• Title/Summary/Keyword: Patient transport

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five year experience of thoracic civilian injuries -481 cases- (최근 5년간의 흉부손상 경험 -481 예-)

  • Son, Gwang-Hyeon;Gu, Bon-Il;Kim, Tae-Yeong
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.421-428
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    • 1986
  • From January 1981 through December 1985, 481 thoracic civilian injuries were reviewed in the Department of Thoracic Surgery, Paik Hospital in Seoul. Sixty two percent of the injuries were caused by traffic accident, 18% fall down, 15% blunt trauma, 2% crushing injury, 2% stab wound, and 0.4% gunshot wound. Peak incidence of the trauma victim was fourth and fifth decades revealing 22% and 27% respectively. Sex ratio was 3.5:1 with male predominance. Elapsed time before admission was less than one hour in 36% and one to six hour in 30%. The types of the injuries were as follows: Non-penetrating injuries were the most part of the wounded, 97.6%. Rib fracture was the most common lesion occupying 292 patient out of 481 [61%]. Of these 292 patients, 72% was multiple rib fracture. The incidence of hemothorax or hemopneumothorax was 19% [102 patients] [Table 4]. Most common associated condition was head injuries, 98 patients [14%]. Thoracoabdominal injuries were seen in 31 patients [0.6%]. Tube thoracostomy was the definitive measures in the 20% of the wounded. Open thoractomy was performed in 5%. Additional procedures for the associated condition were done in the 16% of the cases, for example, reduction of long bone fracture and trephination for the head injury. Among 481 wounded, fatal complication occurred in 13 patients [2.7%]. This paper has also compared two series of patients according to period; one from 1970 to 1980 and the present series [Table 8]. Conclusively, the fatal complications or trauma death may be reduced by the effort 1] rapid transport of the victim, 2] initial correction or resuscitative measures of the circulatory and ventilatory deficit 3] early decision of definitive thoracostomy or thoracotomy and 4] proper prioritizing for the care of the multiple critically injured patient.

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Research on the emission of electromagnetic waves in ambulance (구급차량 내 전자파 방출에 관한 조사)

  • Yun, Jong-Geun
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.61-69
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    • 2019
  • Purpose: The study aims to provide basic data to enhance the health of paramedics responsible for patient transport and treatment by analyzing the exposure level of paramedics to electromagnetic waves generated by electric devices used in ambulances. Methods: The study measured electromagnetic waves in ambulances in N region from July to December 2018. ME3030B produced by German Gigahertz Solutions was used to measure these waves and the maximum value was selected by moving it slowly in various directions. Each measurement part was selected and the mean value was calculated by repeatedly measuring at 10-minute intervals three times in total: $1^{st}$, $2^{nd}$, and $3^{rd}$ phase. Results: Among the electrical devices installed in the patient room of the ambulance measured at distances of 1 cm or 30 cm, results showed a high level of electric waves at the inverter ($26.25{\pm}39V/m$) and high level of electromagnetic waves ($564.00{\pm}31.75nT$) at the ozone sterilizer. According to measurements toward the front near the driver's seat, results indicated high levels of electric waves ($3.67{\pm}1.15V/m$) and electromagnetic waves ($450.00{\pm}19.52nT$) at the black box hard drive. Conclusion: Electromagnetic waves within the ambulance were stable and not beyond the range that might impact human health. However, in the case of the black box hard drive ($3.67{\pm}1.15V/m$, $450.00{\pm}19.52nT$) located under the passenger seat, it may have a direct effect on the human body and, thus it is necessary to move it to a storage area further away from the paramedics to minimized the impact.

