• 제목/요약/키워드: Emergency death

검색결과 345건 처리시간 0.029초

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) (Clinical Studies on 56 Cases of Having Treated patients suffering from Ischemic Stroke through both Urokinase and Therapeutics of Oriental Medicine)

  • 김인섭
    • 대한한의학회지
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    • 제15권2호
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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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중환자실 환자의 입원시 불안정도와 영향요인 (The Level of Anxiety and Relating Factors of ICU Patients)

  • 한경신;박영임
    • 한국간호교육학회지
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    • 제8권1호
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    • pp.155-166
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    • 2002
  • This study was performed to figure out the level of anxiety and relating factors of ICU patients as the hospitalization in ICU grows more recently. Data collection was conducted from July 1st to August 31st, 2001. The subjects of this study were consisted of 101 ICU patients who were selected according to the criteria in S hospital, C city. The instruments of the research were consisted of 14 questions of general characteristics, 20 items of STAI, VAS, 24 questions for the anxiety relating factors. And data were analyzed by t-test, ANOVA, and pearson correlation for group difference and correlation with SPSS Win 10.0 program. The followings were the results of the study: 1. In the anxiety level, mean score on STAI was 53.7(item mean $2.69{\pm}.83$), and mean score on VAS was 5.23. It means that the anxiety level of ICU patients was moderate. 2. Among the relating factors of anxiety, the most highest scores were 'by seeing other patient's emergency situation' and 'by seeing other patient's death' figured 3.85 and 3.79 each. And the lowest marks were 'by the unkind behavior of doctors and nurses'(2.13) and 'nurses' or doctors' indifferent actions'(2.21). And the anxiety according to the environmental factor was the highest (3.17) and the anxiety regarding to the human relationship was the lowest (2.53). 3. In the anxiety level STAI according to the general characteristics, the patients who didn't have to take care of their family showed more anxiety than who had to take care of their family(t=-2.38, p=.02). And the variables that shows a significant difference on VAS was sex and women's anxiety was higher than men's level (t=-2.56, p=.01). 4. When the physical anxiety level was compared, the patients who had to take care of their family showed more anxiety than the people who didn't have to take care of their family(t=-1.95, p=.05). In the level of anxiety relating the human relationship, the patients who had religion showed more anxiety than patients who didn't(t=2.43 p=.02). And the married patients(t=2.43, p=.01) and more educated people(F=3.77, p=.01) showed more anxiety. Even though environmental anxiety was the highest factor, it was not significant with general characteristics. 5. The anxiety and relating factors showed positive significant relationship, and physical anxiety factor showed the strongest relation with STAI(r=.21, p<.01). And VAS level showed stronger relation with every factor of the anxiety than STAI. When the VAS level became higher, the anxiety relating to physical factor(r=.72, p<.01), human relationship(r=.63, P<.01), and environment became higher. According to the above result, the environmental anxiety was the highest level than other factors in ICU patient and thus the environmental nursing intervention becomes very important in ICU. Also nurses in ICU have to support the patients who showed higher level of anxiety in this study and try to develop the nursing intervention to relieve the anxiety of patients. And it is recommended that VAS is convenient and practical instrument for measuring the anxiety level in ICU patients.

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초등학교 저학년 아동들의 안전사고 발생 실태 및 관련요인 분석 (A Study on the Occurrences and Causes of Accidents in Lower Grade Elementary School Children)

