• Title/Summary/Keyword: 외상중증도

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Analysis of Influence Factors on Ventilator-Associated Pneumonia in Severe Trauma Patients (중증 외상환자의 인공호흡기 관련 폐렴 영향 요인 분석)

  • Park, Bit Na;Kim, Eun Joo
    • Journal of Home Health Care Nursing
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    • v.25 no.3
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    • pp.224-231
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    • 2018
  • Purpose: This study was to analyze the factors affecting ventilator-associated pneumonia with severe trauma patients. Methods: This study conducted from May 1, 2018 to May 31, 2018 based on the medical records of the intensive care unit of a university hospital from May 1, 2017 to April 30, 2018 in Gangwon province. The inclusion criteria were 1) Trauma intensive care unit patient, 2) older than 19 years 3) without pneumonia at the time of admission. The collected data were analyzed using descriptive, correlation analysis, ANOVA, t-tests, $x^2$-tests and regression. Results: The severe trauma patients had a total of 2,877 days receiving ventilator, and nine VAP cases. The overall infection rate was 4.0%, and the VAP incidence rate was 3.13 per 1000 ventilator days. VAP in severe trauma patient affected ICU stay(OR=1.03), mechanical ventilator applied day(OR=1.04). Conclusion: Therefore, the development of an individualized VAP prevention bundle and nursing intervention for patients with trauma will be needed and further studies. In addition, there were no findings regarding the relationship between VAP occurrence and the severity of multiple traumatic injuries, so further studies of these factors should be performed.

Analysis of Nursing Interventions in Trauma-Bay at the Regional Trauma Center for Patients with Severe Thoracic Injuries (권역외상센터 중증 흉부외상환자 대상 외상소생실 내 간호중재 분석)

  • Kim, Dong Mi;Seo, Eun Ji
    • Journal of Korean Biological Nursing Science
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    • v.23 no.2
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    • pp.138-150
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    • 2021
  • Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.

A Study on the Injury Charateristics of Trauma Patients by Madical information -Focused on the Patients in a Regional Emergency Medical center in Gwangju

  • Jeun, Young-Ju
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.11
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    • pp.239-244
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    • 2020
  • The purpose of this study is to provide basic data for injury prevention measures through the risk factors of injury occurrence by comprehending injury characteristics of the trauma patients visiting a regional emergency medical center according to distribution based on external causes and injury severity score. This study was analyzed using SPSS-Window(ver. 20.1) for 2585 trauma patients who visited a regional emergency medical center and the research period is for four months from 1st of September, 2019 to 31th of December, 2019. The following were the results of the research. First, it is shown from the analyzed data that the proportion of males (61.3%) is greater than that of females (38.7%) and the group aged from 20 to 50 had a significantly higher occurrence rate of injury but in terms of injury severity, 50 takes up the great proportion(P<.001). Second, roads and traffic areas (35.1%) were the highest in the place of occurrence of injury(P<.001). Third, the time of injury occurrence was as high as 12-18 hours(35.8%)(P<.001). Fourth, the injury part was highest in the head and face (55.4%)(P<.001). Fifth, the type of injury was higher in open wounds (31.2%)(P<.001). Therefore, it is required to establish detailed injury prevention policies according to the characteristics of injury severity.

Severe Open Ankle Sprain (SOAS): A Case Report (중증 개방성 발목 염좌: 증례보고)

  • Yoon, Sung-Hyun;Hwang, Chang-Hwan
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.25-28
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    • 2014
  • Ankle injury is a very common injury. Especially it is the most commonly injured site in cases sports injuries. However, severe open ankle sprain (SOAS), defined as the tearing of the skin over the torn ligament in the ankle, is extremely rare, and no cases have been reported in Korea. In our center, we encountered a patient with a severe ankle open sprain, so we report and discuss that case.

Traumatic Experiences and Posttraumatic Growth of Nursing Students who were in the Clinical Training (간호학생의 임상실습에서의 외상 경험과 외상후 성장)

  • Sung, Kyung Mi;Park, Sun Ah;Oh, Eun Jin;Lee, Seung Min;Lee, Se-Young
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.489-503
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    • 2018
  • The purpose of this study was to explore traumatic experiences and posttraumatic growth of nursing students who were in clinical training. The data were collected from 490 nursing students at four nursing colleges with clinical training experience more than 1 year, from November 20th 2017 to December 20th. Collected data were analyzed through t-test, ANOVA, and $Scheff{\acute{e}}$ test with the SPSS/WIN 25.0 program, and qualitative data were analyzed by content analysis. 26.5% of the subjects had traumatic experiences in their daily life, 61.2% in the clinical practice. Their posttraumatic growth was scored 2.63 out of 5 on average. The contents of traumatic experiences were 'Violence experienced by medical staff','Negative perception of nursing care','Non-Educational Practical Environment' Clinical practice in a harsh environment, Witness of a serious patient, et al. The findings can be used as important basic data for the development of nursing practice education program for encouraging the posttraumatic growth of nursing students.

