Journal of Trauma and Injury

  • 제20권1호
  • /
  • Pages.19-25
  • /
  • 2007
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가?

Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims?

  • 이경원 (대구가톨릭대학교 의과대학 응급의학교실)
  • Lee, Kyung Won (Department of Emergency Medicine, School of Medicine, Daegu Catholic University)
  • 투고 : 2007.03.30
  • 심사 : 2007.06.11
  • 발행 : 2007.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

키워드

참고문헌

  1. Spain DA, Miller FB. Education and training of the future trauma surgeon in acute care surgery: trauma, critical care, and emergency surgery. Am J Surg 2005;190:212-7 https://doi.org/10.1016/j.amjsurg.2005.05.014
  2. Daegu Catholic University Medical Center Annual Report 2004. 19th ed. Daegu: Daegun press; 2005. p140-1
  3. Marx JA. The Rightness of emergency medicine. J Emer Med 2004:27:307-12 https://doi.org/10.1016/j.jemermed.2004.06.006
  4. Kim PK, Dabrowski GP, Reilly PM, Auerbach S, Kauder DR, Schwab CW. Redefining the future of trauma surgery as a comprehensive trauma and emergency general surgery service. J Am Coll Surg 2004;199:96-101
  5. Grossman MD, May AK, Schwab CW, et al. Determining anatomic injury with computed tomography in selected torso gun-shot wounds. J Trauma 1998;45:446-56 https://doi.org/10.1097/00005373-199809000-00004
  6. Gracias VH, Reilly PM, Philpott J, et al. Computed tomography in the evaluation of penetrating neck trauma: a preliminary study. Arch Surg 2001;136:1231-5 https://doi.org/10.1001/archsurg.136.11.1231
  7. Gracias VH, Frankel HL, Gupta R. et al. Defining the learning curve for the focused abdominal sonogram for traum (FAST) examination: implications for credentialing. Am Surg 2001;67:364-8
  8. Maull KI. Current status of nonoperative management of liver injuries. World J Surg 2001;25:1403-4
  9. Ovadia P, Szevczyk D, Walker K, et al. Admission pattern of an urban level I trauma center. Am J Med Qual 2000;15:9-15 https://doi.org/10.1177/106286060001500103
  10. Demetriades D, Murray J, Sinz B, et al. Epidemiology of major trauma and trauma deaths in Los Angeles county. J Am Coll Surg 1998;187:373-83 https://doi.org/10.1016/S1072-7515(98)00209-9
  11. Available at: http://www.moleg.go.kr/. Accessed March 29, 2007
  12. Yun SY, Cheon YJ, Won TH. Clinical pattern of penetrating torso injury at emergency department. J Korean Soc Trauma 2005;18:47-52
  13. Yang HJ, Park CW, Lee K. Clinical analysis of posttraumatic deaths at emergency department . J Korean Soc Emerg Med 1993;4:83-90
  14. Lee KJ, Kim YJ, Lee KH, Suh JG, Youn YK. General scheme for the level I trauma center in South Korea. J Korean Soc Trauma 2005;18:1-16