• Title/Summary/Keyword: Patient's position

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Oral surgery under local anesthesia with dexmedetomidine sedation in a morbidly obese patient with aortic dissection

  • Seto, Mika;Matsuda, Michitaka;Narihira, Kyoichi;Kikuta, Toshihiro
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.162-165
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    • 2016
  • We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations. We administered intravenous DEX for sedation of the patient in Fowler's position. In conclusion, our understanding of the risk factors of DEX enabled us to perform safe invasive oral treatment.

Cervical Traction (경추견인법)

  • Park Ji-Whan;Park Youn-ki
    • The Journal of Korean Physical Therapy
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    • v.3 no.1
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    • pp.203-209
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    • 1991
  • Cervical traction effects its benefits by immobilizing the neck when it is used in a continuous manner from a reclining position. when used intermittently traction functions by elongating the neck and straightening the cervical Lordosis. This position of slight flexion opens the posterior articulations, widens the intervetebral foramina, disengages the facet surfaces, and elongates the posterior muscular tissues and Ligaments. The duration of traction is arbitary but the amount of traction is that which is tolerated by the patient and benefits the patient's problem. Application of traction in slingh flexion accomplishes the same separation with Less force and thus with Less discomfort experienced by the patient. But the effect of traction on the disks is debated.

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Implementaion of Home Healthcare System for a Patient using SAW Tag (SAW 태그를 이용한 재택환자 종합관리시스템 구현)

  • Song, Jai-Chul
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.17 no.3
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    • pp.183-188
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    • 2017
  • This paper is for the a study on home healthcare system for a patient using SAW Tag. This system is useful when there's a patient in home. Many patients are wounded in restroom. But restroom is very private place and nobody want to be disturbed here. The place where the patient is most injured in the house is the toilet, and it is the point where the privacy of the individual should be kept and the patient's condition should be checked and cope with in case of emergency. And using saw tag, we can calculate position and ID through reflected rf signal. Therefore we propose a general home healthcare system. The management system utilized a seat bed system to monitor at-home patients. The system mounts a bio-signal measuring unit on a toilet seat, measures a bio-signal from the bio-signal measuring unit, and the measured bio-signal is transmitted to the main server through the user's smart phone. With proposed system, we can expand operation area to silver town where many patients are cared. In this paper we developed sensor system and saw tag positioning system and showed the result.

A Comparative Study on the Effect of Gel Pad, Sheepskin and Sponge on Prevention and Treatment of Decubitus Ulcers (양털, Gel Pad 및 Sponge의 욕창예방 및 치료효과에 관한 연구)

  • 이은옥;김매자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.93-104
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    • 1974
  • Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

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Study of Nuclear medical imaging tests patient of Claustrophobia (폐소공포증 환자의 핵의학 영상검사에 관한 연구)

  • Kang, Yong-Gil;Hong, Jin-Woong;Yang, Han-Joon;Park, Sung-Su;Lee, Gui-Won;Kim, Keung-Sik
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.1
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    • pp.55-59
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    • 2013
  • Patients who had claustrophobia tend to feel fear when they were scanned by an MRI, CT, PET-CT, or using a gamma camera scan. In this paper, claustrophobic patients were tested to find effective ways by changing patient's positions. For this paper, PET-CT scan in patients who had claustrophobia were used in the prone position. Prone position helped to maintain stable position and to get a h0igh quality of inspection without failure. Thus, as claustrophobic patients were requested taking prone position, they could feel comfortable. In a confined space, prone position for the claustrophobic patients who had a fear of the PET-CT examination would be expected to reduce the failure rate of inspection.

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Case Report of Physical Therapy using Proprioceptive Neuromuscular Facilitation for Activity Improvement in a Patient with Parkinson's Disease (파킨슨 환자의 활동 개선을 위한 PNF 개념을 이용한 물리치료 사례보고)

