• 제목/요약/키워드: Patient transport

검색결과 117건 처리시간 0.027초

외상 및 외상진료체계의 인식도 조사 (Survey of Recognition of Trauma and Trauma Care System)

  • 정일용;김중석;김영철;김성엽
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.165-169
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    • 2014
  • Purpose: Trauma is one of the most common and lethal causes of death in Korea, especially in people under the age of 40. However, a considerable percentage of trauma patients are lost each year due to the scarce resources of the trauma system. The purpose of this study was to determine the recognition of trauma and trauma system. Methods: From April 8th to 22nd, 2014, visitors and in-patients in our medical center were interviewed and surveyed with a questionnaire, which included 28 questions regarding the trauma system, such as the most common cause of death, the locations of trauma centers, the importance of trauma centers, and consent for supporting trauma centers financially. Results: The majority of the respondents recognized trauma as a common cause of death; this was particularly true for people younger than 40. Most respondents' expectancy for the optimal time for trauma patient transport was high, recognizing that major trauma patients should receive urgent care. The respondents felt that trauma centers are important and needed, just as much as police stations and libraries are. Among 178 respondents, 140 (80.5%) were willing to financially support the trauma system. Conclusion: The respondents were aware of the seriousness of trauma and generally agreed on the need for trauma centers. In order to meet the needs and the demands of the people, and to reduce preventable death rate, the trauma system should be improved not only in quality but also in quantity with better and more facilities and manpower, with the aid of publicity from trauma organizations and funding from the government.

한의학의 정신치료(정신분석 측면) (A Psychotherapy of Oriental Medicine - Focus on Psychoanalysis-)

  • 구병수
    • 동의신경정신과학회지
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    • 제14권2호
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    • pp.1-14
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    • 2003
  • Objectives : In order to make a new psychotherapeutic model in the theory of oriental medicine by means of psychoanalysis method. Methods : The research was done by comparing the contents of the Tong-Ui Po-Kam, techniques of Yang Saeng(養生術), with the psychoanalysis Results : 1. There's no difference in the mind state which a doctor has to have between the oriental doctor and the occidental doctor. You should make effort not to project yourself on a patient. A conception of 'doctor' in oriental medicine is one who trains one's mind rather than just healer. 2. Heart(心) in oriental medical conception is revealed by circulation structure of Jeong(精), Gi(氣), and Sin(神). A healthy mind comes from harmony and smooth transport of Jeong(精), Gi(氣), and Sin(神). 3. The conception similar to unconsciousness doesn't exist in oriental medicine, but the contents about the attitudes or the methods of training one's mind correspond to unconsciousness. 4. The psychotherapy of oriental medicine emphasized mutual dynamics between emotions at present, and presented a way of treatment by describing emotions from standpoint of 'Gi(氣)' 5. The special feature of psychological treatment in oriental medicine is that treatment is done by understanding emotions of present time as Gi(氣), and using dynamics of Gi(氣)(; 相生相剋). Also the balanced state can be kept even after treatment and prevention can be done by observing one‘s own unconsciousness(; training one's mind helps circulation of Jeong(精), Gi(氣), and Sin(神)) I think that we need a new realistic therapy model to develop these psychotherapy methods in oriental neuropsychiatry, through studying emotions in the theory of oriental medicine, especially Korean's emotions and spiritual training.

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Measurement of Neutron Production Double-differential Cross-sections on Carbon Bombarded with 430 MeV/Nucleon Carbon Ions

  • Itashiki, Yutaro;Imahayashi, Youichi;Shigyo, Nobuhiro;Uozumi, Yusuke;Satoh, Daiki;Kajimoto, Tsuyoshi;Sanami, Toshiya;Koba, Yusuke;Matsufuji, Naruhiro
    • Journal of Radiation Protection and Research
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    • 제41권4호
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    • pp.344-349
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    • 2016
  • Background: Carbon ion therapy has achieved satisfactory results. However, patients have a risk to get a secondary cancer. In order to estimate the risk, it is essential to understand particle transportation and nuclear reactions in the patient's body. The particle transport Monte Carlo simulation code is a useful tool to understand them. Since the code validation for heavy ion incident reactions is not enough, the experimental data of the elementary reaction processes are needed. Materials and Methods: We measured neutron production double-differential cross-sections (DDXs) on a carbon bombarded with 430 MeV/nucleon carbon beam at PH2 beam line of HIMAC facility in NIRS. Neutrons produced in the target were measured with NE213 liquid organic scintillators located at six angles of 15, 30, 45, 60, 75, and $90^{\circ}$. Results and Discussion: Neutron production double-differential cross-sections for carbon bombarded with 430 MeV/nucleon carbon ions were measured by the time-of-flight method with NE213 liquid organic scintillators at six angles of 15, 30, 45, 60, 75, and $90^{\circ}$. The cross sections were obtained from 1 MeV to several hundred MeV. The experimental data were compared with calculated results obtained by Monte Carlo simulation codes PHITS, Geant4, and FLUKA. Conclusion: PHITS was able to reproduce neutron production for elementary processes of carbon-carbon reaction precisely the best of three codes.

