• Title/Summary/Keyword: Non-emergency

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Analysis of Prehospital Care Report for Improving Emergency Service at Prehospital Phase (병원 전 단계 응급의료서비스 개선을 위한 구급활동일지)

  • Choi, Gil-Soon;Kim, Youn-Kyoung
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.163-174
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    • 2007
  • Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.

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A Study on the Architectural Planning of Plan Type and Area Composition in Medical Emergency Center (지역응급의료센터의 평면유형 및 면적구성에 관한 건축계획적 연구)

  • Kwon, Yongtaek;Roh, Jihwa
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.18 no.2
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    • pp.55-64
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    • 2012
  • Recently, our country is caused with economic growth and development and city intensive brazier being caused by industrial accident, crime accident and suicide of traffic facility, it is caused by with Western dietary life and the emergency patient is to an increase tendency. And the life increases with medical development and the medical emergency demand of the old people are increasing. Approximately 80% of the patients are non-emergent patients who receive ambulatory care and the rest 20% of the patients are serio us- emergent patients Emergency patients because non-strategy it is doing with function as imported medical treatment and provides, equipment, the operation is being impossible with manpower tribal etc.

Clinical Profiles of Patients who Undergone Emergency Angiographic Embolization at Emergency Department (혈관 색전술을 시행한 외상 환자에 대한 임상적 고찰)

  • Sun, Jong Hyo;Kim, Jae Kwang;Lim, Yong Su;Kim, Jin Joo;Jo, Jin Sung;Hyun, Sung Youl;Jeong, Ho Sung;Yang, Hyuk Jun;Lee, Gun;Kim, Jeong Ho
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.248-253
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    • 2009
  • Purpose: Hemodynamically unstable pelvic fractures represent therapeutic challenges for the trauma team. The authors of this article have studied the clinical profiles of the angiographic intervention population at the emergency department during four years (2005~2009) to develop clinical guidelines for preventing deaths due to multiple trauma and for predicting the prognosis during initial evaluation. Methods: We performed a retrospective review of 34 patients who had undergone angiographic interventions at the emergency department and compared the differences in clinical variables between survivors and non-survivors. Results: Representative values were compared between survivors and non-survivors : RTS (revised trauma score) 7.006 (6.376~7.841) vs. 6.128 (4.298~6.494), PRC (packed red cell) units 5.5 (2.0~11.0) vs. 15 (8.0~18.5), and lactate (mmol/L) 3.0 (1.0~7.0) vs. 8.5 (3.5~10.5). RTS (p<0.01) and PRC units before angiographic interventions (p=0.01) and lactate (p=0.02) had correlations to the final outcomes. Conclusion: The availability of an angiographic suite and persistent hypotension after adequate fluid resuscitation for pelvic trauma are good indications of angiographic intervention for pelvic hemorrhage.

A Study on Cognition about 119 Rescue·First Aid Team - Gwangju Area College Student as the Central Figure - (119구조·구급대에 대한 인식도 조사 연구 - 광주지역 보건계열과 비보건계열 대학생을 중심으로 -)

