• 제목/요약/키워드: respiratory management

검색결과 854건 처리시간 0.022초

세명대학교 부속한방병원 야간 진료실 내원환자의 실태분석 (Survey on the Actual Conditions of Patients in Semyung University Attached Oriental Medical Hospital Night Clinic.)

  • 민웅기;남창규
    • 대한한의학회지
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    • 제20권4호
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    • pp.50-61
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    • 2000
  • This study on the visits of the oriental medical night clinic of patients, was made to be used as reference data by examining and analyzing statistically the many actual conditions of patients who had been visited in Semyung University Attached Oriental Medical Hospital during the period from April, 1998 to March, 1999. The purpose of this survey was to understand the characteristics of patients, to evaluate the roles of Night Clinic of oriental medical hospital, and contribute to the systemic and efficient management of night clinic service. The results obtained were as follows: I. Distribution of sex: male 53% (421 cases), female 47% (379 cases) 2. The age distribution of patients showed the highest in under ten, followed by the thirties and fifties, forties and twenties in order. 3. The monthly distribution of patients showed the highest in October 1998, followed by May 1998 and February 1999 in order. 4. The daily distribution of patients showed the highest in Sunday, followed by Saturday, Monday, Friday and Tuesday in order. 5. The regional distribution revealed the highest in Jecheon with 76% of all patients, followed by Danyang in order. 6. The distribution of arrival time showed the highest in 7:00 pm~0:00 am (27%), followed by 5:30 pm~7:00 pm (23%) in order. 7. The admission rate in patients was 17%. Among them direct visiting rate was 85%. Circulatory systemic disease was the highest. 8. The highest incidences by disease were of motor system with 48% (394cases), followed by diseases in circulatory system with 19% (l48cases). The majority of the patients 67% was connected with two diseases. 9. The chief complaint of pediatric diseases was febrile seizure with 64% (32cases), digestive disease was abdominal pain with 44% (90cases), circulatory diseases was motor disturbance with 43% (83cases), motor system disease was leg pain with 37% (l19cases), respiratory disease was fever with 46% ( 41 cases). 10. In the treatment method, a major portion of treatment methods was acupuncture treatment with 32% (373cases), followed by acupuncture & herbal medicine treatment with 23% (275cases). The most commonly used herbal medicines were Hangsapyunguisan(l6%) and Ojeoksan(l4%).

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수술후 통증 조절을 위한 경막외 모르핀 투여방법이 비교 (Comparison of Administration Methods for Epidural Morphine in Postoperative Pain Control)

  • 양성식;최정환;강유진;송호경;이승균
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.220-223
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    • 1993
  • Administration of local anesthetics or morphine through epidural space has the effect of curbing postoperative increases in endocrine hormone. Other benefits include improving metabolic reaction and eliminating postoperative pain. However, repeated administration of local anesthetics through epidural space causes tachyphylaxis, and the unstable blockade of sensory nerve resulting in insufficient analgesia. Morphine has excellent postoperative analgesic effect, but complications including: itching, nausea, vomiting, urinary retention and respiratory depression may be associated with its administration. Sixty patients that fall into the category of ASA class I and II were randomly selected for the purpose of the experiment. Thirty patients were give 4 mg of morphine and the rest, 4 mg of morphine plus 80 ml of 0.25% bupivacaine administered through epidural space with the Baxter infuser. Analgesic effect was satisfactory in both groups. On the day of operation, the effect was stronger in group I (P<0.05) and on postoperative second day, group II showed better analgesic effect (P < 0.05). Group II had more patients who complained of itching (P < 0.05). Other complications were statistically insignificant. The findings indicate that administration of morphine through epidural space for postoperative pain management is an effective procedure. Baxter infuser was found to be very instrumental in pain control while reducing the chance of complications.

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다종의 Pulse Oximeter에서 측정된 산소 분압도의 차이와 상호 비교 결과에 대한 보고 (COMPARATIVE STUDY OF SEVERAL TYPE PULSE OXIMETER AND OXYGEN SATURATION EXTRACTED FROM THEM)

  • 유승훈;김응학;권순원;김종수
    • 대한소아치과학회지
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    • 제27권4호
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    • pp.494-498
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    • 2000
  • 진정요법하의 치과진료에서 환자의 상태를 지속적으로 감시하는 것은 매우 중요하다. 여러 방법 중 가장 널리 사용되는 것 중 Pulse Oximeter가 있다. Pulse Oximeter는 비침습적 방법으로 계속해서 동맥혈액의 산소포화도를 측정할 수 있도록 고안된 장치로서 기기에 나타나는 산소포화도$(SpO_2)$는 실제로 측정한 동맥혈액의 산소포화도$(SaO_2)$와 거의 일치하는 것으로 알려져 있다. 본 진료실에 있는 세종류의 Pulse Oximeter를 이용하여 한 환자에게 동시에 두 개의 기기를 적용하였을 경우, 산출값을 상호 비교한 결과, 짧은(3회) 맥박수를 평균하는 기기가 낮은값이 나왔으며, 다른 두개의 Pulse Oximeter와 유의한 차이가 있는 것으로 밝혀졌다. 짧은 맥박수를 평균하는 기기는 반응이 빠르나, 산소포화도의 값이 작게 산출되고, 외부의 신호에 더욱 민감하여, 오류가 존재할 가능성 또한 높다. 기기의 특성을 알아, 술자는 적절한 기기를 선택하는 것이 중요하다.

