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The Effect of Medication in the Patients with Bee-Sting

약물투여가 벌자상환자에게 미치는 효과

  • 조병준 (강원대학교 응급구조학과) ;
  • 문수재 (강원대학교 응급구조학과) ;
  • 김선예 (충남대학교 약학대학)
  • Received : 2014.12.04
  • Accepted : 2014.12.29
  • Published : 2015.01.28

Abstract

The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

본 연구는 벌자상에 대한 병원 전 응급처치와 약물투여가 환자의 예후에 미치는 영향정도를 파악하여 119 구급대의 병원 전 에피네프린 약물투여를 도입해 보고자 시도하였다. 본 연구는 소방본부 구급활동일지 정보를 통하여 벌자상 환자를 선별하여 후향적으로 조사하였다. 2013년 벌자상으로 119 구급대를 이용한 환자를 대상으로 하였다. 벌자상으로 이송된 22명을 대상으로 119 구급대원에 의해 작성된 구급활동일지와 아나필락시스 환자 응급처치 세부 상황표, 환자의 연령과 성별, 약물투여 여부, 환자 이송시간, 활력징후, 주요 증상, 응급처치내용 등을 조사하였다. 연구결과 환자의 중증도가 심해질수록 산소공급, 정맥로 확보 후 수액투여, ECG 모니터링, 항히스타민제 투여가 나타났다. 케이스별로 보면 의료지도 하에 병원 전 에피네프린을 투여한 경우 환자가 중증이었음에도 불구하고 생존하였다. 결론적으로 벌자상 아나필락시스 환자에 대한 119 구급대의 약물투여와 응급처치는 생존에 중요한 영향을 나타내었다. 산소공급, 기도유지, 정맥로 확보와 함께 약물투여가 환자의 생존에 큰 영향을 미치므로, 119 구급대가 에피네프린을 사용할 수 있는 법적장치를 마련하여 아나필락시스 환자의 생존율을 개선해야할 것이다.

Keywords

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