  • 김소선;이은숙
    • 대한간호학회지
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    • 제29권1호
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    • pp.117-126
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    • 1999
  • Accidents involving children are an important cause of death and disability. They also have enomorous financial implications. In order to prevent childhood accidents, research and education for safety should be strengthened. The purpose of this study was to determine how often young children have accidents and what factors affect the accident rate. The sample consisted of 771 children who were in the second, third and forth grades of two elementary schools located in Kyung-gi Province. One school had students from middle class families living in apartment complexes and the other, students from lower income families mainly living in single houses. The questionnaires included items on the occurance of accidents and the parents' attitudes regarding accidents during the academic year from March 1997 to February 1998. The Questionnaires were distributed to conventiently selected students to be compeleted by their parents and collected during the period of May 28, to June 6, 1998. The data were analyzed using SAS PC statistical package. The results of the study are as follows ; 1. Of 771 student subjects, 393 had 887 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were May, Sunday, and between 1 and 4 p. m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on around their homes followed by school and, then, inside the home 4. Most of the accidents were caused by carelessness on the part of the children and the most frequent type of injury was an abrasion. 5. Children most injured their legs 6. They were treated at home most often and usually emergency treatment was performed by family members with, disinfection being the main type of first aid. Cost of the treatment ranged from 8,000 to 20,000 won in most cases. 7. House type and parents' education level were statistically significant in chi-square analysis. 8. Parents educate their children about traffic safety most frequently followed by fire safety and, then, prevention of violence. 9. Parents think that prevention of violence should be the most important part of injury prevention education both at school and home. 10. To identify factors related to accident occurrence, multiple logistic regression was performed and the main factors were birth order and house type.

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노인 보행자 운수사고 입원환자의 의료적 특성연구 (Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident)

  • 박혜선;김상미
    • 디지털융복합연구
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    • 제17권12호
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    • pp.345-352
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    • 2019
  • 본 연구는 2012년~2016년의 퇴원손상심층조사 자료를 사용하여 운수사고에 따른 노인 보행자 입원환자의 의료적 특성인 재원기간을 파악하였다. 연구결과, 운수사고에 따른 노인 보행자 입원환자의 의료적 특성으로 입원경로, 중증도, 손상부위, 수술유무, 치료결과, 병원소재지, 병상규모가 재원일수에 영향을 주는 요인으로 나타났다. 외래경유 입원인 경우, 치료결과가 호전보다는 호전 안됨이나 사망인 경우, 100-299병상보다는 500-999병상, 1000병상 이상인 경우 재원일수가 짧았다. 그러나, CCI는 0점보다는 1-2점, 3점 이상인 경우, 손상부위가 머리 또는 목보다는 기타부위인 경우, 수술을 한 경우, 병원소재지가 서울보다는 도 지역, 광역시인 경우 재원일수가 길었다. 본 연구는 인구고령화에 따른 보행 운수사고 예방을 위하여 입원환자의 의료적 특성을 파악함으로써 노인의 특성을 고려한 교통안전 및 의료자원을 효율적으로 관리할 수 있는 정책수립의 기초자료로 활용되기를 바란다.

출혈성 쇼크를 일으킨 흰쥐에서 선형회귀 분석모델을 이용한 출혈량 추정 (Blood Loss Prediction of Rats in Hemorrhagic Shock Using a Linear Regression Model)

  • 이탁형;이주형;최재림;양동인;김덕원
    • 전자공학회논문지SC
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    • 제47권1호
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    • pp.56-61
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    • 2010
  • 출혈성 쇼크는 응급실에서 일어나는 사망 원인의 많은 부분을 차지하고 있다. 본 연구의 목적은 출혈량에 따라 변화하는 생리적인 변수들의 특징을 알아보는 것이다. 또한 이를 이용하여 전체 혈액량 대비 손실된 혈액의 비율을 산출하는 선형회귀분석 모델을 만드는 것이다. 총 60마리의 흰쥐를 출혈량에 따라 체중 100g 당 15분 동안 0ml, 2ml, 2.5ml 3ml로 정하여 총 4그룹으로 나누었다. 출혈 중에 변화하는 심박수, 수축기혈압, 이완기혈압, 호흡수, 체온 등을 분석하였다. 분석한 데이터를 무작위로 나누어 360개의 데이터 세트를 선형회귀 분석모델을 만드는데 사용했고 이 모델의 R (결정계수) 제곱 값은 0.80이었다. 나머지 360개의 데이터를 이용하여 만든 모델을 시험한 결과, 추정된 손실 혈액의 비율의 RMS (root mean square) 오차 값은 5.7%가 나왔다. 비록 선형회귀분석모델이 직접적으로 실제 임상에서 사용될 수 없지만 추가적인 연구를 통해 이 방법이 출혈성 쇼크의 소생술을 시행하는데 필요한 용액의 양을 결정하는데 도움을 줄 수 있을 것으로 생각된다.

