density opacity in the stomach, which was suspected to be a PTP. A diagnosis of perforation of the small intestine and presence of foreign body in the stomach caused by accidental ingestion of two PTPs was established; emergency surgery was performed on the same day. On laparotomy, a perforation caused by PTP was found in the small intestine. The PTP was removed and the perforated portion of the small intestine was surgically restored. Subsequently, the PTP in the stomach was endoscopically removed without complications. There have been few reports on gastrointestinal perforation due to multiple PTPs in the digestive tract. We suggest that in patients with gastrointestinal perforation caused by PTPs, the possibility of presence of multiple PTPs be considered to make a correct diagnosis and determine the appropriate treatment approach.