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 the Current Status and Correlation of Traffic Demand according to the COVID-19 Indicator (코로나 19 지표에 따른 교통수요 현황 및 상관관계 분석)

  • Han, Kyeung-hee;Kim, Do-kyeong;Kang, Wook;So, Jaehyun (Jason);Lee, Choul-Ki
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.20 no.6
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    • pp.55-65
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    • 2021
  • In January 2020, the first COVID-19 confirmed patient occurred in Korea, and the pandemic continues to this day. In unprecedented situations, COVID-19 also affected the transportation sector, and there were no appropriate measures against changes in traffic volume and use of public transportation due to changes in citizens' lifestyles. Currently, each local government has not established separate measures for pandemic disease measures. In order to establish future disease countermeasures in the transportation sector, a predictive model was developed by analyzing the traffic volume and the number of public transportation uses, and conducting correlation analysis with the current status of COVID-19. As a result of the analysis, the traffic volume decreased, but the traffic volume decreased due to the increase in personal transportation, but it did not reach the number of public transportation uses. In addition, it was analyzed that the use of public transportation was initially affected by the number of confirmed cases, but over time, it was more sensitive to death and mortality than to the number of confirmed cases.

Lipoid Congenital Adrenal Hyperplasia Diagnosed in an Infant with Hyperpigmentation Only by Targeted Exome Sequencing

  • Kim, Jinsup;Yang, Aram;Jang, Ja-Hyun;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of mucopolysaccharidosis and rare diseases
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    • v.3 no.1
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    • pp.28-32
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    • 2017
  • Lipoid congenital adrenal hyperplasia (LCAH) is the severe form of congenital adrenal hyperplasia and is characterized by adrenal insufficiency with hyperpigmentation and female external genitalia irrespective of genetic sex. The steroidogenic acute regulatory protein (StAR) is required for the transport of cholesterol into the mitochondria for steroidogenesis, and defects in the StAR gene account for the majority of LCAH cases. In this report, we present a two-day-old hyperpigmented infant with phenotypical female genitalia. With consideration of the clinical and laboratory findings, the infant was suspected of having adrenal insufficiency due to LCAH and treated with glucocorticoid, mineralocorticoid, and sodium chloride. Karyotyping revealed 46, XY. Upon pelvis ultrasonography, adrenal hyperplasia with abdominal masses (thought to be the testicles) was reported. Molecular analysis with targeted exome sequencing revealed the homozygote mutation of c.772C>T ($p.Q258^*$) in exon 7 of the StAR gene. The early detection and treatment of adrenal insufficiency in infants with hyperpigmentation can prevent clinically apparent adrenal crises. During follow-up, the patient had a good clinical condition and maintained normal electrolyte and adrenocorticotropic hormone levels with medication.

Effects of Symptom Recognition and Health Behavior Compliance on Hospital Arrival Time in Patients with Acute Myocardial Infarction (급성심근경색증 환자의 증상 인지와 건강행위 이행이 내원시간에 미치는 영향)

  • Han, Eun Ju;Kim, Jeong Sun
    • Korean Journal of Adult Nursing
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    • v.27 no.1
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    • pp.83-93
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    • 2015
  • Purpose: This study was to investigate the relationship among the symptom recognition, health behavior compliance, and the hospital arrival time to identify factors influencing the hospital arrival time in patient with acute myocardial infarction (AMI). Methods: The subjects of this study were 200 patients with AMI in C hospital in D city. Data were analyzed using descriptive statistics, independent t-test, One way ANOVA, Pearson's correlation coefficients, and stepwise multiple liner regression tests. Results: Level of symptom recognition and health behavior compliance was low. The median value of hospital arrival time was 4.48 hours (ST-segment Elevation Ml was 2.43 hours and Non ST-segment Elevation MI was 7.83 hours). Among the studied factors, only symptom recognition had a statistically significant positive correlation with health behavior compliance (r=0.38, p<.001). Factors influencing the hospital arrival time were MI classification, diabetes mellitus (DM) and transport vehicle to the 1st hospital, and they accounted for 13% of the variance for hospital arrival time in AMI patients. Conclusion: To prevent the delay of hospital arrival time in MI patients, a more robust nursing strategic intervention according to MI classification and DM is necessary; further education on the importance of transportation utilization is also mandated.

