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Factors Influencing on Early Patency Rate of Autogenous Arteriovenous Fistula for Hemodialysis (혈액투석을 위한 자가 동정맥루 수술에 있어서 조기개존율에 영향을 미치는 요인)

  • 민선경;한재진;원태희;안재호
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.342-348
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    • 2004
  • It is very important for hemodialysis in patients with end stage renal disease to obtain vascular access that resists repeated punctures and maintains adequate blood flow. This study was designed to indentify factors that may influence early patency rate of autogenous arteriovenous fistula. Material and Method: 49 cases in 47 patients who underwent radiocephalic fistula formation in our hospital from June 2002 through May 2003 were reviewed and analyzed. Result: The early patency rate was 79.6%. Age, sex, hypertension, and diabetes mellitus were not significant factors for patency. Body mass index and duration of hypertension and diabetes did not influence the early results either. Cephalic vein diameter measured preoperatively and blood flow at radio-cephalic fistula were significantly positive correlative factors. Groups with the vein diameter less than 2.7mm, or with the blood flow less than 100 mL/min had significantly lower early patency rate than the other groups. Conclusion: To improve early patency rate of radiocephalic fistula, large sized cephalic vein should be selected and if the intraoperative flow at radiocephalic fistula is less than 100 mL/min, another arteriovenous fistula formation should be considered.

The Effect of Medication in the Patients with Bee-Sting (약물투여가 벌자상환자에게 미치는 효과)

  • Cho, Byung-Jun;Moon, Soo-Jae;Kim, Seon-Rye
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.350-356
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    • 2015
  • The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

Compared the Causes of Problematic Chemo-Ports According to the Types of Chemo-Ports(Valved, vs. Non-Valved) (Valve포트와 Non-Valved포트 사용에 따른 문제점의 비교 분석)

  • You, In-Gyu;Lim, Cheong-Hwan;Han, Beom-Hee;Jung, Hong-Ryang;Joo, Yeong-Cheol
    • Journal of radiological science and technology
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    • v.34 no.1
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    • pp.35-41
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    • 2011
  • Total implanted central venous port (TIAP, Chemoport) is widely used in oncology patients because it does not require external dressing and restricts patient activity. Chemoport only requires monthly flushes of heparinized saline to keep the patency of the catheter and probably less prone to infectious complications than tunneled catheter. Despite the extensive use of permanent central venous access in oncology patients, there are only few reports about clinical experience of the Groshong catheter. The purpose of this study is to compare the complication rate between the traditional open-ended (non-valved) chemoports and valved chemoports (Groshong catheter connected to TIAP). During 5 years (Jan 2006 to May 2010), 438 patients received chemoport insertion procedure in our interventional radiology department. Among them 30 patients was referred to our department for problematic chemoports. We compared the cause of problematic chemoports between two types of chemoports (valved, vs. non-valved). Valved chemoports had higher referral rates than non-valved chemoports. When there is a need to insert valved port, different method of insertion and maintenance procedure seems to be necessary. More than 20 ml of flusing with heparinized saline after blood sampling could be a good suggestion. Adequate care of chemoport is essential for long patency. Also following the guideline from the manufacturing company is necessary.

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.

A Survey on Prehospital Emergency Medical Service for the Improvement of Acute Coronary Syndrome Assessments - Focus on the Jecheon.Danyans Area - (급성관상동맥증후군 환자의 병원 전 119구급의료서비스 실태 및 개선방안 -충북 제천.단양을 중심으로-)

  • Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.22 no.3
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    • pp.293-299
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    • 2008
  • From January, 2004 to July, 2007, 97 patients were diagnosed with Acute coronary syndrome(ACS) in Emergency Medical Center in Jecheon City in Korea. Among 97 patients, the prehospital assessment rates were as follows ; blood pressure check(27.80%, pulse rate check(33.0%), respiration check(23.7%). In hospital emergency care, oxygen supply was 52.6%, absolute bed rest was 12.4%, electrocardiogram(EKG) check was 4.1%, and nitroglycerin and intravenous fluid therapy was 0%. Therefore, ACS patients have not received sufficient prehospital cares till now. In order to improve the proficiency of the first aid emergency medical technicians(EMTs), it is necessary to provide the continuing On-the-job training(OJT) programs for prehospital emergency care.

