• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제31권1호
• /
• pp.35-40
• /
• 2009

Dental emergency varies from toothache to trauma of oromaxillofacial area. Recently, the number of emergency cases after dental treatment is increasing because surgical treatments such as implant installation rise. Dental emergency patients have been looking for emergency room of general hospital and they could be treated only when the dentist of night duty exists. Although there are many analyses on the dental emergency patients visiting general hospitals, research on the dental treatment only has not been provided enough. We anticipated different aspects between the dental emergency patients visiting independent dental hospital and general hospitals. We analyzed dental emergency patients' chief complaints and received procedures for almost 1-year period in Won-Kwang dental hospital in Dae-jeon where there had been no dental emergency settings. With this 1574 patients' result, we tried to find appropriate treatment plans regarding dental emergency patients occurring at night and holidays.

• 의료법학
• /
• 제13권1호
• /
• pp.249-293
• /
• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• 성인간호학회지
• /
• 제26권5호
• /
• pp.500-511
• /
• 2014

Purpose: The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department. Methods: Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires. Results: Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours. Conclusion: Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.

• 한국응급구조학회지
• /
• 제11권3호
• /
• pp.163-174
• /
• 2007

Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.

• Journal of Trauma and Injury
• /
• 제23권2호
• /
• pp.192-195
• /
• 2010

Splenic rupture is a frequent surgical emergency in blunt abdominal trauma patients. There are several treatment options, including conservative treatment, a partial splenectomy, splenorrhaphy, and a splenectomy for splenic injury. Although reports on the safety and the efficacy of an elective laparoscopic splenectomy are abundant in the literature, a laparoscopic splenectomy for a ruptured spleen has only been reported in a few cases. We report a case of a laparoscopic splenectomy in the patient with Grade III traumatic splenic injury. To our knowledge, this is the first report in which a laparoscopic splenectomy was performed in Korea for the treatment of a traumatic splenic injury.

• 대한임상독성학회지
• /
• 제11권1호
• /
• pp.36-40
• /
• 2013

Ethylene glycol poisoning is treated mainly by alcohol dehydrogenase inhibition therapy and hemodialysis. Early recognition and initiation of treatment is important because toxic metabolites increase over time by hepatic metabolism; however, there is no confirmative diagnostic tool in our clinical setting. Therefore, diagnosis is dependent on history, high anion gap acidosis, high osmolal gap, etc.. Diagnosis and treatment are delayed in cases where history taking is not possible, such as a mental changed patient. Authors report on two cases of ethylene glycol poisoning by contrasting clinical outcomes, demonstrating the importance of early diagnosis and treatment for achievement of a good outcome.

• 한국산학기술학회논문지
• /
• 제12권9호
• /
• pp.4075-4082
• /
• 2011

항공기 승무원은 최초 반응자로 비행기내 환자 발생 시 적절하고 신속하게 응급처치를 시행하여야 한다. 승무원의 기본응급처치 의식조사 결과, 출혈 관리, 소아 고열, 경련, 심근경색, 기도유지, 부분기도폐쇄 등에 대한 대처방법은 80.5%~97.8%로 올바르게 의식하고 있었지만 의식 없는 기도폐쇄, 호흡확인 방법, 영아자동제세동기 사용 등에 대한 대처방법은 3.2%~20.0%로 비교적 낮게 나타났다. 따라서, 본 연구결과를 바탕으로 기내에서 발생되는 환자 중 발생빈도가 높은 유형, 해결하기 어려운 유형, 생명을 위협할 수 있는 유형 등에 대한 응급처치 매뉴얼이 마련되어야 된다.