  • Kim, Kab-Sun
    • The Korean Journal of Emergency Medical Services
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    • v.6 no.1
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    • pp.141-152
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    • 2002
  • The purpose of this study is to provide the basic materials for searching the way of improvement to heighten the emergency medical welfare level by one step further. To achieve this purpose, the subjects of this study were selected 452 college students in Gwangju, using a random sampling method. The statistical analysis methods utilized for analyzing the collected data are frequency analysis, $x^2$ test. The conclusions obtained from these analyses are as following ; 1. In question about necessary optimum number of persons for rescue first aid activity, health and non-health major college students responded by 39.2%, 45.3% respectively that rescue team 15 people, first aid team 3 people is most suitable. But there was no significant difference in major department(p<0.05). 2. In question about security of the public health doctor and the emergency medical technician, all health and non-health major college students are recognizing necessity urgently, but there was no significant difference in major department(p<0.05). 3. In question about 119 rescue first aid team member applying for an examination qualification grant to the department of EMT's graduate, all health and non-health major college students were highest by 52.9%, 52.4% respectively in "necessity" item. But there was no significant difference in major department(p<0.05). 4. Because rescue first aid equipment level appears higher than 41.7% in non-health major college student's case by 54.2% in health major college student's case, health major college students are recognizing that equipment level should be supplemented more but there was no significant difference in major department(p<0.05). 5. In question about equipment supplement, all health and non-health major college students appeared highest by 64.8%, 69.3% in accident type different special equipment. But there was no significant difference in major department(p<0.05). 6. In question about rescue ambulance car size, we could know being thinking that health and non-health major college student each 61.2%, 56.5% is small and narrow that large size of the rescue ambulance amount need. But there was no significant difference in major department(p<0.05). 7. In question about patient's state is worsened, because rescue first aid equipment is inferior, health major college student responded sometimes 55.1%, many 29.5%. very many by 11.5%, while non-health major college student responded 65.8%, 23.1%, 4.0% respectively. There was significant difference in major department(p<0.05). 8. In question about emergency patient must utilize for 119 rescue ambulance car, all health and non-health major college students appeared highest by 38.8%, 41.3% in "not so" item. In question about rescue first aid team's first-aid treatment ability improves more, all health and non-health major college students appeared highest by 58.1% and 58.7% respectively in "improve" item. In question about "119 rescue ambulance car must go more rapidly than now", all health and non-health major college students are recognizing that should be quicker by 58.1%, 60.9% respectively. When called to 119 all health and non-health major college students responded highest by 55.5%, 53.3% respectively that we must receive first-aid treatment direction from a doctor. In question about "119 rescue ambulance car must be made the pay system", all health and non-health major college students responded 74%, 80% respectively in "not so" item. There was significant difference in major department(p<0.05). In conclusions, In oder to provide superior rescue first aid service to people, a public health doctor should be placed in the situation room inside the fire station so that the doctor could instruct the proper emergency treatment suitable for each situation to the rescue first aid team. Also, national education about a first-aid treatment that do to all people is necessarily necessary in emergency delivery system and this should be spread extensively through school education and broadcasting medium and education should be gone side by side, and see that will can save emergency patients' life which is more when these education consists continuously fixed period for public institution of policeman, fire officer etc. specially. And for reinforcement of patient transfer system, public organization must procure special ambulance car so that emergency patient receive first aid treatment while transfer.

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The Consequence of Delayed Diagnosis of an Occult Hip Fracture (잠행 고관절 골절의 진단 지연의 결과)

  • Je, Sangbong;Kim, Hyejin;Ryu, Seokyong;Cho, Sukjin;Oh, Sungchan;Kang, Taekyung;Choi, Seungwoon
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.91-97
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    • 2015
  • Purpose: Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture. Methods: We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group. Results: Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment. Conclusion: A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

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The Evaluation of Basic Cardiopulmonary Resuscitation Training Targeted for College Students (대학생의 기본 심폐소생술 교육 평가 - 간호과와 비간호과를 대상으로-)

  • Lee, Jung Eun;Koh, Bong Yeun;Lee, In Mo;Choi, Keun Myung;Park, Shin Il;Ahn, Hong Gi
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.43-54
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    • 2003
  • The purpose of this study was to evaluate the accuracy of CPR skills and the satisfaction of CPR Training targeted for college students. Also, this study made comparative study of nursing students and non-nursing students. The sample consisted of 248 students(132 nursing students, 116 non-nursing students). CPR Training was designed by two components which were a lecture and demonstration by one professor and individual practice by instructors. As tool of measurement estimation satisfaction of CPR Training questionnaires were developed based on educated contents. The accuracy of CPR skills were checked by SkillReporter CPR training manikin. Collected data were computerized and analyzed by SPSS-WIN program. The results were as follows : 1. The skills of CPR were cardiac compression 92.79 times/min, correct cardiac compression rate 90.85%, ventilation 9.93 times/min, correct ventilation rate 79.34%. 2. The mean of the accuracy of CPR skills were 2.94(SD .87). 3. When errors were analyzed, the highest item was stomach distension(51.2%) of ventilation skills and too little(70.6%) of cardiac compression skills. 4. The mean of the satisfaction of CPR training were 2.87(SD .17), the highest item of the satisfaction of CPR Training was practice. 5. We found significant statistical differences based on the accuracy and the error, non-nursing students were high in correct cardiac compression per minute(t=3.615, p=.000) and ventilation too much(t=4.292, p=.000), nursing students were high in correct ventilation rate(t=-3.885, p=.000) and cardiac compression too shallow) t=-2.842, p=.005).

