• Journal of Trauma and Injury
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• 제29권3호
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• pp.82-88
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• 2016

Purpose: Sonongraphic examinations such as extended Focused Assessment with Sonography in Trauma (eFAST) are widely used in Emergency Departments. This study is designed to determine student achievement by teaching medical college students through short training. Methods: 38 participants in their 3rd year of medical school were enrolled in this study. An Emergency Medicine physician trained the students to 2 hours of theoretical training followed by 2 hours of hands on training. Results: The average age of students was $28.1{\pm}3.4$, with 21 male students. The average of pre-educational test results were $60.4{\pm}8.9$ and post-educational exam results were $80.1{\pm}14.5$ (p<0.001). The average success rate of eFAST was 87.5%. But success rate of each items were lowest in checking the hepatorenal recess and the splenorenal recess, each success rate, 65.8% and 68.4%, consecutively. The questionnaires filled out after the study showed that the students were highly interested in this education and that they found the education easy to understand. They also answered that eFAST education is necessary in the medical college curriculum. Conclusion: This study shows that eFAST can be effectively taught to students through short training.

• 한국보건간호학회지
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• 제32권2호
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• pp.288-303
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• 2018

Purpose: This study was a descriptive research to provide basic data for the development of a customized emergency education program to strengthen the capacity of first aid for nursing caregivers. Method: The number of caregivers in region G was 193, and data collection was conducted from April 1 to April 30, 2018. Data were analyzed using a t-test, one-way ANOVA, Pearson's correlation coefficients, and Scheffe test. Results: In the study group 47.2% experienced an emergency situation. The first aid knowledge was 10.21; the correct answer rate was 56.0%; the basic CPR knowledge was 3.99; the correct answer rate was 49.7%. After asking for help, first aid was the most difficult. In general first aid knowledge was 6.21 points and the correct answer rate was 62.2%. They understood well about strokes, injuries and trauma, but had difficulty in consciousness, depression, and burns. For first aid knowledge, there were significant differences according to age, working hours, place of work, working experience, emergency situation, and education. Of the study group, 59.6% experienced emergency training, 96.9% wanted it, and 72.0% had low emergency response skills. Moreover, 93.3% answered for having emergency education. Conclusion: The results suggest that a personalized emergency education program for nursing caregivers should be developed and applied.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.134-143
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• 2015

Purpose: Many patients are injured by trauma. And some of them expire due to severity of trauma. Various scoring systems have been introduced in grading severity and predicting mortality of trauma patients. This study is to evaluation the usefulness of factors for determining the severity and predicting the prognosis of the trauma victims. Methods: Data on the patients who visited our Emergency departments from January 2010 to December 2011 were retrospectively reviewed using electronic medical records. The patients were activated severe trauma team calling system. The patients were categorized as survivors and non-survivors. Univariated associations were calculated, and a multiple logistic regression analysis was used to determine variables associated with hospital mortality. Results: Two hundred sixty two(262) patients were enrolled, and the mortality rate was 25.6%. By multivariate analysis, lower respiration rate, lower Glasgow Coma Score, higher International Normalized Ratio and emergency transfusion within 6 hours were expected as severity and prognosis predict factors (each of odds ratio were 24.907, 14.282, 2.667 and 16.144). Conclusion: As predict factors, respiration rate, Glasgow Coma Score, International Normalized Ratio and emergency transfusion, are useful determining the severity and predicting prognosis of trauma victims.

• 한국응급구조학회지
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• 제15권1호
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• pp.79-88
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• 2011

Purpose : Prehospital emergency care for shockable rhythm is one of major concerns of emergency medical services. But, in Korea, prehospital medical service systems are not yet well established. We tried to offer one of the fundamental data to develop of these system. Method : After application of exclusion criteria, 200 patients who had shockable rhythm from January to December, 2008 were included in this study. Restrospective review of Prehospital care Reports of these patients was done. Result : Total 200 cases of shockable rhythm and prehospital arrest were analyzed. The rates of assessment of vital signs were 89.0%, the rate of level of consiousness was 99.5%. Just 6.0% were communicated with medical director providing the prehospital care. The frequency of defibrillation was performed 58.5%. Conclusion : Survival rate was higher in defibrillation group than that of nondefibrillation group(20.5% vs 2.4%, p=0.000).

• 대한임상독성학회지
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• 제16권1호
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• pp.15-24
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• 2018

Purpose: This study was conducted to analyze the factors associated with intoxicated patient's disposition in the pediatric emergency department. Methods: We retrospectively evaluated pediatric intoxicated patients visiting the pediatric emergency department of a hospital between January 1, 2011 and December 31, 2013. Specifically, we analyzed the association between hospitalization recommended rate and the following variables: patient age group, symptoms, intentional poisoning, decontamination and toxic level of substance. Results: We collected data from 345 patients. A high incidence was noted in the 1-4 years of age group and 10-15 years of age group. Unintentional poisoning occurred in 306 patients (88.7%). A total of 115 patients (33.3%) had symptoms when visiting. Forty three patients (12.5%) ingested cleaning substances, which was the most common agent. Potentially-toxic level was the most common level of the substance. The hospitalization recommended rate associated with visits in 2011 was 2.5 times greater than in 2012 and 2013, decontamination was 2.0 times greater than no decontamination, and poisoning with potentially-toxic substances was 2.6 times greater than poisoning with other toxic substances. Additionally, the hospitalization recommended rate associated with symptomatic patients was 2.4 times greater than that of asymptomatic patients and intentional poisoning was 2.4 times greater than unintentional poisoning. Conclusion: Patients with decontamination, ingestion of potentially-toxic substances, symptoms and intentional poisoning had increased hospitalization rates. In addition, the hospitalization rate for patients who visited in 2011 was greater than that of patients who visited in 2012 or 2013.

