• 제목/요약/키워드: Prevent injury

검색결과 663건 처리시간 0.031초

근거기반 욕창간호 실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Pressure Injury)

  • 김정윤;박경희;박옥경;박주희;이윤진;황지현
    • 임상간호연구
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    • 제29권1호
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    • pp.12-23
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    • 2023
  • Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

의인성 요관손상: 언제, 어떻게 치료할 것인가? (Iatrogenic Ureteral Injury: When and How to Treat?)

  • 서강일;이종복
    • Journal of Trauma and Injury
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    • 제21권1호
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    • pp.8-14
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    • 2008
  • Iatrogenic ureteral injury is a complication that can occur during a variety of pelvic or abdominal surgeries. The most frequent causes are gynecological ones, followed by colon and vascular surgeries. Management of ureteric injury depends on the time of diagnosis and the severity of organ damage. Injuries diagnosed intraoperatively should be treated immediately. Occasionally, intraoperative ureteral injury is overlooked, and symptoms of the late diagnosis of ureteral injury are usually nonspecific; therefore, the diagnosis is delayed for days or weeks postoperatively. Management of injuries diagnosed postoperatively is more complex. There are differing opinions on whether an initial conservative or immediate operative intervention is the best line of action. Delayed repair is suggested on the grounds that it will reduce inflammation and tissue edema. However, many authors are in favor of early repair, perhaps because tissue planes are easier to find before fibrosis becomes too dense. Ureteral injuries occurring at the level of the pelvic brim should be best managed with an end-to-end anastomosis, preferably around a ureteric stent. More distal injuries also should be ideally managed with an end-to-end anastomosis, after excision of the crushed or compromised segments. However, if the remaining distal segment is short, ureteral reimplantation is the procedure of choice. The Boari flap technique for ureteral reimplantation is invaluable in cases with a short proximal segment. Delayed recognition of iatrogenic ureteral injury may be associated with serious complications, so prompt recognition of ureteral injuries is important. Recognition of the injury before closure is the key to easy, successful, and complications-free repair. Increased awareness of the risk for ureteral damage during certain operative maneuvers is vital to prevent injury, and to decrease the incidence of iatrogenic injury. A sound knowledge of abdominal and pelvic anatomy is the best prevention.

척수 손상 환자에 관한 실태 조사 (A Study of the Evaluation of the Spinal Cord Injuries)

  • 김명훈
    • 대한물리치료과학회지
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    • 제3권2호
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    • pp.1011-1019
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    • 1996
  • The incidence of spinal cord injury increase due to traffic accident, industrial accident and leisure sports. Spinal cord injury damages motor and sensory function below the injury level, also affects autonomic functions associated with voiding and defecation. Sexual dysfunction and psychosocial, vocational maladaptations are also some of the unwanted consequences of injury. The purpose of this study is look for means to prevent and to manage complications in spinal cord injury through investigation and analysis. The subjects of this study in spinal cord injured patients were admitted to the department of physical therapy, Kwangju christian Hospital, Nam Kwang Hospital, Chun Nam university Hospital and Cho Sun university Hospital, from April, 1, 1995 to March, 31, 1996. The results are as follows: 1. The subjects comprised 96 cases of spinal cord injury, ranging from 17 to 85(mean-40.8 yrs) and included 72 males and 24 females. Among these patients, 58 were cervical injury, 20 were thoracic injury and 18 were lumbar injury. 2. As for a major causative of spinal cord injury were traffic accident(59.4%), fall down (27.1 %), and motocycle(4.2%).. 3. The bladder control were taken by indwelling cathetar(41.7%), Crede maneuver(37.5%) and self voiding(16.7%). The bowel control were taken by all aid(61.5%), assitance(32.3%) and self defecation(6.2%). 4. Possible of sexual function were 35 cases (47.9%). 5. The device of transfer used wheel chair(69.8%) and bed(16.7%). 6. The patients with higher cord lesion got more serious pain than lower cord lesion. Also the patients with higher cord lesion got a serious spasticity. 7. The incidence of decubitus ulcer among 96 patients were in case 46(47.9%). The largest group of the pressure sore sites were sacral portion(82.0%), less than 1 month of onset occured a large numbers(50%). Incidence of pressure sore by spasticity occured many patients in case of mild or moderate. Incidence of pressure sore by pain occured many patients in case of severe pain.