간호학생이 내린 간호진단 분석에 관한 연구 (A Study on the Classification of Nursing Diagnoses by Student Nurses)

  • 민순
    • 대한간호학회지
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    • 제25권3호
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    • pp.457-471
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    • 1995
  • This research was done to promote improvement of practical application of nursing diagnoses and to improve the quality of nursing. The subjects of this research were 156 second year students of C junior nursing college who were giving adult patient care. The nursing diagnoses of 312 reports were analyzed using NANDA. In these case reports only nursing diagnoses were considered, of which there were a total of 982. In the data analysis the 9H of the nursing students' nursing diagnoses matched with 105 NANDA nursing diagnoses, Of these, the most frequent diagnoses were pain(165, 17.48%), anxiety(101, 10.70%), alteration in nutrition(83, 8.79%) , sleep disturbance (67, 7.10%), in activity intolerance (67, 7.10%), ineffective breathing pattern(51,5.40%). The etiology for the students' nursing diagnoses were compared with NANDA's nursing diagnoses by frequency. The most frequent etiology for the nursing diagnoses of pain was a biological etiology(50, 31%), for anxiety, situation crisis(58, 57.43%), for alteration in nutrition, indigesion(23, 27.71%), for sleep disturbance, external etiology(25, 37.32%), for activity intolerance, immobile position(22, 32.84%), for ineffective breathing pattern, pain(35, 68.63%), and for ,impaired physical mobility, pain(31, 65.96%). The most frequent etiology for constipation was inadquate digestion of water and cellulose (16, 34.78%), for fluid volume felicity, loss of body fluid (21, 52.50%), for impaired skin integrity, external etilogy(16, 43.24%), for impaired physical mobility, pain(22, 62.86%) , for knowledge deficits, cognition disturbance(9, 27.27%), for ineffective air way clearance, secretion obstruction(14, 48.27%) , for impaired gas exchange, loss of transport ability of blood oxygen(9, 37.50%) , and for powerlessness, therapy environment (5, 22.73%). The number of nursing diagnoses by pattern was exchange(16), moving(6), feeling(4), choosing(4), relating(3), communication(1), perceiving(1), knowing(1), valuing(1).

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Effects of and barriers to hospital-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

  • Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
    • Physical Therapy Rehabilitation Science
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    • 제9권2호
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    • pp.82-89
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    • 2020
  • Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

유니버셜 디자인 관점에서 본 의료 로봇 침대 색채에 관한 연구 -(주)나인벨의 의료용 로봇 침대의 유니버셜 디자인 색채 사례를 중심으로- (A Study on the Color of Medical Robot Bed from the Universal Design Perspective -A Case Study on the Universal Color Design of Ninebell Corporation's Medical Robot Bed-)

  • 조현경
    • 문화기술의 융합
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    • 제5권4호
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    • pp.203-208
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    • 2019
  • 의료용 컬러 그래픽 연구는 의료용 로봇의 생산 시대를 통해 회사 제품의 디자인 품질을 세계적으로 확대하고 보급하는 기반이 될 것이다. 본 연구에서는 의료 로봇 침대 확대 시대에 걸맞은 기술과 내용, 유니버셜 의료색 적용, 인체공학적 색채 등을 기반으로 하였다. 이와 함께 유니버셜 디자인의 관점에서 의료용 침대 로봇의 색채 연구방향을 제시하였다. 이에 따라, 국내업체에서 개발 중인 의료용 로봇의 기능을 사례로 하여 유니버셜 컬러 설계를 제안하였다. 이 로봇 침대의 특성은 기능별로 3가지로 구분할 수 있는 바, 첫째는 치유성(Curative)으로 욕창 예방을 위한 치료 특성을, 두 번째는 의료 환경을 위한 청결성(Clean)으로 시트 자동교환을, 세 번째는 편의성(Convenient)으로 환자이송을 구현하는 기능을 갖는 것으로 파악된다. 본론으로 이에 적합한 기능 색채의 조합을 제시하였다. 결과적으로 제시한 색채분석 및 유니버설 컬러설계 기법이 첨단 의료용 로봇 침대의 외형과 기능을 잘 표현하는 데 유용한 방법론이 될 수 있을 것이다.

