• 제목/요약/키워드: Emergency patient

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문제중심학습 개념의 환자관리 Core Skill-TLP 교육교재 개발 및 적용 (An Examples Development and Implementation of Core Skill-TLP Package in Patient Management)

  • 이영아
    • 한국응급구조학회지
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    • 제14권2호
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    • pp.25-40
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    • 2010
  • Purpose : The purpose of this study was to develop and apply a Core Skill-TLP(Core Skill-Tutorial, Laboratory, Practicum) package in Patient Management and to effect of core skill-TLP education. Methods : This study was used to developed Patient Management' Core Skill-TLP package throughout 14 steps of Core Skill-TLP package development model. Then, Core Skill-TLP Learning methodology was implemented in first year student in the undergraduate emergency medical technology, and survey was done. Results : 1. Core Skill-TLP package model was presented based on conceptual model of PBL(S-PBL). 2, The student in OSCE did significantly better in clinical patient management core skills performance. 3. As to the satisfaction of Core Skill-TLP package management, student, tutor and self-satisfaction score was 3.21, 3.42, 3.38 respectively. Conclusion : This study was suggested that Core Skill-TLP education would be necessary with well-structured package and achieved advantage of simulation and PBL.

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다발성 외상 환자에서 Emergency Room Transfusion Score (ETS)를 이용한 응급수혈의 예측인자 (Factors for Predicting the Need for an Emergency Blood Transfusion to a Multiple Trauma Patient Using Emergency Room Transfusion Score (ETS))

  • 조현규;박용진;김선표;김성중;조수형;조남수
    • Journal of Trauma and Injury
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    • 제28권1호
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    • pp.1-8
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    • 2015
  • Purpose: The purposes of this study are finding the elements for a fast determination of the need for a transfusion to a multiple trauma patient arriving at this clinic in the initial stage establishing objective bases for a doctor in an emergency department to determine the need for a transfusion immediately after a patient has arrived at the emergency department, and providing treatment by considering various factors based on the nine criteria suggested in the emergency room transfusion score (ETS). Methods: This study was conducted on 375 multiple-trauma patients who visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team from January 2010 to December 2013. The patients were divided into the transfused group and the non-transfused group by retrospectively analyzing their medical records. Subsequently, the medical records were examined using the nine items suggested by the ETS and the results were analyzed. Results: Three hundred seventy-five patients with multiple traumas visited the Chosun University Hospital Emergency Medical Center and activated the Emergency Trauma Team. Among them, 258 died and 117 recovered and left the hospital. The deceased patients consisted of 182 males and 76 females with an average age 45. Of the 375, 165 were transferred from other hospitals, and 245 were blunt trauma patients. One hundred sixty-nine patients were injured in traffic accidents, and 119 of those 169 who had systolic blood pressure less than 90 mm Hg died. Two hundred twenty-six (60.3%) out of the 375 patients with multiple traumas received an emergency blood transfusion and their average age was 48. The 375 patients consisted of 156 males, 151 who had been transferred from other hospitals, 218 who presented with blunt trauma, 134 who had been injured in traffic accidents, 156 who had a systolic blood pressure less than 90 mm Hg, 134 who scored higher than 9 points on the GCS, and 162 who had a stable pelvic fracture of these 143 died. Conclusion: During this study, 226 (60.3%) out of the patients with multiple traumas received an emergency blood transfusion. After analyzing the results related to emergency blood transfusion by using ETS, we found that an emergency blood transfusion had to be prepared quickly when patients were transferred from other hospitals when the systolic blood pressure was less than 90 mmHg. when abnormalities had been detected by ultrasonography and when the patient presented with a stable pelvic fracture.

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119구급대원의 저혈당 환자에 대한 병원 전 응급처치현황과 개선방안 (Prehospital Treatments of the Patient with Hypoglycemia by 119 Emergency Medical Technicians - Analysis of the Current Data and Survey -)

  • 안희정
    • 한국응급구조학회지
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    • 제14권1호
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    • pp.31-46
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    • 2010
  • This study was intended to analyze the clinical characteristic of the patient with hypoglycemia and the status of prehospital treatments by 119 emergency medical technicians well as the cause of inappropriate emergency treatment by 119 emergency medical technicians in a bid to seek the measures for improvement, thereby enhancing the emergency medical services before medical treatment at hospital. Examination of the daily work log on 430 patients suffering with hypoglycemia who were sent to the university hospital in Gyunggi-Province by 119 emergency medical technicians, beginning on Jan 1, 2004 till Dec 31. 2008 was carried out and the survey of 206 119 emergency medical technicians working at the region of Gyunggid-Province was conducted from Sep 19 through Oct 6, 2009. Evaluation of the frequency and percentage and ANOVA analysis using SPSS WIN 14.0 program was carried out. In view of the examination of daily emergency work log and questionnaire, prehospital treatment for the patients with hypoglycemia needs to be further improved in general, and to provide the emergency treatment in accurate and timely manner, improvement of the system such as assignment of licensed rescue members and development of protocol that will replace the medical consultant system, mandatory emergency treatment, constant and efficient training and maintenance of emergency rescue records shall be implemented, and furthermore, social recognition to 119 emergency medical technicians shall be improved to encourage them to perform more positive way and manner.

