• Title/Summary/Keyword: The Triage

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The Effectiveness Evaluation of Helicopter Ambulance Transport among Neurotrauma Patients in Korea

  • Park, Kyoung Duck;Seo, Sook Jin;Oh, Chang Hyun;Kim, Se Hyuk;Cho, Jin Mo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.42-47
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    • 2014
  • Objective : Helicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea. Methods : This retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT. Results : Ninety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001). Conclusion : In this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.

A Study on the Design and Implementation of an Digital Evidence Collection Application on Windows based computer (윈도우 환경에서의 증거 수집 시스템 설계 및 구현에 관한 연구)

  • Lee, SeungWon;Roh, YoungSup;Han, Changwoo
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.23 no.1
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    • pp.57-67
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    • 2013
  • Lately, intrusive incidents (including system hacking, viruses, worms, homepage alterations, and data leaks) have not involved the distribution of an virus or worm, but have been designed to acquire private information or trade secrets. Because an attacker uses advanced intelligence and attack techniques that conceal and alter data in a computer, the collector cannot trace the digital evidence of the attack. In an initial incident response first responser deals with the suspect or crime scene data that needs investigative leads quickly, in accordance with forensic process methodology that provides the identification of digital evidence in a systematic approach. In order to an effective initial response to first responders, this paper analyzes the collection data such as user usage profiles, chronology timeline, and internet data according to CFFPM(computer forensics field triage process model), proceeds to design, and implements a collection application to deploy the client/server architecture on the Windows based computer.

The Factors Influencing Preparedness on Disaster Nursing among Nursing Students (간호대학생의 재난간호 준비도 영향 요인)

  • Kim, Myung Ja;Jung, Hyang Mi;Kim, Nam Hee;Lee, Yeon Hee;Kim, Myo Sung
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.283-292
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    • 2021
  • The purpose of this study was to identify the factors influencing the disaster nursing preparedness of nursing students. A descriptive survey study was carried out from June 12 to October 16, 2017, the subjects were junior and senior grade nursing students. Data were analyzed by t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis using the SPSS program. The influencing factors on the disaster nursing preparedness were lower confidence of disaster nursing (β =-.21, p<.001) and disaster nursing knowledge (β=.15, p=002). 10.2% of the variance in disaster nursing preparedness was explained by these two factors on multiple regression analysis. In order to improve the preparedness of nursing students for disaster nursing, nursing students' confidence in disaster nursing should be improved, and a systematic and practical disaster nursing curriculum should be developed.

Perceived Usefulness and Attitude toward Smart-glass for First-aid Remote Support among Coast Guards in Korea (응급처치 원격지도용 스마트글래스 사용에 대한 한국 해양경찰의 인지된 유용성 및 태도)

  • Choi, Jongmyung;Kim, Sun Kyung;Lee, Youngho;Yoon, Hyoseok;Go, Younghye;Byun, Kyung Seok
    • Journal of Korea Society of Industrial Information Systems
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    • v.26 no.4
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    • pp.1-9
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    • 2021
  • This study was to investigate the types of emergencies transported by the Southwestern Coast Guard, the need for telemedicine guidance, and the perception and attitude of smart glasses as a communication method targeting 31 coast guards. A relatively high frequency and training requirement were confirmed for bleeding, abrasion, and abdominal pain. The demand for telemedicine guidance on medication and triage was higher, and the perceived usefulness and attitude scores for the use of smart glasses were 3.76±0.61 and 3.64±0.45, respectively. A moderate correlation between perceived usefulness and attitude toward smart glasses was confirmed (r=.630, p<.01). With the development of technology, it is time to actively introduce new devices such as smart glasses.

