• Title/Summary/Keyword: 응급실 내원

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Psychosocial Characteristics and Factors Associated with Referral to Psychiatric Care in the Suicide Attempters Visiting Emergency Center (응급실에 내원한 자살 시도자들의 정신사회학적 특성과 정신건강의학과 진료 의뢰 관련 요인)

  • Kwon, Jung-Woo;Ko, Young-Hoon;Han, Chang-Su;Lee, Moon-Soo;Yoon, Ho-Kyung;Lee, Hongjae
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.106-113
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    • 2013
  • Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.

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Intralobar Pulmonary Sequestration with Hemoptysis and Hemothorax (혈흉과 각혈을 동반한 내엽성 폐분리증)

  • Park, Jeong-Min;Oh, Bong-Suk
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.708-710
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    • 2007
  • A 60-year-old female entered the emergency unit with a chief complaint of hemoptysis. Based on the computer tomographic image analysis of the chest, the patient was diagnosed as having an intralobar pulmonary sequestration that accompanied a hemothorax, and the hemothorax was do to the rupture of a pseudocyst. Pulmonary lobectomy of the left lower lobe and primary closure of an aberrant artery were both performed as an emergency operation. After one week following the operation, the patient was discharged without any postoperative complications.

The Effects of COVID-19 on the Self-Harm in Children and Adolescents Observed in a University Hospital (대학병원에서 관찰한 코로나19가 소아청소년 자해에 미치는 영향)

  • Oh, Sae-Bom;Kim, Seung-Jun;Kim, Ji-Woong;Oh, Hong-Seok;Im, Woo-Young;Lee, Na-Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.128-135
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    • 2021
  • Objectives : The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. Methods : Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. Results : During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months before the COVID-19 outbreak (𝛘2=14.397, p<0.001; 𝛘2=24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). Conclusions : In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the incidence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.

Laceration of Left Main Bronchus and Azygos Vein Following Stab Wound - 1 case report - (자상에 의한 기정맥 및 좌측 주 기관지 열상 - 치험 1례 -)

  • 이신영;신원선;곽영태;배철영;김동원;윤영철;이경호
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1243-1246
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    • 1998
  • Tracheobronchial injuries are uncommon. Except for the cervical region, most tracheobronchial injuries are due to blunt chest trauma in Korea. The depth of the tracheobronchial trees renders these structures relatively safe from stab wound. We experienced a case of left main bronchial laceration with azygos vein tear following stab wound in the back of right chest firstly in Korea. The patient was a 24 years old male. A routine chest radiography showed a knife in chest at emergency room. We didn't remove the knife at emergency room. This patient was carried to operation room in 30 minutes after arrival of our hospital without computed tomography and bronchoscopy. The operation was performed through standard right posterolateral thoracotomy and then the knife was removed. The left main bronchus and azyos vein were lacerated obliquely. The penetrated azygos vein was ligated and the laceration of the left main bronchus was repaired. Postoperative course was uneventful.

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The Psychiatric Treatment Link Characteristics of Suicide Attempters Visiting Emergency Room (응급실 내원 자살시도자의 정신과 진료 연계 관련 특성)

  • Park, Han Na;Jun, Seong-Sook;Byun, Eun Kyung
    • Journal of East-West Nursing Research
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    • v.20 no.2
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    • pp.93-102
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    • 2014
  • Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, ${\chi}^2$-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters' refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was "I'm not mad. I don't need the psychiatric treatment". Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

The Clusters of Fever-Related Symptoms among Patients at the Emergency Room (발열 증상 클러스터 - 응급실 내원 성인 환자를 대상으로)

