• 제목/요약/키워드: 외상중증도

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

  • 박빛나;김은주
    • 가정간호학회지
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    • 제25권3호
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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.

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

  • 김동미;서은지
    • Journal of Korean Biological Nursing Science
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    • 제23권2호
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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
    • 한국컴퓨터정보학회논문지
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    • 제25권11호
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    • pp.239-244
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    • 2020
  • 본 연구는 광주지역 권역응급의료센터에 내원한 환자의 의료정보를 기초로 외상의 중등도별 특성 분석을 통한 손상발생의 위험요소를 파악하여 손상예방대책을 위한 보건예방정책 제언 및 기초 자료를 마련하는데 목적이 있다. 2019년 9월 1일부터12월 31일까지 4개월간 응급의료센터에 내원한 2585명의 환자를 대상으로 손상외인 관련성을 연구의 통계학적 분석을 위하여 SPSS-Window(ver. 20.1)프로그램을 이용하였다. 연구 분석결과는 다음과 같다. 응급의료센터에 내원한 손상 환자 중 전체 2585명 환자에서 성별은 남성(61.3%)이 여성(38.7%)보다 더 많았으며, 20대에서 50대까지의 연령층에서 발생률이 높았으며 중증도를 감안하면 50대(16.8%)의 연령층이 가장 많았다(P<.001). 둘째, 중등도에 따른 손상외인의 발생장소로는 도로 및 교통지역(35.1%)이 가장 높았다(P<.001). 셋째, 중등도에 따른 손상발생의 시간은 12-18시(35.8%)로 높았다(P<.001). 넷째, 중등도에 따른 손상부위는 두부 및 안면부(55.4%)에서 가장 높았다(P<.001). 다섯째, 중등도에 따른 손상 유형은 열린상처(31.2%)에서 높았다(P<.001). 향후 손상에 대한 지속적인 관심과 연구로 외상환자 등 중증도별 특성에 따라 구체적인 보건예방정책 수립이 요구된다.

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

  • 윤성현;황창환
    • Journal of Trauma and Injury
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    • 제27권2호
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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.

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

  • 성경미;박순아;오은진;이승민;이세영
    • 디지털융복합연구
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    • 제16권12호
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    • pp.489-503
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    • 2018
  • 본 연구는 임상실습을 하는 간호학과 학생의 외상 경험과 외상 후 성장에 대해 조사한 연구이다. 자료수집 기간은 2017년 11월20일부터 12월20일까지였으며 대상자는 4개 간호학과에 재학 중으로 임상실습 경험이 1년 이상된 4학년 학생 490명이었다. 자료는 SPSS/WIN 25.0으로 t-test, ANOVA 및 $Scheff{\acute{e}}$ test로 분석하였고, 외상경험은 내용분석법으로 분석하였다. 일상생활 중 외상경험을 한 경우는 26.5%였으나 임상실습 중 외상경험은 61.2%로 높았고, 외상 후 성장 점수는 5점 만점에 2.63점이었다. 외상경험 내용은 의료진의 폭력경험, 간호직에 대한 부정적 인식, 비교육적인 실습환경, 열악한 환경에서의 실습, 중증 환자 목격 등이 있었다. 본 연구의 결과는 향후 간호학과 학생의 외상 후 성장을 돕기 위한 임상실습교육 프로그램 개발의 기초자료로 활용 될 수 있다.

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

  • 권석준;노승호
    • 생물정신의학
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    • 제12권1호
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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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중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구 (The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion)

  • 정호형;한상균;이성화;박성욱;박순창;염석란;민문기;김용인;류지호
    • Journal of Trauma and Injury
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    • 제27권4호
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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.

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

  • 박수로;박재승
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제19권3호
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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.

중증외상환자 CT 검사 시 검사보조자의 방사선피폭 경감을 위한 융합적 망토 차폐체의 유용성 연구 (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)

  • 서선열;한만석;김창규;전민철;김용균;김갑중
    • 한국융합학회논문지
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    • 제8권9호
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    • pp.211-216
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    • 2017
  • 중증외상 환자 CT(Computed Tomography)검사 시 검사 보조자의 방사선 피폭경감을 위하여 새로운 융합적 모델의 망토 차폐체를 제작하여 그 유용성을 평가하고자 한다. 실험 방법으로 뇌혈관 CT 검사와 동일한 조건에서 두부 팬텀과 인체 팬텀을 이용하여 기존 차폐체와 새롭게 개발된 망토 차폐체를 이용하여 심장, 양쪽 액와부 그리고 갑상샘 부위를 유리선량계로 피폭선량을 측정하였다. 새롭게 개발된 차폐체가 기존의 차폐체 보다 방사선 차폐율이 심장 61.9 %, 좌측액와부 46.2 %, 우측액와부 69.8 %, 그리고 갑상샘 71.1 % 로 각각 높게 측정되었다. 새롭게 개발된 망토 차폐체가 방사선 피폭을 감소시키는데 매우 유용하며 향후 새롭게 개발된 융합적 모델의 망토 차폐차가 방사선 피폭을 감소시키는데 있어 큰 기여를 할 것으로 판단된다.

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

  • 김민형;감민성;류호성;박준혁;전민수;최형우;민준기
    • 문화기술의 융합
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    • 제9권5호
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    • pp.605-611
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    • 2023
  • 건설 현장의 사고는 중증외상환자가 발생하기 쉬운 특성 탓에 사망으로 이어지는 비율이 매우 높다. 중증외상환자의 사망률을 줄이기 위해서는 빠른 대처가 필요하며, 빠른 사고 대처를 위해 인공지능 기술과 카메라를 이용하여 사고를 감지하는 시스템들이 개발되었다. 그러나 기존 사고 감지 시스템들은 단일 카메라만을 사용하여, 사각지대로 인해 건설 현장의 모든 사고를 감지하기에 한계가 있다. 따라서, 본 논문에서는 다수의 카메라를 사용하여 감지 사각지대를 최소화하는 시스템을 구현하였다. 구현된 시스템은 다수의 카메라의 영상에서 YOLO-pose 라이브러리로 특징점을 추출하고, 추출된 특징점을 장단기 메모리(Long Short Term Memory) 기반 순환신경망에 입력하여 사고를 감지하였다. 실험 결과, 우리는 제안하는 시스템이 복수의 카메라 사용으로 감지 사각지대를 최소화하면서도 높은 정확도를 가지는 것을 확인하였다.