Prevalence of High Risk Human Papillomavirus Infection with Different Cervical Cytological Features among Women Undergoing Health Examination at the National Cancer Institute, Thailand

  • Laowahutanont, Piyawat;Karalak, Anant;Wongsena, Metee;Loonprom, Komson;Pukcharoen, Phuttalak;Jamsri, Paphawin;Sangrajrang, Suleeporn
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5879-5882
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    • 2014
  • High-risk (HR) human papillomavirus (HPV) testing is important in cervical cancer screening for triage colposcopy. The objective of the study was to evaluate the prevalence of HR HPV infection with different cervical cytological features among women undergoing health examination. A total of 2,897 women were retrospectively evaluated between May 2011 to December 2011. DNA was extracted from residual specimens collected during routine liquid-based cytology tests at the National Cancer Institute. Overall, HR HPV prevalence was 9.3% including 1.6% of HPV-16 and 0.4% of HPV-18. Of all 270 HPV positive samples, 211 (78.1% were HR-HPV non 16/18; 47 (17.4%) were HPV-16 and 12 (4.4%) were HPV-18. The prevalence of HPV infection was similar in all age groups, although a higher rate was observed in women age 31-40 years. Among women with normal cytology, HR HPV positive were found in 6.7%. In abnormal cytology, HR HPV were found 46.7% in atypical squamous cells (ASC), 54.8% in low-grade squamous intraepithelial lesions (LSIL) and 80.0% in high-grade squamous intraepithelial lesions (HSIL). HPV-16 was detected in 8.6%, 6.4% and 12.0% of ASC, LSIL and HSIL, respectively. The results of this study provide baseline information on the HPV type distribution, which may be useful for clinicians to decide who should be monitored or treated more aggressively.

Plasma Neutrophil Gelatinase-Associated Lipocalin as a Marker of Tubular Damage in Diabetic Nephropathy

  • Kim, So Young;Jeong, Tae-Dong;Lee, Woochang;Chun, Sail;Sunwoo, Sung;Kim, Soon Bae;Min, Won-Ki
    • Annals of Laboratory Medicine
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    • v.38 no.6
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    • pp.524-529
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    • 2018
  • Background: An increase in neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular injury. Diabetic nephropathy causes typical changes in the kidney, characterized by glomerulosclerosis and eventual tubular damage. We validated the usefulness of plasma NGAL (pNGAL) as a biomarker of tubular damage in patients with diabetic nephropathy. Methods: We included 376 patients with diabetes mellitus (260 patients with chronic renal insufficiency who had not received hemodialysis and 116 hemodialyzed due to diabetic nephropathy) and 24 healthy controls. Patients with chronic renal insufficiency were divided into three groups according to urinary albumin excretion (UAE) levels. pNGAL levels were measured using the Triage NGAL test (Alere, San Diego, CA, USA) and were compared between groups. We also examined whether pNGAL level was related to the degree of albuminuria and cystatin C-based glomerular filtration rate (GFR). Results: Mean pNGAL levels of the healthy controls, chronic renal insufficiency patients with diabetes mellitus, and hemodialyzed patients were $61.9{\pm}5.3ng/mL$, $93.4{\pm}71.8ng/mL$, and $1,536.9{\pm}554.9ng/mL$, respectively. pNGAL level increased significantly in patients with severe albuminuria (P <0.001) and had a moderate correlation with the degree of albuminuria (r=0.467; P <0.001) and GFR (r=0.519; P <0.001). Multivariate regression analysis showed that the pNGAL level was associated with tubular damage independent of patient age, sex, and GFR. Conclusions: pNGAL level independently reflects the degree of tubular damage in patients with diabetic nephropathy. Measurement of pNGAL, combined with UAE, would enable simultaneous, highly reliable assessments of tubular damage for such patients.

Patient characteristics associated with length of stay in emergency departments (응급실 재원시간과 관련된 환자의 특성)

  • Chung, Seol-Hee;Hwang, Jee-In
    • Health Policy and Management
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    • v.19 no.3
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    • pp.27-44
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    • 2009
  • The length of stay in emergency departments has been used as a quality indicator to reflect the overall efficiency of emergency care. Identifying characteristics associated with length of stay is critical to monitor overcrowding and improve efficient throughput function of emergency departments. This study examined the level of waiting time for initial assessment by physician and length of stay in emergency departments. Furthermore, we investigated the characteristics of patients' attendance associated with length of stay. An observational study was performed for a sample of 1,526 patients visiting ten nation-wide emergency departments. A structured form was designed to collect information about patients' demographics, route of admission, time and mode of arrival, triage level, cause of attendance, initial assessment time by physician, departure time, and disposition. Multiple regression analysis was performed to determine factors associated with length of stay. The average length of stay was 209.4 minutes (95% confidence interval [CI]=197.1-221.7), with a mean waiting time for initial assessment of 5.9 minutes (95% CI=5.1-6.7). After controlling for emergency department characteristics, increasing age, longer waiting times, attendance due to diseases, higher acuity, multiple diagnoses($\geq$2) and requiring admission or transfer to other health care facilities were positively associated with length of stay in emergency departments. The findings suggest that both patients' characteristics and the flow between emergency departments and parent hospitals should be taken into account in predicting length of stay in emergency departments.

