• Title/Summary/Keyword: Patient location

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Comparisons of the qualities of chest compression according to various positions of rescuer to patient at the in-hospital cardiopulmonary resuscitation model (병원내 심폐소생술 모형에서 환자와 구조자의 거리 및 위치에 따른 가슴압박의 질 비교)

  • Kim, Geon-Nam;Choi, Seong-Woo;Jang, Jin-Yeong;Ryu, So-Yeon
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.7-15
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    • 2014
  • Purpose: The purpose of the study is to evaluate the distance and location of the rescuer to patient for the effective chest compressions qualities. Methods: The subjects were 42 students who earned the basic lifesaving technique and had informed consents to participate in the study from May 1 to 20 in 2013. The position of the rescuers included model-0(reference point), model-1(10 cm distance), model-2(20 cm distance), and model-kn(kneeling up). Results: The mean depth of compression was $50.6{\pm}6.6mm$ in Model-0, $48.7{\pm}8.2mm$ in Model-1, $44.2{\pm}10.4mm$ in Model-2, and $51.8{\pm}6.0mm$ in Model-kn. There were statistically significant differences between each Model(p<.001). Conclusion: The closer distance between rescuer and patient could provide more effective chest compressions. Kneeling on the bed stance provided the deeper chest compression consistently than the stool stance.

A Case Study about Treatment of soyangin Patient diagnosed as ICH without operated (뇌내출혈(ICH)환자의 비수술적 요법으로 치료한 1례(例)에 대한 증례보고(症例報告))

  • Park, Hye-Sun;Bae, Young-Choon;Ju, Jong-Cheon;Kim, Hyoung-Soon
    • Journal of Sasang Constitutional Medicine
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    • v.14 no.2
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    • pp.106-114
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    • 2002
  • The etiology of spontaneous intracerebral hematoma is aneurysmal rupture, arteriovenous malfomation, brain rumor, blood dyscrasia, cerebral infaction, cerebra inflammatory vascular disease, hypertension, and unknown causes. And the primary intracerebral hematoma is caused by unknown causes including hypertension. The clinical diagnosis of intracerebral hematoma, size, location, ventricular penetration, and evolution of brain parenchyme by hemorrhage are confirmed by CT scan. The authors have experienced 1 case of spontaneous intracerebral hematoma confirmed by CT scan. We have diagnosed the patient as Soyangin and treated by east integrated therapy. We classified this case as Soyangin-liyoiljung(少陽人裏熱證) and prescribed Yangkyuksanhwatang' Jihwangbaekhotang Hyungbangsabaeksan to the principle of Cheongyangsangsung(淸陽上升). In the result, we had the improvement of the symptoms. This report discribed the process and contents about the way the patient was cured.

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The application of electrochemotherapy in three dogs with inoperable cancers

  • Yeom, Seung Chul;Song, Kun Ho;Seo, Kyoung Won
    • Korean Journal of Veterinary Research
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    • v.61 no.1
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    • pp.9.1-9.6
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    • 2021
  • Factors such as location, volume, and the type of neoplasm complicate achieving tumor control. Electrochemotherapy (ECT) is a supplementary treatment for inoperable neoplasms in veterinary patients. Three dogs were diagnosed with a tumor. Two were squamous cell carcinoma (SCC), and the other was liposarcoma, each with a single tumor with the size range of 1 to 5 cm. The tumor locations were the cervical, oral, and abdominal cavity. ECT was selected as a treatment. Bleomycin was injected intratumorally at the dose of 0.5 to 1.0 mg/㎤. Five minutes after the injection, electric pulses applied in a sequence of eight pulses lasting 100 μsec each, were delivered in 1,000 V/cm. An evaluation was performed after 1 week, and the next session was administered 2 weeks later. In a patient with oral SCC, the tumor was in partial remission after two sessions of ECT. Another patient with SCC on her neck was showed complete remission after 2 weeks of ECT administration. A third patient showed stable disease for 8 weeks. Complications were mild and transient and included skin necrosis, edema, local pain, and gait disturbance. ECT is a valid adjuvant, especially for inoperable, cutaneous, or accessible intra-abdominal tumors.

Endoscopic retrograde cholangiopancreatography-related complications: risk stratification, prevention, and management

  • Clement Chun Ho Wu;Samuel Jun Ming Lim;Christopher Jen Lock Khor
    • Clinical Endoscopy
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    • v.56 no.4
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    • pp.433-445
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    • 2023
  • Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

Hydration-induced rapid growth and regression after indirect revascularization of an anterior choroidal artery aneurysm associated with Moyamoya disease: A case report

