• Title/Summary/Keyword: Oxygen Saturation

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Simulation training applying SBAR for the improvement of nursing undergraduate students' interdisciplinary communication skills (SBAR 적용 시뮬레이션 교육이 간호학생의 의료팀간 의사소통능력 향상에 미치는 효과)

  • Ha, Yikyung;Lee, Yoonju;Lee, Yeon Hee
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.2
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    • pp.407-419
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    • 2017
  • In this paper, we aim to evaluate the effect of simulation training with a focus on the application of SBAR for the improvement of communication skills of nursing students with physician. The results of the analysis of 25 videos recorded pre/post-simulation were as follows: In terms of the SBAR score, "the most recently measured vital signs" in stage B increased significantly (Z = -2.448, p =.014); the frequency of step-by-step progress in SBAR did not advance to the SBA or SBAR stage in the pre-simulation stage, but increased to 48% post-simulation. The frequencies of SBAR evaluation items mentioned in the post-simulation were the following order: the name of the patient (96%), nurse's name (80%), most recently measured oxygen saturation (76%), and main symptoms (60%). The results of the nurse's judgment (A), request for additional prescription or request for the doctor's direct patient visit (R) were not mentioned. Therefore, it is necessary to consider the application of SBAR in simulation training, which requires problem solving through cooperation with physicians, because it has a positive effect on education in nurse-physician communication.

THE COMPARATIVE STUDY ON THE SEDATIVE EFFECT OF ORAL MIDAZOLAM AND INTRAMUSCULAR MIDAZOLAM IN SEDATING YOUNG PEDIATRIC DENIAL PATIENTS (소아 환자에서 미다졸람의 경구 투여와 근육 투여에 의한 진정 효과의 비교 연구)

  • Min, Yu-Jin;Yu, Seung-Hoon;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.33 no.1
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    • pp.53-61
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    • 2006
  • When routine behavior control is impossible, midazolam is often used for sedation, because it has wide margin of safety, relatively few side-effects and multiple route of administration. Although intramuscular administration of all administration route is frequently used, it is a major source of anxiety, discomfort, and trauma in children. To the contrary, oral administration of midazolam is easily administered and accepted by children. But, it's therapeutic drug concentration has not been established. The purpose of this study was to compare sedation effect and physiologic parameter of oral midazolam which palliate demerits of intramuscular administration in sedating young pediatric patients with intramuscular midazolam Twelve negative children, mean age 62.5 months, who needed at least two separate restorative visits, requiring local anesthesia participated in this study On every visit, one of the following 2 different sedative regimen was given : (1) 0.30mg/kg midazolam by intramuscular administration (2) 0.75mg/kg by oral administration. Physiologic parameter(oxygen saturation, heart rate) was recorded by ten procedure and behavior was videotaped and rated using Ohio State University Behavior Rating Scale and Automated Counting System by one investigator, blind to administration route The analyzed sedative effect of oral midazolam resulted in good sedative effect, comparing to intramuscular route, And there is no statistically difference between oral and intramuscular administration of midazolam (p>0.05).

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Relationship between Arousal Indices and Clinical Manifestations in Patients Who Performed Polysomnography (수면다원검사를 시행한 환자들의 각성지수와 임상양상과의 관계)

  • Kim, Sung Kyoung;Lee, Sang Haak;Kang, Hyeon Hui;Kang, Ji Young;Kim, Jin Woo;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak;Moon, Hwa Sik
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.183-190
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    • 2009
  • Background: Repeated arousals during sleep have been known to be associated with excessive daytime sleepiness and cardiovascular complications. We investigated the relationship between arousal indices and clinical parameters. Methods: We retrospectively reviewed medical records of 41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome. We defined total arousal index (TAI) as the number of arousals per hour and respiratory arousal index (RAI) as the number of arousals associated with apnea or hypopnea per hour. Results: There were significant positive correlations between arousal indices and apnea-hypopnea index (AHI) (RAI vs. AHI, r=0.958, p<0.001; TAI vs. AHI, r=0.840, p<0.001). RAI and mean oxygen saturation showed a significant negative correlation with each other (r=-0.460, p=0.002). TAI revealed a significant positive correlation with mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP) (TAI vs. MSBP, r=0.389, p=0.014; TAI vs. MDBP, r=0.373, p=0.019). There was no significant correlation between arousal indices and parameters of sleepiness. RAI had a significant positive correlation with body mass index (BMI) and neck circumference (NC) (RAI vs. BMI, r=0.371, p=0.017; RAI vs. NC, r=0.444, p=0.004). When partial correlation analysis was performed to adjust for other variables, there was significant correlation between RAI and AHI (r=0.935, p<0.001). Conclusion: This study shows that respiratory arousal index could be a useful index reflecting of severity of obstructive sleep apnea syndrome. Arousal during sleep would be concerned in the development of cardiovascular complication of obstructive sleep apnea. And some anthropometric factors would contribute to the development of arousals during sleep. Further studies are needed to clarify any cause-effect relationship.