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외상성 십이지장 손상의 치료 성적 (Treatment Outcomes of Traumatic Duodenal Injury)

  • 유병혁;조자윤;임경훈;박진영
    • Journal of Trauma and Injury
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    • 제28권3호
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    • pp.129-133
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    • 2015
  • Purpose: The purpose of this study is to evaluate the surgical outcome of duodenal injuries and to analyze the risk factors related to the leakage after surgical treatment. Methods: A retrospective review of 31 patients with duodenal injuries who managed by surgical treatment was conducted from December 2000 to May 2014. The demographic characteristics, injury mechanism, site of duodenal injury, association of intraabdominal organ injuries, injury severity score (ISS), abdominal abbreviated injury scale (AIS), injury-operation time lag, surgical treatment methods, complications, and mortality were reviewed. Results: Duodenal injury was more common in male. Twenty four (77.4%) patients were injured by blunt trauma. The most common injury site was in the second portion of the duodenum (n=19, 58.6%). Fourteen patients (45.2%) had other associated intraabdominal organ injuries. The mean ISS is $13.6{\pm}9.6$. The mean AIS is $8.9{\pm}6.5$. Eighteen patients (58.1%) were treated by primary closure. The remaining 13 patients underwent various operations, including exploratory laparotomy (n=4), pancreaticoduodenectomy (n=3), pyloric exclusion (n=3), Resection with end-to-end anastomosis (n=2), and duodenojejunostomy (n=1). Most common postoperative complications were intraabdominal abscess (n=9) and renal failure (n=9). Mortality rate was 9.7%. Conclusion: ISS, AIS>10, operative time, pancreaticoduodenectomy, sepsis, and renal failure are significant predictors of a postoperative leak after duodenal injury. Careful management is needed to prevent a potential leak in patient with these findings.

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손상감시체계를 통한 천안지역 초․중․고교생의 손상실태 분석 (Students injuries and Injury Surveillance System in Cheonan)

  • 강창현;강현아;박지현
    • 한국학교보건학회지
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    • 제22권2호
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    • pp.157-167
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    • 2009
  • Purpose : The purpose of this study is to explore the students injuries by analyzing the data which has been inputted by the emergency center of the cooperated hospitals and the 119 rescue party through the injury surveillance system in Cheonan city. Method : Students were divided into the elementary, middle, high school students with the 776 cases of children and teenagers(7-19years old) of injury surveillance system in Cheonan area from january to june in 2009. Frequency analysis and $x^2$-test was done to recognize the features of students injuries among the groups. The program to be used for the statistical analysis is SPSS 17.0. Result : Out of the injury incidence rate, the elementary school students(52.1%) are first, the high school students (24.9%) are second, the middle school students appear to be 23.1%. Male is about two times higher than female by 66.6% in the injury incidence. In terms of the injury mechanism, the injury(22.2%) by hit is the first, the traffic accident(21.5%) is the second, the slippery(16.8%) is followed. The injuries were occurred most largely at 16:00-20:00(33.4%), and the 33.6% of injury by daily leisure activity occurs at 16:00-20:00 chiefly. Conclusion : Analysis using the data of the injury surveillance system has some advantages compared to the previous research such as reliability and specification. To prevent the students injuries, not the individual problem but the social dimension should be acknowledged so that we can secure and promote the safety from the risk. Therefore, we must organize the role assignment and the cooperative network in the school, home and community.