• Journal of Trauma and Injury
• /
• 제22권2호
• /
• pp.172-178
• /
• 2009

Purpose: We performed this study to determine how the emergency trauma team affects the treatment of patients with multiple severe trauma and to discuss the effect and the direction of the emergency trauma team's management. Methods: We performed a retrospective analysis of 518 patients who visited our emergency department with severe trauma from August 2006 to July 2008. We divided the severe trauma patients into 2 groups : patients before and after trauma team management (Group 1 and Group 2). Then, we compared demographic characteristics, mechanisms of injury, and treatment outcomes (lengths of stay in the ED, admission ratio, and in-hospital mortality) between the 2 groups. In the same way, patients with multiple severe trauma were divided into 2 groups, that are patients before and after trauma team management (Group 3 and Group 4) and analyzed. Results: There was no significant difference, except mean age, between groups 1 and 2. In group 4 patients, compared to group 3 patients, the lengths of stay in the ED were lower (p value < 0.001), and the admission ratio were higher (p value = 0.017), but there was no significant difference in the in-hospital mortality between the groups 3 and 4. Conclusion: When patients with multiple severe trauma visit the ED, the emergency trauma team' management can decrease the lengths of stay in the ED and increase the admission ratio, but does not produce a decrease in the in-hospital mortality rate. Further investigations of emergency trauma team management are needed to improve treatment outcomes for patients with multiple severe trauma.

• Journal of Dental Anesthesia and Pain Medicine
• /
• 제15권2호
• /
• pp.77-83
• /
• 2015

Background: To prepare for possible emergency situations during dental treatment, it is helpful to know how often and what kinds of emergencies may arise. This study set out to evaluate the incidences, causes, treatments, and outcomes of emergency situations in the outpatient clinic of a dental teaching hospital in Korea. Methods: We retrospectively reviewed the records of patients who had experienced an emergency situation and emergency response team activated in a selected outpatient clinic between November 2004 and November 2013. Specific information about the emergency cases was collected, including the patient characteristics and the frequency, types, treatments, and outcomes of the emergency situations. Results: We identified 35 instances of emergency situations in 2,890,424 patients (incidence = 0.012 per 10,000 outpatients). The number of cases was as follows: 10 (28.6%) in the Department of Periodontics, 10 (28.6%) in the Department of Oral and Maxillofacial Surgery, 6 (17.1%) in the Department of Oral and Maxillofacial Radiology, 4 (11.4%) in the Department of Prosthodontics, 2 (5.7%) in the Department of Conservative Dentistry, 2 (5.7%) in the Department of Pediatric Dentistry, and 1 (2.9%) in the Department of Orthodontics. Three (8.6%) of the emergency situations arose before treatment, 22 (62.9%) during treatment, 7 (20.0%) after treatment, and 2 (5.7%) in a patient's guardian. Conclusions: In accordance with the growing elderly population and more aggressive dental procedures, the number of emergency situations may increase in the future. We recommend that clinicians keep in mind airway management and the active control of emergency situations.

• 한국산학기술학회논문지
• /
• 제19권12호
• /
• pp.636-644
• /
• 2018

본 연구는 응급처치 교육프로그램이 간호대학생의 셀프리더십, 진로결정자기효능감 및 수행능력에 미치는 효과를 파악하고자 시도하였다. 연구방법은 비동등성 대조군 전후설계의 유사실험연구이며, 자료수집 기간은 2017년 6월 1일부터 8월 31일까지였다. 연구대상자는 D시 D대학 간호학과 학생 중 연구참여를 희망하고 동의한 실험군 27명과 대조군 25명으로 총 52명이었다. 대조군은 2017년 6월 1일 사전 설문조사 후 어떠한 처치도 없이 2주 후 사후 설문조사를 시행하였다. 실험군은 7월 25일 실험처치인 응급처치 교육 프로그램 시행 전에 사전 설문조사를 시행하였으며, 중재 후 8월 31일까지 사후 설문조사를 시행하였다. 실험군에게 제공된 응급처치 교육프로그램은 성인심폐소생술과 기도폐쇄, 화상, 출혈 및 골절에 대한 응급처치 교육내용 2시간 수강, 자율적인 동영상 시청, 강사로서 4시간 동안 초등학생 응급처치 교육수행 등으로 진행되었다. 자료분석방법은 SPSS/WIN 20.0 프로그램을 이용하여 기술통계, independent t-test, $x^2$ test 및 paired t-test로 분석하였다. 응급처치 교육프로그램 적용 전후 두 집단 간 차이를 분석한 결과 셀프리더십(t=2.08, p<.05), 진로결정자기효능감((t=4.22, p<.05), 및 수행능력(t=5.02, p<.05)은 통계적으로 유의한 차이가 나타났다. 즉, 본 연구에서 적용한 응급처치 교육프로그램은 간호대학생의 셀프리더십, 진로결정자기효능감 및 수행능력을 증가시키는데 효과적임을 알 수 있다.