• Title/Summary/Keyword: Emergency Department

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The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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Two Cases of Intoxication with Phentermine (Phentermine 과량복용 2례)

  • Ku, Jae Eun;Joo, Young Seon;You, Je Sung;Chung, Sung Phil;Lee, Hahn Shick
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.35-38
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    • 2014
  • Phentermine has been widely used as an appetite suppressant since 2004 in Korea. The authors experienced two cases of acute phentermine overdose and report with the literature review. A 36-year-old man and a 24-year-old woman presented together to the emergency department with taking 13 tablets (390 mg) of phentermine 16 hours ago. They had tachycardia, hypertension and complained visual symptoms, nausea, insomnia and anxiety. These symptoms were resolved by conservative management.

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Epidemiologic Characteristics of Intentional Poisoning: Emergency Department Based Injury in-depth Surveillance During 2011-2015 (의도적 중독으로 응급실을 방문하는 환자들의 특성: 2011-2015년 응급실 손상환자 심층조사 분석)

  • Lee, Hak Soo;Han, Juhee;Kim, Ji Hoon;Kim, Sunpyo;Kim, Sun Hyu;Lee, Ji Sook;Cho, Gyu Chong;Han, Chul;Park, Joon Min;Chung, Sung Phil;Kim, Min Joung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.2
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    • pp.131-139
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    • 2017
  • Purpose: The purpose of this study was to investigate the epidemiologic characteristics of patients who visited emergency departments (EDs) after intentional poisoning in Korea. Methods: This study retrospectively analyzed the data of of 23 hospitals during a five-year period, between 2011 and 2015. We included patients who inflicted injury to themselves - attempt of suicide - by means of poisoning. Results: A total of 18,121 patients visited an ED after intentional poisoning. Among them, 58.3% were females; however, there were more males among those aged 60 years or older. The mortality rate for males was 8.6%, which was 3.1 times higher than that for females with 2.8%. The most common poison was pesticides (35.4%) in males and sedative-hypnotics (44.0%) in females. The most common causative agent of death was pesticide in both sexes (75.2% and 65.3%, respectively). Since the production of paraquat was discontinued in 2011, the number of deaths from pesticide poisoning has decreased. The mortality rate declined in both males and females, from 12.6% and 4.5% in 2011 to 7.1% and 2.1% in 2015, respectively. Conclusion: In this study, we analyzed the epidemiologic characteristics of intentional poisoning, especially the frequency of suicide attempts by gender and age group, the cause of suicide, and the causative agent. This can be used as basic data for establishing policies to reduce and prevent suicide attempts by poisoning.

Satisfaction Gaps among Physicians, Nurses, and Patient Family in the Emergency Department (응급실 서비스 만족도에 대한 환자 가족의 평가와 의료진의 인식 차이)

  • Kang, Kyunghee
    • Health Policy and Management
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    • v.23 no.2
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    • pp.145-151
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    • 2013
  • Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

Acute Pneumonitis Induced by Intravenous Thinner Injection in a Case of Suicidal Attempt (시너(Thinner) 정주로 발생한 급성 폐질환 1례)

  • Lee, Hae Ji;Choi, Byung Ho;Kim, Mi Jin;Hong, Jung Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.33-35
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    • 2015
  • A 24 year-old man attempted suicide by injection of 1 cc of thinner into his left antecubital vein; 3 hours later, he visited our emergency room because of left chest pain. We suspected a chemical pneumonitis based on the abnormal findings of his chest X-ray and computed tomography. On the 3rd day after admission, a cellulitis also occurred at the injection area. His symptoms were relieved after supportive care for 2 weeks. There is significant experience with intoxication of thinner inhalation, whereas intoxication of intravenous thinner is rare.

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Emergency Nurses' Perception and Performance of Tuberculosis Infection Control Measures (응급실 간호사의 결핵감염관리에 대한 인식과 수행)

  • Kim, Soo-Jung;Kang, Ji-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.3
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    • pp.351-361
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    • 2010
  • Purpose: The purpose of this study was to investigate the perception and performance of tuberculosis infection control measures among emergency department nurses. Methods: A structured questionnaire was administered to a convenience sample of 227 emergency department nurses from 20 hospitals in B City. Results: The mean perception score was 4.52 out of a possible 5, and the mean performance score was 3.31 out of a possible 5. There were big differences between the perception and performance score on the items regarding wearing a gown or mask, while there were small differences on the items regarding dealing with patients' articles or medication. Conclusion: Emergency nurses showed high perception and low performance score on the items related to facilities and regulation such as visitation restriction or patient isolation. There was a positive correlation between perception and performance score. Conclusion: For emergency nurses, perception is higher than performance of tuberculosis infection control measures. The findings indicate the importance of providing continuing education for emergency nurse professionals seeking to update and increase their knowledge and to develop evidence-based nursing protocols on tuberculosis infection control in emergency department.