스키에 의한 전방십자인대 손상에 대한 고찰 (The study of anterior cruciate ligament injury after a ski accident)

  • 박주환;전성화;양난희;김용권;김지혁
    • 대한물리치료과학회지
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    • 제10권1호
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    • pp.222-231
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    • 2003
  • The ACL(Anterior cruciate ligament) is the smallest of the four main ligaments of the knee, but it is the primary stabilizer. Injuries have a tendency to occur when the foot is firmly planted and the knee is twisted. Any sports that requires acceleration, change of direction and deceleration can increase the chances of suffering an ACL tear. The incidence of severe knee sprains that involve the ACL are at an all-time high. Since 1980, the number of these injuries have increased at least three-fold. Although the rate of increase has been much less dramatic since the middle 1980s, even the ultra-modem releasable ski binding has not been able to start reducing the incidence of ACL injuries. An ACL injury prevention program developed for downhill skiers by the Vermont Safety Research group emphasized increasing awareness of situations that can potentially result in an ACL injury and pre-planning strategies if events, leading to these situations, begin to fall in place. As part of the above study by Ettlinger et al., an educational prevent program was developed to teach these principles and thus reduce the rate of serious knee injuries. Four thousand instructors and patrol at 20 ski resorts who received the training had a 62% decline in serious knee injuries compared to a similar group that did not receive this training. Whenever you fall, try not to fully straighten your legs. Don't try to get up until you've stopped sliding(unless you are try to avoid an obstacle or other skier). When you're down, stay down. And don't land on your hand. So, if you feel yourself falling: arms forward, ski plates together, hands over knee. Then you will be able to save your ACL.

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유소년 태권도 선수들의 골밀도 및 심폐기능과 스포츠 손상과의 융복합 연구 (Convergence Analysis of the betweenBone Mineral Density, Cardiorespiratory Functional Capacity and sports injury of youth Taekwondo Athletes)

  • 김준철;박기준
    • 한국융합학회논문지
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    • 제11권10호
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    • pp.125-131
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    • 2020
  • 본 연구는 엘리트 유소년 태권도 선수들을 대상으로 골절 발생 위험을 감소시키고, 골다공증의 조기진단을 평가하는 지표로 사용되는 골밀도와 운동 수행능력을 판단하는 지표인 심폐기능, 그리고 선수들에게 최대의 적인 스포츠 손상과의 관계를 알아보고자 하였다. 골밀도와 심폐기능 그리고 스포츠 손상 간의 관계를 알아보기 위해 Pearson 상관관계 분석을 시행하였다. 또한, 골밀도가 심폐기능 및 스포츠 손상에 미치는 영향을 알아보기 위해 단순 선형회귀 분석을 시행하였다. 골밀도는 환기량(r=.388) 및 최대산소 능력(r=.478) 그리고 스포츠 손상과 상관관계가 있었다(r=-.292). 또한, 골밀도가 .002, 및 .006씩 증가하면 환기(p=.001) 및 최대 산소능력은(p=.006) 1씩 높아진다. 또한, 골밀도가 .016씩 감소하면, 스포츠 손상의 발생이 1씩 증가한다(p=.044). 선수들의 골밀도 향상으로 스포츠 손상을 예방할 수 있으며, 향후 스포츠 손상 예방 프로그램으로 활용할 수 있을 것이다.

