• Title/Summary/Keyword: Emergency treatment

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Effect of trauma center operation on emergency care and clinical outcomes in patients with traumatic brain injury

  • Han Kyeol Kim;Yoon Suk Lee;Woo Jin Jung;Yong Sung Cha;Kyoung-Chul Cha;Hyun Kim;Kang Hyun Lee;Sung Oh Hwang;Oh Hyun Kim
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.22-31
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    • 2023
  • Purpose: Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI. Methods: The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study. Results: On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center. Conclusions: The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

  • Tanriverdi, Ozgur;Beydilli, Halil;Yildirim, Birdal;Karagoz, Ulku
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.687-690
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    • 2014
  • Background: Emergency departments are visited by cancer patients for palliation of cancer-related symptoms, management of treatment-related side effects, oncologic emergencies, co-morbidities, and/or end of life care. In this study, we aimed to identify the characteristics of cancer patients admitted to an emergency medicine department in Southwest Turkey. Materials and Methods: In this retrospective descriptive study, a total of 304 emergency department admissions of 102 patients with cancer due to medical conditions were evaluated. Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression test were used. Results: The majority of patients visiting to emergency departments were male (n=66, 65%) and over 65 years of age (53, 52%). Some 30% (n=31) had a lung cancer diagnosis, 32% (n=33) presentation with dyspnea, 53% (n=55) with metastasis, 30% (n=16) with multiple metastatic lesions in lung, and 68% (n=70) had a poor ECOG performance status (score 3 to 4). Conclusions: Emergency departments have valuable roles in managing and caring for patients with malignancies.

Effects of community emergency medical resources on survival in out-of-hospital cardiac arrest (지역사회 응급의료 자원이 병원 밖 심장정지 환자의 생존에 미치는 영향)

  • Jo, Yoon-Joo;Kim, Kwang-Kee
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.205-221
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    • 2021
  • Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients' and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

A study of Nursing care need and the patient's satisfaction level of the nursing care in the emergency department (응급실 환자의 간호 요구도 및 만족도 분석)

  • Park, Yeong-Sook;Yoon, Jung-Won
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.1
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    • pp.73-85
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    • 2009
  • Purpose : The purpose of this study was to analyze the nursing care needs which can properly cope with patients' needs in emergency room, and grasp the patients' satisfaction level which can assess the care quality. It was aimed to check the level of today's care and provide basic data for care performance and care standard. Method : Data were collected from 192 patients in general hospitals in Daegu. The results are as followed. Results : First, the result of analysis conducted on the degree of overall patients' need for nursing care revealed that the need for nursing information (4.21+57) was the highest, followed by the order of information of patient's condition (4.05+53), emotional support (3.98+47), and nursing participation (3.65+54). Secondly, our study revealed that there was a significant negative correlat interrelation between care need and care satisfaction (r=.516, p<.01), indicating the higher the overall emergency room patients' nursing care need, treatment and nursing information, patient's condition, emotional support and nursing participation were, the lower the actual feeling of their satisfaction turned out. Conclusion : The study shows that treatment and nursing related information is the most highly needed and the patients' satisfaction level relies on actual care participation.

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Ultrasonographic findings in Fitz-Hugh-Curtis syndrome: a thickened or three-layer hepatic capsule

  • Moon, You Ho;Kim, Jung ho;Jeong, Won joon;Park, Sin-Youl
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.127-129
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    • 2018
  • Fitz-Hugh-Curtis syndrome (FHCS) is characterized by inflammation of the perihepatic capsules associated with the pelvic inflammatory disease (PID). FHCS is not a serious disease, but if not treated properly, it can result in increased medical costs, prolonged treatment, and dissatisfaction with treatment. However, early recognition of FHCS in the emergency department can be difficult because its symptoms or physical findings may mimic many other diseases. Although contrast-enhanced computed tomography (CECT) is the useful imaging modality for recognition of FHCS, it is available only when a high suspicion is established. We performed point-of-care ultrasonography in an 18-year-old woman who had a sharp right upper quadrant (RUQ) abdominal pain without PID symptoms and found a thickened or three-layer hepatic capsule. These findings coincided with areas showing increased hepatic capsular enhancement in the arterial phase of CECT. These results show that if the thickened or three-layer hepatic capsule without evidence of a common cause of RUQ pain is observed on ultrasonography in women of childbearing age with RUQ abdominal pain, the physician can consider the possibility of FHCS.