The Disaster Preparedness and Professional Quality of Life among Nurses in Emergency Rooms of Regional Emergency Medical Center

  • Lee, Min-Hee;Kim, Kye-Ha
    • Journal of Integrative Natural Science
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    • v.11 no.4
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    • pp.184-191
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    • 2018
  • The purpose of this study was to investigate the disaster preparedness and professional quality of life among nurses in emergency departments. The participants in this study were 56 nurses in emergency departments in two cities. The data were collected by questionnaires survey from January to August 2016. All statistical analyses were performed using SPSS ver. 23.0 program. Participants' disaster preparedness was different according to position (t=-2.32, p=.004), type of working (t=-2.32, p=.004), and frequency of traumatic events (F=5.26, p=.009). There were significant differences by gender (t=2.88, p=.006), desire for continuous work in the emergency room (t=2.95, p=.005), and job satisfaction (F=10.81, p < .001) in compassion satisfaction. Burnout was different according to gender (t=-2.05, p=.045), choice of an emergency department (t=-2.37, p=.021), desire for continuous work in the emergency room (t=-2.31, p=.025), and job satisfaction (F=11.99, p < .001). Disaster preparedness and compassion satisfaction had positively significant correlations. Compassion satisfaction of nurses in emergency department was an important variable that should be considered to improve their disaster preparedness.

Edge Computing-Based Medical Information Platform for Automatic Authentication Using Patient Situations

  • Gyu-Sung Ham;Mingoo Kang;Suck-Tae Joung;Su-Chong Joo
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.17 no.4
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    • pp.1049-1065
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    • 2023
  • Recently, with the development of IoT, AI, and mobile terminals, medical information platforms are expanding. The medical information platform can determine a patient's emergency situation, and medical staff can easily access patient information through a mobile terminal. However, in the existing platform, emergency situation decision is delayed, and faster and stronger authentication is required in emergency situations. Therefore, we propose an edge computing-based medical information platform for automatic authentication using patient situations. We design an edge computing-based medical information platform architecture capable of rapid transmission of biometric data of IoT and quick emergency situation decision, and implement the platform data flow in emergency situations. Relying on this platform, we propose the automatic authentication using patient situations. The automatic authentication protects patient information through patient-centered authentication by using the patient's situation as an authentication factor, and enables quick authentication by automatically proceeding with mobile terminal authentication after user authentication in emergencies without user intervention. We compared the proposed platform with existing platforms to show that it can make quick and stable emergency decisions. In addition, comparing the automatic authentication with existing authentication showed that it is fast and protects medical information centered on patient situations in emergency situations.

Difference of visiting time and major cause of disease by operating time changes of a university dental emergency room (일개 치과대학병원 응급실 운영시간 변경에 따른 환자의 방문시기와 주요상병의 차이)

  • Noh, Hie-Jin;Mun, So-Jung;Jeon, Hyun-Sun;Bae, Sung-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.4
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    • pp.661-669
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    • 2015
  • Objectives: The purpose of the study is to investigate of visiting time and major cause of disease by operating time changes of a university dental emergency room. Methods: This study was a retrospect study carried out by reviewing 9,172 records visiting the university emergency room from January 1997 to December 2009. Data were analyzed by frequency test, chi-square test, and logistic regression using SAS version 9.3. Results: Twenty four hours emergency room had 19 percent more patients than those in daytime emergency room. Daytime emergency room had more male patients during spring(26.6%) and winter(20.2%) than female patients(p<0.05). Female patients exceeded male patients during summer(24.4%) and autumn(36.2%)(p<0.05). Twenty-four hours emergency room had the maximal patients in autumn and the minimal patients in winter(p<0.05). The most common injury in the daytime was tooth fracture from 0 to 19 years old(p<0.05). Tooth fracture, jaw fracture, and soft tissue injury were the most common injury in dental emergency room and majority of the patients were the male(p<0.05). Conclusions: Twenty-four hours dental emergency room had a variety of causes of dental emergency thant that in the daytime. Twenty four hours dental emergency room must be prepared for the dental emergency patients at any time provided with personnel and facilities.

Influencing factors of prevention practices against infection exposure among emergency medical technicians in emergency rooms (응급실 응급구조사의 감염노출 예방행위 수행정도에 영향을 미치는 요인)

  • Sim, Kyung-Yul;Kim, Jee-Hee;Lee, Hyo-Cheol;Kim, Chul-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.1
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    • pp.21-34
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    • 2018
  • Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in emergency rooms. Methods: A self-reported questionnaire was filled out by 100 EMTs in emergency rooms from June 1 to August 31, 2017. The questionnaire consisted of items concerning the defensive environment for the prevention of infection exposure, perception of preventive behavior, and degree of performance of preventive actions against infection based on a five-point Likert scale. Data were analyzed by descriptive statistics, ${\chi}^2$ test, ANOVA, Pearson's correlation coefficients, and linear regression. Results: The defensive environment for the prevention of infection exposure was 4.12. The perception of preventive action was 4.71, and the degree of performance of preventive actions against infection was 4.54. There was a significant relationship between the degree of performance of preventive actions against infectious exposures and the degree of perception of preventive behavior(r=.506, p=.01) and prevention of infectious exposure(r=.506, p=.01). The protective environment(B=.360, t=3.236, p=.002) and perceived level (B=.904, t=4.662, p=.000) were influenced by the degree of prevention of infection exposure. Conclusion: It is important to manage the protection environment for infection exposure prevention and to enhance the awareness of infection prevention actions against infection exposure among the EMTs in emergency rooms.