• Title/Summary/Keyword: 병원전처치

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고령 위암 환자에서 술 후 처치 및 영양지원

  • 김인호
    • Journal of Gastric Cancer
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    • v.2 no.3
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    • pp.127-132
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    • 2002
  • 1) 병원에 입원하는 환자들 중 상당수에서 어느정도의 여양실조가 있는 것으로 보고되므로 수술하기 위해 입원하는 환자에서 영양과 관계있는 측면에서 병력청취 및 이학적 검사상 약 6개월간 평소체중의 $10\%$ 이상 감소, 혈장단백(알부민,트란스페린) 저차, 총임파 구수감소 등이 있으면 철저한 영양평가를 시행하여 중등도 이상의 위험군에서는 술 전 약 $7\∼10$일간 영양지원을 하는 것이 약 $10\%$의 술 후 합병증을 줄이는 것으로 보고되나 이는 수술의 스트레스 정도, 술 후 영양섭취 지연의 기간 및 정도 및 수술의 응급여부에 의해 결정한다. 2) 영양지원이 결정되면 그 경로는 경장이 좋으며 그것이 안될 때 정맥영양을 시행한다. 3) 술 전 영양지원을 받지않은 중등도 이상의 영양실조 환자에서 술 후 조기 영양지원에 대한 연구에서는 TPNrns에서 대조군보다 오히려 약 $10\%$의 합병증 발생률이 높다. 4) 영양실조가 없는 환자에서도 술 후 약 7일 이상의 금식이 예상되면 TPN을 시행하는 것이 좋다.

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고령위암 환자에서 술 후 처치 및 영양지원

  • 김인호
    • 대한위암학회:학술대회논문집
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    • 2002.04a
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    • pp.53-60
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    • 2002
  • 1. 병원에 입원하는 환자들 중 상당수에서 어느정도의 영양실조가 있는 것으로 보고되므로 수술하기 위해 입원하는 환자에서 영양과 관계있는 측면에서 병력청취 및 이학적 검사상 약 6개월간 평소체중의 $10\%$ 이상 감소, 혈장단백(알부민, 트란스페린 등) 저하, 총임파 구수감소 등이 있으면 철저한 영양평가를 시행하여 중등도 이상의 위험군에서는 술 전 약 $7\~10$일간 영양지원을 하는 것이 약 $10\%$의 술 후 합병증을 줄이는 것으로 보고되나 이는 수술의 스트레스 정도, 술 후 영양 섭취 지연의 기간 및 정도 및 수술의 응급여부에의 해 결 정한다. 2. 영양지원이 결정되면 그 경로는 경장이 좋으며 그것이 안될 때 정맥영양을 시행한다. 3. 술 전 영양지원을 받지않은 중등도 이상의 영양실조 환자에서 술 후 조기 영양지원에 대한 연구에서는 TPN군에서 대조군보다 오히려 약 $10\%$의 합병증 발생률이 높다. 4. 영양실조가 없는 환자에서도 술 후 약 7일 이상의 금식이 예상되면 TPN을 시행하는 것이 좋다.

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A Study on Civil and Criminal Liabilities of 119 Rescue and Its Legal Protection (공무원인 119구급대원의 직무수행과 관련하여 발생할 수 있는 민$\cdot$형사상 책임과 그에 따른 법적 보호를 위한 대책에 관한 연구)

  • Bae Hyun-A;Yun Soon-Young;Jung Koo-Young;Lee Kyung-Whan;Kim Chan-Woong
    • Fire Science and Engineering
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    • v.19 no.2 s.58
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    • pp.45-62
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    • 2005
  • This thesis has defined the legal status of 119 rescue who plays a major role in the Korean prehospital emergency medical system and reviewed the various issues that may occur depending on work related legal liabilities. As a result, the purpose of this study was to represent the countermeasures for legal protection of 119 rescue required for the quality improvement of prehospital emergency medical system and as well as the countermeasures for risk management prepared for its related lawsuits. The legal liabilities of 119 rescue officers can be divided largely into public law liabilities and civil and criminal liabilities. In order to decrease the incidences of legal problems and provide the legal protection to rescue officers, the liability of supervising physician should be emphasized when the emergency medical practice is performed by a rescue officer under their supervision by consolidating medical control and the rescue officer should have legal liability on his emergency medical practice. itself Also, the emergency medical service guideline for 119 rescue officers should be prepared and their works should be performed according to such a guideline and procedures. In addition, the accurate legal documentation on emergency medical system from on-site to ER and related mobilization should be framed and preserved. Moreover, it is required to enact a new law such as the Good Samaritan Act or the Rescue Officers Protection Act.