• 대한임상독성학회지
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• 제16권2호
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• pp.141-148
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• 2018

Purpose: The Korean government approved selected nonprescription drugs (Over-The-Counter drug; OTC drug) to be distributed in convenience stores from 15. Nov. 2012. This study examined the changes in the incidence and the clinical outcome of acute pharmaceutical drug poisoning after the deregulation of OTC drug sales. Methods: This study analyzed the data of Emergency Department based Injury In-depth Injury Surveillance (EDIIS), Korea Centers for Disease Control and Prevention, from 2011 to 2014. The following items were examined: age, gender, intention, alcohol association, pharmaceutical drugs resulting acute poisoning, the clinical outcomes in emergency department, and the admission rate of intensive care unit (ICU). This is a retrospective cross section observational study. Results: A total of 10,162 patients were subject to pharmaceutical drug poisoning. Acute poisoning by acetaminophen and other drugs were 1,015 (10.0%) and 9,147 (90.0%) patients, respectively. After the deregulation of OTC drug sales, acute poisoning by other drugs increased from 4,385 to 4,762 patients but acute poisoning by acetaminophen decreased from 538 to 477 patients (p<0.05). The rate of admission of acetaminophen poisoning increased from 36.1% (194/538) to 46.8% (223/477). The admission rate to the ICU by acetaminophen poisoning increased from 4.6% (25/538) to 11.3% (54/477) after the deregulation of OTC drug sales (p<0.05). Conclusion: Since the deregulation of OTC drugs sales, pharmaceutical drug poisoning has increased but acetaminophen poisoning has decreased. The rate of hospitalization and ICU admission by pharmaceutical drug poisoning with or without acetaminophen has also increased.

• 한국의료질향상학회지
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• 제5권2호
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• pp.216-223
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• 1998

We surveyed the discordance rate of principal diagnosis made at emergency room(ER) & made at ward on discharge of the patients. Subjects were four hundred eighty cases who came to the ER of one third-line hospital from January 1, 1998 to January 31, 1998. The discordance rate was higher in patients admitted to medical department(8.2%) than surgical department(1.5%). If the patients were transferred to other department during hospital stay, discordance rate increased from 3.3% to 6.3%. In conclusion, discordance rate of principal diagnosis made at ER and made at ward was higher in patients with complicated problems. Medical record department should keep these findings in mind if it has a plan to support the management of ER record.

• 대한임상독성학회지
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• 제3권1호
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• pp.33-39
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• 2005

Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.

• Korean Journal of Radiology
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• 제23권9호
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• pp.878-888
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• 2022

Objective: To investigate the clinical impact of a quality improvement program including dedicated emergency radiology personnel (QIP-DERP) on the management of emergency surgical patients in the emergency department (ED). Materials and Methods: This retrospective study identified all adult patients (n = 3667) who underwent preoperative body CT, for which written radiology reports were generated, and who subsequently underwent non-elective surgery between 2007 and 2018 in the ED of a single urban academic tertiary medical institution. The study cohort was divided into periods before and after the initiation of QIP-DERP. We matched the control group patients (i.e., before QIP-DERP) to the QIP-DERP group patients using propensity score (PS), with a 1:2 matching ratio for the main analysis and a 1:1 ratio for sub-analyses separately for daytime (8:00 AM to 5:00 PM on weekdays) and after-hours. The primary outcome was timing of emergency surgery (TES), which was defined as the time from ED arrival to surgical intervention. The secondary outcomes included ED length of stay (LOS) and intensive care unit (ICU) admission rate. Results: According to the PS-matched analysis, compared with the control group, QIP-DERP significantly decreased the median TES from 16.7 hours (interquartile range, 9.4-27.5 hours) to 11.6 hours (6.6-21.9 hours) (p < 0.001) and the ICU admission rate from 33.3% (205/616) to 23.9% (295/1232) (p < 0.001). During after-hours, the QIP-DERP significantly reduced median TES from 19.9 hours (12.5-30.1 hours) to 9.6 hours (5.7-19.1 hours) (p < 0.001), median ED LOS from 9.1 hours (5.6-16.5 hours) to 6.7 hours (4.9-11.3 hours) (p < 0.001), and ICU admission rate from 35.5% (108/304) to 22.0% (67/304) (p < 0.001). Conclusion: QIP-DERP implementation improved the quality of emergency surgical management in the ED by reducing TES, ED LOS, and ICU admission rate, particularly during after-hours.

• 대한임상독성학회지
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• 제13권1호
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• pp.11-18
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• 2015

Purpose: The aim of this study was to compare the clinical characteristics in emergency endotracheal intubation between patients with acute drug intoxication and medical disease. Methods: Data for airway registry collected in two emergency departments (ED) between April 2006 and March 2010 were reviewed retrospectively. The airway registry data included patient's demographic information and variables such as Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, complications of intubation, and clinical outcomes after intubation. Results: A total of 1480 patients were enrolled; 62 patients were classified as belonging to the intubation group after the drug intoxication group. No significant differences in Cormack-Lehane grade, 3-3-2 finger analysis, success rate, the number of attempts at intubation, and complications after intubation were observed between patients with acute drug intoxication and medical disease. However, significant difference was observed for indication of emergency endotracheal intubation. While emergency endotracheal intubations were usually performed in medical patients because of failure of airway patency, they were performed in intoxicated patients with the goal of preventing serious complications. Conclusion: Anatomical structures related to endotracheal intubation, the process and clinical outcome of intoxicated patients are not significantly different from those for medical patients.