• Title/Summary/Keyword: 비응급

Search Result 272, Processing Time 0.032 seconds

The study of Health Care Utilization and Direct Medical Cost in the Diabetes Mellitus Client (당뇨병 질환자의 의료이용 및 직접의료비 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
    • /
    • v.1 no.4
    • /
    • pp.87-101
    • /
    • 2015
  • This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.

Risk Factors of Morbidity and Mortality after Coronary Artery Bypass Grafting (관상동맥우회로 이식술 후 이환과 사망의 위험요인)

  • 박창률;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
    • /
    • v.31 no.12
    • /
    • pp.1159-1164
    • /
    • 1998
  • Background: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. Material and Method: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery(CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. Result: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6%(9 of 137) with the mortality of 3.9%(5 of 128) for elective operation, and 44.4%(4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men(4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. Conclusion: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.

  • PDF

Is hyperbaric oxygen therapy more effective than normobaric oxygen therapy for improving acute neuropsychologic status due to carbon monoxide poisoning? (고압산소치료가 정상압 산소치료에 비해 일산화탄소 중독의 급성 신경-정신 상태 개선에 더 효과적인가?)

  • Koh, Chan Young;Cho, Hyun Young;Choi, Han Joo
    • Journal of The Korean Society of Emergency Medicine
    • /
    • v.29 no.5
    • /
    • pp.509-518
    • /
    • 2018
  • Objective: The evidence that hyperbaric oxygen (HBO) therapy is more effective for improving the acute neuropsychological status (ANS) of carbon monoxide poisoning than normobaric oxygen (NBO) therapy is not convincing. This is because the levels of carboxyhemoglobin (COHb) do not correlate with the clinical severity of carbon monoxide poisoning and there is no universally accepted severity scale of carbon monoxide poisoning. This paper suggests a new scale for the clinical and neurological severity of carbon monoxide poisoning, called the ANS, and assesses the effect of HBO therapy for each level of ANS compared to NBO therapy. Methods: A total of 217 patients who had been hospitalized because of carbon monoxide poisoning from January 2009 to July 2013 were studied. ANS was suggested as a new severity scale of carbon monoxide poisoning considered in the Glasgow Coma Scale, acute neuro-psychologic signs and symptoms, or cardiac ischemia on the initial medical contact. HBO therapy is indicated in those who have a loss of consciousness, seizure, coma, abnormal findings on a neurological examination, pregnancy, persistent cardiac ischemia, level of COHb >25%, or severe metabolic acidosis (pH <7.2). The end point is the day of discharge, and recovery is defined as a normal neuro-psychological status without any sequelae. Results: The levels of troponin T and creatinine increased significantly with increasing ANS score. In the moderate to severe group (ANS 2 and 3), the recovery rate was significantly higher when treated with HBO therapy than with NBO therapy (P=0.030). On the other hand, the development of delayed neuro-psychological sequelae (DNS) did not correlate with any level of ANS, type of oxygen therapy, or recovery on discharge. Conclusion: In the moderate to severe poisoned group, HBO therapy is more effective for improving the ANS from carbon monoxide poisoning than NBO therapy. On the other hand, the development of DNS of HBO therapy is no more preventable than with NBO therapy. Although the level of ANS is low, the patient needs to be provided with sufficient information and a follow-up visit is recommended for any abnormal symptoms because the ANS does not correlate with the development and degree of DNS.

Prehospital Care of 119 EMT for Non-traumatic Cardiac Arrest and Improvement to Increase Advanced Care Rate (119 구급대원의 비외상성 심정지 환자의 병원전 처치실태 및 전문 처치율 향상을 위한 개선 방안)

