• Title/Summary/Keyword: Basic emergency treatment

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A Case of Acute Dapsone Poisoning Complicated with Methylene Blue-induced Hemolytic Anemia (급성 댑손 중독 환자에서 메틸렌블루 치료중 유발된 메트헤모글로빈혈증과 중증 용혈성 빈혈 1례)

  • Lee, Mi-Jin;Park, Kyu-Nam
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.170-174
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    • 2006
  • Methylene blue is a basic thiazine dye frequently used for histologic staining. In clinical toxicology settings, it is also used to treat clinically significant methemoglobinemia. It has dose-dependent oxidation or reduction properties, acting as a reducing agent at lower doses and as an oxidizing agent at higher doses. Hemolytic anemia and hyperbilirubinemia are known toxic effects of methylene blue treatment that have been reported clinically. A 42-year-old woman developed significant methemoglobinemia after acute dapsone overdose; she was treated appropriately with intravenous methylene blue in the therapeutic range. The patient's methemoglobin levels returned to normal. However, 2-4 days later she was noted to have rebound methemoglobinemia, hemolytic anemia, and hyperbilirubinemia. A repeat of Coomb's test and other anemia workups were negative. For management of methylene blue-induced hemolytic anemia, she was administered steroid therapy, N-acetylcysteine, and a blood transfusion. She ultimately recovered, and there were no long-term sequelae from the methylene blue poisoning.

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The Work and Job Satisfaction of Paramedics in the Emergency Room of University Hospitals (대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도)

  • Lee, Ok-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.47-63
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    • 2011
  • Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

A Study on the Nursing Profession as Stipulated by Health & Medical Laws of Korea (우리나라 보건의료법령에 명시된 간호에 관한 연구)

  • Kim, Eun-Young
    • Research in Community and Public Health Nursing
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    • v.8 no.1
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    • pp.116-132
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    • 1997
  • The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.

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A Study on the Spatial Configuration for Regional Trauma Center in Korea by Using Space Syntax (공간구문론을 이용한 국내권역외상센터 공간구성에 관한 연구)

  • Park, Su-Roh;Park, Jae-Seung
    • Korean Institute of Interior Design Journal
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    • v.26 no.6
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    • pp.172-179
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    • 2017
  • The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

Factors Affecting Burnout of Staff in Emergency Medical Service (Focusing on 119 rescuers in Busan and Gyeongnam) (응급의료종사자의 소진 영향요인 (부산, 경남 지역 119구급대원 중심으로))

  • Hong, Hui-Jeong;Sung, Mi Hae
    • Korean Journal of Occupational Health Nursing
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    • v.21 no.2
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    • pp.164-173
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    • 2012
  • Purpose: This study aims to investigate the degree of burnout of 119 rescuers, to determine factors influencing their burnout, and to provide basic data for development of intervention programs to prevent the burnout. Methods: Subjects of this study were all 119 rescuers working at fire stations located in Busan and Gyeongnam. The data were collected from May 1, 2010 to June 30, 2010. The collected data were analyzed with SPSS/WIN 17.0. Results: When the difference in the degree of burnout by general characteristics was investigated, the means of burnout were significantly different depending on age, period of service, position, license, annual salary, desire to work continuously and types of working hours. Job stress, job satisfaction, social support, self efficacy and self esteem showed a statistically significant correlation with burnout. The degree of burnout became higher with more job stress and lower job satisfaction, social support, self efficacy and self esteem. As a significant factor affecting the degree of burnout of 119 rescuers, job stress showed 47.3% of explanatory power. The explanatory power of all of job stress, job satisfaction, self efficacy, types of working hours, annual salary and license was 62% and the power of job stress was the highest. Conclusion: From these results, job stress, job satisfaction and self-efficacy were found to be factors affecting the burnout of 119 rescuers. Therefore, intervention programs to reduce job stress and to improve job satisfaction, social support, self efficacy and self esteem should be developed to lower the degree of burnout of 119 rescuers. In addition, further researches to analyze works of 119 rescuers and legal and institutional strategies to improve their treatment are necessary and supplementary training in various practices by different circumstances based on standardized protocols should be conducted.