Utility of the Dispatch Protocol to Triage the Emergency Patients who presented with Symptoms of Stroke or Chest Pain (흉통 및 뇌졸중 증상 환자에 대한 전화 중증도분류 지침의 유용성)

  • Cho, Suck-Ju;An, Byeung-Ki;Park, Jae-Yong
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.345-355
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    • 2012
  • Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.

The Regional Characteristics of 119 Ambulance Dispatch, the Distance and Response Time to the Scene (119 구급서비스 지역별 출동특성 및 출동거리와 현장도착시간과의 관계)

  • Lee, Kyoung-youl;Moon, Jun-dong;Choi, Eun-sook
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.482-492
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    • 2016
  • Purpose This study is to investigate regional characteristics of 119 ambulance dispatch and the relationship between the distance and response time to the scene. Methods This study was retrospectively conducted 119 running sheets with 1,321 patients who had been transferred to the hospital by 119 ambulance during ambulance attendant training. The training was performed at two, five and three fire station in Seoul, Daejeon and Chungnam respectively, from June 24, 2013 to July 19, 2014. Results Almost the emergency medical services provided were no more than basic first aid in all regions. The patients transferred by 119 ambulance in Seoul were more than other region. The time of call to scene and scene to hospital were the slowest in Chungnam. The major reason of call 119 was due to disease in Seoul and Daejeon, however due to injury in Chungnam. Conclusion Our study suggests that learning from ambulance attendant training course could diverse from region to region. It is, therefore, needed that standardization of ambulance attendant training course, appropriate logistics and resource allocation for providing universal quality of emergency medical services.

Analysis of characteristics of out-of-hospital cardiac arrest patients by region in Chungcheong buk-do (충청북도 내 지역별 병원 전 심장정지 환자의 특성에 대한 분석)

  • Seong Bin Im;Hyeon Mo Yang;Young Jae Kim
    • Smart Media Journal
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    • v.13 no.5
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    • pp.33-44
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    • 2024
  • Chungbuk has various regional characteristics in terms of population composition by region, industrial facilities, and distribution of emergency medical institutions. However, there are no studies yet that have analyzed regional characteristic factors related to the occurrence characteristics of cardiac arrest patients. Therefore, this study provided basic data to establish a response system for OHCA patients suitable for the characteristics of the Chungcheongbuk-do region by analyzing the characteristics of OHCA patients and the transfer status of 119 paramedics in Chungcheongbuk-do. This study is a retrospective study that analyzed 1,188 cardiac arrest patients transferred by ambulance based on raw data from the survey on acute cardiac arrest in Chungbuk (2020). There are a total of 11 emergency medical institutions in Chungbuk-do, which are concentrated in city-level areas, so the transfer time of patients to hospitals in county-level areas was delayed. In the county-level area, the frequency of dispatch of special paramedics was relatively small, and the frequency of administration of cardiac arrest drugs to help resuscitate cardiac arrest patients was also low. In conclusion, efforts should be made to improve accessibility of emergency medical services (deployment of emergency vehicles in marginal areas, proper placement of emergency medical institutions, etc.), to promote prevention of traumatic cardiac arrest patients, and to expand the scope of work to strengthen the first aid expertise of paramedics.

