• 한국응급구조학회지
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• 제10권1호
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• pp.13-21
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• 2006

Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

• 기본간호학회지
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• 제22권1호
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• pp.16-24
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• 2015

Purpose: This study was done to identify essential nursing diagnoses using NANDA and their related factors and defining characteristics of patients who were cared in an emergency room. Methods: The research checklist developed by the researcher consisted of 44 nursing diagnoses with defining characteristics and related factors and was applied to 235 patients who were admitted to an emergency room from November 1 to December 31, 2012. Results: Forty-one of forty-four nursing diagnoses were identified. The most frequent nursing diagnoses were acute pain, risk for falls, and activity intolerance. The most frequent defining characteristic for the nursing diagnosis of 'acute pain' was verbal report of pain. The agreement rate with NANDA (2009)'s defining characteristics was 66.7%. Conclusion: Results indicate that identification of essential nursing diagnoses and their defining characteristics and related/risk factors is important for emergency patient nursing care to facilitate use of NANDA taxonomy in the emergency nursing practice and documentation systems.

• 한국의료질향상학회지
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• 제5권2호
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• pp.216-223
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• 1998

We surveyed the discordance rate of principal diagnosis made at emergency room(ER) & made at ward on discharge of the patients. Subjects were four hundred eighty cases who came to the ER of one third-line hospital from January 1, 1998 to January 31, 1998. The discordance rate was higher in patients admitted to medical department(8.2%) than surgical department(1.5%). If the patients were transferred to other department during hospital stay, discordance rate increased from 3.3% to 6.3%. In conclusion, discordance rate of principal diagnosis made at ER and made at ward was higher in patients with complicated problems. Medical record department should keep these findings in mind if it has a plan to support the management of ER record.

• 한국경영과학회지
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• 제37권4호
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• pp.111-124
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• 2012

Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.91-97
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• 2015

Purpose: Occult hip fracture is not evident on radiographs and the diagnosis is often missed or delayed. This study was undertaken in order to identify the clinical characteristics and complications of patients with a delayed diagnosis of an occult hip fracture. Methods: We retrospectively reviewed patients with occult hip fracture who had normal findings on initial radiographs, the diagnosis was made on additional studies between August 2006 and February 2012. Patients who were diagnosed as having occult hip fractures at the first visit were categorized as non-delayed group and those who were not diagnosed at the first visit were categorized as delayed group. Results: Non-delayed group included 43 patients (86%). In the remaining 7 patients (delayed group), the diagnosis was delayed by a mean of 9.6 days (range 3~19 days). Patients who were diagnosed with an occult fracture on the initial visit presented later than those with a delayed diagnosis (41/43 .vs. 3/7, p=0.002). Other clinical features were no difference between the two groups. Patients in the delayed diagnosis group were more likely to have fracture displacement (4/7 .vs. 0/43)15patients in non-delayed group (34.9%) needed operative treatment, whereas all delayed patients (100%) needed operative treatment. Conclusion: A delayed diagnosis of occult hip fractures was associated with increased rate of displacement and operation. In patients suspected of having occult hip fractures, additional studies should be recommended.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.78-79
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• 2018

최근 시간적, 공간적, 의료기술 적용의 한계를 극복하기 위하여 의료 기술과 IT 기술의 융합을 시도하고 있다. 본 연구에서는 응급 의료 서비스를 위한 원격 의료 지도를 지원하기 위한 앱을 개발하였다. 개발된 스마트 원격 의료 지도 지원 앱은 원격지에 있는 의사가 응급 구조사로부터 응급 환자의 상황을 실시간으로 전달 받을 수 있다. 또한 환자의 상태 진단 및 응급 치료를 지도할 수 있으며 응급실에서의 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• 한국정보통신학회논문지
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• 제22권12호
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• pp.1625-1630
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• 2018

응급 상황에서 응급 구조사는 외상 평가와 치료가 주요 업무이다. 하지만 응급 처치를 할 수 있는 범위가 협소하며 병원의 응급실로 이송하는 일을 주로 수행하고 있다. 응급 상황에 맞는 전문의를 연결하여 원격 의료 지도를 통한 응급 처치가 이루어진다면 정확한 진단과 적절한 치료에 도움을 줄 수 있다. 본 논문에서는 응급 의료 서비스를 위한 원격 의료 지도를 지원하기 위한 앱을 개발하였다. 개발된 스마트 앱은 응급 구조사가 원격지에 있는 의사를 호출하여 응급 환자의 상태를 생체 신호와 영상으로 실시간 전송할 수 있다. 이를 통하여 환자의 상태를 정확하게 진단하는데 도움을 줄 수 있다. 또한 응급 치료를 지도할 수 있으며 응급실에서의 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권5호
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• pp.246-250
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• 2015

Objectives: This study investigated patients with oral and maxillofacial lacerations who visited the emergency room over a three-year period in an effort to determine the optimal treatment for these injuries. Materials and Methods: This study examined 1,742 patients with oral and maxillofacial lacerations with 2,014 different laceration locations who visited the emergency room of Pusan National University Hospital (Busan, Korea) over three years, from January 2011 to December 2013. Patients were classified by sex, age, visit day, cause of injury, injury site, and the presence or absence of soft tissue and tooth injuries. Results: The male to female ratio was 2.50:1. Patients under 10 years old were seen most frequently. Most emergency room visits were on weekends. Among intra-oral lacerations, the lip area was the most vulnerable site; among extra-oral lacerations, the chin area was most frequently injured. The most frequent etiology was a slip down. Most lacerations occurred without bone fracture or tooth damage. Conclusion: Laceration may differ in large part as compared with the fracture. Therefore, it is necessary to continue collecting data on oral and maxillofacial lacerations to establish optimal emergency room diagnosis and treatment strategies.

• Journal of Trauma and Injury
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• 제19권1호
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• pp.8-13
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• 2006

Purpose: Traumatic head injury is very common in the emergency room. Early diagnosis and treatment can significantly reduce mortality and morbidity. When diagnosis is delayed, however, it could be critical to the patients. In reality, it is difficult to take a brain CT for all patients with head trauma, so this study examined the relationship between type and size of scalp injury and intracranial injury. Methods: This prospective study was conducted from May 2005 to July 2005. The participants were 193 patients who had had a brain CT. Head trauma included obvious external injury or was based on reports of witnesses to the accident. Children under three years of age were also included if there was a witness to the accident. The size of the injury was measured based on the maximum diameter. Results: Out of the total of 193 patients, patients with scalp bleeding totaled 126 (65.2%), and patients without scalp bleeding totaled 67 (34.8%). Among patients with scalp bleeding, patients with intracranial injuries numbered nine, and among patients without scalp bleeding, patients with intracranial injuries numbered 17 (P=0.001). Among patients who showed evidence of scalp swelling with no scalp bleeding, the relationship between the size of the scalp swelling and intracranial injury was statistically significant when the size of the scalp swelling was between 2 cm and 5 cm. Conclusion: Among patients who visit an emergency medical center due to traumatic head injury, patients with no scalp bleeding, but with scalp swelling between 2 cm and 5 cm, should undergone more accurate and careful examination, as well as as a brain CT.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.39-45
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• 2022

Background: The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria. Methods: A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0-5/high power field [HPF] vs. >5/HPF) in urine. Results: More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0-5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140-0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room. Conclusion: The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.