• Title/Summary/Keyword: Suctioning

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A Case of Endobronchial Urokinase for Relief of Bronchial Obstruction by Blood Clots (좌측 주기관지 피덩이를 우로키나아제 기관내 국소주입으로 제거한 1예)

  • Choi, Jung;Lee, Sa Ra;Kwak, Choong Hwan;Pae, Hyun Hye
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.3
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    • pp.297-302
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    • 2003
  • Background : Airway obstruction due to blood clot occurs unusually but in a variety of clinical settings. Initial efforts for removal of the endobronchial blood clot involve flexible bronchoscopic evaluation with saline lavage and suctioning and then forceps extraction. If unsuccessful, further options include rigid bronchoscopy, Fogarty catheter dislogement of the clot, and topical thrombolytic agents. The several successful uses of endobronchial streptokinase or urokinase to dissolve an endobronchial blood clot have been previously reported, but not yet in Korea. Herein we describe a 51-year old man with superior vena cava thrombosis secondary to Behcet's disease who experienced life threatening airway obstruction after hemoptysis due to a large organized blood clot in left main bronchus. Urokinase(260,000 U), injected through a fiberoptic bronchoscope, totally dissolved the clot. No complications occurred.

Endoscopic treatment for rectal neuroendocrine tumor: which method is better?

  • Seung Min Hong;Dong Hoon Baek
    • Clinical Endoscopy
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    • v.55 no.4
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    • pp.496-506
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    • 2022
  • Recently, research on rectal neuroendocrine tumors (NETs) has increased during the last few decades. Rectal NETs measuring <10 mm without atypical features and confined to the submucosal layer have only 1% risk of metastasis, and the long-term survival probability of patients without metastasis at the time of diagnosis is approximately 100%. Therefore, the current guidelines suggest endoscopic resection of rectal NETs of <10 mm is regarded as a safe therapeutic option. However, there are currently no clear recommendations for technique selection for endoscopic resection. The choice of treatment modality for rectal NETs should be based on the lesion size, endoscopic characteristics, grade of differentiation, depth of vertical involvement, lymphovascular invasion, and risk of metastasis. Moreover, the complete resection rate, complications, and experience at the center should be considered. Modified endoscopic mucosal resection is the most suitable resection method for rectal NETs of <10 mm, because it is an effective and safe technique that is relatively simple and less time-consuming compared with endoscopic submucosal dissection. Endoscopic submucosal dissection should be considered when the tumor size is >10 mm, suctioning is not possible due to fibrosis in the lesion, or when the snaring for modified endoscopic mucosal resection does not work well.

Comparison of Domestic and International Research (1992-2011): Intensive Care Nursing Studies (국내·외 중환자간호 연구의 동향 분석: 양적 연구를 중심으로)

  • Choi, Eun Hee;Jang, Eun Hee;Choi, Ji Youn;Lee, So Jung;Seo, Hyo Kuyng;Park, Kyung Sook
    • Korean Journal of Adult Nursing
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    • v.27 no.4
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    • pp.384-396
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    • 2015
  • Purpose: The purpose of this study was to describe the approaches, methods and questions asked in intensive care unit studies published in Korean journals and the American Journal of Critical Care (AJCC) from 1992 to 2011. Only quantitative studies were reviewed. Methods: A total of 144 studies published in four Korean Journals and 521 studies published in American Journal of Critical Care (AJCC) were analyzed using descriptive statistics. Results: The most frequently used research design reported in Korean journals were surveys (83.5%), protocol development (10.1%), and randomized controlled trials (6.2%). In AJCC, the most frequently reported design was survey research (90.4%) and randomized controlled trials (16.1%). The most frequent nursing intervention reported in the AJCC was tube care (10.8%), and in Korean journals the intervention of suctioning (10.8%). In Korea, nurses were more likely to study instrument measurements (31.0%) and positioning (13.5%). In reported studies in the AJCC there were more reports on emotional support, exercise, and measurement research. Conclusion: There is overlap in the type of studies between the two countries in term of study design, whereas the types of nursing problems studied differed in United States and Korea. The result suggests that there were gaps and those more diverse studies and physiological measurements are needed.