Identification of Putative Regulatory Alterations Leading to Changes in Gene Expression in Chronic Obstructive Pulmonary Disease

  • Kim, Dong-Yeop;Kim, Woo Jin;Kim, Jung-Hyun;Hong, Seok-Ho;Choi, Sun Shim
    • Molecules and Cells
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    • 제42권4호
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    • pp.333-344
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    • 2019
  • Various genetic and environmental factors are known to be associated with chronic obstructive pulmonary disease (COPD). We identified COPD-related differentially expressed genes (DEGs) using 189 samples accompanying either adenocarcinoma (AC) or squamous cell carcinoma (SC), comprising 91 normal and 98 COPD samples. DEGs were obtained from the intersection of two DEG sets separately identified for AC and SC to exclude the influence of different cancer backgrounds co-occurring with COPD. We also measured patient samples named group 'I', which were unable to be determined as normal or COPD based on alterations in gene expression. The Gene Ontology (GO) analysis revealed significant alterations in the expression of genes categorized with the 'cell adhesion', 'inflammatory response', and 'mitochondrial functions', i.e., well-known functions related to COPD, in samples from patients with COPD. Multi-omics data were subsequently integrated to decipher the upstream regulatory changes linked to the gene expression alterations in COPD. COPD-associated expression quantitative trait loci (eQTLs) were located at the upstream regulatory regions of 96 DEGs. Additionally, 45 previously identified COPD-related miRNAs were predicted to target 66 of the DEGs. The eQTLs and miRNAs might affect the expression of 'respiratory electron transport chain' genes and 'cell proliferation' genes, respectively, while both eQTLs and miRNAs might affect the expression of 'apoptosis' genes. We think that our present study will contribute to our understanding of the molecular etiology of COPD accompanying lung cancer.

Outcomes of Urgent Interhospital Transportation for Extracorporeal Membrane Oxygenation Patients

  • Jun Tae, Yang;Hyoung Soo, Kim;Kun Il, Kim;Ho Hyun, Ko;Jung Hyun, Lim;Hong Kyu, Lee;Yong Joon, Ra
    • Journal of Chest Surgery
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    • 제55권6호
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    • pp.452-461
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    • 2022
  • Background: Extracorporeal membrane oxygenation (ECMO) can be used in patients with refractory cardiogenic shock or respiratory failure. In South Korea, the need for transporting ECMO patients is increasing. Nonetheless, information on urgent transportation and its outcomes is scant. Methods: In this retrospective review of 5 years of experience in ECMO transportation at a single center, the clinical outcomes of transported patients were compared with those of in-hospital patients. The effects of transportation and the relationship between insertion-departure time and survival were also analyzed. Results: There were 323 cases of in-hospital ECMO (in-hospital group) and 29 cases transferred to Hallym University Sacred Heart Hospital without adverse events (mobile group). The median transportation time was 95 minutes (interquartile range [IQR], 36.5-119.5 minutes), whereas the median transportation distance was 115 km (IQR, 15-115 km). Transportation itself was not an independent risk factor for 28-day mortality (odds ratio [OR], 0.818; IQR, 0.381-1.755; p=0.605), long-term mortality (OR, 1.099; IQR, 0.680-1.777; p=0.700), and failure of ECMO weaning (OR, 1.003; IQR, 0.467-2.152; p=0.995) or survival to discharge (OR, 0.732; IQR, 0.337-1.586; p=0.429). After adjustment for covariates, no significant difference in the ECMO insertion-departure time was found between the survival and mortality groups (p=0.435). Conclusion: The outcomes of urgent transportation, with active involvement of the ECMO center before ECMO insertion and adherence to the transport protocol, were comparable to those of in-hospital ECMO patients.