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한 대학병원 응급실 내원환자의 방사선촬영 실태 (Radiographic Status of the Visited Patients at University Hospital Emergency Room)

  • 안병주
    • 한국방사선학회논문지
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    • 제5권2호
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    • pp.81-92
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    • 2011
  • 응급상황에서 방사선 촬영 분포 분석 및 문헌을 토대로 응급상황 대처 및 서비스 효율성을 개선시키기 위하여 연구를 하였다. 2010년 12월, 광주 광역시 한 대학병원에 응급실을 내원한 1270명 응급 외래환자를 분석하여 방사선 촬영 분포 데이터를 분석하였다. 결과는 다음과 같다. 응급 방사선 촬영은 56.6% 일반 방사선 촬영, 2.5% 특수촬영, CT 34.2%, 초음파 6.7%였으며, 일반 방사선 촬영에서 남성은 51.7%, 흉부외과의 촬영률 90.0%, 입원환자 77.9% 및 응급실에서 머무르는 시간이 긴 환자에게서 촬영하였다. 특수 촬영의 비율은, 비뇨기계 28.6%, CT에서는 신경외과 49.2%, 신경과 36.7%의 높은 비율을 나타냈다. 초음파의 경우 여성이 8.8%, 내과가 15.9% 비율을 나타냈다. 방사선 촬영의 분포도를 분석하면, 일반 방사선 촬영에서 흉부촬영 55.3%, 특수 촬영에서는 1.2%의 비뇨기계, CT에서는 두부 검사가 40.0%로 높은 비율을 차지했다. 일반 촬영의 진료과의 분포도에 따르면, 두부가 64.6% 신경외과, 흉부검사는 흉부외과는 90.9%, 복부가 58.0% 일반외과, 척추는 신경외과 40.0%, 골반 및 상하지는 정형외과가 15.9%, 20.5%, 31.8%를 차지하였다. 일반 촬영의 환자 1인당 평균검수는 전체 인원을 고려하여 성별, 연령별, 전원 여부별 모두에서 유의한 차이를 나타냈다(p<0.05). 촬영만을 고려한 경우에는 성별에서 남자가 2.2건 높았으며, 연령대에서는 30대에서 2.7건이, 진단부분에서는 신경외과가 3.4건이 더 높게 차지하였다. 전체 촬영 부위 건수에서는 흉부가 998건으로 가장 많았다. 결과를 고려해보면, 응급실에서 근무하는 방사선사는 응급 촬영에서 노년층을 돌봐야 하며, 촬영동안에 가능한 2차 손상을 특수 촬영인 비뇨기계 계통이 기구와 관련이 되어 있기 때문이다. 줄이기 위한 부상응급 환자를 검사하는 모든 방사선사는 방사선 촬영하는 동안에 긴급 상황에 대처해야 한다. 방지 대처가 필요하다. 왜냐하면, 특히 야간에 CT 촬영하는 두부 손상 환자는 환자 처치가 매우 중요하다. 담당 의사는 언제나 CT실에 상주하여 환자를 지켜봐야 한다. 응급실에서 방사선 촬영은 여러 진료과에서 관여 한다. 일반 방사선 촬영의 높은 비율, 응급 방사선 촬영에 대한 특수 촬영실이 응급실 내에 설치하여만 하고, 능력이 있는 응급 환자 처치를 할 수 있는 방사선사가 필요로 하고 응급환자 증가로 적절한 인원배치가 필요하다.

An Application Design for Emergency Medical System: A Software Engineering Approach

  • 최인렬;허준호
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2017년도 춘계학술발표대회
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    • pp.728-730
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    • 2017
  • The proposed application design for emergency medical system includes the functions that help securing the window of opportunity for the patients in an emergency situation and efficiently link rescue agency, emergency medical treatment center and patients together. First, the treatment time can be saved at the emergency room by understanding the patient's condition by entering his/her health information such as anamnesis, family history, social history and blood type together with an identification number. Also, if the siren function which signals whereabouts of patients to the rescue crew is used, it will be much easier to find the location of the patient in need. The design allows rescue crew to call the patient to check whether he/she is conscious or not. Just by receiving the call, he/she will be deemed conscious.