Neogambogic acid relieves myocardial injury induced by sepsis via p38 MAPK/NF-κB pathway

  • Fu, Wei;Fang, Xiaowei;Wu, Lidong;Hu, Weijuan;Yang, Tao
    • The Korean Journal of Physiology and Pharmacology
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    • v.26 no.6
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    • pp.511-518
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    • 2022
  • Sepsis-associated myocardial injury, an invertible myocardial depression, is a common complication of sepsis. Neogambogic acid is an active compound in garcinia and exerts anthelmintic, anti-inflammatory, and detoxification properties. The role of neogambogic acid in sepsis-associated myocardial injury was assessed. Firstly, mice were pretreated with neogambogic acid and then subjected to lipopolysaccharide treatment to induce sepsis. Results showed that lipopolysaccharide treatment induced up-regulation of biomarkers involved in cardiac injury, including lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), and troponin I (cTnI). However, pretreatment with neogambogic acid reduced levels of LDH, CK-MB, and cTnI, and ameliorated histopathological changes in the heart tissues of septic mice. Secondly, neogambogic acid also improved cardiac function in septic mice through reduction in left ventricular end-diastolic pressure, and enhancement of ejection fraction, fractional shortening, and left ventricular systolic mean pressure. Moreover, neogambogic acid suppressed cardiac apoptosis and inflammation in septic mice and reduced cardiac fibrosis. Lastly, protein expression of p-p38, p-JNK, and p-NF-κB in septic mice was decreased by neogambogic acid. In conclusion, neogambogic acid exerted anti-apoptotic, anti-fibrotic, and anti-inflammatory effects in septic mice through the inactivation of MAPK/NF-κB pathway.

The Clinical Investigation of Gastric Lavage in Patients with Acute Poisoning (급성 약물 중독 환자에서 위세척의 치료 실태)

  • Ok Taek Geun;Cho Jun Hwi;Park Chan Woo;Cheon Seung Whan;Lee Seung Yong;Kim Sung Eun;Choi Ki-Hoon;Hae Ji Hoon;Seo Jeong Yeul;Ahn Hee Cheol;Ahn Moo Eob;Cho Byung Ryul;Kim Yong Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.1
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    • pp.22-26
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    • 2005
  • The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.

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A Study on the Architectural planning of Spatial Organization Feature in Emergency Medical Facilities (응급의료시설의 공간구성요소에 관한 건축계획적 연구)

  • Choi, Chung-Ho;Park, Jae-Seung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.14 no.2
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    • pp.25-34
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    • 2008
  • The purpose of this study was to spatial organization feature and area composition of the over 500beds general hospital that will be expected construct in Seoul, Gyeonggi-do area after 2000year. From this study, we can suggest architectural planning for the efficiency operating of emergency medical facilities that can be used as preliminary data. The Spatial organization of emergency medical facilities are categorize into 4 session as medical examination and treatment, diagonosticradiology, staff, public and the others. We can find spatial organization system and area composition that compare area composition of 6 hospital the subject of research in a emergency medical facilities. The result of this study were as follows : spatial distribution of its field, grasping of spatial organization factor and recognize its merits and demerits should be researched in advance. Through this kind of recognizing emergency system, realistic medical local and condition architectural planning for spatial organization will be operate.

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Work and job satisfaction of military emergency medical technicians (군 응급구조사의 업무분석 및 직무만족도)

  • Heo, Jung-Im;Park, Jeong-Mi
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.3
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    • pp.33-49
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    • 2015
  • Purpose: This study aimed to investigate the work and job satisfaction of military emergency medical technicians (EMTs). Methods: We selected 122 military EMTs who participated in the refresher education in 2012. This study was conducted from November 12 to December 21, 2012. Results: The most frequent duties of military EMTs were scene assessment, cardiopulmonary resuscitation, surgical treatment, prehospital first-aid, transfer to the hospital, education, and call response. The air force and navy EMTs had better performance than the army EMTs. As for job satisfaction, the work itself ranked highest, whereas payment ranked lowest. Conclusion: The scope of the work of the military EMTs varied in the 14 fields of work but should be considered for further evaluation. In order to increase the job satisfaction of EMTs, their work conditions should be improved such as through salary increase and extra pay for those with professional certificates.