• Title/Summary/Keyword: 외상환자

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A Convergence Study on the Characteristics of Length of Hospital Stays of Injured and Traumatic Death Patients - Based on the Korea National Hospital Discharge Injury Survey Data (손상 및 외상 사망 환자의 재원일수 특성에 관한 융합 연구 -퇴원손상심층조사자료를 중심으로)

  • Song, Yu-Rim;Lee, Moo-Sik;Kim, Doo-Ree;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.8 no.5
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    • pp.87-96
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    • 2017
  • This study was carried out to provide basic data for prevention of death from injuries and traumas by analyzing the characteristics of length of hospital stay of patients with injuries and traumas, utilizing in-depth investigation data of discharged injuries. The study subjects were 233 patients discharged from January 1 to December 31 in 2014 whom the final treatment result was 'death' and the main diagnosis were injuries and accidental external causes(S00-T98). According to the research findings, the length of hospital stay of females was longer than that of males. Based on the main diagnosis, the longest length of hospital stay had complication of other internal prosthetic devices, implants and grafts(T85). In conclusion, it is necessary to develop a policy to identify the factors affecting the length of hospital stays of patients and to manage them intensively.

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
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    • v.25 no.5
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    • pp.21-31
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    • 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.

Arthroscopic Bankart Repair using Suture Anchors (봉합나사를 이용한 Bankart 병변의 관절경적 봉합술)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Shin, Sang-Howa;Kwak, Jong-Ill
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.173-177
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    • 2006
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint. Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 90 cases and evaluated the results with the functional grading system of Rows and Zarins after patients were followed up for more than 24 months. Results: Combined pathologies identified under arthroscopy were Hill-sachs lesion in 46 cases, SLAP lesion in 12 cases, Rotate cuff lesion in 7 cases. The results were excellent or good in 82(91.1%) cases and redislocation was happened only 3 cases. Conclusion: We concluded that arthroscopic Bankart repair with suture anchors is one of the reliable and effective method for recurrent shoulder dislocation with Bankart lesion.

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급성 후두기관손상 환자의 수술적 치료

  • Tae, Kyung;Jung, Yeon-Ki;Jung, Jin-Seok;Cho, Seok-Hyun; Lee, Seung-Hwan;Lee, Hyung-Seok
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 2003.09a
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    • pp.110-110
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    • 2003
  • 후두기관외상은 두경부 부위의 다른 외상에 비해 흔하지 않은데, 이는 연골의 유연성과 후두의 가동성, 후두가 하악과 흉골사이에 위치하여 외상시 보호 받게 되는 해부학적 특성에 기인한다. 그러나, 후두는 호흡과 발성에 중요한 기관으로 조기 진단과 정확한 평가, 적절한 치료를 못할 경우 생명을 위협 할 수 있고 삶의 질에 지대한 영향을 줄 수 있다. 이에 저자들은 급성 후두기관손상으로 수술적 치료를 받은 환자를 대상으로 손상 기전 및 임상 양상, 손상부위, 손상 정도 치료 등을 알아보고 향후 치료에 도움을 얻고자 하였다. 1996년부터 2003년까지 급성 후두기관 손상으로 수술적 치료를 받은 10명을 대상으로 후향적으로 조사를 하였다. 손상정도는 Schaefer의 분류를 따랐으며 술후 결과는 발성과 기도유지로 평가하였다. 발성의 경우 수상전과 동일하거나 유사할 경우 성공(good)으로, 수상전과는 다르지만 기능을 하는 경우는 양호(fair)로, 거의 음성이 나지 않거나 알아들을 수 없는 경우 불량(poor)로 분류하였고, 기도유지는 수상전과 동일하거나 유사할 경우 성공(good)으로, 경한 흡인이나 운동 유발성 호흡곤란이 있는 경우(fair)로 발관이 되지 않는 경우를 불량(poor)으로 분류하였다. 남녀 성비는 8대 2였고 30~40대가 4명으로 가장 많았다. 손상의 원인은 둔상인 경우(4예) 교통사고가 2례, cloth line 손상 2례, 관통상(6례)는 모두 칼에 의한 좌상이었다 증상은 피하기종이 9례, 애성이 7례, 호흡 곤란이 6례로 많았으며 손상부위는 갑상연골 골절이 5례(50%), 기도손상과 갑상선 손상이 각각 4례에서 관찰되었다. 그 외에도 윤상 연골 골절과 윤상갑상막 손상 등이 관찰되었다. 또한 점막 손상이 7례에서 관찰되었다. 성대마비는 내원시 4례에서 관찰되었다 치료는 수상 후 조기수술을 시행하였고 수상 부위를 개방하여 손상된 연조직을 일차 봉합하거나, 골절을 정복 고정하였고 3례에서 스텐트를 삽입하였다. 술후 기도유지는 모두 성공적이었고 발성기능은 6례에서 성공(good)적이었고 4례에서 양호(fair)의 결과를 보였다. 양호의 결과를 보인 모든 예가 내원시 성대 움직임의 마비나 저하를 보인 예였다. 급성 후두기관손상환자에서 조기 진단과 적절한 수술적 치료는 환자의 생명을 유지시키고 술후 발성 지능의 보존에 양호한 결과를 보였다.

