• Title/Summary/Keyword: 응급환자분류

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A Chronological Study on the Transformation and the Spatial Characteristics of Emergency department in the United States (미국의료시설 응급부의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.17-27
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    • 2018
  • Purpose: This study aims to examine spatial characteristics of emergency department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight emergency departments, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing case studies. Results: The spatial configuration of emergency department has been changed from five or more emergency department specialties to four or less specialties such as psychiatric, pediatrics, emergency, and trauma. In the case of care initiation area, the concentrated arrangement mode was switched from the distributed arrangement mode. The spatial maps indicate that it can be seen that the tree structure changes to an annular structure emphasizing the connection between the spaces in the emergency department. This shows that the space efficiency, safe, visual control and flexibility in the planning of the emergency department are important factors affecting the spatial structure of the emergency department. Implications: In the future, it is expected that Korean emergency department will be more focused on efficiency, safe, visual control, and flexibility in the planning as in the case studies of the United States.

Triage level and treatment time according to mode of arrival to emergency department in patients with acute coronary syndrome (급성 관상동맥 증후군 환자의 응급실 내원 수단에 따른 중증도 분류와 치료시간 비교)

  • Park, Chang-Je;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.51-66
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    • 2020
  • Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).

Comparative length of emergency department stay of patients with different Korean Triage and Acute Scale severities: A descriptive analysis (응급실에 내원한 환자의 한국형 중증도 분류 결과)

  • Jang, Kyeongmin
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.1
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    • pp.151-166
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    • 2022
  • Purpose: The severity classification in association with the time of visit to and the appropriateness of using a public ambulance for visiting the emergency department (ED) have not been thoroughly evaluated, and we aimed to evaluate these aspects. Methods: In this descriptive research, we retrospectively reviewed and analyzed the medical records of patients who visited the ED of the B General Hospital, Seoul from January to December 2019. Results: Of the 54,297 patients who were included in the analysis, 34,629 (63.8%) and 14,065 (25.9%) visited the ED directly and through public ambulances, respectively; 10,328 (73.4%) patients who used public ambulances were discharged home. In the daytime and nighttime, 24,891 (45.8%) and 29,406 (54.2%), respectively, visited the ED. The mean length of ED stay (LoS) of emergency and non-emergency patients was 326 and 159 minutes, respectively, and of patients classified as Korean Triage and Acuity Scale levels 1 and 2 was 427 and 430 minutes, respectively, which was longer than the total of 236 minutes. Conclusion: Patients who visited the ED using public ambulances constituted nearly 25% of all ED visits, and more than 70% of these patients were discharged home. Patients with high severity had a longer mean LoS, and daytime ED visits were characterized by higher numbers and severity of patients than nighttime ED visits.

A Mining-based Healthcare Multi-Agent System in Ubiquitous Environments (마이닝 기반 유비쿼터스 헬스케어 멀티에이전트 시스템)

  • Kang, Eun-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2354-2360
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    • 2009
  • Healthcare is a field where ubiquitous computing is most widely used. We propose a mining-based healthcare multi-agent system for ubiquitous computing environments. This proposed scheme select diagnosis patterns using mining in the real-time biosignal data obtained from a patient's body. In addition, we classify them into normal, emergency and be ready for an emergency. This proposed scheme can deal with the enormous quantity of real-time sensing data and performs analysis and comparison between the data of patient's history and the real-time sensory data. We separate Association rule exploration into two data groups: one is the existing enormous quantity of medical history data. The other group is real-time sensory data which is collected from sensors measuring body temperature, blood pressure, pulse. Proposed system has advantage that can handle urgent situation in the far away area from hospital through PDA and mobile device. In addition, by monitoring condition of patient in a real time base, it shortens time and expense and supports medical service efficiently.

A Study on the Patients Who Attempted Suicide with Drug Intoxication (약물중독 자살환자에서 사망군과 생존군의 비교)

  • Han, Jung-Su;Yun, Seong-Woo;Choi, Sung-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1863-1870
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    • 2013
  • The purpose of this study is when the cases will be found, used as a basic data for clinical severity prediction, and research on suicide prevention. By classifying the group of survival and death about the patients who visit the Emergency Medical Center by attempt suicide by drug addiction, identifying the condition when visiting and results of the treatment after visiting. From June 2009 to May 2011, last two years data that among the drug abusers who visited the Emergency Medical Center in C-University Hospital in Gwang-Ju, only suicidal patients, except with unintentional accidents were collected. The findings, among the drug addiction patients who high age, lower level of education and living alone were the mortality rate was higher. And if who drunk the agricultural chemicals, the convalescence was not good. If the causes of suicide were economic problems and depression, the mortality rate was higher. And when visit hospital, if the consciousness was stupor and semi-coma/coma, the convalescence was not good. As grasp the risk for suicide patients of drug addiction, help on the Prediction of clinical severity, also stamp the appropriate drug education with psychological support is more important on them.

Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island (울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태)

  • Kim, Tae-Hun;Lim, Hyun-Sul;Lee, Kwan
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.115-123
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    • 2002
  • Objective: The aim of this study was to evaluate the patterns of helicopter emergency medical services (HEMS) in Ullung Island. Methods : The authors reviewed the records from emergency room diaries and the lists of helicopter transfers in the Ullung Public Health Medical Center over the 5-year period from Jan 1, 1997 to Dec 31, 2001. Results : One hundred thirteen cases were transferred by helicopters in 88 flights. According to year, the number of flights was 13(14.8%) and the number of cases was 15(13.3%) in 1997; 17(19.3%) and 21(18.6%) in 1998; 18(20.5%) and 20(17.7%) in 1999; 17(19.3%) and 20(17.7%) in 2000; and 23(26.1%) and 37(32.7%) in 2001. According to the kind of helicopter, the number of flights was 46(52.3%) and the number of cases was 60(53.1%) by Maritime police; and 19(21.6%) and 28(25.1%) by 119 rescue. According to time zone, there were no night flights. According to sex and age, there were 75 male cases(66.4%) and 28 cases(28.3%) of patients aged sixty years and over. The number of flights was 11(12.5%) and the number of cases was 15(13.3%) in November; 10 flights(11.4%) and 14 cases(12.4%) in March; and 7 cases(8.0%) in each of September, October and April. The most common season of helicopter transfer cases was autumn. According to transfer area, there were 48 cases (42.5%) in Pohang city, Gyeonsangbukdo; 35(31.0%) in Gangnung city, Gangwondo; and 17(15.0%) in Daegu metropolitan city. According to condition, there were 27 cases(23.9%) of cerebro-vascular accident, 13(11.5%) of fracture and 11(9.7%) of head injury. According to admission department, there were 42 cases(37.2%) in Neurosurgery, 21(18.6%) in Internal Medicine and 13(11.5%) in Orthopedic Surgery. According tothe Korea Standard Classification of Disease(3-KSCD), circulatory systemic disease(IX) and injury, intoxication and others (XIX) were the two most frequent categories with 34 cases(30.1%) each, followed by digestive system disease (XI) with 23 cases(20.4%). Conclusions : HEMS in Ullung Island leave much to be desired. Helicopters cannot make a night flight and are not equipped with medical facilities. HEMS in islands such as Ullung Island are essential. We hope that night flights, equipment-monitoring systems for emergency patients in the helicopters, and a law related to HEMS in the island will all be established.

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A Study on the Demand of K-Nursing in Southeast Asian Nursing Colleges to Activate International Exchange Convergence in the Untacked Era (언택드 시대에 국제교류융합 활성화를 위한 동남아시아 간호대학에서 한국 간호에 대한 수요도 조사연구)

  • Kim, Seon Jeong;Kim, Kyung-yong;Choi, Byung Hwan;Song, Mei Ling
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.429-438
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    • 2020
  • The purpose of this study was to investigate the demand of K-nursing in Southeast Asian nursing colleges, and to promote international exchange convergence. In this study, we surveyed the professors and students who were living in Thailand, Vietnam, and the Philippines. For investigating the demands of the topics, two times of surveys were conducted using the google form In the first survey, the emergency care and infectious control showed the most frequent. In the second survey, the classification of emergency patients, showed the most, according the highest priority of emergency department. In infectious control department, management of new infectious diseases, such as COVID-19, showed the most, according to the highest priority. Based on the result, we make a suggestion to develop the contents, according to the highest priority, and to utilize them in international exchange programs.