  • Na, Sun Gyoung;Shin, Hyun A;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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    • pp.20-29
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    • 2017
  • Purpose: The purpose of this study was to investigate symptoms experienced by patients who reported fever at the emergency room (ER) and to identify any existing cluster of symptom related to fever. Methods: The study used a retrospective and descriptive design with secondary data analysis. Data were abstracted from 665 medical records of patients with fever who visited ER from September 1, 2015 to August 31, 2016 at a tertiary hospital. Results: The most frequently reported symptoms included cold (43.9%), myalgia (24.1%), headache (16.2%), general weakness (15.3%), respiratory symptoms (12.3%), gastrointestinal (GI) symptoms (12.0%), mental change (4.5%), sweating(1.8%), and warmth (0.9%). Analysis of the symptoms related to fever revealed seven symptom clusters; Cluster 1 (n=190) included cold (100%) and myalgia (28.9%); Cluster 2 (n=37), headache (100%) and myalgia (32.4%); Cluster 3 (n=33), GI symptoms (100%), general weakness, headache, and cold; Cluster 4 (n=34), cold (100%), myalgia, headache, and respiratory symptoms; Cluster 5 (n=241), respiratory symptoms (10.8%); Cluster 6 (n=76): myalgia (75.0%) and general weakness, and Cluster 7 (n=54), cold (87.0%), general weakness, and respiratory symptoms. Conclusion: The results of this comprehensive symptom assessment are hoped to be helpful in developing better symptom management for ER patients with fever than before. Further research is warranted to verify the symptom clusters of this study in different clinical settings.

Development of Evidence-based Nursing Practice Guidelines for Febrile Children in Emergency Room (응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발)

  • Jeong, Min-Jin;Shin, Hyun-A;Kim, Yun-Hee;Lee, Jee-Hyang;Lee, Seung-Ja;Song, Mi-Ra
    • Child Health Nursing Research
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    • v.18 no.4
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    • pp.214-221
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    • 2012
  • Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

Guillain-Barré Syndrome Caused by Influenza Virus (인플루엔자 바이러스로 인한 길랭-바레 증후군 1예)

  • Choi, Hyun Gil;Yeon, Gyu-Min
    • Pediatric Infection and Vaccine
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    • v.23 no.3
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    • pp.236-239
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    • 2016
  • $Guillain-Barr{\acute{e}}$ syndrome (GBS) is caused by antecedent infectious diseases in approximately two-thirds of cases. GBS is considered an autoimmune response. Among reported preceding infections, influenza virus is relatively rare. Several reports have identified antibodies related to GBS pathogenesis. However, no case report has described the detection of influenza virus in the cerebrospinal fluid (CSF) of a patient with GBS by polymerase chain reaction (PCR). Here we report the case of a 6-year-old girl who was diagnosed with influenza A 1 week prior and was treated with oseltamivir, after which she visited our hospital for headache and bilateral leg weakness that had persisted for 1 day. We diagnosed her with GBS based on physical and neurologic examination findings, CSF analysis, nerve conduction velocity test results, spinal magnetic resonance imaging, and detection of influenza A virus in her CSF by PCR. She was treated with intravenous immunoglobulin and her symptoms slowly improved. This case report suggests that GBS may be caused by influenza virus through penetration of the CSF.

Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

Perception of Uncertainty and Satisfaction for Nursing Service of Children's Parents Visiting to Pediatrics Outpatient Department and Emergency Room (소아과 외래와 응급실 내원 아동 부모의 불확실성 인지와 간호서비스 만족도)

  • Oh, Jin-A
    • Korean Parent-Child Health Journal
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    • v.13 no.1
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    • pp.35-43
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    • 2010
  • Purpose: This study was a descriptive research to provide fundamental data in ensuring a high quality of nursing service needed by children's parent according to perception of uncertainty and care satisfaction of them between pediatric outpatient department and emergency room. Methods: For this study, 192 children's parents were questioned in a general hospital located in Busan from August 1 to 31. 2009. The collected data were scored by use of frequencies, $x^2$ test, t-test, AONVA, Pearson's correlation coefficient via SPSS/WIN 17.0. Results: With the compare of characteristics related to children's parents visiting emergency room and pediatric outpatient department, there were statistically significant difference in relation and age of parent, main caregiver, cause of arrival, and waiting time from arrival to procedure. The perception of uncertainty for parent in the emergency room showed significant difference to outpatient department. In nursing service, the highest score was category of professional skill and technic. In addition, overall parents' perceptions on providing information showed lower than any other nursing service. Last but not least, a significant correlation indicated between the perception of uncertainty and satisfaction of nursing service. Conclusion: Efforts to improve parent satisfaction for nursing service are needed to decrease their perception of uncertainty. Providing information and communication by nurses are necessary to improve quality of nursing service.

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