의료기관 선택에 영향을 미치는 요인 분석 : 외래환자 중심으로 (Comparative Analysis of Medical Center Choice Factors : Outpatient Center)

  • 박현상;이혜승
    • 한국엔터테인먼트산업학회논문지
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    • 제13권6호
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    • pp.319-328
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    • 2019
  • 병원 경영에서 가장 중요한 것은 환자들의 필요와 욕구를 파악하는 것이라고 할 수 있다. 이 연구에서는 이를 위해 상대적 중요도를 파악할 수 있는 분석기법인 AHP를 이용하여 환자들이 병원을 선택함에 있어서 AHP의 적용을 통한 그 요인들 간의 상대적인 우선순위를 파악하려는 데 그 목적이 있다. 환자들의 병원선택요인을 파악함으로써 의료기관이 중요성을 분석하여 병원이미지 개선 및 의료의 질 향상에 도움이 될 수 있도록 모색해 보고자 한다. 먼저 12개의 병원선택요인 중에서 병원의 전문성, 다양한 진료과목, 직원의 친절도, 의사의 설명 및 진찰시간 등과 같이 환자와 직접적으로 연관되어 있는 요인들이 중요도 및 가중치가 높게 나타났다. 또한 병원 주차장, 대중교통의 편의성, 의료장비 등이 상대적으로 중요도 및 가중치가 낮게 나타났다. 이러한 연구 결과는 병원의 효과적인 이미지 개선 및 의료의 질 향상 전략에 중요하다고 볼 수 있다. 따라서 광주시 소재 의료기관들은 병원 마케팅을 위해 병원선택에 영향을 미치는 요인들을 고려한 병원경영 방침을 개선하여 병원이미지 개선 및 의료의 질 향상에 노력할 필요가 있다.

급성호흡곤란증후군 환자에서 복와위(prone position)와 산화질소흡입(nitric oxide inhalation) 병용 치료의 효과 (The Combined Therapy of Inhaled Nitric Oxide and Prone Positioning Has an Additive Effect on Gas Exchange and Oxygen Transport in Patients with Acute Respiratory Distress Syndrome)

  • 고윤석;임채만;이기만;진재용;심태선;이상도;김우성;김동순;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제45권6호
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    • pp.1223-1235
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    • 1998
  • 연구배경 : 급성호흡곤란증후군(ARDS) 환자의 폐 산소화를 개선시키기 위한 보조적 치료법인 복와위 자세에서의 인공환기는 대상 환자의 약 61%에서, 흡입 산화질소 투여는 60-80%에서 효과가 있는 것으로 보고되어 있다. 산소화 호전의 주된 기전은 복와위시는 이환이 심한 등쪽 폐의 환기 호전에 의한 단락 감소이며, 산화질소 투여 시는 이환부위로부터 정상 폐포로의 폐 혈류의 재분포에 의한 단락 감소안 것으로 알려져 있다. 그러므로 복와위와 산화질소의 병용 치료 시 산소화 개선에 상승 효과를 기대할 수 있으나 이에 관한 임상 연구는 없었다. 이에 저자들은 ARDS환자에서 두 치료의 병합이 가스 교환 및 혈류 역학에 미치는 영향을 관찰하였다. 방 법 : ARDS 환자 12명(연령 $56{\pm}12$ 세, 남 : 여=9 : 3)을 대상으로 앙와위에서 호흡 및 혈류역학적 지표를 측정한 후 복와위로 전환하였다. 복와위 30분과 2시간에 동일 지표들을 측정한 뒤 산화질소를 투여하고 (5-10 ppm), 이후 30분, 2 시간 및 산화질소 투여 중단 후 10분에 각각 동일 지표들을 재 측정하였다. 결 과 : 가스 교환 지표 : 복와위에서 산화질소 병용 치료시, 앙와위 및 복와위에서보다 $PaO_2/FiO_2$가 증가되었고(각각 p< 0.01) 폐동맥혈 산소분압차($AaDO_2$)는 감소하였다(각각 p<0.005). 호흡 역학적 지표 : 폐 탄성, 호흡기계 탄성, 기도 저항 및 흡기말 기도압은 치료 방법에 따른 차이가 없었다. 혈류 역학적 지표 : 복와위에서 산화질소 병용 치료시, 앙와위 및 복와위에서보다 심 박출량 및 조직산소전달량($DO_2$)이 증가되었으며(각 P< 0.05), 폐혈관 저항, 평균 폐동맥압 및 폐동맥쐐기압은 감소되었다(각 P< 0.05). 결 론 : 급성호흡곤란증후군 환자에서 복와위 및 산화질소 홉업의 병용 치료는 복와위 단독 치료에 비해 폐산소화 호전에 상승 작용이 있으며, 조직으로의 산소 전달량도 증가시키므로 급성호흡곤란증후군 환자의 보조적인 치료법으로써 유용할 것으로 사료되었다.

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