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신생아중환자 분류도구 개발을 위한 간호활동 규명 및 표준간호시간 조사연구 (A Study on Identifying Nursing Activities and Standard Nursing Practice Time for Developing a Neonatal Patient Classification System in Neonatal Intensive Care Unit)

  • 고범자;유미;강진선;김동연;복정희;장은경;박선자;오순자;최윤진
    • 임상간호연구
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    • 제18권2호
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    • pp.251-263
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    • 2012
  • Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.

Pierre Robin sequence 환아에서 하악골신장술 (MANDIBULAR DISTRACTION OSTEOGENESIS IN AN INFANT WITH PIERRE ROBIN SEQUENCE: REPORT OF A CASE)

  • 유선열;권준경;김선국
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.460-467
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    • 2008
  • Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

기관절제술후 기관 단단문합술 치험 결과 (Results of Tracheal Resection with End-to-end Anastomosis)

  • 신동진;조우진;백승국;우정수;권순영;정광윤
    • 대한기관식도과학회지
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    • 제10권1호
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    • pp.41-45
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    • 2004
  • Tracheostomy and endotracheal intubation are often performed in patients with acute and chronic respiratory failure. Recently, the incidence of iatrogenic tracheal stenosis has increased. Tracheal resection and end-to-end anastomosis would be one of the most physiologic treatment options for severe tracheal stenosis. Also, this treatment can be applied to the management of trachea invaded by thyroid cancer and tracheal neoplasm. The authors aimed to analyze the outcomes of end-to-end anastomosis of trachea following segmental resection in tracheal stenosis and tracheal invasion of cancer that we have recently experienced. Materials and methods Authors retrospectively studied 19 cases treated by tracheal resection with end-to-end anastomosis between Feburuary 1996 and January 2003. 12 patients had tracheal stenosis, 6 patients had tracheal invasion by thryroid cancer and 1 patient had tracheal cancer. We analyzed the direct causes of tracheal stenosis, preoperative vocal cord function, operation technique, early and delayed postoperative complications, and the outcome of end-to-end anastomois. Result Decannulation without significant aspiration was achieved in 16 cases($89.5\%$). A 27 year-old man could not be decannulated because of restenosis. A 62 year-old woman could not be decannulated because of bilateral vocal cord palsy. Conclusion End-to-end anastomosis is a safe and effective surgical method for tracheal stenosis. Case selection for end-to-end anastomosis and preservation of recurrent laryngeal nerve during operation is very important.

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임산부의 약물 인식 및 복약 순응도 조사연구 (Drug Safety Perception and Medication Adherence in Pregnancy)

  • 유기연
    • 한국임상약학회지
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    • 제23권3호
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    • pp.197-205
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    • 2013
  • Background: Many factors including drugs, dietary supplements, and food intake can affect the development and organ formation of fetuses. Because of this, subject tends to avoid consuming things like coffee, alcohol, or cigarettes due to the risks they pose during pregnancy. Therefore, analysis of drugs and favorite food consumption is needed and important to ensure safe health management for subject. Purpose: This study was conducted domestically to analyze these factors in South Korea. Method: The survey was conducted from pregnancy-related online communities for six days and the survey results were received via email for analysis. Result: A total of 127 subjects answered the questionnaire via email; the characteristics of subjects are widely varied in their ages, education levels, job statuses, and residences. The questionnaire included the intake of dietary supplements during pregnancy including vitamins and the result showed that the subjects took 2.23 different kinds of supplements on average. In order of highest frequency, 101 subjects took multivitamins; 79 subjects took an iron supplement; 30 subjects took analgesics; 20 subjects took prescribed antipyretic and medication for upper respiratory diseases; 12 subjects took antibiotics; 7 subjects took antiemetics. Their compliances were different in each medication categories. Only 8% of subjects answered that they had asked a pharmacist for medication information during pregnancy. In addition, 78% of subjects answered that they never counseled with anyone about pregnancy related medication use. Conclusion: In conclusion, many subjects took medication including dietary supplements. The role of pharmacists should be actively developed to improve subject care such as education about subject's medication uses and their food consumption behavior.