Long-term effects of chlorhexidine varnish treatment on microbial changes of dental plaque in orthodontic patients with fixed appliances (Chlorhexidine varnish 처치 후 고정식 교정장치 장착 환자의 치태내 균주 변화 양상에 대한 장기간 관찰 연구)

  • Chang, Young-Il;Yang, Won-Sik;Nahm, Dong-Seok;Kim, Tae-Woo;Baek, Seung-Hak
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.335-342
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    • 2000
  • The authors observed the long term effects of chlorhexidine varnish treatment on microbial change of dental plaque in orthodontic patients with fixed appliances. The initial sample was 100 patients who were arranged to be treated with fixed orthodontic appliances. The final sample consisted of 21 patients who could be traced for 32 weeks after application of fixed orthodontic appliances. They were classified into the experimental group (12 patients) and the control group (9 patients). The experimental group was treated with chlorhexidine varnish once a week for 4 weeks before application of fixed orthodontic appliance. The control group was not treated with chlorhexidine varnish before application of fixed orthodontic appliance. The experimental group was treated once more after 20 weeks. The microbial changes of dental plaque were analysed by indirect immunofluorescence technique at pre-treatment, post-treatment 4, 8, 20, and 32 weeks. The results were as follows. 1. In the experimental group, streptococus mutans was significantly suppressed during experimental period. (p<0.01) But, in the control group, streptococcus mutans was significantly increased after placement of fixed orthodontic appliances during experiment period. (p<0.05) 2. Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, md Actinomyces naeslundii did not show significant change between the experimental and the control group during experiment period. So, if we treat the orthodontic patients with chlorhexidine varnish before application of fixed appliances, we may suppress the major cariogenic bacteria, Streptococcus mutans, selectively for long period.

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A Research of Prehospital 119 Emergency Medical Service for Stroke Patients (병원 전 뇌졸중 환자의 구급의료 실태 분석)

  • Song, Hyun-Mok;Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.26 no.3
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    • pp.14-20
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    • 2012
  • This study analyzes the influencing factors of prehospital 119 Emergency Medical Service for Stroke Patients in prehospital. From July, 2010 to June, 2011, 123 patients were diagnosed with Stroke in Emergency Medical Center. Among 123 patients, the prehospital assessment rates were as follows : blood pressure checked 73.2 %, pulse checked 73.2 %, respiratory checked 64.2 %, $SpO_2$ checked 79.7 %, pupil reflex test 88.6 %, Electrocardiogram checked 14.6 %, blood sugar checked 19.5 %. Prehospital emergency medical care, Oropharyngeal airway insertion 2.4 %, Manual airway maneuvers 17.1 %, endotracheal intubation 2.7 %, oxygen supply 35.4 %, and suction and intravenous fluid therapy 0 %. The property of mental status evaluation by 119 Emergency Medical Service was nearly perfect, but the patients assessment and emergency medical care were not.

Design of Fire-fighting Ambulance Interior (119 구급자동차의 내부 디자인 개발에 관한 연구)

  • Shin, Dong-Min;Park, Min-Jung;Han, Yong-Taek
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.121-129
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    • 2016
  • Ambulances are an important element of pre-hospital emergency medical services, and also an important space for improving the work efficiency of paramedics. Paramedics use the interior environment to maximize the capabilities of the space, but ambulances need to be improved to help with the responsibilities of paramedics. A Seamless space was constructed in accordance with the placement of first-aid emergency medical equipment and drugs, and a patient room was loaded in the interior space of an ambulance. This study was to improve the treatment space of an ambulance to improve the efficiency of work by paramedics The new design provides safety and efficiency for emergency medical services through planning of interior storage suitable for the duties of paramedics and through identification and analysis of the problems in the environment.

Pediatric Outpatient Anesthesia (소아 외래마취의 특성)

  • Seo, Il-Sook
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.145-169
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    • 2001
  • In recent years, health care cost containment concerns have resulted in an increase in outpatient (or same-day) surgery. Many procedures previously performed on an inpatient surgery basis have been shifted to outpatient settings. Anesthesia for outpatient surgery is exactly the same as inpatient anesthesia, except that the primary concern is the selection of patients who can be discharged safely on the day of surgery. The anesthesiologist should have a sound rational basis for choice of pharmacologic agents that are geared to expeditious patient discharge from the hospital. Cost concerns aside, outpatient surgery has many additional advantages in the pediatric setting. It minimizes the length of time the child is hospitalized, decreases separation anxiety, promotes parental involvement in the child's postoperative care in the more congenial environment of home, and decreases risk of nosocomial infection and iatrogenic illness.

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