• 제목/요약/키워드: Pediatric emergency department

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한방병원 응급실에 내원한 소아 환자에 관한 임상적 고찰 (A Clinical Study of the Pediatric Patients Who Had Visited the Emergency Room (ER) at the Oriental Medical Hospital)

  • 김지은;백정한
    • 대한한방소아과학회지
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    • 제28권4호
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    • pp.30-44
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    • 2014
  • Objectives By analyzing data of the pediatric patients who had visited the emergency room of the oriental medical hospital, we can understand their characteristics and diseases. The purpose of this study was to introduce the excellence of the Oriental medicine, to develop various treatments, and to revitalize pediatric emergency care at the oriental medical hospital. Methods The study was composed of 334 pediatric patients who had visited the emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital from January 2011 to December 2013. Results 1. It has showed that between 7 to 12 years old patients (27.8%) were the most common age populations. 2. The number of pediatric patients was increased during February. According to the weekly distribution data, the number of pediatric patients who had visited on Sunday was the highest (28.7%). Also, the number of pediatric patients who had visited the ER between 21 to 24 hours (29.0%) was the highest. 3. The two major reasons for inpatient hospitalization were digestive and nerve-related symptoms. Nerve-related symptoms were the most common in infants while digestive symptoms were the most common in other child development stages. 4. The duration of time interval from the onset of symptoms to the ER visit was most commonly within 6 hours (50.3%). An acupuncture and herbal medication treatment (70.1%) were the most common medical treatments. The majority of the pediatric patients (95.5%) were discharged after their medical treatments. Conclusions A serious acute illness was not the most common reason for the ER visit among the pediatric patients. The most common disease states that have preferred to be treated with the oriental medicine were dyspepsia, crying, facial palsy, and ankle sprain. We have to introduce the excellence of the oriental medicine. We also need to try developing other treatments such as magnetic acupuncture, aromatherapy, and revitalizing pediatric emergency care at the oriental medical hospital.

Parental satisfaction with pediatric emergency care: a nationwide, cross-sectional survey in Korea

  • Jang, Hye Young;Kwak, Young Ho;Park, Ju Ok;Kim, Do Kyun;Lee, Jin Hee
    • Clinical and Experimental Pediatrics
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    • 제58권12호
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    • pp.466-471
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    • 2015
  • Purpose: This study attempted to examine parental satisfaction with pediatric emergency care (PEC) in Korea and investigate the features influencing overall satisfaction. Methods: A nationwide, cross-sectional survey was conducted among parents who had taken their children to an Emergency Department (ED) in the three years prior to the study. A 21-item, structured questionnaire was administered to the parents through a web-based system. Participants' satisfaction levels and the strength of the association between PEC components and overall satisfaction were rated using a 7-point Likert scale. Results: In total, 1,000 parents participated in the survey, of which 402 (40.2%) stated that they were generally satisfied with the delivered PEC. Female participants, mothers, and parents with low-acuity patients were more likely to be dissatisfied with the delivered PEC. Although the ED environment was the lowest level of satisfaction, it did not significantly influence the respondents' overall levels of satisfaction. The most influential factors in terms of overall satisfaction were "nurses' professionalism" and "doctors' attitude and proper explanation". Conclusion: Parents' overall level of satisfaction with PEC is relatively low and is closely related to factors associated with ED personnel.

Using nasal cannula for sevoflurane deep sedation in emergency dental treatment

  • Kim, Jongbin;Yoo, Seunghoon;Kim, Jongsoo;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제15권1호
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    • pp.11-15
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    • 2015
  • Background: Emergency room doctors run into difficulties in treating injured pediatric patients because usually they fell into panic after trauma. In these situation, deep sedation with sevoflurane is fully recommendable method. The conventional way can interrupt common dental treatment procedure. Methods: In the present study, nasal cannula was used for sevoflurane deep sedation in 11 dental emergency treatment. Age ranged from 0 to 3 years old (average of 1.8 years). Results: Treatment duration was from 10 to 35 minutes (average of 16.7 minutes). Average duration of sedation was 25.5 minutes ranging from 15 to 45 minutes. Conclusions: It has advantages to use nasal cannula for sevoflurane deep sedation rather than conventional intubation; saves time and secures good operation field.