수술후 통증 관리의 Patient-Controlled Analgesia와 마약류의 전통적인 근육내 주사와의 비교 (A Comparison of Patient-Controlled Analgesia and Conventional Intramuscular Opioid Regimen in Relation to their Post-Operative Pain Control and Side Effects)

  • 이상훈;이진경;이규창;우남식;이예철
    • The Korean Journal of Pain
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    • 제6권1호
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    • pp.55-59
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    • 1993
  • Using a visual analogue scale, we compare the effect of patient-controlled analgesia and conventional intramuscular opioid regimen in 68 patients undergoing lower abdominal or gynecological surgery. We also recorded the incidence of side effects. We checked visual analogue scale 4 hours interval for 30 cases managed by patient-controlled analgesia and 38 cases of conventional intramuscular opioid group managed by obstetrician. We maintained fentanyl $0.33{\mu}g/kg/hr$ and set self administrable bolus dose $5.0{\mu}g$(lockout interval: 15 min) in patient-controlled analgesia group. Conventional intramuscular bolus injection group were administered meperidine 50 mg for 4 hour interval. Mean visual analogue scale scores obtained by patient-controlled analgesia group and intramuscular bolus injection group were $2.49{\pm}0.67$ and $4.53{\pm}1.28$(p<0.05). Side effects such as; no significant incidence of respiratory depression, urinary retention, postural hypotension, nausea, vomiting and pruritus were developed by either group. These results suggest that patient-controlled analgesia was more effective method compared with conventional intraumuscular opioid injection regimen for post-operative pain management.

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영유아 대상 시설의 실내공기질 특성 비교 및 개선방안에 대한 연구 (Infant target facilities and facilities for children in elementary school Comparison and Improvement of Indoor Air Quality for Research)

  • 서병원;이주화;박지훈;강선홍
    • 상하수도학회지
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    • 제27권5호
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    • pp.591-601
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    • 2013
  • In modern society, we are living indoor at 80 - 90 % or more of the day, therefore most people are exposed to unconscious indoor air pollutants by various causes. When mother and infant, whose level of immunity are weak, are exposed to polluted indoor air, respiratory diseases and atopy can occur by the growth of bacteria. Therefore, appropriate indoor air quality management is important especially at nursery, elementary school and postpartum clinic etc. In this study, we compared the characteristics of the indoor air qualities of primary school facilities and infant facilities. In this study, seasonal effects were investigated. Also the effects of individual activity area were studied for indoor air quality. During summer season(May-August), the air qualities of each 16 elementary school and nursery school were investigated. During winter season(October-december), the air qualities of each 10 elementary school and nursery school were investigated. As a result, during winter season in 10 of 16 nursery school, $CO_2$ concentration exceeded regulation level of 1000 ppm. This resulted from the operation of heating system and poor ventilation. Also the air quality of all parameters during winter season were worse than during summer, maybe due to poor ventilation. Except HCHO, the concentrations of other parameters were higher in nursery school. This seems to result from relatively low individual activity area of nursery school than elementary school. From this research, more strong regulation for ventilation and installation of air purifier should be implemented.

외과적 자연기흉의 임상적 고찰 (Clinical Investigation of Surgical Spontaneous Pneumothorax)

  • 윤윤호
    • Journal of Chest Surgery
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    • 제1권1호
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    • pp.19-24
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    • 1968
  • A clinical investigation was reported on 17 cases of spontaneous pneumothorax requiring surgical mana-gement. Males outnumbered females 15:2. Determination of the etiology in this series showed that the majority were pulmonary tuberculosis and paragonimiasis. Several others had pneumonia, lung abscess, cyst and blebs. It is of particular interest that the acute inflammation of respiratory system was younger age group, pulmonary tuberculosis & paragonimiasis were between 2 nd and 3 rd decades, and lung abscess, cyst, blebs were above 4 th decade. Pulmonary tuberculosis was far advanced bilateral and active. The ratio of right to left side was 13:6 and both side involved in 2 cases. In about half cases of patients, above 50%-collapsed lung associated with mediastinal shifting developed. The complications were pleural effusion and bronchopleural fistula. The former was 13 cases [76.4%] in which 3 cases combined with mixed infection, and latter was 5 cases. As the management, 11 cases were subjected to intercostal or rib resection drainage with continuous suc-tion. Among 11 drainage cases, 8 cases were successful in acute stage and 3 cases failed in chronic stage. This faiure was due to interference with re-expansion of collapsed lung for peel formation and broncho-pleural fistula. The open thoractomy was applied in 9 cases, among which primary operation were 5 cases and drainage failure were 4 cases. Among 11 cases subjected to the open thoracotomy, wedged resection was performed in 3 cases including paragonimiatic cyst, and pneumonectomy in 1 case-tuberculosis, and decortication only was performed in 2 cases in paragonimiasis. Decortication & lung resection was carried out in 2 patients among which ruptured lung abscess 1 case and ruptured multiple blebs 1 case. There was no case of death but prognosis of the tuberculosis may be poor because of far advanced bilateral and active pulmonary tuberculosis.

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