Effects on Nurses' Hand Washing Behavior and Reduction of Respiratory Isolation Rate of MRSA of the Hand Washing Education (손씻기 교육이 간호사의 손씻기 행위와 중환자의 호흡기로의 MRSA 분리율 감소에 미치는 영향)

  • Kim, Nam-Cho;Choi, Kyung-Ok
    • Korean Journal of Adult Nursing
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    • v.14 no.1
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    • pp.26-33
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    • 2002
  • Purpose: This is a clinical experimental study aimed to provide basic data to ensure quality care. The purpose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA. Method: This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000. Results: 1.The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education. Conclusion: The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICU patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphasized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

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A Study in the Physical Load related to Working Posture with Nurses in ICU (중환자실 간호사의 작업자세에 따른 신체부담도에 관한 연구)

  • Lee, Iu-Jin
    • Korean Journal of Occupational Health Nursing
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    • v.11 no.2
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    • pp.121-131
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    • 2002
  • Objective: The purpose of this study was to determine the physical load by identifying harmfully working postures and to develop recommendations for improving the existing situation with nurses in ICU, thereby to provide the basis for development of work-related musculoskeletal preventive program. Method: Various types of tasks were recorded with a video camera to chart and analyze different postures by OWAS(Ovako Working Posture Analysing System). Collected data showed that poor postures were adopted, not only for lifting or repositoning a patient, but also for other tasks. Data Analysis: The performed activities were then divided into Nursing Intervention Classification. Altogether 128 postures were selected for analysis. Then they were classified into different OAC (OWAS Action Categories). From all the observation, unhealthy postures, for which corrective measures had to be considered immediately (i.e., 75% classified as OACII+III+IV) were found. Collected data were analyzed in terms of percentage, 2-tail Mann-Whitney U test. Result: Poor postures mainly occur during 'positioning the patient' and 'airway suctioning' in NIC. No difference was found (p=0.060) between the percentage of harmful posture adopted during the patient handling tasks and non-patient handling tasks. Conclusion: This study shows, that in the nursing profession with ICU not only occur during patient handling, but also during other activities. The OWAS method was useful in determining the physical load by locating potential activities due to harmfully working postures, providing a detailed description with analysis, and suggesting successful means to reduce postural load.

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End to End Anastomosis of Type A(long gap) Esophageal Atresia in 1,200 gram Premature Baby A Case Report (1,200gram 미숙아에서 Type A 식도 폐쇄증의 식도 단단문합술 -1례 보고-)

  • Jo, Sam-Hyeon;O, Bong-Seok;Lee, Dong-Jun;Choe, Yeong-Ryun
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.236-240
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    • 1997
  • The management of neonate with long gap atresia without a fistula(type A) is complex and controversial. Various esophageal reconstruction include use of native esophagus or replacement with colon, stomach and small bowel. A severe premature male, at 28 weeks gestation weighing 1.2kg, was born with type A esophageal atresia in Chonnam University Hospital. Initial treatment consisted of gastrostomy under the local anesthesia and suctioning of proximal pouch, and than underwent delayed esophageal end to end anastomosis. A minimal leakage and mediastinitis ocurred postoperatively, but was treated by adequate drainage and negative suction from the leakage site through the gastrostomy. The patient was discharged in good general condition and normal weight of 5.4kg after 4 months after the surgery.

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A Study on Handwashing Knowledge and Attitudes of Nurses (간호사의 손씻기에 대한 지식 및 태도 연구)

  • Lim, Hyun-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.5-16
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    • 1996
  • The purpose of this study is to identify the handwashing knowledge and attitudes of resistered nurses on general wards. Subjects for this study include 182 nurses working in general wards of a hospital in Seoul area. Data were collected by a questionnaire from July 30 to August 10,1996. Statistical analyses were done by the SPSS/PC program. The techniques used in this sudy included frequencies, chi-square test. The results of this study are summarized as follows. 1. 34.6% of the respondents reported that they washed their hand an average of 5 to 7 times during the work day. 2. 38.5% of the respondents reported always washing after each patient contact. Only 9.9% always washed before contact with a patient. 3. 56.6% of the respondents reported a washing time of 10 to 20 seconds, whereas 29.1% washed 21 to 30 seconds. Chi-square tests were employed to determine any differences in handwashing frequency and duration by age, working years, work position. There were no satistically significant differences among the variables. 4. 95.6% of the subjects used water and plain soap during the washing process. The respondents washed the palms of the hands, the backs of their hands and between their fingers(33%). Only 17.6% removed rings before handwashing. Similarly, 11% removed their wristwatch. The majority(96.2%) reported that they used communal textile towel to dry their hands. When asked what method they used to turn off the water faucet after washing, 98.4% reported using direct hand-to-faucet contact. 5. Nursing activities that showed the highest handwashing rates was after wound dressing(22.9%), followed by suctioning(21.4%), injection(21.2%), inserting catheter(18%). 6. Reasons cited for reduced handwashing frequency included being too busy to wash more often(74.7%), no need to wash more often(11.0%) and dry skin caused by frequent handwashing(3.3%). 7. When asked where they obtained their current knowledge of handwashing techniques, they reported professors(73.6%), resisted nurses(14.8%) and supervisor(6.6%). 8. Nursing staff thought that proper handwashing was important factor in decreasing nosocomical infections(72.4%).