  • Gi Yeop Lee;Byung-Kyu Cho;Sung Hwan Hwang;Haewon Roh;Jang Hun Kim
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.1
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    • pp.75-80
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    • 2023
  • The prevalence of aneurysm formation in adults with Moyamoya disease (MMD) is higher than that in the general population. The treatment strategy is often individualized based on the patient's disease characteristics. A 22-year-old man was diagnosed with MMD after presenting a small thalamic intracerebral and subarachnoid hemorrhage in the quadrigeminal cistern. Cerebral angiography revealed a small aneurysm (2.42 mm) in the left anterior choroidal artery. Since the hemodynamics in the left hemisphere was compromised, an indirect bypass surgery was performed. The patient's condition deteriorated postoperatively because of poor perfusion of the internal carotid artery, and massive hydration was required. During neurocritical care, the aneurysm increased in size (5.33 mm). An observation strategy was adopted because of the distal aneurysmal location and the high risk involved. Subsequently, the patient recovered, and newly developed collateral flow appeared from the external carotid artery. Additionally, a dramatic size reduction of the aneurysm (1.51 mm) was noticed. Our case suggests that MMD-related dissecting aneurysms on a distal cerebral artery, which present a high risk of embolization, could be managed by indirectly reducing the hemodynamic burden. Massive hydration in such cases should be avoided or balanced to avoid the risk of rapid growth and aneurysm rupture.

Pleural Lipoma; A Case Report (흉막지방종의 수술치험;1례 보고)

  • 양성린
    • Journal of Chest Surgery
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    • v.26 no.6
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    • pp.505-506
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    • 1993
  • Lipomas are common tumors occuring mostly in the skin and subcutaneous tissue. This tumors are rare in the thorax. They frequently represent on incidental roentgengraphic finding or symptomes depending primarily on their location and size. The patient was 23-month-old male complained of fever and coughing. His chest X-ray and CT scan were revealed soft tissue density featured of pleural mass in the left lower hemithorax. And thoracotomy was performed for accurate diagnosis and treatment. So, experience of parietal pleural lipoma is reported here in.

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Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

  • Rhee, Seung-Hyun;Baek, Seung-Hak;Park, Sang-Hun;Kim, Jong-Cheol;Jeong, Chun-Gi;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.41.1-41.6
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    • 2019
  • Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

Rehabilitation Need on-Hospital with Disabilities (입원환자의 재활요구도)

  • Kim, Keum-Soon;Kim, Jeong-Hwa;Park, Jong-Im;Cho, Bok-Hee;Cho, Nam-Ok;Yoo, Kyung-Hee;Chon, Mi-Young;Lee, Cha-Yeon;Lee, Hea-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.8 no.2
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    • pp.102-109
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    • 2005
  • Purpose: The purpose of this study were to investigate the health status, the currency of rehabilitation therapy, and the patient learning needs on hospital with disabilities. Method: The subjects consisted of 87 disabled adults on hospital. Data was collected from February until to June 2005, where they asked structured questionnaires. A descriptive survey design was used and the SPSS 12.0 program was used for data analysis, which included t-test, ANOVA and Duncan's multiple comparison test. Result: There are a lot of patient through the transfer from the general hospital and the rehabilitation hospital. Their heath status changed good after hospital admission. Patients took exercise therapy the most, which is one of the rehabilitation therapy. But they need to enough physical therapy because patients have limited time for treatment. The education-need-level was high on hospital with disabilities, especially the need of support and care are the highest on the subscale of patient learning need. There are significant patient learning need differences in income and admission location(p<.05). Conclusion: Disabled persons on hospital needs to help and learning exercise by nurses. There should be rehabilitation programs for patients who are ready to leave the hospital. After discharging, there needs to be various rehabilitation services, support and care for the community based rehabilitation.

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Management of gunshot wounds near the elbow: experiences at a high-volume level I trauma center

  • Umar Ghilzai;Abdullah Ghali;Aaron Singh;Thomas Wesley Mitchell;Scott A. Mitchell
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.3-10
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    • 2024
  • Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.

Virtual reality education program including three-dimensional individualized liver model and education videos: A pilot case report in a patient with hepatocellular carcinoma

  • Jinsoo Rhu;Soyoung Lim;Danbee Kang;Juhee Cho;Heesuk Lee;Gyu-Seong Choi;Jong Man Kim;Jae-Won Joh
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.285-288
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    • 2022
  • Three-dimensional (3D) modeling of the liver can be especially useful for both the surgeon and patient to understand the actual location of the tumor and planning the resection plane. Virtual reality (VR) can enhance the understanding of 3D structures and create an environment where the user can focus on contents provided. In the present study, a VR platform was developed using Unreal Engine 4 software (Epic Games, Potomac, MD, USA). Patient's liver based on magnetic resonance image was imported as a 3D model that could distinguish liver parenchyma, vascular structure, and cancer. Preoperative education videos for patients were developed. They could be viewed inside the VR platform. To evaluate the usefulness of VR education program for patients undergoing liver resection for hepatocellular carcinoma, a randomized clinical trial evaluating the knowledge and anxiety of the patient was designed. The case presented in this report was the first experience of performing the VR education program and examining the knowledge and anxiety using questionnaires. When the knowledge score increased, the anxiety score also increased after the education program. Based on findings of this pilot case study, the timing and place where the questionnaire will be answered can be modified for formal initiation of the randomized controlled study to examine the usefulness of VR in patient education.