소아 흉부 둔상 환자의 임상적 고찰 (Clinical Investigation of Pediatric Blunt Thoracic Trauma)

  • 정태교;현성열;김진주;류일;이근;조진성;황성연;이석기
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.119-126
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    • 2005
  • Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

환자 분류체계를 이용한 응급실 방문 환아에 대한 고찰 (Review of Pediatric Patients visiting Emergency Center used Clinical Classification System)

  • 문선영;김신정
    • 간호행정학회지
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    • 제6권3호
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    • pp.375-388
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    • 2000
  • This study was attempted to help in explore new direction about Clinical Classification System of the pediatric patients visiting emergency center. Data were collected from 276 patients who visited emergency center of E University Hospital during 3 months period form March 1, to May 31, 1999. The results were as follows: 1. Distribution of pediatric patients according to Clinical Classification System, class I(59.9%) topped followed by class II(23.9%), class III(14.1%), class IV(2.0%). Average score of pediatric patients according to Clinical Classification System showed class I.00, class II .02, class III .05, class IV .07. and total mean score of items lowed averaged .01. 2. With the resepect to the Clinical Classification System according to the pediatric patients visiting emergency center, there were stastically significant difference in visiting time($x^2=27.839$, P=.023), experience of admission($x^2=11.365$, p=.010), disease classification($x^2=89.998$, p=.000), state of airway patency($x^2=18.781$, p=.000), consciousness level($x^2=59.774$, p=.000), period of symptom manifestation($x^2=34.112$, p=.000), pediatric patients protector's thinking about pediatric patients state($x^2=49.998$, p=.000), treatment outcome($x^2=72.278$, p=.000), duration of stay at emergency center($x^2=103.062$, p=.000). 3. There were significant correlation between the state of pediatric patients and Clinical Classification System(r=.530, p=.000).

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Comparison of pediatric injury patterns before and during the COVID-19 pandemic in Korea: a retrospective study

  • Geom Pil Nam;Woo Sung Choi;Jin-Seong Cho;Yong Su Lim;Jae-Hyug Woo;Jae Ho Jang;Jea Yeon Choi
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.343-353
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    • 2023
  • Purpose: The COVID-19 pandemic led to significant changes in the lifestyle patterns of children and affected the patterns of pediatric injuries. This study analyzed the changing patterns of pediatric injury overall and by age groups, based on the datasets before and during the COVID-19 pandemic. Methods: This study is based on the data of patients who presented with injuries at 23 hospital emergency departments participating in the Emergency Department-based Injury In-depth Surveillance (EDIIS) conducted by the Korea Disease Control and Prevention Agency. The surveillance data was categorized by injury mechanism, location, activity, and severity. We analyzed the injury patterns of pediatric patients aged 0 to 15 years. Subgroup analysis was conducted by age group in children aged 7 to 15 years, 1 to 6 years, and <1 year. Results: When comparing the COVID-19 pandemic period to the pre-COVID-19 period, the total number of pediatric patients with injuries decreased by 38.7%, while the proportions of in-home injuries (57.9% vs. 67.9%), and minor injuries (38.9% vs. 39.7%) increased. In the 7 to 15 years group, bicycle riding injuries (50.9% vs. 65.6%) and personal mobility device injuries (2.4% vs. 4.6%) increased. The 1 to 6 years group also showed an increase in bicycle accident injuries (15.8% vs. 22.4%). In the <1 year group, injuries from falls increased (44.5% vs. 49.9%). Self-harm injuries in the 7 to 15 years group also increased (1.6% vs. 2.8%). Conclusions: During the COVID-19 pandemic period, the overall number of pediatric injuries decreased, while injuries occurring at home and during indoor activities increased. Traffic accidents involving bicycles and personal mobility devices and self-harm injuries increased in the 7 to 15 years group. In the <1 year group, the incidence of falls increased. Medical and societal preparedness is needed so that we might anticipate these changes in the patterns of pediatric injuries during future infectious disease pandemics.

소아응급의료센터에 내원한 중독 환자의 입원 결정과 관련 있는 요인 분석 (Factor Analysis of Intoxicated Patients Disposition in Pediatric Emergency Department)