Personality Assessment Inventory Profiles of Patients with Mild and Severe Traumatic Brain Injury (경증 및 중증 외상성 뇌손상 환자의 성격평가 질문지 프로파일)

  • Kweon, Seok-Joon;Rho, Seung-Ho
    • Korean Journal of Biological Psychiatry
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    • v.12 no.1
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    • pp.20-31
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    • 2005
  • Objectives:This study was designed to investigate the characteristics of personality changes and emotional distress using the Personality Assessment Inventory (PAI) in patients with traumatic brain injury(TBI), divided into mild (MTBI) and severe (STBI) groups according to the severity of injury. Methods:The subjects were consisted of 25 patients with MTBI, 25 patients with STBI, and 25 normal controls. They were interviewed with the PAI. The data were analyzed by ${\chi}^2$ test, analysis of variance and Tukey test. Results:The results were the followings. First, Negative Impression in validity scales was elevated above cutoff point(T score 70) in both MTBI and STBI groups. Second, the clinical scales of which scores elevated above the cutoff point were Somatic Complaints, Anxiety, Anxiety-Related Disorders, Depression, and Schizophrenia in the MTBI, and Somatic Complaints and Depression in the STBI. Third, the clinical subscales above the cutoff point were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Traumatic Stress, Cognitive Depression, Affective Depression, Physiological Depression, Thought Disorder, and Affective Instability in the MTBI, and Health Concerns, Cognitive Depression, Affective Depression, and Physiological Depression in the STBI. Fourth, Suicide Ideation in treatment scales was the only scale above the cutoff point in the MTBI and the others of the treatment and interpersonal scales in the MTBI and all of these scales of the STBI were not elevated above the cutoff point. Fifth, the scales of which scores showed significant difference between the MTBI and the STBI were Somatic Complaints, Anxiety, Depression, and Suicide Ideation, the subscales were Conversion, Somatization, Health Concerns, Affective Anxiety, Physiological Anxiety, Physiological Depression, and Psychotic Experiences. Conclusion:These results suggest that the patients with MTBI had more somatic and anxiety symptoms, depressed mood, and suicidal ideation than the patients with STBI. These characteristics are generally consistent with clinical observation and findings from previous studies of the patients with TBI, and the PAI seems to be a beneficial adjunctive assessment tool for the evaluation of patients with traumatic brain injury.

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The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion (중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구)

  • Jung, Ho Hyung;Han, Sang Kyoon;Lee, Sung Wha;Park, Sung Wook;Park, Soon Chang;Yeom, Seok Ran;Min, Moon Gi;Kim, Yong In;Ryu, Ji Ho
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.108-114
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    • 2014
  • Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.

A Study on the Spatial Configuration and Area Composition in Severe Trauma Center - Focused on Regional Emergency Medical Center (중증외상특성화센터의 공간구성 및 면적구성에 관한 연구 - 권역응급의료센터를 중심으로)

  • Park, Soroh;Park, Jaeseung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.19 no.3
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    • pp.29-39
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    • 2013
  • Purpose: As emergency medical service fund is further expanded due to amendment of the law on emergency medical services in 2008, Korean government has prepared to intervene in a comprehensive manner to strengthen a trauma treatment system. As a result, it announced a master plan to establish a serious trauma treatment center in 16 areas across the nation. Therefore, this study has attempted to investigate the current status of the serious trauma treatment centers and suggest the goal and improvement plan of future serious trauma treatment centers. Methods: As of 2011, Korea operates 23 emergency cerebrovascular service centers, 23 emergency heart disease centers and 35 severe trauma treatment centers across the country. 12 emergency medical service centers have been chosen among the serious trauma treatment centers. Then, top six (6) centers chosen at Emergency Medical Institute Assessment 2011 by Ministry of Health and Welfare have been selected, and floor layout and spatial allocation by usage have been reviewed and analyzed. Results: Consequently, this study has investigated the spatial components, circulation layout and spatial allocation of a serious trauma treatment. For construction planning in consideration of the fundamental objectives and goal of emergency medical services, it is essential to allot spaces and select exact spatial components. It appears that it is necessary to design spaces for emergency medical services and come up with construction planning through appropriate spatial allocation.

A study on the usefulness of a fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT of severely injured patient (중증외상환자 CT 검사 시 검사보조자의 방사선피폭 경감을 위한 융합적 망토 차폐체의 유용성 연구)

  • Seo, Sun-Youl;Han, Man-Seok;Kim, Chang-Gyu;Jeon, Min-Cheol;Kim, Yong-Kyun;Kim, Gab-Jung
    • Journal of the Korea Convergence Society
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    • v.8 no.9
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    • pp.211-216
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    • 2017
  • The purpose of this study is to evaluate the usefulness of a newly fusion model designed cloak shield to reduce the radiation exposure of the assistant during CT(computed tomography) of severely injured patient. Radiation dose was measured in the heart, both axillary and thyroid areas using newly designed cloak shield and existing shield with head phantom and human phantom under the same conditions as brain vascular CT scan. The newly designed cloak shield was measured higher for radiation shielding rate than the existing shields, 61.9 % for heart, 46.2 % for left axillary, 69.8 % for right axillary and 71.1 % for thyroid gland, respectively. a newly developed fusion model of cloak shields are useful for reducing radiation exposure. It is expected to make a significant contribution to reduction of radiation exposure.

Accident Detection System for Construction Sites Using Multiple Cameras and Object Detection (다중 카메라와 객체 탐지를 활용한 건설 현장 사고 감지 시스템)

  • Min hyung Kim;Min sung Kam;Ho sung Ryu;Jun hyeok Park;Min soo Jeon;Hyeong woo Choi;Jun-Ki Min
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.5
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    • pp.605-611
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    • 2023
  • Accidents at construction sites have a very high rate of fatalities due to the nature of being prone to severe injury patients. In order to reduce the mortality rate of severely injury patients, quick response is required, and some systems that detect accidents using AI technology and cameras have been devised to respond quickly to accidents. However, since existing accident detection systems use only a single camera, there are blind spots, Thus, they cannot detect all accidents at a construction site. Therefore, in this paper, we present the system that minimizes the detection blind spot by using multiple cameras. Our implemented system extracts feature points from the images of multiple cameras with the YOLO-pose library, and inputs the extracted feature points to a Long Short Term Memory-based recurrent neural network in order to detect accidents. In our experimental result, we confirme that the proposed system shows high accuracy while minimizing detection blind spots by using multiple cameras.