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Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools (예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석)

  • Kim, Yong-Joon;Sim, Kyoung-Yul;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.7-18
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    • 2022
  • Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

Analysis of Nursing Records for Elderly Patients with Abdominal Pain in the Emergency Medical Center (응급의료센터에 내원한 복부통증 노인 환자에 대한 간호기록 분석)

  • Lee, Hyeo Ki;Kim, Jong Im
    • Journal of muscle and joint health
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    • v.26 no.1
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    • pp.27-34
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    • 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.

A Characteristics Analysis of Pre-hospital Acute Poisoning in The Elderly

  • Choi, IL-Soon;Kim, Seon-Rye;Cho, Byung-Jun
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.8
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    • pp.123-129
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    • 2019
  • This study selected all patients with acute poisoning carried by the 119 emergency services in K-Province from January 1 to December 31, 2015 for complete enumeration. The subjects were 1,627 patients who were classified as poisoning suspected in chemicals and animal/insect poisoning by Rescue Emergency Activity Information System(Emergency Statistics) in fire-fighting portal system of K-province fire-fighting officers. The 119 activity journals were analyzed retrospectively. The major results are as follows. Regarding the demographic characteristics of the elderly and the non-elderly, the most people were unemployed in the elderly group, other job, the non elderly group about their occupations and in both groups, the most people lived in rural areas about their living places. Regarding the poisoning characteristics of the elderly and the non-elderly, the most causing substance was bee sting about the poisoning causing substances and most of patients didn't get drunken about drunken state in both group. Regarding the time factors of the elderly and the non-elderly, both groups had the most accidents in afternoon about the poisoning time and in summer about the seasonal distribution.

Clinical Characteristics and Prognosis of Heat Stroke (열사병의 임상적 특징 및 예후에 관한 연구)

  • Park, Noh Han;Ryoo, Hyun Wook;Seo, Kang Suk;Park, Jung Bae;Chung, Jae Mung
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.113-120
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    • 2006
  • Purpose: The aim of this study was to evaluate the clinical characteristics of classic heat stroke in Korea and to identify factors of prognosis for heat stroke by comparing a survival group with a non-survival group. Methods: We retrospectively analyzed 27 patients with heat stroke who visited the Emergency Department of Kyungpook National University Hospital from March 2001 to February 2005. First, we divided the patients into two groups, the classic heat stroke group and the exertional heat stroke group, and compared them. Second, we compared the survival group with the non-survival group. Age, sex, cause, place where patients were found, underlying diseases, cooling time, performance of endotracheal intubation, initial Glasgow Coma Scale, initial vital sign, and laboratory findings were reviewed. Results: Five of 27 patients in heat stroke died. The classic heat stroke group had 20 patients. They were old and had more patients in the bathroom than the exertional heat stroke group had. The non-survival group showed lower blood pressure, lower initial GCS score, and higher respiratory rate than the survival group. In laboratory findings, the non-survival group also showed lower$HCO_3-$ level, lower albumin level, lower glucose level, more prolonged PT, and higher CK-MB level than the survival group. Delay in recognition of heat stroke and cooling were poor prognostic factors in heat stroke. Conclusion: The classic heat stroke group had patients who were old and found in the bathroom. Early recognition and treatment of heat stroke is important to reduce mortality. Cooling time, initial GCS score, mean arterial pressure, resipratory rate, $HCO_3-$, PT, CK-MB, and albumin seem to be meaningful when forming a prognosis for heat stroke patients.