• Title/Summary/Keyword: bed sore

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Three Cases of Pressure Ulcer Treated with Hwangryunhaedok-tang Pharmacopuncture and Jaungo (黃連解毒湯약침과 紫雲膏도포를 병행한 욕창 환자 치험 3례)

  • Heo, Jong-won;Eom, Tae-min;Oh, Jeong-min;Choi, Ko-eun;Kim, Hyun-tae;Seol, In-chan;Kim, Yoon-sik;Yoo, Ho-ryong;Jo, Hyun-kyung
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.419-426
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    • 2015
  • Objectives This study reports three cases of pressure ulcer treated with Hwangryunhaedok-tang pharmacopuncture. Methods Three patients with pressure ulcers were treated by Hwangryunhaedok-tang pharmacopuncture and Jaungo at the Oriental Medicine Hospital of Daejeon University. Hwangryunhaedok-tang pharmacopuncture and Jaungo was administrated once a day with simple dressing. Thereafter, we observed the pressure ulcers macroscopically. Results and Conclusions After 3 weeks, wound sizes were reduced and tissue regeneration was accelerated. In conclusion, Hwangryunhaedok-tang pharmacopuncture and Jaungo are effective to treat pressure ulcers, but more studies will be required to validate its use in pressure ulcers.

Emergency Treatment and Nursing Activities of Severe Trauma Patients according to Elapsed Time and Vital Signs (중증외상환자의 치료경과 시간과 활력징후에 따른 응급처치 및 간호활동)

  • Kim, Myung Hee;Park, Jung Ha;Kim, Myung Hee;Koo, Ji Ehun
    • Journal of Korean Biological Nursing Science
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    • v.16 no.3
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    • pp.182-191
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    • 2014
  • Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar's test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

Clinical Observation for the 120 Cases of CVA (뇌전산화단층촬영(CT)상 확진된 120예의 뇌졸중환자에 대한 임상적 고찰)

  • Bae, Sung-Han;Nam, Chang-Gyu
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.168-184
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    • 1998
  • Clinical Observation was made on 120 Cases of CVA that were confirmed through brain CT of Oriental Medical hospital of Se-Myung University from July in 1997 to June in 1998. 1. The CVA cases were classified into the following kinds : cerebral infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH), and the greatest in number among them were the cases of cerebral infarction. 2. The most cases were 50 of age in all cases, in cerebral infarction were over 70 of age. There is no significant difference in the frequency of strokes between the male and female. the ratio was 1.07 : 1. 3. The frequency of strokes seems to have no relation to month and season. 4. The course of entering hospital, most patients visited this hospital directly(not through any other hospital) within 24hours. 5. The first attack was noted in 80.8%, the recurrance attack in 19.2% and the cerebral infarction had high recurrance ratio compared with cerebral hemorrhage. 6. The average duration of hospitalization was 25.2 days. 7. The most ordinary preceding disease was hypertension. 8. The common symptoms were motor disturbance and dysphasia. 9. The most frequent location of the lesion in cerebral infarction was parietal lobe, in cerebral hemorrhage was basal ganglia. 10. According to electrocardiography findings, abnormality was noted in cerebral infarction more than cerebral hemorrhage, subarachnoid hemorrhage. 11. The hypercholesterolemia and hypertriglyceridemia were found more frequently in cerebral infarction than cerebral hemorrhage, subarachnoid hemorrhage. 12. The average time to start physical theraphy was 7.76 days after admission. 13. The most common complications were pneumonia and bed sore.

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Charcot Spinal Arthropathy with Extensive Vertebral Body Destruction and Cerebrospinal Fluid Collection: A Case Report Mimicking Infective Spondylitis (척추체의 광범위한 파괴와 뇌척수액 축적이 동반된 샤르코 척추 관절병증: 감염성 척추염과 유사한 소견을 보이는 증례보고)

  • Cho, Kyu-Jung;Kim, Yeo-Ju;Kim, Young-Tae;Youn, Yung-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.348-353
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    • 2020
  • A 68-year-old man presented with a bed sore with pus discharge on lower back. Radiographs showed extensive destruction of the L4 vertebral body. Magnetic resonance imaging (MRI) showed fluid collection with an enhanced wall at the defect of the L4 vertebral body extending into both psoas muscles. The primary diagnosis was neuropathic spondylopathy, but infective spondylitis was not ruled out. Initially, he was treated with antibiotics for two weeks. A follow-up MRI showed no improvement of the abscess, so surgical exploration was done. Charcot spinal arthropathy resulted in extensive vertebral body destruction that may be similar to infectious spondylitis, particularly in the case with fluid accumulation due to rupture of dura.

The Contents and Satisfation of Home Care Progral Delivered by Seoul Nurses Association (서울시 간호사회 가정간호시범사업 서비스 내용 및 만족도 분석)

  • Lim, Nan-Young;Kim, Keum-Soon;Kim, Young-lm;Kim, Kwuy-Bun;Kim, Si-Hyun;Park, Ho-Ran
    • The Korean Nurse
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    • v.36 no.1
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    • pp.59-76
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    • 1997
  • The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.

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Clinical Change of Terminally Ill Cancer Patients at the End-of-life Time (임종 전 말기 암 환자의 임상 증상 및 징후의 변화)

  • Koh, Su-Jin;Lee, Kyung-Shik;Hong, Yeong-Seon;Yoo, Yang-Sook;Park, Hyea-Ja
    • Journal of Hospice and Palliative Care
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    • v.11 no.2
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    • pp.99-105
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    • 2008
  • Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.

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Clinical Observation on C.V.A. (뇌졸중(腦卒中)에 관(關)한 임상통계적(臨床統計的) 연구(硏究))

  • Yun, Jin-Goo;Cho, Ki-Ho;Kim, Young-Suk;Lee, Kyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.10 no.1
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    • pp.25-38
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    • 1989
  • Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

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Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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