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Use of Home Nursing Therapy and Need of Home Care Equipments (가정간호환자의 치료적 간호서비스 제공과 의료기구 사용 및 요구도)

  • Ryu, Ho-Shin;Park, Chai-Soon;Kim, In-A;Kwon, Young-Dae;Kang, Sung-Wook
    • Research in Community and Public Health Nursing
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    • v.19 no.2
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    • pp.157-166
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    • 2008
  • This study was conducted with whole home care nurses nationwide to provide secondary analyzed data to understand on their usage of medical equipments and their need of them for a month. This study found that treatments given by home care nurses were nelaton catheterization, bladder washing/urethral washing, newborn care, exchange and care for nasogastric tube and suction in that order of frequency. Second, instruments and equipments used for home care were reported to be stethoscope, patient monitor, blood pressure measuring equipment, air flotation mattresses, beds for patients, mattresses, suctioning device sets, enteral feeding equipment and dressing set in that oder of frequency. Moreover, need assessment of medical instruments and equipments showed renal dialysis was most needed and patient monitor, blood pressure measuring equipment, enteral feeding equipment, solution and other supplies for renal dialysis and beds for patient were necessary in that order. In conclusion, the results of this study investigating special treatments and medical instruments and equipments used for home care patients and analyzing patients' need, were expected to be useful for expansion of application of long-term care insurance for the elderly and health insurance as well as for quality control of home care and development of medial instruments and equipments used at home.

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Reliability and Validity of Nonverbal Pain Assessment Scale for Patients who Stayed a Intensive Care Units (무의식 중환자의 비언어적 통증사정 도구의 신뢰도와 타당도 검증)

  • Kim, Jung-Soon;Kang, In-Soon;Park, Kyu-Hyun
    • The Korean Journal of Health Service Management
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    • v.9 no.2
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    • pp.89-102
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    • 2015
  • Patients unable to speak are at higher risk for untreated pain. Use of valid behavioral and physiologic measures for pain is highly recommended for uncommunicative patients. This study was performed to compare the reliability and validity of NVPS-K and CPOT-K for pain assessment of nonverbal patients. This study was conducted from July to November 2011. A total of 29 nonverbal adult patients admitted to a university hospital intensive care unit participated in this study. Interrater reliability of the NVPS-K and CPOT-K had intermediate to high intraclass correlation coefficients (NVPS-K 0.680 ~ 0.921, CPOT-K 0.710 ~ 0.896). Discriminant validity was supported with higher instrument scores during turning and endotracheal suctioning than that of NIBP. For criterion validity, the NVPS-K scores were correlated to the self-reported pain of the patients but not the CPOT-K scores. The areas under the ROC curve for the NVPS-K and CPOT-K were 0.748 and 0.696 with cutoff points of 1 and 2, respectively. Thus, the NVPS-K and CPOT-K had a sensitivity and specificity of 94.7% and 45.0%, and 60.5% and 75.0%, respectively. The NVPS-K and CPOT-K are reliable and valid tools to assess pain in nonverbal patient and thus, are recommended for the assessment of the pain in nonverbal patients.

Pain Response to Procedural Pain in Premature Infants (미숙아의 시술 관련 통증 반응)

  • Kim, Jung-Sook;Lee, Eun-Jung;Ham, Eun-Ha;Kim, Ji-Hyun;Yi, Young-Hee
    • Child Health Nursing Research
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    • v.16 no.4
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    • pp.352-359
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    • 2010
  • Purpose: To explore premature infants' pain response to routine procedures in the neonatal intensive care unit (NICU). Methods: The participants were 56 preterm infants who showed 149 pain responses to 8 high frequency routine procedures which were evaluated using the Premature Infant Pain Scale (PIPS). Videotaped recording was used for data collection. Data were analyzed with descriptive analysis, paired t-test, and Pearson's correlation coefficient. Results: PIPS scores for each procedure were as follows; for removal of central catheter dressing, 6.17 (2.04), venous sampling, 6.12 (2.87), intramuscular injection, 6.05 (2.38), insertion of a peripheral line, 5.38 (2.16), insertion of feeding tube, 4.40 (1.34), heel stick, 4.33 (1.23), insertion of central line, 4.00 (2.12), and endotracheal suctioning, 2.90 (1.25). PIPS score was negatively correlated with gestational age (r=-.218, p=.007) and birth weight (r=-.249, p=.002) among general characteristics of the infants. Conclusion: The majority of 8 routine procedures were found to be painful for premature infants in the NICU. Therefore, adequate pain management related to procedures should be provided to premature infant in the NICU.