• Journal of muscle and joint health
• /
• v.26 no.1
• /
• pp.27-34
• /
• 2019

Purpose: This study was done to analyze nursing assessment and nursing care for pain in the electronic nursing records for the elderly patients with abdominal pain visiting the Emergency Medical Center. Methods: This study is a descriptive study based on nursing records from January to December 2015. A total of 1155 records for elderly patients with abdominal pain were gathered. Results: The mean age of elderly patients whose records were analyzed was 75.2 years. Analysis of nursing records regarding pain management showed that semi-urgent severity (93.7%), direct emergency room visits (58%), and 6.01 hours of emergency room stay (6.01 hours)were the most frequently documented characteristics of the elderly patients with pain complaints. Recording time of nursing assessment for abdominal patients was 1.01 hour; the average pain intensity was 3.97. The mostly used nursing intervention for abdominal pain was medication (65.1%). There was no record of non-pharmacological pain nursing interventions. Conclusion: The results of this study showed that improving knowledge and nursing practice for pain management is much of necessity. In particular, development of the non-pharmacological nursing interventions for pain is needed. Further research is also imperative to develop and evaluate record systems for pain management that can be used in the emergency room.

• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.125-130
• /
• 2013

Purpose: This study was undertaken in order to identify the characteristics of patients diagnosed with occult an hip fracture after hip trauma. Methods: We retrospectively reviewed the medical records and radiology reports of all patients who underwent hip skeletal computed tomography (CT) for suspected hip fractures but had normal initial X-rays after hip trauma between August 2006 and January 2012. The variables evaluated included age, gender, body mass index (BMI), accident mechanism, previous fracture, independence, late presentation, ability to bear weight, pain on passive rotation, tenderness of the groin area, diagnosis and treatment. Patients were divided into two groups, with hip fracture (occult hip fracture group) and without hip fracture (no fracture group) to evaluate the characteristics associated with an occult hip fracture. Results: The patients, a total of 139, had a mean age of 58.3 years and included 72 male patients(51.8%). The occult hip fracture group included 43 patients(30.9%). Of those 43, 21 patients(48.8%) had intertrochanteric or trochanteric fractures, 8 patients(18.6%) had femur neck fractures and 14 patients(32.6%) had acetabular fractures. Of the 43, 15 patients(34.9%) needed operative treatment. Age was higher in the occult hip fracture group than it was in the no fracture group($64.4{\pm}19.1$ years vs. $55.5{\pm}23.6$ years, p=0.021). A previous fracture was associated with the presence of a new fracture (p=0.014; OR=3.971, 95% CI=1.314-11.997). Conclusion: Further evaluation of patients who are older or have history of fractures is prudent, even though the initial X-rays are normal.

• The Korean Journal of Emergency Medical Services
• /
• v.25 no.3
• /
• pp.189-200
• /
• 2021

Purpose: We aimed to provide effective emergency medical services (EMS) response strategies for coping with high acuity patients during the pandemic by analyzing the influence of the COVID-19 and social distancing on EMS. Methods: In this retrospective observational study, we analyzed the distribution of high acuity patients transported by Daejeon 1-1-9 EMS during the COVID-19 pandemic period, between February 1, 2020 and October 31, 2020 and the same period in 2019, as well as the level 3 social distancing enforced period, between July 27, 2020 and October 31, 2020. Results: The EMS dispatches decreased by 17% during the observed COVID-19 pandemic period compared to the same period in 2019. The number of cases with cardiac arrest and positive prehospital stroke scale rose by (p<.001). Patients with cardiac arrest, trauma, and positive prehospital stroke scale increased by during the level 3 social distancing period. Conclusion: Unlike the decreased EMS call volume and patient transports during the COVID-19 pandemic, cardiac arrest cases and the severity of high acuity patients tended to increase. We suggest that EMS systems should contrive a response strategy considering the collateral effect of major epidemics on the incidence rate of high acuity patients.

• Journal of Trauma and Injury
• /
• v.22 no.1
• /
• pp.108-115
• /
• 2009

Purpose: We designed a retrospective study to measure the accuracy of the ICD-10 (International Classification of Disease-10) code for trauma patients. We also analyzed the error of the ICISS (International Classification of Disease based Injury Severity Score) due to a missing or an incorrect ICD-10 code. Methods: For the measuring the accuracy of the ICD-10 code for trauma patients in a tertiary teaching hospital's emergency department, two board certified emergency physician performed a retrospective chart review. The ICD-10 code was classified as a main code or a sub-code. The main code was defined as the code of the main department of treatment, and the sub-code was defined as a code other than the main code. We calculated and compared two ICISS for each patient one by using both the existing code and the other by using a corrected code. We compared the proportions of severe trauma (defined as an ICISS less than 0.9) between when the existing code and the corrected code was used respectively. Results: We reviewed the records of 4287 trauma patients who had been treated from July 2008 to November 2008. The accuracy of the main code, the sub-code of emergency department, main-code, the sub-code of hospitalized patients were 97.1%, 59.8%, 98.2% and 57.0%, respectively. Total accuracy of the main and sub-code of emergency department and of hospitalized patients were 91.4% and 58.6%. The number of severe trauma patients increased from 33 to 49 when the corrected code was used in emergency department and increased from 35 to 60 in hospitalized patients. Conclusion: The accuracy of the sub-code was lower than that of the main code. A missing or incorrect subcode could cause an error in the ICISS and in the number of patients with severe trauma.