Classification Modeling for Predicting Medical Subjects using Patients' Subjective Symptom Text (환자의 주관적 증상 텍스트에 대한 진료과목 분류 모델 구축)

  • Lee, Seohee;Kang, Juyoung
    • The Journal of Bigdata
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    • v.6 no.1
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    • pp.51-62
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    • 2021
  • In the field of medical artificial intelligence, there have been a lot of researches on disease prediction and classification algorithms that can help doctors judge, but relatively less interested in artificial intelligence that can help medical consumers acquire and judge information. The fact that more than 150,000 questions have been asked about which hospital to go over the past year in NAVER portal will be a testament to the need to provide medical information suitable for medical consumers. Therefore, in this study, we wanted to establish a classification model that classifies 8 medical subjects for symptom text directly described by patients which was collected from NAVER portal to help consumers choose appropriate medical subjects for their symptoms. In order to ensure the validity of the data involving patients' subject matter, we conducted similarity measurements between objective symptom text (typical symptoms by medical subjects organized by the Seoul Emergency Medical Information Center) and subjective symptoms (NAVER data). Similarity measurements demonstrated that if the two texts were symptoms of the same medical subject, they had relatively higher similarity than symptomatic texts from different medical subjects. Following the above procedure, the classification model was constructed using a ridge regression model for subjective symptom text that obtained validity, resulting in an accuracy of 0.73.

Imaging Findings of Gastrointestinal Emergency in Infants and Young Children (영유아 환자 위장관 응급 질환의 영상 소견)

  • Ji Young Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.794-805
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    • 2020
  • Acute abdomen is a condition with sudden abdominal pain that may require immediate surgical treatment. The causes of acute abdomen in pediatric patients are diverse, and can be categorized in broad range from diseases requiring surgery to diseases requiring medication or clinical observation only. The role of the imaging study in children with acute abdomen is to distinguish between patients who need medication and patients who need surgery by identifying diseases that cause abdominal pain, if possible. Since intussusception and appendicitis are the leading causes of acute abdomen requiring surgical treatment in children, it is important to exclude intussusception in young infants complaining of acute abdominal pain and exclude acute appendicitis in older children with acute abdomen. In this paper, we introduce intussusception, acute appendicitis, midgut volvulus, Meckel's diverticulum and duplication cyst, which has characteristic imaging finding of the disease that can cause acute abdomen in pediatric patients.

Medical Information Dynamic Access System in Smart Mobile Environments (스마트 모바일 환경에서 의료정보 동적접근 시스템)

  • Jeong, Chang Won;Kim, Woo Hong;Yoon, Kwon Ha;Joo, Su Chong
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.47-55
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    • 2015
  • Recently, the environment of a hospital information system is a trend to combine various SMART technologies. Accordingly, various smart devices, such as a smart phone, Tablet PC is utilized in the medical information system. Also, these environments consist of various applications executing on heterogeneous sensors, devices, systems and networks. In these hospital information system environment, applying a security service by traditional access control method cause a problems. Most of the existing security system uses the access control list structure. It is only permitted access defined by an access control matrix such as client name, service object method name. The major problem with the static approach cannot quickly adapt to changed situations. Hence, we needs to new security mechanisms which provides more flexible and can be easily adapted to various environments with very different security requirements. In addition, for addressing the changing of service medical treatment of the patient, the researching is needed. In this paper, we suggest a dynamic approach to medical information systems in smart mobile environments. We focus on how to access medical information systems according to dynamic access control methods based on the existence of the hospital's information system environments. The physical environments consist of a mobile x-ray imaging devices, dedicated mobile/general smart devices, PACS, EMR server and authorization server. The software environment was developed based on the .Net Framework for synchronization and monitoring services based on mobile X-ray imaging equipment Windows7 OS. And dedicated a smart device application, we implemented a dynamic access services through JSP and Java SDK is based on the Android OS. PACS and mobile X-ray image devices in hospital, medical information between the dedicated smart devices are based on the DICOM medical image standard information. In addition, EMR information is based on H7. In order to providing dynamic access control service, we classify the context of the patients according to conditions of bio-information such as oxygen saturation, heart rate, BP and body temperature etc. It shows event trace diagrams which divided into two parts like general situation, emergency situation. And, we designed the dynamic approach of the medical care information by authentication method. The authentication Information are contained ID/PWD, the roles, position and working hours, emergency certification codes for emergency patients. General situations of dynamic access control method may have access to medical information by the value of the authentication information. In the case of an emergency, was to have access to medical information by an emergency code, without the authentication information. And, we constructed the medical information integration database scheme that is consist medical information, patient, medical staff and medical image information according to medical information standards.y Finally, we show the usefulness of the dynamic access application service based on the smart devices for execution results of the proposed system according to patient contexts such as general and emergency situation. Especially, the proposed systems are providing effective medical information services with smart devices in emergency situation by dynamic access control methods. As results, we expect the proposed systems to be useful for u-hospital information systems and services.