• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.81-90
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• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.

• Journal of Korean Biological Nursing Science
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• 제23권2호
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• pp.138-150
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• 2021

Purpose: This retrospective study aimed to investigate nursing interventions in patients with severe thoracic injury in trauma bay of a regional trauma center. Methods: Of the 1,780 patients admitted to the trauma bay of a regional trauma center in a university hospital in the Gyeonggi Province between January 1, 2019 and December 31, 2019, 120 adult patients with severe thoracic injury who met the inclusion criteria were enrolled. Participants' clinical characteristics and nursing interventions were collected from electronic medical records after receiving ethical approval. Nursing interventions were classified using the terminology in the Nursing Intervention Classification. Results: The mean age of participants was 52.25 years and 72.5% of participants were male. The main areas of thoracic injury included lung parenchyma and pleura (95.8%). The mean Abbreviated Injury Scale (AIS) for thoracic injury was 3.13 and the mean Injury Severity Score (ISS) was 17.81. Fluid resuscitation, invasive hemodynamic monitoring, chest tube care, respiratory monitoring, artificial airway management, gastrointestinal tube care, mechanical ventilation management: airway insertion and stabilization, blood product administration, allergy management, and surgical preparation were performed significantly more frequently in thoracic injury patients with unstable vital signs or a higher AIS score. Conclusion: This study is significant as it investigated the types of nursing interventions given to patients with severe thoracic injury in the trauma bay. These results would contribute to developing more detailed educational materials for initial nursing interventions in trauma bay.

• 한국실내디자인학회논문집
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• 제26권6호
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• pp.172-179
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• 2017

The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

• 근관절건강학회지
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• 제27권2호
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• pp.122-131
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• 2020

Purpose: This study aims to investigate major traumatic events experienced by nurses in regional trauma centers and explore the relationship among their traumatic events experience, perceived stress, and stress coping. Methods: Data were collected from 208 nurses in the trauma emergency room (trauma-bay) and trauma intensive care unit at four regional trauma centers. Results: The mean score of the traumatic events experience was 44.3 out of 76 points. The scores for physical injuries caused by traffic accidents or falls as well as patient care with abnormal behaviors were high. Significantly positive correlations among traumatic events experience, perceived stress, and stress coping were identified. Conclusion: Nurses working in the regional trauma centers experienced many various traumatic events, leading to high levels of stress. This study suggests that it is necessary to establish a regular surveillance system for nurses' traumatic events experience and perceived stress.

• 보건행정학회지
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• 제28권4호
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• pp.411-422
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• 2018

Background: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. Methods: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ${\geq}15years$. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). Results: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. Conclusion: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.

• 한국융합학회논문지
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• 제11권3호
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• pp.321-331
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• 2020

본 연구의 목적은 권역 외상 중환자실 간호사의 교육 현황, 교육 요구 및 간호사 역량을 파악 하는데 있다. 자료 수집은 5개 권역 외상 중환자 치료센터에 근무하는 123명 간호사로부터 설문지를 수집하였다. 조사 설문지는 외상 중환자실 간호사의 교육 현황, 교육 요구 및 간호사의 역량으로 구성되었다. 연구 분석은 SPSS 21.0 프로그램을 이용하여 서술통계, t-test, One-way ANOVA, Pearson Correlation으로 분석하였다. 연구결과 국내 외상 중환자 간호 교육 참여는 78.9%이었다. 외상 중환자 간호 교육 중요도 결과 '태도'는 3.64, '지식'은 3.52, '기술'은 3.47로 나타났다. 교육 요구도 결과 '지식'은 3.18, '태도'는 3.05, '기술'은 2.97로 나타났다. 간호사의 역량 조사 결과 '윤리적 역량'은 3.62, '심미적 역량'은 3.53, '인격적 역량'은 3.39, '과학적 역량'은 3.37로 나타났다. 결론적으로 현시점에 맞고 적용 가능한 외상 간호교육의 표준화된 교육과정 및 실습위주의 교육개발에 초점을 두는 것이 필요하다. 또한 외상 중환자실 간호사의 전문성과 간호역량증진을 위한 전략모색이 필요하다.

• Journal of Korean Biological Nursing Science
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• 제23권4호
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• pp.257-266
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• 2021

Purpose: The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). Methods: Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients' data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. Results: There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. Conclusion: This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.

• 대한의사협회지
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• 제61권12호
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• pp.710-714
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• 2018

A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.29-39
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• 2013

Purpose: As emergency medical service fund is further expanded due to amendment of the law on emergency medical services in 2008, Korean government has prepared to intervene in a comprehensive manner to strengthen a trauma treatment system. As a result, it announced a master plan to establish a serious trauma treatment center in 16 areas across the nation. Therefore, this study has attempted to investigate the current status of the serious trauma treatment centers and suggest the goal and improvement plan of future serious trauma treatment centers. Methods: As of 2011, Korea operates 23 emergency cerebrovascular service centers, 23 emergency heart disease centers and 35 severe trauma treatment centers across the country. 12 emergency medical service centers have been chosen among the serious trauma treatment centers. Then, top six (6) centers chosen at Emergency Medical Institute Assessment 2011 by Ministry of Health and Welfare have been selected, and floor layout and spatial allocation by usage have been reviewed and analyzed. Results: Consequently, this study has investigated the spatial components, circulation layout and spatial allocation of a serious trauma treatment. For construction planning in consideration of the fundamental objectives and goal of emergency medical services, it is essential to allot spaces and select exact spatial components. It appears that it is necessary to design spaces for emergency medical services and come up with construction planning through appropriate spatial allocation.

• 보건행정학회지
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• 제31권4호
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• pp.399-408
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• 2021

The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.