• Title/Summary/Keyword: Medical Emergency Center

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A Study on Estimating the Nursing Cost of Home Hospice Care (가정 호스피스 간호 수가 개발)

  • Lee, Tae-Wha;Sung, Young-Hee;Choe, Wha-Sook;Hwang, Na-Mi;Park, Hee-Ok;Hwang, Moon-Sook;Jang, Ok-Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.2
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    • pp.182-195
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    • 2008
  • Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.

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Psychosocial Assessment and Related Factors for Kidney Transplantation Candidates in South Korea: A Descriptive Correlational Study (한국 신장이식 대기자의 심리사회적 평가 및 영향 요인)

  • Chong, Hye Jin
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.249-258
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    • 2019
  • Purpose: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status. Methods: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT. Results: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk. Conclusion: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.

A Study on the Relationship Between Level of Pain and Depression in Middle-aged Women with Chronic Low Back Pain (중년여성이 경험하는 만성요통의 통증정도와 우울)

  • Seo, Bok-Nam;Ham, Young-Lim;Ahn, Yang-Heui
    • Journal of muscle and joint health
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    • v.14 no.2
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    • pp.118-126
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    • 2007
  • Purpose: The purpose of the study was to examine the relationship between the level of pain and depression in middle-aged women with chronic low back pain. Method: A descriptive correlational research design was utilized. The participants were middle-aged women who visited two back pain clinics in Wonju from October, 2006 through February, 2007. A total of 195 low back pain patients agreed to participate in this study, and data from 177 were analyzed. Data was collected using a questionnaire which included Visual Analogue Scale (VAS), Center Epidemiology Studies Depression Scale(CES-D), and general characteristics. Descriptive statistics, t-test, ANOVA and Pearson correlation coefficients were utilized in the analysis. Results: The mean score for chronic low back pain as measured by the VAS was 4.99 (SD 2.41). The average score for depression as measured by the CES-D was 22.00 (SD 10.18). There was a significant relationship between the level of pain and depression (r=.372, p<.001). Conclusion: Nurses need to take into consideration depression of middle-age women with chronic low back pain for assessment and intervention. In the future, developing a strategy for integrating intervention of pain-control and depression will be needed in nursing care for middle-aged women with chronic low back pain.

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Assessment of Obesity Indices in Consideration of Gender and Age (성별과 연령을 고려한 비만 지표 평가)

  • Min, Gyung-Hun;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.9
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    • pp.4046-4053
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    • 2011
  • In order to increase the accuracy and efficiency in measuring obesity conducted outside the hospitals, we examined not only the Body Mass Index and cutoff values of waist circumference of 3,281 adults but also considered their gender, age and various body characteristics. This study included 1,505 males (45.9%) and 1,776 females (54.1%) who visited the comprehensive health checkup center. The average body fat content of male participants was 22.2%, and their Body Mass Index was 24.4kg/$m^2$. The average Body Mass Index of female participants was 22.9kg/$m^2$. The average of waist circumference of male subjects was 86.2cm while that of female subjects was 76.9cm. The conventional method to measure obesity using BMI and WC only does not reflect the actual body fat which may change according to one's gender and age. Therefore, for those who visit individual's place to measure obesity outside the hospitals only based on BMI and WC, we need a new standard to measure obesity more accurately.

Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study

  • Siddiqui, Meraj;Gultekingil, Ayse;Bakirci, Oguz;Uslu, Nihal;Baskin, Esra
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.364-369
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    • 2021
  • Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.

A Peripherally Inserted Central Catheter is a Safe and Reliable Alternative to Short-Term Central Venous Catheter for the Treatment of Trauma Patients

  • Ryu, Dong Yeon;Lee, Sang Bong;Kim, Gil Whan;Kim, Jae Hun
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.150-156
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    • 2019
  • Purpose: To determine whether a peripherally inserted central catheter (PICC) meets the goals of a low infection rate and long-term use in trauma patients. Methods: From January 2016 to June 2018, the medical records of patients who underwent central venous catheterization at a level I trauma center were retrospectively reviewed. Data collected included age, sex, injury severity score, site of catheterization, place of catheterization (intensive care unit [ICU], emergency department, or general ward), type of catheter, length of hospital stay during catheterization, types of cultured bacteria, time to development of central line-associated bloodstream infection (CLABSI), and complications. Results: During the study period, 333 central vein catheters (CVC) were inserted with a total of 2,626 catheter-days and 97 PICCs were placed with a total of 2,227 catheter-days. The CLABSI rate was significantly lower in the PICC group when the analysis was limited to patients for whom the catheter was changed for the first time in the ICU after CVC insertion in the ER with similar indication and catheter insertion times (18.6 vs. 10.3/1,000 catheter-days, respectively, p<0.05). The median duration of catheter use was significantly longer in the PICC group than in the CVC group (16 vs. 6 days, respectively, p<0.05). Conclusions: The study results showed that the duration of catheter use was longer and the infection rate were lower in the PICC group than in the CVC group, suggesting that PICC is a safe and reliable alternative to conventional CVC.