  • 이현정;조영순;장혜영;임훈;황보영
    • 대한임상독성학회지
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    • 제16권1호
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    • pp.15-24
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    • 2018
  • Purpose: This study was conducted to analyze the factors associated with intoxicated patient's disposition in the pediatric emergency department. Methods: We retrospectively evaluated pediatric intoxicated patients visiting the pediatric emergency department of a hospital between January 1, 2011 and December 31, 2013. Specifically, we analyzed the association between hospitalization recommended rate and the following variables: patient age group, symptoms, intentional poisoning, decontamination and toxic level of substance. Results: We collected data from 345 patients. A high incidence was noted in the 1-4 years of age group and 10-15 years of age group. Unintentional poisoning occurred in 306 patients (88.7%). A total of 115 patients (33.3%) had symptoms when visiting. Forty three patients (12.5%) ingested cleaning substances, which was the most common agent. Potentially-toxic level was the most common level of the substance. The hospitalization recommended rate associated with visits in 2011 was 2.5 times greater than in 2012 and 2013, decontamination was 2.0 times greater than no decontamination, and poisoning with potentially-toxic substances was 2.6 times greater than poisoning with other toxic substances. Additionally, the hospitalization recommended rate associated with symptomatic patients was 2.4 times greater than that of asymptomatic patients and intentional poisoning was 2.4 times greater than unintentional poisoning. Conclusion: Patients with decontamination, ingestion of potentially-toxic substances, symptoms and intentional poisoning had increased hospitalization rates. In addition, the hospitalization rate for patients who visited in 2011 was greater than that of patients who visited in 2012 or 2013.

소아 진정시 사용하는 포크랄 약물의 투여 방법 및 효율성 비교 (Administration and Efficiency Comparison of Chloral Hydrate during Pediatric Sedation)

  • 배정아;최윤희;김아진;이선화
    • 대한임상독성학회지
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    • 제14권1호
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    • pp.9-15
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    • 2016
  • Purpose: In most emergency department (ED), sedation is required before carrying out an invasive procedure on a pediatric patient. In the ED setting, it is essential to determine the optimal dose and administration route of CH for successful sedation. The aim of this study was to determine the optimal dose of CH for an invasive procedure and to examine the effectiveness of the drug's different administration routes. Furthermore, in this study, we performed simple survey using questionnaire which composed of Likert-scale to evaluate satisfaction of medical staffs in ED with administration routes. Methods: This study was conducted prospectively. The study participants were pediatric patients under 8 years old who visited the ED in two tertiary hospitals in South Korea within a period of 12 months. Results: Overall, 300 patients were included in this study. The age, sex, and weight of the patients were not shown to influence the sedation time. Chloral hydrate dosage is the independent factor to influence the both sedation and discharge time (p<0.01). In the comparison of the groups, groups 1, 2, and 5 showed no significant difference. On the other hand, groups 3 and 4 were shown to be statistically significantly different from group 1. Conclusion: Up to 100 mg/kg CH is safe to use in the emergency department for pediatric patients, but the initial dose of 50 mg/kg for oral administration should be considered in advance because it can provide safe and effective sedation with a lower possibility of causing an adverse effect.

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Pediatric advanced life support and sedation of pediatric dental patients

  • Kim, Jongbin
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권1호
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    • pp.9-15
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    • 2016
  • Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

세보플루란 깊은 진정의 응급과 비응급적 사용에 관한 실태조사 (A Survey of Non-Emergency and Emergency Deep Sedation using Sevoflurane Inhalation for Pediatric or Disabled Patients)

  • 김승오
    • 대한소아치과학회지
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    • 제41권1호
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    • pp.18-26
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    • 2014
  • 심한 불안이나 불수의적인 움직임으로 행동조절이 어려운 소아와 장애인의 치과치료를 위해 깊은 진정법이 고려된다. 응급 치과진료에 있어 세보플루란 흡입을 이용한 깊은 진정이 빠른 유도와 회복으로 인해 선호된다. 2013년 1월부터 2013년 10월까지 세보플루란을 이용한 깊은 진정을 받은 소아와 장애인 121명을 대상으로 조사분석하였다. 깊은 진정법을 사전 계획한 환자군과 소아외상이나 장애인의 특성 등으로 응급으로 시행한 환자군을 비응급 세보플루란진정군과 응급 세보플루란진정군으로 나누었다. 비응급 세보플루란진정을 받은 환자는 95명이었고 응급 세보플루란진정을 받은 환자는 26명이다. 두 군간에 성별, 나이, 진정법을 시행한 이유, 유도방법, 진정시간 및 치료시간, 치료내용, 진료과를 비교분석하였다. 비응급 세보플루란진정은 소아와 장애인의 행동조절에 안전하고 효과적으로 사용되었고 응급 세보플루란진정은 외상을 입은 어린 소아환자의 짧고 간단한 치료에 유용하게 사용되었다. 세보플루란을 이용한 깊은 진정은 점차적으로 전신마취의 사용을 줄이고 소아와 장애인 환자의 응급 치과진료에 유용한 방법이었다.