• Health Policy and Management
• /
• v.19 no.3
• /
• pp.27-44
• /
• 2009

The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.2 no.1
• /
• pp.63-66
• /
• 2004

Hydrofluoric acid (HF), one of the strongest inorganic acids, is used mainly for industrial purpose. Hydrofluoric acid injuries has a potential for both systemic as well as severe local tissue destruction. One of the most serious consequences of severe exposure to HF by any route is marked lowering of serum calcium (hypocalcemia) and other metabolic changes, such as hypomagnesemia and which may result in a fatal outcome if not recognized and treated. promptly cardiotoxicity is not well known except arrhythmias, which are a primary cause of death. We report a case of myopericarditis by ingestion of hydrofluoric acid.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.7 no.1
• /
• pp.38-40
• /
• 2009

Formalin is a water-soluble, colorless, pungent, irritating and highly reactive gas. A 40% solution of formaldehyde in water, also known as formalin, is used as a disinfectant, antiseptic, deodorant, tissue fixative and embalming fluid. Ingestion can lead to immediate deleterious effects on almost all systems of the body including gastrointestinal tract, central nervous system, cardiovsacular system and hepato-renal system, causing gastrointestinal hemorrhage, cardiovsacular collapse, unconsciousness or convulsions, severe metabolic acidosis and acute respiratory distress syndrome. We treated a 39-year-old woman who ingested 300 ml formalin in a suicidal attempt. Despite hemodialysis, death occurred after 23 h.

• The Korean Journal of Emergency Medical Services
• /
• v.24 no.3
• /
• pp.29-40
• /
• 2020

Purpose: This study looked into the reality of the emergency medical technology department by analyzing the major indicators of university information disclosure systems and finding the competitiveness of the department of emergency medical technology by reviewing various evaluation indices. Methods: This study is a survey of 24 colleges with emergency medical technology and emergency medical technology departments across the country. Quantitative index data from 2017 to 2019 were collected and analyzed through the university information disclosure center web site. Results: Departments of emergency medical technology are generally higher than the target colleges in quantitative indicators, but the indices are somewhat insufficient in terms of "rate of faculty in full service" and "research performance of per one faculty in full service." Conclusion: Based on the results of this study, we recommend increasing the low indicators to enhance the competitiveness of the departments of emergency medical technology.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.4 no.2
• /
• pp.158-160
• /
• 2006

Acute methemoglobinemia is induced by various causes, especially ingestion of oxidizing agents such as phenazopyridine, dapsone, and nitrite. Indoxacarb is an oxadiazine insecticide with high insecticidal activity and low mammalian toxicity. It is known to block voltage-gated Na+ channels in insects and mammals, but the mechanism is not yet well understood. We describe a case of a 41-year-old woman with methemoglobinemia that developed following Indoxacarb ingestion, which improved after intravenous injection of methylene blue. This is the first known such case. If signs and symptoms of methemoglobinemia occur after Indoxacarb ingestion, antidotal therapy with methylene blue should be considered as a necessary treatment.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.4 no.2
• /
• pp.147-150
• /
• 2006

Neurotoxic shellfish poisoning (NSP) can result from eating filter-feeding shellfish carrying brevetoxins produced by the marine dinoflagellate Krenia brevis (formally Gymnodinium breve). Brevetoxins enhance sodium entry into cells via voltage-sensitive sodium channels and have an excitatory effect. The incubation period is three hours (range 15 minutes-18 hours). NSP is characterized by gastroenteritis combined with neurologic symptoms. Gastrointestinal (GI) symptoms include abdominal pain, nausea, diarrhea and burning pain in the rectum. Neurologic symptoms are paresthesia, reversal of hot and cold temperature sensation, myalgia, headache, vertigo, and ataxia. Other symptoms may include malaise, tremor, dysphagia, bradycardia, decreased reflexes, dilated pupils, seizure, and coma. The health problem caused by K. breviscan be associated with a red tide bloom. We encountered 3 cases of neurotoxic shellfish poisoning. They all presented with GI and neurologic symptoms andrecovered after conservative treatment.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.20 no.3
• /
• pp.402-412
• /
• 2014

Purpose: This study was to investigate the importance of nurses' caring behaviors as perceived by nurses and patients at emergency departments, and to determine the differences between the two groups. Methods: The subjects of this study were 159 nurses working at emergency departments in 9 general hospitals in B Metropolitan City and 153 in-patients in 6 general hospitals, who were transferred to a general ward after being admitted to an emergency room. Research tool was a self-report questionnaire, which was a translated version of Caring Behavior Assessment(CBA). In this study, Cronbach's ${\alpha}$ was ranged from .83 to .93 in the seven subscale's reliability of CBA. Results: In terms of caring behaviors at emergency departments, both nurses and patients perceived that the most important subscale was . The subscale which showed the least importance from both groups was . Conclusion: The results of this study have demonstrated that nurses' caring behaviors can meet the patient's needs if the gap in perceptions between nurses and patients would be reduced.

• Journal of muscle and joint health
• /
• v.25 no.3
• /
• pp.176-186
• /
• 2018

Purpose: The purpose of the study was to describe work experiences of triage nurses working at emergency departments in Korea. Methods: A qualitative descriptive research method was used. Twenty-one nurses of emergency department participated in the first interview and 16 of them participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis was utilized to analyze the data. Results: Forty-eight codes, 12 categories, and six themes emerged from the data analysis: caring on the frontline, burden as an initial evaluator, handling things alone, lack of others' understanding, becoming an expert, and needs for improvement. Participating triage nurses faced many challenges and difficult situations in emergency departments. They felt burden and loneliness as initial evaluator. Also, they felt pride in their work and struggled to become a professional. Conclusion: This study is the first qualitative study that has focused on exploring the experiences of triage nurses in emergency departments in Korea. The results provide description and in-depth understanding of working experiences of triage nurses. The results provide valuable fundamental data for regulation, clinical practice, education, and research for triage nurses in Korean emergency departments.

• Journal of Korean Academy of Nursing Administration
• /
• v.4 no.2
• /
• pp.405-418
• /
• 1998

The purpose of this study was to describe patients satisfaction with nursing care in the emergency department and factors influencing satisfaction rates. 1. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety: 2.67 for technical competence: 2.49 for information giving: and 1.35 for discharge teaching. 2. Patient satisfaction with nursing care services provided. according to the general characteristics of the patients. was revealed as being significantly high for the groups of patients made up of those who were male. those over 51years of age. married subjects. those with an education level of high school or below level. housewives. Buddhists. and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine. neurology or psychiatry. those admitted for the first time. those for whom the distance from the department to home was less than 30 minutes. patients who visited between monday and Friday and between 8AM and 4PM. patients who did not have to wait to be seen and those who stayed in the department less than 24 hours. 3. The correlation between the patients' general characteristics. nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service. 4. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included 'over worked nurses' and 'too many patients' in the emergency department. In conclusion. the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments: and the need for adequate support from hospital administrators to improve patients' service utilization.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.4 no.2
• /
• pp.155-157
• /
• 2006

Myoclonus is manifested in a variety of situations including metabolic derangements, brain lesions, epilepsy, and drugs toxicity. We reported a rare case of amitriptyline-induced myoclonus. A 64-year-old man with a tension-type headache was administered amitriptyline at 15 mg/day. Eight days after initiation of amitriptyline, multifocal myoclonus developed, involving the face and upper extremities. Two hours after the administration of clonazepam at 1 mg, myoclonus resolved completely.