  • Lee, Kyoung-Youl;Yun, Seong-Woo
    • Fire Science and Engineering
    • /
    • v.25 no.5
    • /
    • pp.21-31
    • /
    • 2011
  • This study aimed at evaluating and developing 119 emergency medical technicians' prehospital care for non-traumatic cardiac arrest. Total 322 EMT in Chungnam province and Daejeon city filled out the self-administered questionnaire. The data were analyzed by SPSS 18.0 for descriptive statistics. Among the 322 EMT, 309 (97%) and 169(53%) always or almost performed CPR and AED for nontraumatic cardiac arrest patient, respectively. Among the advanced EMT and nurse, IV were sometimes or not performed at 94.7% and medication including epinephrine which commonly used for survival of cardiac arrest were treated just at 9.3 % (14 person). The reason they did not perform each procedure for airway management, AED or IV was lack of manpower, limit of time or joggle of ambulance and legal restrictions. In conclusion, to increase survival rate of non-traumatic cardiac arrest in out-of-hospital, it is necessary to increase manpower, legal protection of EMS, establishment of standard operating procedure, practice for improvement technique and use of medication for ACLS.

Development of Wireless Healthcare System for Emergency Treatment (응급상황을 대비한 무선의료관리시스템 개발)

  • Park, Sung-Chul;Moon, Byung-Hyun;Lim, Byung-Hyun;Hwang, Bum-Suk;Choi, Sang-Min
    • Journal of Korea Society of Industrial Information Systems
    • /
    • v.14 no.5
    • /
    • pp.125-130
    • /
    • 2009
  • Today, the handicapped or old people require continuous care, but there are a lot of practical difficulties. In this paper, the system measuring health conditions of the handicapped or old people (pulse and temperature) is developed. If urgent health conditions occur, measurement values are delivered to doctors or close family members using SMS (Short Message Service) of cellular phone. In the developed system, Pulse rate is measured by sensing bloodstream using high luminance LED and CdS illumination sensors. Body temperature is also measured by contactless temperature sensor. Also, the measured values are transmitted to a server computer using Zigbee communications. Also, the measured values the average of measurements and the time are saved. The wireless healthcare system is designed to help the emergency for the handicapped and old people by using SMS.

Arterial Embolization as the Management of Massive Hemoptysis (대량 객혈 환자에서 동맥색전술의 지혈효과)

  • Kang, Jeong-Seong;Jung, Byung-Hak;Cho, Kyoo-Hye;Chang, Keun;Jeong, Eun-Taik;Roh, Byung-Suk
    • Tuberculosis and Respiratory Diseases
    • /
    • v.40 no.2
    • /
    • pp.165-170
    • /
    • 1993
  • Background: Massive hemoptysis that may induce acute asphyxia can be a fatal problem. Bronchial arteries and other nonbronchial systemic arteries of lungs must be searched by angiography, because they are main source of hemoptysis. Arterial embolization is a well-accepted and widely used for management of massive hemoptysis. This study was designed to evaluate the effectiveness of this method. Method: Prospective analysis was done in 23 cases, that underwent arterial embolization from June 1990 to July 1992. Hemorrhaged arteries were embolized with Gelfoam particles. In cases with severe broad hemorrhagic findings, Coils were added to Gelfoam particles. And they were observed for 6 months at least. Results: Immediate cessation of hemoptysis was achieved in all cases. Recurrent hemoptysis was observed in 7 cases (30%). The patients with nonbronchial artery hemoptysis had increased tendency of recurrence (6/13) than only bronchial artery hemotysis (1/10). The 7 cases treated with Coils had not any recurrence. Conclusion: Arterial embolization in massive hemoptysis is a useful and safe procedure for immediate control. But, the patients with this procedure had a potentiality of recurrence. So diagnostic and therapeutic efforts for underlying causes should be performed.

  • PDF

Emergency Cranial Irradiation Effects in Adult Leukemia with Extremely High Leukocytosis (극심한 백혈구 증다증이 동반된 성인 백혈병에 있어서 응급 두개부 방사선 조사의 효과)

  • Park Seoung-Ho;Cho Moon-June;Kim Samyong
    • Radiation Oncology Journal
    • /
    • v.10 no.2
    • /
    • pp.255-259
    • /
    • 1992
  • We have treated adult acute leukemia 64 patients between January 1990 and October 1991 at the Chungnam National University Hospital. They were examined for the impact of presenting WBC count on the initial course and from them we have chosen twenty patients whose leukocyte count is over one hundred thousands per cubic milimeter, We divided the twenty patients into 4 groups on the base of treatment modalities: conservative therapy only, chemotherapy only, cranial irradiation only, and chemotherapy with cranial irradiation. Early sudden death rate is lower in cranial irradiation with/without chemotherapy groups than the conservative only or chemotherapy only patients. Also the remission rate is high in cranial irradiation with chemotherapy patients. Therefore we suggest that the rapid intervention of cranial irradiation in adult acute leukemia could be helpful in reducing the early sudden death rate and perhaps in increasing the remission rate.