  • Shin, Jae-Wook;Kim, Jwa-Jun
    • PNF and Movement
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    • v.14 no.3
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    • pp.219-229
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    • 2016
  • Purpose: Patients with Parkinson's disease suffer many restrictions in daily life. This case report investigated how intervention with proprioceptive neuromuscular facilitation (PNF)-based physical therapy can affect the activities of Parkinson's patients. Methods: The subject was a 67-year-old female patient diagnosed with Parkinson's disease 3 years ago. Since the last five months, overall activities have become difficult for her, and she finally visited a hospital to take outpatient physical therapy because of the gait difficulties she suffered. The patient's medical history, system review, body structure and function, and activities were evaluated. The patient had difficulties in activities such as lying down, sitting, standing, maintaining a standing position, and walking. The PNF-based intervention was used for treating the impairments and improving the activities. The intervention was performed for 30 min a day, three times a week, for eight weeks. The qualifier of the international classification of functioning, disability, and health was used to measure the result, and the measurement was conducted before and after the intervention for eight weeks. Results: According to the result, the scores for maintaining a standing position, moving around within the home, and going to the toilet improved to "no problem" from "moderate problem." The scores for shifting the body's center of gravity, walking short distances, and washing oneself improved from "moderate problem" to "mild problem." The scores for sitting and standing improved to "no problem" and "mild problem" from "complete problem." The scores for preparing meals and doing housework improved from "severe problems" to "mild problem" or "moderate problem." The scores for walking long distances, moving around outside the home and other buildings, and using transportation did not show significant changes. Conclusion: Intervention with PNF-based physical therapy improved the activity of patients with Parkinson's disease, thus proving its effectiveness. The case report suggested that a therapist can use PNF as a physical therapy intervention for patients with Parkinson's who suffered restrictions in daily activities.

A Study on Needs of the Spinal anesthesia Patients (척추마취 수술환자의 간호요구)

  • Nam, Soung Mi;Kim, Myung Hee
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.666-677
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    • 2000
  • The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

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Endotracheal Intubation of Paramedics in a Moving Ambulance (이동 중 구급차에서 1급 응급구조사의 기관내 삽관)

  • Shim, Gyu-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.11
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    • pp.5292-5298
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    • 2012
  • The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

Effects of Using PNF in Progressive Sitting Position on Dynamic Balance in a Patient with a Cerebellar Injury -Single Subject Design- (점진적 앉은 자세에서의 PNF운동이 소뇌 손상환자의 동적 균형능력에 미치는 효과 -단일 사례 연구-)

  • Kim, Dae-Kyeong;Na, Eun-Jin;Moon, Sang-Hyun
    • PNF and Movement
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    • v.14 no.2
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    • pp.149-155
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    • 2016
  • Purpose: The purpose of this study was to investigate the effects of using proprioceptive neuromuscular facilitation (PNF) exercise in the progressive sitting position on the dynamic balance ability of a patient with a cerebellar injury. Methods: The subject had ataxia due to cerebellar injury. The subject participated in a PNF bilateral scapular pattern exercise with stabilizing reversal technique during a progressive sitting position session as well as baseline for 20 minutes a day for 4 weeks. In the first session, PNF exercises were performed at a height of 40 cm for 10 minutes, and in the second session they were performed at 50 cm for 10 minutes from a lower center of gravity (COG) to a higher COG sitting position. We used the Berg Balance Scale (BBS), Five-Times-Sit-to-Stand Test (FTSST), and the Timed Up and Go Test (TUGT) to measure the subject's dynamic balance ability every two days through the entire session. Results: After participating in the program, the subject's dynamic balance ability improved compared to the first baseline, as measured by BBS (2 points increased), FTSST (5.3 sec decreased), and TUGT (2 sec decreased). The increase was also maintained in the second baseline session. Conclusion: PNF exercise using bilateral scapula patterns with a stabilizing reversal technique helps to enhance the dynamic balance ability of a cerebellar injury patient.

Development of Knee Weight-bearing Radiography Assist Device (무릎 체중부하 촬영 보조장치 개발)

  • Yon-Lae Kim;Young-Woo Yoon
    • Journal of radiological science and technology
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    • v.46 no.5
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    • pp.395-399
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    • 2023
  • The knee arthritis patients are generally performed standing position radiography. However, patients with pain caused by degenerative diseases or injuries in the knee have difficulty maintaining a standing position. Therefore, this study aims to develop a knee joint standing weight bearing projection assist device to solve these problems when patients undergo knee radiography due to various diseases. The design of the knee joint weight-bearing radiography assist device is carried out with 3D design and drawing production to secure basic data, electric support and frame manufacture. A fixed device for maintaining the patient's knee standing weight-bearing projection, an electric digital height device, a digital protractor, and a safety device were designed. The arm support is made of PVC with a cushion to relieve the impact and make it easier to remove debris. The digital electric device can be moved up and down according to the patient's height, and a remote control is attached. The safety device is made to be adjustable in size by attaching metal hooks on both sides of the frame and to shield the scrotum. A digital protractor was attached to the side frame to set the desired knee angle. When a self-made assist device was used to perform a knee joint standing weight bearing projection, it helped maintain arm support and lower extremities position. In addition, the height could be adjusted using an assist device during standing projections, which helped the patient maintain the position.