농촌지역 초등학교 저학년 학생들의 안전사고 발생실태 (A Study on the Occurrences of Accidents among 1 st to 3rd Grade Rural Elementary Students)

  • 김복주;김정남;류미경
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.815-827
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    • 2001
  • Accidents involving students are an important cause of death and disability. They also have enormous financial implications. In order to prevent childhood accidents. research and education for safety should be strengthened. The purpose of this study was to determine how often lower grade elementary students have accidents and what factors affect the accident rate. The study population consisted of 676 students who were in the 2nd, 3rd and 4th grades of twelve elementary schools located in Kun Wi Gun. The questionnaires were distributed to all of the 2nd to 4th grade student in the Kun Wi Gun to be completed by their parents about all the accidents which happened last one year and collected during the period of March 19, to March 30, 2001. The data were analyzed by using SPSS WIN 10.0 statistical package. The results of the study are as follow: 1. Among 676 students. 270 students had 540 accidental injuries during the study period. 2. The month, the day and the time with the highest accident rate were April. Monday. and between 1 and 4 p. m. each. 3. In the analysis of the location where the injury took place, the most frequent place was on school, around their homes and. then inside the home. 4. Most of accidents were caused by carelessness on the part of the students and the most frequent type of injury was an abrasion. 5. Students most injured part of the body was their legs. 6. They were treated at home most often and usually emergency treatment was performed by family members with disinfectant as first aid measure. Cost of the treatment of the accident ranged from 10.000 to 30,000 won in most cases. 7. Students' personality. type of family composition. mother's age and parents' education level were statistically significant. As a conclusion. 1st to 3rd grade rural elementary students need their assessment for accident involving condition. This study gave a very useful and important data to prepare accident prevention teaching program and to prepare accident prevention strategies.

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무선 디지털청진기를 이용한 동물 진단시스템 (Animal Diagnosis System Using Wireless Digital Stethoscope)

  • 박기영;홍수미;이종하;박진호;정의붕
    • 한국통신학회논문지
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    • 제38B권9호
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    • pp.722-727
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    • 2013
  • 동물 의료는 병의 정도나 치료의 필요성에 관계없이 보호자의 의향이 앞서는 어려운 의료행위이다. 특히, 동물치료 중 심장 질환은 필요한 치료법의 결정이나 치료 효과의 확인에 대해서 동물 환자로부터 직접적인 답을 얻기가 어렵다. 그래서 동물 환자의 경우, 심장질환은 증상의 악화로 급변하거나 돌연사 등의 응급사태를 예측하고 그것에 대처하는 것은 거의 불가능하다. 심장 및 몸 안의 질환을 확인하는 1차 진단 방법은 청진이다. CT나 X-ray, 초음파 등의 최첨단 영상장비들을 이용하여 정확하게 측정할 수 있지만 장비가 비싸고, 이를 활용할 수 있는 전문인력이 요구되는 등 경제성으로 인해 2차 진단장비로 활용되어질 뿐 1차 진단을 위한 가장 좋은 진단도구로 여전히 청진기가 이용되어지고 있다. 본 논문에서는 수의사가 귀에 대지 않고 청진음을 분석하고 무선으로 어디서나 진단 할 수 있는 무선디지털 진단시스템에 대해 자세하게 서술하고, 이 시스템을 통해 진단되는 청진음에 대한 레벨교차율(LCR)과 에너지레벨을 통해 질병의 관계에 대해 새로운 개념의 진단시스템 환경을 제시한다.