Outcomes of Home Monitoring after Palliative Cardiac Surgery in Infants with Congenital Heart Disease (선천성 심질환으로 고식적 수술을 시행 받은 영아의 홈모니터링의 성과)

  • Kim, Sang Wha;Uhm, Ju-Yeon;Im, Yu Mi;Yun, Tae-Jin;Park, Jeong-Jun;Park, Chun Soo
    • Journal of Korean Academy of Nursing
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    • v.44 no.2
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    • pp.228-236
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    • 2014
  • Purpose: Common conditions, such as dehydration or respiratory infection can aggravate hypoxia and are associated with interstage mortality in infants who have undergone palliative surgery for congenital heart diseases. This study was done to evaluate the efficacy of a home monitoring program (HMP) in decreasing infant mortality. Methods: Since its inception in May 2010, all infants who have undergone palliative surgery have been enrolled in HMP. This study was a prospective observational study and infant outcomes during HMP were compared with those of previous comparison groups. Parents were trained to measure oxygen saturation, body weight and feeding volume and to contact the hospital through the hotline for emergency situations. Telephone counseling was conducted by clinical nurse specialists every week post discharge. Results: Forty-one infants were enrolled in HMP. Nine hundred telephone counseling sessions were conducted. Seventy-three infants required telephone triage with the most common conditions being gastrointestinal (50.7%) and respiratory symptoms (32.9%). With HMP intervention, interstage mortality decreased from 18.6% (8/43) to 9.8% (4/41) (${\chi}^2$=1.15, p=.283). Conclusion: Results indicate that active measures and treatments using the HMP decrease mortality rates, however further investigation is required to identify various factors that contribute to hemodynamic complications during the interstage period.

Developing Telephone Guidelines for Symptom Management of Cancer for Outpatients with Cancer after Chemotherapy (항암화학요법 후 퇴원한 암 환자의 증상관리를 위한 전화상담 가이드라인 개발)

  • Park, Ihn Sook;Kim, Eun Mi;Oh, Pil Ju;Kim, Soo Jin;Kim, Hye Jin;Kim, Bo Kyung;Hwang, Eun Kyung;Park, Se Rim;Lee, Mi Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.317-328
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    • 2012
  • Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

Research on the Conflicts and Future Direction of Integrative Medicine in Korea (한.양방 통합의료의 갈등과 방향에 대한 연구 - 한.양방 의료 및 관련 종사자 대상 심층면접을 중심으로 -)

  • Lim, Eun Jin;Kim, So Yun;Sohn, Myoung Sei;Choe, Pyung Nak;Oh, Byeong Sang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.2
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    • pp.243-250
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    • 2014
  • This study examined the knowledge and understanding of integrative medicine in Korea, specifically conflicts between western and oriental medicine within Parallel (Dual) health care systems. Qualitative methodology using grounded theory guided semi-structured, in-depth interviews with Western Medical Doctors (W.M.D., n = 6), Oriental Medical Doctors (O.M.D., n = 5) and Traditional Chinese Medicine Practitioners (T.C.M.P., n = 4). Thematic analysis was used to determine broad themes from the interviews. 15 professionals (W.M.D. (40%), O.M.D. (33%), T.C.M.P. (27%), 10 males (67%) and 5 females (33%), mean age 45) were interviewed, recorded, and transcribed. Thematic analysis revealed three key themes: systematic conflicts, integration and future directions. Subthemes of systematic conflicts included: credibility of Oriental Medicine, commercial imperatives, maintaining social standing of O.M.D., professional qualifications and lack structures supporting collaborative practice. Integration subthemes included lack of academic linkage and clarity for appropriate triage, opposing medical paradigms and limited social imperative. Future directions should include: social justification, guarantee of oriental medicine legitimacy, role of government and understanding of scientific evidence. To successfully integrate dual medical systems there is a need to address differences in social-environmental factors and perceptions of scientific understanding, as well as developing strong academic links in clinical practice.