• Title/Summary/Keyword: The Triage

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A Study for General Emergency Medical Service Systems in Disaster (재난발생 시 일반응급의료체계에 관한 연구)

  • Lee, Maria
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.1
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    • pp.23-39
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    • 2006
  • In Korea, There are many disasters, like the collapse of Sampung department store, the strike of severe typhoon 'Rusa' and the subway tragedy in Taegu, because of global warming, urbanization, high-density and high-rise of buildings. So, the government made 'The Framework Act' on the safe and management of disaster and 'The National Emergency Management Agency' was established. But emergency medical service systems in Korea is not growing so much. The purpose of this research is to give basic data for the development of emergency medical service systems in Disaster by comparing of disaster management systems and emergency medical systems among the nations of the world, analysing emergency medical systems in disaster in Korea and suggesting some improvement methods. The improvment methods are like this ; First, establishing the National Disaster Medical System in Korea, making the good triage by EMT, expansion of EMT's working area, developing protocols and framing of medical director increasing the working force of EMT, broad inner cavity of ambulance for treatment of patientent, supplement of professional equipments, active using of helicopters are needed in prehospital are. Second, equal establishment of emergency medical center and increase of working force of emergency medical team are needed in hospital area. Finally, enforcement of the dispatcher's qualification, smooth communication among EMSS systems and actualization of medical direction through screen are needed in the Telecommunication system.

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Traumatic urethra injury presenting as urethral cancer : A case study (외상성 요도 손상으로 오인된 요도암)

  • Shin, Sang-Yol;Hwang, Yong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.147-154
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    • 2020
  • Purpose: The purpose of the study was to investigate traumatic urethral injury in a 63-year-old patient with hematuria. Methods: A hematuria patient was transferred by paramedics. At the time of the visit, the patient's blood pressure (151/91mmHg), pulse rate (86/min), body temperature (37.1℃), and other vital signs were stable. Their KTAS (Korean Triage and Acuity Scale) was Level 4. The patient had no damage to the injured area, but a large contrast defect was observed between the prostate urethra and the bladder in urethral angiography performed due to persistent hematuria and pain in the injured area. Results: Following radiological evaluation of a suspected liposarcoma or neuroma mass of the prostate urethra, the mass was removed through urethral tumor resection. The result of histologic evaluation provided a diagnosis of highly differentiated invasive urethral cell carcinoma that had invaded the muscle layer. The patient was given additional treatment for urethral cancer but was rejected and is currently being followed. Conclusion: The prognosis for urinary tract cancer has distinct differences for patients with lymph node metastasis and tumor characteristics. The presence or absence of urethral cancer should be confirmed through angiography, CT, MRI, and cystoscopy.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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Factors affecting use of the emergency department at superior hospitals on public holidays (상급종합병원 응급실 공휴일 이용의 영향 요인)

  • An, Byeung-Ki
    • Korea Journal of Hospital Management
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    • v.24 no.1
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    • pp.11-20
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    • 2019
  • The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity (간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증)

  • Park, Jung-Ho;Kim, Eun-Hye
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.5-16
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    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

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Stroke Rehabilitation Performance and Outcomes among Hospitals (뇌졸중 재활치료에 있어서 병원군집간 의료서비스 제공실태와 치료성과 -일본 뇌졸중 환자 데이터베이스를 이용하여-)

  • Inoue, Yusuke;Jeong, Seung-Won;Kondo, Katsunori;Seo, Young-Joon
    • The Korean Journal of Health Service Management
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    • v.5 no.3
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    • pp.53-61
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    • 2011
  • This study was to assess the differences in rehabilitation outcomes between the different facilities in Japan, and to determine if there was any variation in patients' functional recovery at hospital discharge across the different facilities. This study focused on acute patients in the rehabilitation ward using the data of 1,830 patients from 8 hospitals after adjusting for triage at admission obtained from the Rehabilitation Patients Databank in Japan (issued in February, 2011) and compared the therapeutic results of each hospital. We estimate the expected value of levels of activities of daily living(ADL) at discharge for rehabilitation patients using regression analysis and Cluster analysis. There were differences among hospitals in their therapeutic results. The differences in the participation of physicians registered as rehabilitation specialists, amount of exercise, self-exercise without therapist, and exercise in wards, were statistically significant differences between hospitals.

Risk Stratification for Patients with Upper Gastrointestinal Bleeding (상부위장관 출혈 환자에서 위험의 계층화와 이에 따른 치료 전략)

  • Lee, Bong Eun
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.225-230
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    • 2018
  • Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

A Study on Mapping Users' Topic Interest for Question Routing for Community-based Q&A Service (커뮤니티 기반 Q&A서비스에서의 질의 할당을 위한 이용자의 관심 토픽 분석에 관한 연구)

  • Park, Jong Do
    • Journal of the Korean Society for information Management
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    • v.32 no.3
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    • pp.397-412
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    • 2015
  • The main goal of this study is to investigate how to route a question to some relevant users who have interest in the topic of the question based on users' topic interest. In order to assess users' topic interest, archived question-answer pairs in the community were used to identify latent topics in the chosen categories using LDA. Then, these topic models were used to identify users' topic interest. Furthermore, the topics of newly submitted questions were analyzed using the topic models in order to recommend relevant answerers to the question. This study introduces the process of topic modeling to investigate relevant users based on their topic interest.

Study on Cancer Patients Who Visited an Emergency Department with the Side Effects of Chemotherapy (응급실 내원 암환자의 항암화학요법 부작용에 대한 후향적 조사연구)

  • Lim, Soo Jung;Yi, Myungsun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.75-89
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    • 2014
  • Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

Multifaceted Usage of HPV Related Tests and Products in the Management of Cervical Cancer - a Review

  • Nalliah, Sivalingam;Karikalan, Barani;Kademane, Kumaraswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2145-2150
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    • 2015
  • HPV viruses are integral to the development of cervical cancer. The pathogenesis has been extensively studied. To date, numerous HPV tests and products have been developed and successfully utilized in diagnosis, treatment and prevention of cervical cancer. The HPV DNA test, when combined with other routine cervical cancer screening and diagnostic tests namely exfoliative cytology, visual inspection with acetic acid (VIA) and colposcopy has increased the detection rate of cervical cancer. HPV DNA products could also be measured in other body fluids like urine, lymph node tissue, and serum. HPV association could also be quantified by measuring other parameters like HPV mRNA, viral load, viral integration and methylation status. Vaccination against HPV has been found to decrease the incidence of cervical cancer. Further, therapeutic vaccines for cervical cancer against HPV continue to evolve. All these findings pertaining to HPV could possibly decrease the incidence of cervical cancer in the near future. This review aims to give an overview of the HPV tests and products in use and those under trial currently.