스노우보드 손상 (Snowboard Injury)

  • 서중배;이성철;박진영
    • 대한정형외과스포츠의학회지
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    • 제3권1호
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    • pp.22-24
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    • 2004
  • Snowboarding has become one of the premier alpine sports. The past decade has seen the popularity of snowboarding increase dramatically and the recent Winter Olympic Game showcased the strong visual appeal of the sport and the youth-oriented lifestyle and culture that accompanies it. The injury profile of the sport has also undergone change along with technological advances in boot and binding systems and the changing demographics of the sports participants. Central to the development of injury-prevention strategies is knowledge of the profile of injuries that occur, understanding those who are at particular risk and, if possible, the biomechanical factors involved in each injury type. Snowboarding was initially considered a dangerous, uncontrolled, alpine sport - an opinion based on little or no scientific evidence. That evidence has rapidly grown over the past decade and we now know that snowboard injury rates are no different to those in skiing; however, the injury profile is different. The purpose of this review is to give some perspective to the current snowboard injury literature. It discusses not only the demographic profile of those injured and the type of injuries that occur, but also gives some insight into the progress that has occurred in determining the impact of specific prevention strategies, such as splints to prevent injuries to the wrist/forearm. As the literature indicates, however, some things will not change, e.g. injuries are more likely to occur in beginners and lessons need to be reinforced as a fundamental aspect of any injury-prevention strategy.

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백서 도상 피부피판에서 허혈-재관류 손상의 예방: Histamine 수용체 봉쇄약물과 L-arginine의 효과 비교 (PREVENTION OF ISCHEMIA-REPERFUSION INJURY IN RAT SKIN ISLAND FLAP: COMPARISON OF HISTAMINE RECEPTOR BLOCKING AGENTS WITH L-ARGININE)

  • 서영교;김욱규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권4호
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    • pp.287-294
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    • 2006
  • Vascular thrombosis and ischemic necrosis still remain the most significant threats to the survival of free flaps. To date, neutrophils have been implicated in the pathogenesis of postischemic injury. Several studies have demonstrated that modulating the neutrophil response to ischemia-reperfusion injury can decrease the extent of the injury. In addition, some authors noticed that mast cell counts were also increased in flaps exposed to state of ischemia/reperfusion. So, we designed to evaluate the role of mast cells in ischemia/reperfusion by blocking histamine and to compare the effect of L-arginine, a nitric oxide precursor which is known to prevent neutrophil-mediated tissue injury. Epigastric island skin flaps were elevated in 30 rats and rendered ischemic. Thirty minutes prior to reperfusion, the rats were treated with intraperitoneal saline, diphenhydramine, cimetidine, and L-arginine. The necrosis rate of flap at 7 days, the number of neutrophils and mast cells at 20 hours were evaluated. In conclusion, histamine receptor blockers as well as L-arginine significantly decreased flap necrosis in a rat skin island ischemia-reperfusion flap model, but the protective effect was not significantly different in both agent groups.

Prevention of Pediatric Acute Kidney Injury

  • Cho, Heeyeon
    • Childhood Kidney Diseases
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    • 제19권2호
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    • pp.71-78
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    • 2015
  • The incidence of acute kidney injury (AKI) in critically ill pediatric patients has been reported as increasing to 25 %, depending on population characteristics. The etiology of AKI has changed over the last 10-20 years from primary renal disease to the renal conditions associated with systemic illness. The AKI in pediatric population is associated with increased mortality and morbidity, and prevention is needed to reduce the consequence of AKI. It is known that the most important risk factors for AKI in critically ill pediatric patients are clinical conditions to be associated with decreased renal blood flow, direct renal injury, and illness severity. Renal hypoperfusion leads to neurohormonal activation including renin-angiotensin-aldosterone system, sympathetic nervous system, antidiuretic hormone, and prostaglandins. Prolonged renal hypoperfusion can result in acute tubular necrosis. The direct renal injury can be predisposed under the condition of renal hypoperfusion, and appropriate treatment of volume depletion is important to prevent AKI. The preventable causes of AKI include contrast-induced nephropathy, hemodynamic instability, inappropriate mediation use, and multiple nephrotoxic insults. Given the evidence of preventable factors for AKI, several actions such as the use of protocol for prevention of contrast-induced nephropathy, appropriate treatment of volume depletion, vigorous treatment of sepsis, avoidance of combinations of nephrotoxic medications, and monitoring of levels of drugs should be recommended.