Development of Constant Delivery Micro Pump in a Variable Pressure Environment for Intrathecal Drug Administration System (레져버에 압력이 가해지는 환경에서의 미소 정량 토출 펌프의 개발)

  • Lee, Tae Gyeong;Lee, Cheol Su;Jung, Yu Seok;Park, Gyeong Geun
    • Journal of the Korean Society of Manufacturing Technology Engineers
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    • v.26 no.4
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    • pp.387-394
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    • 2017
  • This paper develops a pump system for patient with chronic pain or cancer. The pump module is consists of two micro-valve and membrane. The micro-valve is operated by a solenoid. With two solenoid valves which are connected via a drug transport line, the inlet and outlet are completely blocked. A silicon rubber membrane located between the two valves makes the flow-rate constant without any backflow. This pump module can control the flow-rate of drugs by controlling the time that the valves are opened and closed. The reservoir consists of a drug chamber and a gas chamber. As the gas chamber encloses the drug chamber, propellant gas which is injected into the gas chamber pressurizes the drug chamber regardless of volume of the drug chamber. To design the pump module, analysis a constant efficiency test, and accuracy test for the pump module were conducted.

A Study on Improvement of Emergency Medical Service System in Kwangju (광주광역시 응급의료체계 개선에 관한 연구)

  • Lee, Young-Hyun
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.29-38
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    • 2005
  • The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

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Alpers-Huttenlocher Syndrome First Presented with Hepatic Failure: Can Liver Transplantation Be Considered as Treatment Option?

  • Park, Sowon;Kang, Hoon-Chul;Lee, Jin-Sung;Park, Young Nyun;Kim, Seung;Koh, Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.4
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    • pp.259-262
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    • 2017
  • Mitochondria play essential role in eukaryotic cells including in the oxidative phosphorylation and generation of adenosine triphosphate via the electron-transport chain. Therefore, defects in mitochondrial DNA (mtDNA) can result in mitochondrial dysfunction which leads to various mitochondrial disorders that may present with various neurologic and non-neurologic manifestations. Mutations in the nuclear gene polymerase gamma (POLG) are associated with mtDNA depletions, and Alpers-Huttenlocher syndrome is one of the most severe manifestations of POLG mutation characterized by the clinical triad of intractable seizures, psychomotor regression, and liver failure. The hepatic manifestation usually occurs late in the disease's course, but in some references, hepatitis was reportedly the first manifestation. Liver transplantation was considered contraindicated in Alpers-Huttenlocher syndrome due to its poor prognosis. We acknowledged a patient with the first manifestation of the disease being hepatic failure who eventually underwent liver transplantation, and whose neurological outcome improved after cocktail therapy.

Creation of 3D Maps for Satellite Communications to Support Ambulatory Rescue Operations

  • Nakajima, Isao;Nawaz, Muhammad Naeem;Juzoji, Hiroshi;Ta, Masuhisa
    • Journal of Multimedia Information System
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    • v.6 no.1
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    • pp.23-30
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    • 2019
  • A communications profile is a system that acquires information from communication links to an ambulance or other vehicle moving on a road and compiles a database based on this information. The equipment (six sets of HDTVs, fish-eye camera, satellite antenna with tracking system, and receiving power from the satellite beacon of the N-star) mounted on the roof of the vehicle, image data were obtained at Yokohama Japan. From these data, the polygon of the building was actually produced and has arranged on the map of the Geographical Survey Institute of a 50 m-mesh. The optical study (relationship between visibility rate and elevation angle) were performed on actual data taken by fish-eye lens, and simulated data by 3D-Map with polygons. There was no big difference. This 3D map system then predicts the communication links that will be available at a given location. For line-of-sight communication, optical analysis allows approximation if the frequency is sufficiently high. For non-line-of-sight communication, previously obtained electric power data can be used as reference information for approximation in certain cases when combined with predicted values calculated based on a 3D map. 3D maps are more effective than 2D maps for landing emergency medical helicopters on public roadways in the event of a disaster. Using advanced imaging technologies, we have produced a semi-automatic creation of a high-precision 3D map at Yokohama Yamashita Park and vicinity and assessed its effectiveness on telecommunications and ambulatory merits.