만성질환자의 상용치료원 보유 및 형태와 다빈도 응급실 이용 (The usual source of healthcare and frequent visits to emergency departments)

  • 한진옥;강경희;임준
    • 한국응급구조학회지
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    • 제21권3호
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    • pp.97-107
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    • 2017
  • Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

응급의료정보시스템의 보호를 위한 보안 구조 (Security Structure for Protection of Emergency Medical Information System)

  • 신상열;양환석
    • 디지털산업정보학회논문지
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    • 제8권2호
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    • pp.59-65
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    • 2012
  • Emergency medical information center performs role of medical direction about disease consult and pre-hospital emergency handling scheme work to people. Emergency medical information system plays a major role to be decreased mortality and disability of emergency patient by providing information of medical institution especially when emergency patient has appeared. But, various attacks as a hacking have been happened in Emergency medical information system recently. In this paper, we proposed security structure which can protect the system securely by detecting attacks from outside effectively. Intrusion detection was performed using rule based detection technique according to protocol for every packet to detect attack and intrusion was reported to control center if intrusion was detected also. Intrusion detection was performed again using decision tree for packet which intrusion detection was not done. We experimented effectiveness using attacks as TCP-SYN, UDP flooding and ICMP flooding for proposed security structure in this paper.

Completeness of Patient Care Report (PCR) by Paramedics

  • Lee, HyoJu;Kim, JongHo;Yun, Seong Woo
    • Journal of information and communication convergence engineering
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    • 제20권3호
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    • pp.204-211
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    • 2022
  • This study evaluated the completeness of patient care report (PCR). A retrospective quality analysis was conducted using raw data of 122,140 EMS activity reports prepared by paramedics in Gyeonggi-do from April 1 to May 31, 2021. In all, 67,830 cases of normal transfers were statistically analyzed using IBM SPSS Statistics version 22, and statistical significance was set at p<0.5. The 119EMT_2 certificate was omitted in 50,037 (73.8%) cases, followed by time-related items in 1,227 (1.8%) cases. In the primary assessment of vital signs, systolic blood pressure was omitted and erroneous in 1,218 (1.9%) and 1,129 (1.8%) cases, respectively. In the secondary assessment, the completeness of all vital sign items was approximately 70%. Advanced emergency care and online medical control (OLMC) reporting showed discrepancies in all items. As the severity of the patient's condition increased, the errors in the Patient care report (PCR) also increased, at a significant level (p= .00). Paramedics must be aware of the importance of completing the activity report.

응급실 간호사의 회복탄력성, 환자안전관리에 대한 인식, 선도적 행위가 표준주의 수행에 미치는 영향 (The Influence of Resilience, Awareness of Patient Safety Management, and Proactive Behavior on Performance of Standard Precautions among Nurses Working in Emergency Department)

  • 차운겸;정선영
    • 임상간호연구
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    • 제30권2호
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    • pp.104-113
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    • 2024
  • Purpose: This study investigated the correlations among resilience, the awareness of patient safety management, proactive behavior, and the performance of standard precautions among nurses working in the emergency department. Additionally, it aimed to identify the factors influencing the performance of standard precautions. Methods: Data were collected through a descriptive survey conducted between June 10 and July 9, 2023. The participants included 208 nurses working in the emergency department in Korea. The collected data were analyzed using SPSS/WINdows software version 29.0, based on the frequency, percentage, mean, standard deviation, t-test, one-way analysis of variance, Scheffé test, Pearson's correlation coefficients, and multiple regression. Results: The analysis based on the participants' general characteristics showed that performance of standard precautions varied significantly according to age (t=2.10, p=.036), size of the emergency department (F=7.46, p<.001), average number of patients treated per day while working in the past month (t=-3.88, p<.001) and standard precautions training experience (t=2.16, p=.032). The main factors influencing the performance of standard precautions among nurses working in the emergency department are awareness of patient safety management (β=.62, p<.001), resilience (β=.18, p=.042), and age (β=-.15, p=.007), with a total explanatory power of approximately 46.0%. Conclusion: It is necessary to establish programs and an effective education system to increase resilience and awareness in patient safety management to improve the performance of standard precautions among nurses working in the emergency department.

의식저하로 내원한 에틸렌 글리콜 중독 환자 1례 (Treatment of Ethylene Glycol Poisoning Patient Presented with Mental Change)

  • 민진홍;이장영;민문기;정성필;김승환;유인술
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.129-132
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    • 2004
  • Ethylene glycol poisoning can cause profound morbidity and is almost universally fatal if untreated. Central nervous system depression, pulmonary edema, and acute oligulic renal failure with crystalluria are among the most commonly encountered complication of ingestion. Ingestion of ethylene glycol may be an important contributor in patients with metabolic acidosis and subsequent renal failure. The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement of ethylene glycol. As a result, diagnosis and treatment sometimes can be delayed. We describe 52-year-old man who visited to emergency department with mental change of unknown origin. The patient has high anion gap metabolic acidosis and renal failure due to ingestion of antifreeze that contained ethylene glycol. We used hemodialysis for elimination technique. The patient was discharged with minimal complication.

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