요로결석 위치 진단에 대한 복부자세 변화에 따른 연구 (A Study on the Diagnosis of Urinary Stone Location by Abdominal Positioning Variations)

  • 김동진;채종상;유채민;이배원
    • 대한방사선기술학회지:방사선기술과학
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    • 제41권1호
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    • pp.7-12
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    • 2018
  • Patients who visit the emergency room with urinary stones have difficulty lying down in a supine position due to severe pain when performing the KUB test. The purpose of this study was to find methods to reduce the patients' pain and image distortion, and obtain medical images with high diagnostic values. After checking the standard classification of disease and cause of death, the target group consisted of 121 patients who had clearly distinguished stones from computed tomography. Patients with stones in the ureteralvesical junction were excluded. Qualitative image evaluation was performed by confirming the location of the stone in the computed tomography images. and evaluated the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray. Quantitative image evaluation was performed on the KUB, abdominal plain X-ray images. The transverse process of the first lumbar vertebrae served as the standard point, and the length from this point to the lower part of the stone was measured. Results from looking at the rate of visual discrimination of stones possible through KUB and abdominal plain X-ray showed: 94 patients (77.6%) for KUB images and 91 patients (75.2%) for computed tomography images. The standard deviation for KUB and abdominal X-ray was 3 (2.4%). Comparing and analyzing the location from KUB images and abdominal plain X-ray images, the stone position was 10.1 mm in the kidney, 10.5 mm in the ureteropelvic junction, and 9.7 mm in the ureters. It was shown that the stone moved 10 mm on average with significant statistical difference (P<0.05). In cases where the pain is so severe that it is impossible to perform the test in the supine position, an alternative may be to check the stone position by performing a modified KUB test by having the patient stand in a vertical position. In the future, this will provide convenience to both the examiner and the patient when performing the examination, and it will contribute with its reproducibility.

의무기록자료를 이용한 중증질환자의 재원일수에 미치는 요인 분석 (Analysis of Factors Affecting Length Of Stay for A Serious Patients Using Medical Records)

  • 김석환;이정아
    • 한국학교ㆍ지역보건교육학회지
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    • 제20권2호
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    • pp.69-80
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    • 2019
  • Objectives: In this study, we tried to analyze the factors affecting Length Of Stay for serious patients in Republic of Korea. Methods: The study included 139,172 serious patients in the 2012-2016 discharge details. Using the SPSS 23.0 program, we conducted a rank regression analysis with social and social demographic characteristics as control variables, medical institution characteristics and medical use characteristics as independent variables, and Average Length Of Stay as a dependent variable. Results: Average Length Of Stay for participants was found to be 9.92days. And the location and bed size of medical institutions were not statistically significant, the hospitalization path was more urgent(B=0.43) than the outpatient (p<0.001), and there was no secondary diagnosis(B=0.35). However, Average Length Of Stay was higher (p<0.001) than there was no main surgery(B=0.80). After discharge, Average Length Of Stay for funding(B=0.43) and death(B=0.72) was long (p<0.001). Average Length Of Stay for participants was found to be 9.92days. And the location and the bed size of the medical institution were not statistically significant, and the hospitalization pass had longer Length Of Stay for emergency patients(B=0.43) than for outpatients(p<0.001). There was a longer Length Of Stay(B=0.35) than none was diagnosed. There were longer Length Of Stay(p<0.001) than there was no major surgery(B=0.80). After discharge, the outpatients had longer Average Length Of Stay(B=0.43) and deaths(B=0.72) than those who returned home(p<0.001). Conclusion: As a result of analyzing the factors affecting Average Length Of Stay of the participants, it was confirmed that regardless of the location and bed size of medical institutions, hospitalization route, department diagnosis, main surgery, and whereabouts after discharge. Therefore, appropriate interventions and necessary support must be provided so that efficient Length Of Stay can be managed according to the medical use characteristics of serious patient.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model

  • Mohd Fazeli Sazali;Syed Sharizman Syed Abdul Rahim;Ahmad Hazim Mohammad;Fairrul Kadir;Alvin Oliver Payus;Richard Avoi;Mohammad Saffree Jeffree;Azizan Omar;Mohd Yusof Ibrahim;Azman Atil;Nooralisa Mohd Tuah;Rahmat Dapari;Meryl Grace Lansing;Ahmad Asyraf Abdul Rahim;Zahir Izuan Azhar
    • Tuberculosis and Respiratory Diseases
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    • 제86권2호
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    • pp.82-93
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    • 2023
  • Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.