Study on Formation Mechanism of Iron Oxide Nanoparticles (산화철 나노입자의 형성 메커니즘에 대한 연구)

  • Kim, Dong-Young;Yoon, Seok-Soo;Takahashi, Migaku
    • Journal of the Korean Magnetics Society
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    • v.22 no.5
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    • pp.167-172
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    • 2012
  • In order to analyze the formation mechanism of iron oxide nanoparticles, we measured the heat flow of $Fe(OL)_3$ precursor with temperature, and TEM images and AC susceptibility of aliquots samples sequentially taken from the reaction solution, respectively. The thermal decomposition of two OL-chain from $Fe(OL)_3$ produced the Fe-OL monomer, which were contributed to the formation of iron oxide nanoparticles. In the initial stage of nanoparticles formation, the small iron oxide nanoparticles had ${\gamma}-Fe_2O_3$ structure. However, as the iron oxide nanoparticles were rapidly growth, the iron oxide nanoparticles showed ${\gamma}-Fe_2O_3$-FeO core-shell structure which the FeO layer was formed on the surface of ${\gamma}-Fe_2O_3$ nanoparticles by insufficient oxygen supply from the reaction solution. These nanoparticles were transformed to $Fe_3O_4$ structure by oxidation during long aging time at high temperature. Finally, the $Fe_3O_4$ nanoparticles with high saturation magnetization and stable in the air could be easily synthesized by the thermal decomposition method.

LONG TERM FOLLOW UP OF EFFECTIVENESS AND COMPLICATIONS OF PALATOPHARYNGOPLASTY (구개인두성형술의 효과 및 합병증에 관한 장기추적관찰)

  • 박재훈;이용배;남순열;김원일
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.100-100
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    • 1993
  • Palatopharyngoplasty has been widely performed for the treatment of chronic snoring and obstructive sleep apnea syndrome. Lack of literature for long term effectiveness and complications of palatopharyngoplasty made us to report our result with minimum follow up of 5 years, compare to preop and postop 8 weeks deta. We evaluated subjective symptom and objectively documented polysomnographic improvement of 25 among 37 patients undergoing palatopharyngoplasty from 1987 to 1985. The remaining 12 patients were lost to follow up (1) snoring was abolized in 10 patients(40%) of these 25 patients and with vary degree(Grade 1-3), reduced in remainders except 3 patients (2) Sleep apnea seen preoperatively in 15 patient (AI > 20) was reduced to Grade 0 or Grade 1 in 13 patients. And marked change in AI & body weight was not seen at 5 year after operation. (3) 3 cases of mild velopharyngeal insufficiency, 1 case of asymmetry of soft palate 5 cases of pharyngeal dryness, were observed in this retrospective study and there was no nasopharyngeal stenosis loss of taste respiratory and cardiovascular complications.

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THE USE OF BISPECTRAL ANALYSIS AND HEMODYNAMIC MONITORING IN PATIENTS UNDERGOING INTRAVENOUS SEDATION FOR MINOR ORAL SURGERY (구강악안면외과 소수술시 정맥 의식하 진정법에서의 Bispectral Index and Hemodynamics monitoring을 이용한 진정 깊이에 관한 연구)

  • Shin, Jung-Sub;Min, Hyun-Gi;Lee, Ju-Hyon;Lee, Dong-Hyun;Kim, Myung-Rae;Kang, Na-Ra
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.6
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    • pp.567-571
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    • 2008
  • Purpose: The purpose was to assess the usefulness of midazolam in patients undergoing minor oral surgery under conscious sedation. Materials and methods: Bispectral index was examined in 20 patients receiving oral minor surgery with conscious sedation supplemented with local anesthesia. All patients included were ASA I and had no contraindications to the study medications. The patients were escorted to the day surgery operation room where, before the commencement of the sedation and surgical procedures, routine monitoring was applied, including the noninvasive monitoring of arterial blood pressure, arterial oxygen saturation, and 3-lead electrocardiogram (Electrocardiogram). Bispectral index electrodes were applied on the frontotemporal region after cleansing the skin with alcohol. Bispectral index was calculated with the Electrocardiogram monitor (A-2000; Aspect Co.). Midazolam was then titrated (initially 3mg wait 2min and 2mg). Vital sign and Bispectral index checked every 5 minute until the end of the procedure. The results were then compared. Results: The Bispectral index index values throughout the sedation study period alter many level. The index was dropped at 5 minutes after administration, but raised at injection and odontomy procedure. During the operation, mean Bispectral index index was higher than conscious sedation index range($60{\sim}80$). The amnesic effect was shown 17 cases out of 20 cases(85%). Conclusion: Conscious sedation technique using midazolma is a safe and effective method of controlling behavior in oral and maxillofacial surgery.

Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients (중환자실 환자의 욕창 관련 경계압력 예측요인)

  • Shine, Ji Seon;Kim, Soo Jin;Lee, Ji Hyun;Yu, Mi
    • Journal of Korean Academy of Nursing
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    • v.47 no.6
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    • pp.794-805
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    • 2017
  • Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

The Effects of $O_2$ Partial Prewwure on Soft Magnetic Properties of Fe-Hf-O Thin Films (Fe-Hf-O계 박막에서 산소 분압 변화가 박막특성에 미치는 영향)

  • 박진영;김종열;김광윤;한석희;김희중
    • Journal of the Korean Magnetics Society
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    • v.7 no.5
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    • pp.243-248
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    • 1997
  • The effect of $O_2$ partial pressure on microstructure and soft magnetic properties of as-deposited Fe-Hf-O thin film alloys, which are produced by rf magnetron sputtering method in $Ar+O_2$ mixed gas atmosphere, are investigated. Saturation magnetization ($4{\pi}M_s$) of Fe-Hf-O film were decreased with increasing $O_2$ partial pressure, the best soft magnetic properties exhibit at $O_2$ partial pressure of 10%. With further increase of $O_2$ partial pressure, soft magnetic properties decreased continuously. The $Fe_{82}Hf_{3.4}O_{14.6}$ film with $P_{O2}=10%$ exhibits good soft magnetic properties with $4{\pi}M_s=17.7kG$, $H_c=0.7Oe$ and ${\mu}_ {eff}$ (1~100 MHz)=2,500, respectively. The addition of O is effective in grain refinement. In case of $P_{O2}=15%$, it is observed that $Fe_3O_4$ compound is formed and high frequency soft magnetic properties are decrease. The electrical resistvity($\rho$) of Fe-Hf-O film is increased with increasing $O_2$ partial pressure. Electrical resistivity of $Fe_{82}Hf_{3.4}O_{14.6}$ film was 5 times higher than that of the film without oxygen. Thus, it is considered that the good magnetic properties of $Fe_{82}Hf_{3.4}O_{14.6}$ film results from decreasing the $\alpha$-Fe grain size by precipitates (Hf and O), high electrical resistivity.

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Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

  • Choi, Ji Soo;Lee, Eun Hye;Lee, Sang Hoon;Leem, Ah Young;Chung, Kyung Soo;Kim, Song Yee;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Chang, Joon;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.4
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    • pp.276-282
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    • 2020
  • Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO2) or SpO2 <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV1), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV1 (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV1 tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

Degradation of Polyvinyl Alcohol in Dye-Processing Wastewater by Agar-Acrylamide Microbial Immobilization Method (한천-아크릴아마이드 미생물 고정화법에 의한 폐수 중 폴리비닐알콜의 분해)

  • 김재훈;김정목조무환
    • KSBB Journal
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    • v.10 no.3
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    • pp.241-248
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    • 1995
  • For the treatment of poorly biodegradable polyvinyl alcohol(PVA) in dye-processing wastewater, immobilized microbial beads were prepared by uslng agar-acrylamide method. PVA removal efficiency for the synthetic wastewater was 85% at the PVA volume loading rate of $3.1g/\ell$.day. In case of real desizing wastewater, PVA removal efficiency was 81.3% at the PVA volume loading rate of $3.25g/\ell$.day. In observation of cross section of immobilized bead passed 5 months with diameter of 2.4mm, the growth of cell was limited by the resistance of substrate and oxygen transfer for the inners region of more than 48% of bead radius from the surface. It was estimated that 70% of total removed PVA was degraded by the immobilized cells in the continuous immobilized reactor. Substrate utilization rate in the suspended reactor was decreased with increasing dilution rates above 0.083 hr-1, but that in the immobilized reactor was increased with increasing dilution rates up to 0.125hr-1. The substrate removal efficiency of immobilized reactor was much superior to that of suspended reactor with increasing dilution rates. Saturation constant of substrate utilization rate equation, Ks was $6.6 g PVA/\ell$, and maximum specific substrate utilization. k was 0.175g PVA/g cell.hr

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