  • PDF

Acute Gastric Dilatation in Rhesus (Macaca mulatta) and Cynomolgus (Macaca fascicularis) Monkeys (Rhesus 및 Cynomolgus 원숭이에서 급성위확장 증례)

  • Lee, Jae-Il;Kang, Byeong-Cheol
    • Journal of Veterinary Clinics
    • /
    • v.25 no.4
    • /
    • pp.314-316
    • /
    • 2008
  • Acute gastric dilatation (AGD), one of the common causes of emergency occurs in macaca monkeys that are accommodated as laboratory-housed nonhuman primates. This report introduces some cases of occurrence in raising primates. The primates revealed an acute gastric dilatation, including the histories that were trained by monkey chair, anesthetized for the study or intact case. The clinical signs were comatose condition with sever abdominal distension, dehydration, cyanosis and apnea. One case died by deterioration of systemic body condition and performed necropsy. The other cases recovered from the AGD by the emergency treatment using the gastric tube and fluid therapy. Necropsy revealed the huge stomach filled with water, gas and ingesta. This report suggests that etiologic factors of AGD may include non-specific factors like these cases, with special emphasis on the incidence and management of AGD in nonhuman primates.

Utilization of Medical Oversight and Related Factors among Some 119 Rescue Workers (119 구급대원의 직접의료지도 이용경험과 관련요인)

  • Joo, Mi Hyun;Han, Mi Ah
    • Fire Science and Engineering
    • /
    • v.30 no.3
    • /
    • pp.124-132
    • /
    • 2016
  • Medical oversight (MO) means the advice and direction provided by a physician to rescue workers who provide medical care or carry patients at the scene of an emergency. The purpose of this study was to investigate the utilization of MO and related factors among some 119 rescue workers in Gwangju. A self-reported questionnaire was completed by 153 rescue workers in these 119 safety centers. The data were analyzed by SAS version 9.3. Overall 82.4% of the subjects utilized MO during the past month. In the multiple logistic regression analysis, the married subjects (OR = 3.87, 95% CI = 1.22~12.27), level 1 emergency medical technicians (OR = 2.87, 95% CI = 1.02~8.09), and subjects who treated cardiovascular emergency patients (OR = 9.19, 95% CI = 1.87~45.08) had significantly higher odds ratios for the utilization of MO. The experience of MO accounted for 82%. The development of strategies and education plans taking these results into consideration will help to improve the utilization of MO.

A Systematic Review of the Variables Related to Post-Traumatic Stress Disorder in Firefighters (소방공무원의 외상 후 스트레스 장애 관련변인에 관한 체계적 문헌고찰)

  • Kang, Min-Ju;Kim, Young-Hwa;Han, Seung-Woo
    • Fire Science and Engineering
    • /
    • v.33 no.2
    • /
    • pp.164-172
    • /
    • 2019
  • This study examined the Post-Traumatic Stress Disorder (PTSD)-related variables of firefighters through a systematic literature review. Electronic databases were searched, including RISS, National Assembly Library, NDSL, KmBase. The search terms were PTSD, Post-Traumatic Stress, Post-Traumatic Stress Disorder and Firefighter. Eleven studies from 146 references screened were included. All studies were non-experimental and correlational analyses. The positive correlation factors were age, duration of work, traumatic events, frequency of mobilization, number and strength of traumatic events experienced, work burden, coping method, D-type personality, depression, and anger rumination. The negative correlation factors were resilience, social support, self-esteem. To improve the mental health of firefighters in the future, professional intervention programs should be constructed to improve resilience, social support, and self-esteem, which are protective factors of PTSD.