Rapidly growing pediatric trampoline-related injuries in Korea: a 10-year single center retrospective study

  • Cho, Min Jeng;Kim, Jihoon;Kim, Sung Jeep;Kyoung, Kyu Hyouck;Keum, Min Ae;Park, Sung Kyun
    • Clinical and Experimental Pediatrics
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    • v.62 no.3
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    • pp.90-94
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    • 2019
  • Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

Derivation of External Exposure Characteristics of Industrial Radiography Based on Empirical Evidence

  • Cho, Junik;Kim, Euidam;Kwon, Tae-Eun;Chung, Yoonsun
    • Journal of Radiation Protection and Research
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    • v.47 no.2
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    • pp.93-98
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    • 2022
  • Background: This study aims to derive the characteristics of each work type for industrial radiography based on empirical evidence through expert advice and a survey of radiation workers of various types of industrial radiography. Materials and Methods: According to a Korean report, work types of industrial radiography are classified into indoor tests, underground pipe tests, tests in a shielded room (radiographic testing [RT] room test), outdoor field tests, and outdoor large structure tests. For each work type, exposure geometry and radiation sources were mainly identified through the expert advice and workers' survey as reliable empirical evidence. Results and Discussion: The expert advice and survey results were consistent as the proportion of the work types were high in the order of RT room test, outdoor large structure test, underground pipe test, outdoor field test, and indoor test. The outdoor large structure test is the highest exposure risk work type in the industrial radiography. In most types of industrial radiography, radiation workers generally used 192Ir as the main source. In the results of the survey, the portion of sources was high in the order of 192Ir, X-ray generator, 60Co, and 75Se. As the exposure geometry, the antero-posterior geometry is dominant, and the rotational and isotropic geometry should be also considered with the work type. Conclusion: In this study, through expert advice and a survey, the external exposure characteristics for each work type of industrial radiography workers were derived. This information will be used in the reconstruction of organ dose for health effects assessment of Korean radiation workers.

Bow Hunter's Syndrome Caused by Bilateral Dynamic Occlusion of the Subaxial Vertebral Arteries during Neck Extension (경추 신전 시 축하 척추동맥의 양측성 동적 폐쇄로 인해 발생한 보우 헌터 증후군)

  • Yi, Jemin;Han, Ho Sung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.85-89
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    • 2020
  • Bow hunter's syndrome is a rare disease that shows the symptoms of vertebrobasilar insufficiency resulting from a dynamic obstruction or stenosis of the vertebral arteries during neck movement. This paper reports a case of a 59-year-old male who visited the emergency room with diplopia, tinnitus, and gait disturbance. Magnetic resonance imaging and angiography revealed a multiple cerebellar infarct, total obstruction of the right vertebral artery, and dynamic obstruction of the left vertebral artery during neck extension. As the infarction worsened, a thrombectomy was done. Posterior decompression and fusion at C5-6 were performed for the left vertebral artery. The left vertebral arterial patency was confirmed by intraoperative and postoperative angiography. No recurrence of the symptoms was observed for six months after surgery. Physicians need to pay attention to the diagnosis of vertebrobasilar insufficiency caused by an obstruction of the vertebral arteries during neck extension in cervical instability patients.

Impact of Highway Construction on the Regional Economy: Gangil-Chuncheon Highway (고속도로 건설이 지역경제에 미치는 기여도 분석연구: 강일~춘천 고속도로)

  • Na, Sung-Yong;Lee, Du-Heon;Kim, Hyun-Woo
    • Journal of the Korean Society of Industry Convergence
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    • v.25 no.6_3
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    • pp.1183-1190
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    • 2022
  • Recently, the Ministry of Strategy and Finance announced a plan to reduce the proportion of economic evaluation in non-metropolitan areas and strengthen balanced development evaluation through the reorganization of the preliminary feasibility study system. In addition, the social value of the quality of life, such as job, environment, and safety, which may be affected by the implementation of transportation facility investment projects, was reflected as the main item of policy evaluation. In this study, the ripple effect of the project in terms of social value was reviewed for the Gangil-Chuncheon. The effect of highway opening was investigated by reviewing the feasibility report, post-evaluation report, and statistical indicators. Recently, the Gangil-Chuncheon highway is getting used by around 110,000 people per day. The number of tourists in Chuncheon rapidly has increased from 5 million a year to more than 11 million now. In addition, it was confirmed to produce effects such as population migration, net inflow and land price increase, improvement of living convenience, and expansion of emergency medical care. Although this ripple effect was influenced by various socio-economic factors as well as the opening of the highway, it is clear that it is difficult to occur without the opening of the highway. It is judged that the evaluation of indirect benefits and social values due to the opening of the highway can be quantified through continuous research and data construction. Post-evaluation of construction works, including project efficiency evaluation and ripple effect evaluation, is performed for construction works with a construction cost of more than 50 billion won. In the future, we will continuously improve the evaluation system in order to evaluate the indirect benefits and social values of public investment projects.