A Safe Method of Central Venous Catheterization by Peripheral Venous Cutdown in Infants (소아에서 말초정맥을 이용한 중심정맥로 확보법)

  • Han, Seck-Joo;Choi, Seung-Hoon;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.46-52
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    • 1995
  • Percutaneous infraclavicular subclavian catheterization has been widely used for a total parenteral nutrition, hemodynamic monitoring and for venous access in difficult clinical situations. Many authors have claimed the infraclavicular cannulation of the subclavian vein in the tiniest infants can be performed with safety and ease, but there are always possibility of serious complications in this method. We present our experiences of peripheral venous cutdown with Broviac catheter. Author routinely introduced Broviac catheter into central vein via peripheral venous cutdown. There was no life threatening complications and no catheter related death. The complication rate was very low. The catheter related sepsis was documented in only two patient(4.7%). The average catheter longivity was 19.59 days. In view of the safety and low rate of complication, we think that peripheral venous cutdown with Broviac catheter should be the method of choice when central venous access is necessary in infants. The infraclavicular subclavian catheterization should be reserved in infants with few accessible peripheral vein.

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Upper Gastrointestinal Bleeding in Children (상부 위장관 출혈)

  • Kim, Joon Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.29-34
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    • 2008
  • Upper gastrointestinal bleeding (UGIB) is defined as bleeding in the gastrointestinal tract where the source of bleeding is proximal to the ligament of Treitz. UGIB is uncommon, but a potentially serious lifethreatening problem in children. The clinical manifestation of UGIB in children ranges from asymptomatic microcytic anemia to hypovolemic shock. As the etiology of UGIB varies with age, it is important to be aware of the specific etiologies at different ages when assessing children with UGIB. It is imperative that each child with UGIB be evaluated carefully, including an assessment of the patient's cardiorespiratory status along with other diagnostic studies for determining the underlying cause of bleeding.

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Effect of Observation Window at Peripheral Intravenous Catheter Site on Early Recognition of Infiltration among Hospitalized Children (아동의 말초정맥관 삽입 부위 관찰창 확보가 침윤조기감지에 미치는 효과)

  • Jeong, Ihn Sook;Park, Soon Mi;Park, Kyung Ju
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.534-541
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    • 2016
  • Purpose: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. Methods: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using ${\chi}^2$-test, independent samples t-test and multiple logistic regression. Results: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of $2^{nd}$ stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). Conclusion: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.

The Effect of a Mechanical Chest Compressions for Out-of-hospital Advanced Cardiac Life Support (병원 전 전문심장소생술을 위한 기계적 가슴압박기의 효과)

  • Lee, Hyeon-Ji
    • Journal of Convergence for Information Technology
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    • v.9 no.11
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    • pp.227-233
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    • 2019
  • The purpose of this study is to evaluate the quality of chest compression by conducting comparison research between mechanical chest compressor(LUCAS) and manuale cardiopulmonary resuscitation(CPR) in a out-of-hospital environment and suggest effective advanced cardiac life support using mechanical chest compressors. For this, a out-of-hospital cardiac arrest was simulated with a team of 3 ambulance workers, and manuale CPR and CPR using LUCAS were performed on site and during transport in an ambulance. The research results are as follows: the comparison of manuale CPR between on site and in an ambulance revealed that on-site manuale CPR showed significant differences in the average compression depth, compression rate, and relaxation rate. Second, the comparison between manuale CPR and LUCAS in an ambulance showed significant differences in the average compression depth, compression rate, the number of compression per minute.

Ventricular Tachycardia during Arthroscopic Shoulder Surgery - A Case Report - (관절경하 견관절 수술 시 발생한 심실성 빈맥 - 증례 보고 -)

  • Jo, Seung-Hyeon;Lee, Jin-Ung;Jo, Nam-Su;Lee, Yong-Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.84-84
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    • 2008
  • 최근 견관절 질환의 상당수가 관절경 수술로 이루어지고 있다. 좌체위(beath chair position)를 이용한 관절경 수술은 시술 중 관헐적 방법으로의 전환이 용이하고 공간에 대한 orientation을 쉽게 잡을 수 있어 선호되고 있다. 또한 관절경 수술 시 시야 확보를 위해 epinephrine을 혼합한 세척액이 통상적으로 사용되고 있다. 관절경 수술 시 심부 정맥 혈전증(deep vein thrombosis), 가스 색전증, 세척액에 사용하는 epinephrine에 의한 심실성 빈맥 등과 같은 치명적인 부작용이 가끔 보고되어 있다. 관절경하 견관절 수술 도중 심실 빈맥의 발생은 매우 드문 경우이며 이에 대한 보고도 거의 없는 상태이다. 저자들은 2주의 기간 동안 좌체위로 관절경하 견관절 수술을 하는 도중 갑작스럽게 발생한 심실 빈맥 2예를 경험하였기에 원인 및 치료 과정을 보고하고자 한다. 좌체위로 인한 뇌혈류 저하, 가스 색전증 등의 증세는 없었다. 관절경술 도중 세척액에 투입된 소량의 epinephrine이 동시에 체내로 급속히 유입되어 심실 빈맥이 왔으리라 추정하고 있으며, 실험을 통해 이를 증명하고자 하였다.

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