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Prevalence of Emergency Traumatic Injuries in 100 Wild Boar Hunting Dogs (100마리의 야생 멧돼지 사냥견에서 응급 외상성 질환의 분류)

  • Ko, Jae-Jin;Kim, Se-Hoon;Ji, Joong-Ryong;Shim, Kwan-Seob;Kim, Nam-Soo
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.718-722
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    • 2010
  • To investigate patterns and severity of hunting-related emergency traumatic injuries in wild boar hunting dogs. One hundred wild boar hunting dogs with emergency traumatic injuries sustained during wild boar hunting as a result of wild boar attack and accidental shooting of ensnarement in a trap. The retrospective study involved 100 dogs brought to CAMC for treatment of emergency traumatic injury sustained during wild boar hunting in Jeon-buk province from August 2007 to April 2008. Medical information obtained from the medical records included signalment; cause of injury; number, location and severity of injuries; and mortality. The 100 patients displayed 136 injuries (single injury in 71 dogs and multiple injuries in 29 dogs). Causes of the emergency traumatic injuries were wild boar attack (n = 92), accidental shooting (n = 7), and entrapment (n = 1). The thoracic area was the most common site of injury. The most common injury severity score (ISS) was code 2. The mortality rate was 9%, and all deaths involved thoracic injury. Emergency traumatic injuries sustained during wild boar hunting are most commonly thoracic injuries caused by prey attack. The nature of the injuries can differ from those typically encountered by small animal veterinarians.

당뇨병성 족부질환 - 당뇨족

  • Kim, Seong-Yeop
    • The Monthly Diabetes
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    • s.289
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    • pp.37-41
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    • 2013
  • 당뇨 족은 하지 절단의 비외상성 원인의 가장 많은 부분을 차지한다고 합니다. 당뇨 환자에서는 하지를 절단할 가능성이 당뇨가 없는 환자보다 최저 15배에서 최고 46배까지 높다는 보고가 있습니다. 더욱이 당뇨족에 의한 합병증은 당뇨 환자의 입원 이유 중 25%에 이른다는 보고도 있습니다. 대부분의 당뇨 족 환자에서 합병증은 피부 궤양에서 시작되는데 일찍 발견하여 적절히 치료하는 것이 하지 절단을 피하는 것에 있어 매우 중요합니다. 이를 방치하였을 때 하지 절단으로 이어질 수 있는 당뇨 족의 원인 예방, 진단 및 치료에 대해 알아보도록 하겠습니다.

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The Relationship between Psychiatric Consequences and Injury Severity Following Traffic Accidents (교통사고후 외상심각도와 정신과적 증상의 관계)

  • Lee, Moon-In;Park, Sang-Hag;Kim, Sang-Hoon;Kim, Jae-Min;Kim, Hack-Ryul
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.66-75
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    • 2004
  • Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

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The Prognostic Factors of Traumatic Diaphragmatic Rupture (외상성 횡격막 파열에서 예후에 영향을 미치는 인자)

  • Cho, Sukki;Lee, Eung-Bae;Seok, Yang-Ki
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.47-52
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    • 2010
  • Background: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. Material and Method: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. Result: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. Conclusion: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.

OROS Methylphenidate Treatment of Secondary Adult ADHD after Traumatic Brain Injury (외상성 뇌손상 후 이차적으로 발생한 성인 주의력결핍 과잉행동장애에서 OROS Methylphenidate의 치료효과:증례 및 고찰)

  • Lim, Myung Ho;Lee, Woo Chul
    • Korean Journal of Biological Psychiatry
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    • v.12 no.2
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    • pp.221-226
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    • 2005
  • The incidence of the Attention Deficit Hyperactivity Disorder secondary to the traumatic brain injury, such as traffic accidents, is increasing;the variety of the treatment modality is also increasing. This case was studied to see if OROS Methylphenidate(Concerta), which is one of the most commonly used medication in Attention Deficit Hyperactivity Disorder patients, not only improves the patient's attention, but also their impulsivity, hyperactivity and aggression. According to the case result, the medication showed an improvement of the impulsivity, aggression, and attention in the secondary Attention Deficit Hyperactivity Disorder patients after the traumatic brain injury.

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Surgical Treatment of Tracheobronchial Injury due to 81un1 Trauma (둔상에 의한 외상성 기도손상의 외과적 치료)

  • Lee, Seon-Hui;Gwon, Jong-Beom;Choe, Seung-Ho
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.208-212
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    • 1996
  • From 1990 to 1994, 10 patients were treated for tracheobronchial injury due to blunt trauma. 7 injuries resulted from motor vehicle accident. Common presenting signs included subcutaneous emphysema, dyspnea and hemoptysis. The most common radiologic findings were pneumothorax, pneumomediastinum and hemothorax. The fiberoptic bronchoscopy was highly accurate method for the diagnosis. The operation method is simple closure except one patien underwent right pneumonectomy. One patient died because of respiratory distress and 9 patients recovered uneventfully and returned to normal activity. Early recognition and proper treatment of tracheobronchial injury is important.

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