A Study on knowledge and attitude in freshmen of an university about HIV/AIDS (일부 대학 신입생의 에이즈에 대한 지식 및 태도)

  • Kim, Jin-Hue
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.2
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    • pp.63-76
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    • 2006
  • This study was designed to get basic data about AIDS educational program development of students of university, especially for students of the department of Emergecy Medical Technology. The objective of this study was to identify the level of AIDS related Knowledge and Attitude of freshmen of university. The subject for this study consisted of 2022 male and female students who entered in 2005to Gongju National university in Chungnam province. Data was colledted by self-reporting questionaire consist of 66 items on 20th, February, 2005. The findings of this study can be summarized as follows. 1) The mean overall knowledge score was estimated to be 70.22%. 2) The knowledge score about definition of AIDS was high(93.2%). but knowledge score about progression and incubation period was low(48%). 3) AIDS related knowledge about diagnosis with blood was was high(91.2%), but those about period of antibody formation was relatively low(66.2%). 4) The score about latent appearance of AIDS-related symptoms was hlgh(93.7%), but those of apprehension of individual symptom was very low(57.5%). 5) Percentage of correctly answered respondent about transmission with needle and transfusion was very high(>94%), but the score of transmission through the anal and oral sex was relatively low(75-79%). 6) The knowledge score about prevention with condom was high(89.5%), but misconception of disinfection and vaccination was also high. 7) Acknowledgement about utility of consultation, information, treatment was very low (10-17%). In the end, the study concludes that it is necessary to develop comprehensive AIDS education programs to improve knowledge about the disease as well as to allay the fears and anxiety of the contact.

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Dental hygienist's knowledge measurement tool for emergency treatment related to systemic disease (치과위생사의 전신질환과 관련된 응급처치 지식 측정도구 개발)

  • Yoon, Yong-Ha;Lee, Jung-Hwa;Noh, Hie-Jin;Han, Sun-Young;Mun, So-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.22 no.2
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    • pp.133-142
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    • 2022
  • Objectives: This study was conducted by clinical dentistry hygienists to develop knowledge measurement tools and evaluate knowledge necessary to cope with emergencies related to systemic diseases occurring in dentistry. Methods: Basic questions were developed on the six most frequently occurring diseases in the dental office: diabetes, syncope, respiratory disease, coronary artery disease, cerebrovascular disease, and epilepsy. Fifty-eight preliminary questions were composed in a survey format through expert validation. The survey was then conducted on 290 dental hygienists to verify the composition validity and reliability. Factor and reliability analyses were performed using the SPSS 23.0 program, and the correct answer rate for each question was calculated. Results: 49 items of a total of 13 factors were adopted as the final items for signs, symptoms, prevention and treatment of five diseases. The question with the highest percentage of correct answers for each question was "Slowly set up the unit chair when raising the patient"(97.9%) during the prevention of unconsciousness and question with the lowest correct answer rate was "soft substances such as cloth should be put in the mouth to prevent trauma while the seizure persists" (16.6%). Conclusions: A total of 49 questions have been developed as tools to measure the knowledge of dental hygienists' first aid related to systemic diseases and it is expected that related curriculum can be operated or evaluated by using them.

Clinical Studies on 56 Cases of Having Treated patients suffering from Ischemic Stroke through both Urokinase and Therapeutics of Oriental Medicine (Urokinase와 동의학적요법(東醫學的療法)으로 동시치료(同時治療)한 허혈성뇌졸중환자(虛血性腦卒中患者) 56례(例)에 대(對)한 임상적(臨床的) 연구(硏究))

  • Kim, In-Sup
    • The Journal of Korean Medicine
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    • v.15 no.2 s.28
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    • pp.46-91
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    • 1994
  • l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

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The Study on Improving Medical Care Service by Analyzing the Time While the Homeless Patients Length of Stay Emergency Medical Institution (행려환자의 응급의료기관 체류시간 분석을 통한 의료서비스 개선방안에 대한 연구)

  • Lee, Jin-Woo;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.11 no.10
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    • pp.619-627
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    • 2013
  • This study reviews the time while the homeless patients Length of Stay emergency medical institution according to their medical treatment when they visit a hospital and characteristics of pathogenesis to understand the related factors affecting the case. Such review aims at providing basic data and information on how to improve medical care services of our society. 691 homeless patients visited an emergency medical care institution in Chungnam-si for one year from January 1, 2012 until December 31, of the same year were surveyed. Methods adopted were the analysis of frequency, ANOVA, correlation analysis and multiple regression analysis was conducted by making an independent variable as a dummy. This study came to a conclusion that first of all a medical care institution is required to avoid negative awareness and it should provide the homeless patients with medical care of better quality, having emergency care support system. Second, as most of the homeless patients are in their 40 or 50's, they are still in the age of high productivity of our society. Therefore, proper policy should be established and managed by the government on the program for their returning to the society as well as providing them with better medical care and support.

Analysis of Risk Factors for Complication after Hip Fracture Surgery in the Elderly According to Geriatric Interdisciplinary Team Care and Orthopedic Care (노년내과와 정형외과의 협진 여부에 따른 노인의 고관절 골절수술 후 합병증 발생 위험 요인분석)

  • Park, Eun Young;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.18 no.4
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    • pp.193-202
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    • 2016
  • Purpose: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. Methods: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. Results: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. Conclusion: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.