• The Korean Journal of Pain
• /
• v.32 no.2
• /
• pp.97-104
• /
• 2019

Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

• Journal of Korean Public Health Nursing
• /
• v.10 no.1
• /
• pp.106-117
• /
• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• Spatial Information Research
• /
• v.12 no.2
• /
• pp.193-209
• /
• 2004

The purpose of this study is to analyze the service area of emergency medical centers using GIS-based spatial analysis methods in Seoul, focusing on the behaviour of patients on the choosing of emergency centers. For this analysis, six emergency centers were selected to collect data for the information on the addresses of patients from September to November hi 2003. Analysis on the service area, which was carried out by measuring the distribution of patients in terms of distance from emergency medical centers, clearly reveals that the majority of patients was located within or adjacent districts at the emergency medical center. However, the size of the primary service area f3r six emergency medical centers was much different, implying that the decision to visit specific emergency medical center by patients was closely related to the size, perception, and preference of the emergency medical center. Based on the results of the spatial characteristics of emergency medical service area, this research tries to construct the surface map of the emergency medical service level supplied by 32 regional emergency medical centers located in Seoul. Considering the levels of infrastructure for emergency medical centers, the coverage for the degree of supply of emergency medical service by each emergency medical center was constructed in terms of a distance decaying in the distribution of patients from emergency medical center imposing different weights on distance bands. Spatial overlay utilizing map algebra function was performed in order to calculate total supply level of emergency service. The results clearly show that spatial inequality exists in the supply levels of the emergency medical service among local areas of Seoul.

• The Journal of Korean Medicine
• /
• v.28 no.3 s.71
• /
• pp.197-206
• /
• 2007

Objectives : By recording basic data of patients visiting the emergency room of the oriental medicine center, we can understand their characteristics and gain better insight about them. Methods : We performed a retrospective study of 2,674 patients who visited the emergency room of Kyunghee Oriental Medical Center, from June 1, 2006 to May 31, 2007. Results : 1. Of 2,674 total patients, the male to female ratio was 0.94:1 and the 6th decade of life was the peak age group. 2. The majority of patients visited our emergency room between 06:00 and 24:00(midnight). 3. Most patients visited on a Saturday or Sunday. 4. By monthly distribution, the patients increased slightly during June, July, August and October. 5. The majority of patients visited the emergency room within 24 hours of onset. 6. The patients were categorized as follows: neurological diseases 71.15%, musculoskeletal diseases 16.02%, internal medical disease 9.04%, psychiatric and related disease 3.79%. 7. The average transit time was about 1 hour 30 minutes. 8. Admission rate was 48% and the rate of admission to the intensive care unit (ICU) was 5% of total visiting patients. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of patients who visiting the emergency room of the oriental medical center.

• Journal of forensic and investigative science
• /
• v.3 no.1
• /
• pp.50-59
• /
• 2008

The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.

• The Journal of Pediatrics of Korean Medicine
• /
• v.24 no.3
• /
• pp.1-15
• /
• 2010

Objectives: By analyzing data of pediatric patients who had visited the emergency room of an oriental medical hospital, we can understand their characteristics and diseases. The purpose of this study was to introduce the excellence of Oriental medicine, to develop various treatments and to revitalize pediatric emergency care at oriental medical hospital. Methods: The study was composed of 371 pediatric patients who had visited the emergency room of the $\bigcirc\bigcirc$ university oriental hospital from January 2008 to December 2009. Results: 1. Average age of the pediatric patients was 4.28 years old, and it has showed that 1 to 3 years old patients (36.7%) were the most common age. 2. The number of pediatric patients was increased in June. According to the weekly distribution data, the number of pediatric patients who had visited on Sunday was the most (29.1%). Also, the number of pediatric patients who had visited ER for 18 to 21 hours(35.6%) were the most common. 3. The major problems of hospitalization were digestive symptoms and nervous symptoms. The nervous symptoms were the most at infancy. The musculoskeletal symptoms were the most common in adolescence. The digestive symptoms were common in other stages of development. 4. The time interval between arrival and onset; within 6 hours were the most(48.0%). Acupuncture and herbal medication treatment(75.2%) were the most common medical treatments. Most of the pediatric patients(97.3%) were discharged after medical treatments. Conclusions: Pediatric patients who had visited emergency room at the oriental medical hospital were mostly not due to acute form of serious diseases. The most common disease states that have preferred to treat with oriental medicine were dyspepsia, crying, febrile fit, and ankle sprain. We have to introduce the excellence of oriental medicine, and we need to try to develop other treatments such as magnetic acupuncture, moxa therapy, aroma therapy and revitalize pediatric emergency care at oriental medical hospital.