• Title/Summary/Keyword: 중증응급질환

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Strategy of Chungnam-type Doctor UAM for Transfering Emergency Patient in Island area (도서지역 응급환자 이송을 위한 충남형 닥터 UAM 개발 전략)

  • Song, Doo-youl;Kim, Taehong
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2021.10a
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    • pp.167-169
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    • 2021
  • There are only 14 public medical facilities available to residents regularly in the island area of Chungcheongnam-do, one health life support center, and one hospital ship, and these facilities and equipment cannot effectively respond to emergency patients such as severe trauma, cerebrovascular and cardiovascular diseases. The fastest means of transporting emergency patients is to use a doctor helicopter deployed at Dankook University Hospital (based in Cheonan). However, there is only one doctor helicopter deployed, and it cannot operate at night, and since it is in charge of all areas of Chungcheongnam-do, there is a limit to rapid transport in the event of a large number of patients. Therefore, we would like to review the necessity of "Chungnam-type Doctor UAM Development" to compensate for the problems of the urban aviation mobility (UAM) industry and the emergency patient transport system in islands, a field of the 4th industry.

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A Review on the Improvement of the Meaning and Composition Requirements of Interference with Fire Protection Activities - Focusing on Interference with 119 EMS Activities - (소방활동방해죄의 의미와 구성요건 개선에 관한 검토 -119구급활동 방해를 중심으로-)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.105-124
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    • 2023
  • Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

Usefulness of the Neutrophil Gelatinase-Associated Lipocalin (NGAL) Kit for Acute Kidney Injury Patients at the Emergency Medical Center in Daegu (대구지역 응급의료센터에 내원한 급성 콩팥손상 환자의 진단을 위한 호중구 젤라티나제 관련 리포칼린 키트의 유용성)

  • Lee, Seung-Jin;Park, Sangwook
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.49-53
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    • 2016
  • Acute kidney injury (AKI) is a common syndrome resulting in kidney damage and malfunction within a few days or even a few hours. The diagnosis of AKI depends on routine biochemical tests, including serum creatinine, aspartate aminotransferase (AST), alanine aminotransaminase (ALT), blood urea nitrogen (BUN), and electrolytes. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker that shows correlation with the severity of acute infections and kidney injuries. The predictive value in other conventional assays for kidney functions has been reported to cause distraction for AKI syndrome. The aim of this study is to verify the predictive value of plasma NGAL in patients with established AKI. The NGAL kit for checkup demonstrates sensitivity of ${\geq}300$ (92.2%), ${\geq}200$ (95.6%), ${\geq}100$ (99.6%), specificity of ${\geq}300$ (95.1%), ${\geq}200$ (97.3%), ${\geq}100$ (99.4%), positive predictability of ${\geq}300$ (93.3%), ${\geq}200$ (93.4%), ${\geq}100$ (99.2%), and negative predictability of ${\geq}300$ (96.7%), ${\geq}200$ (97.7%), ${\geq}100$ (98.1%), respectively. The plasma NGAL compared with the enzyme-linked immunosorbent assay (ELISA) has been shown to be an early predictive biomarker of AKI. The NGAL kit, recently developed for point-of-care of plasma specimens, is thought to be a useful and reliable biomarker for the early diagnosis of decreased kidney functions.

Surgical Management of Critical Pulmonary Stenosis -A case report- (중증 폐동맥협착증의 외과적 치료 -1례 보고-)

  • Jung, Tae-Yeol;Ban, Dong-Gyu;Kim, Hyuck;Kim, Young-Hak;Chung, Won-Sang;Kang, Jeong-Ho;Jee, Heng-Ok;Lee, Chul-Bum;Kim, Nam-Su;Seoh, Jung-Kuk
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.963-967
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    • 2000
  • 정상심실중격의 폐동맥협착은 흔한 선천성 심장질환이지만 신생아기에 심한 증세를 보이는 위기적 폐동맥 협착은 드물며 예후도 대단히 나쁘다. 경피적 풍선 판막성형술의 발달과 함께 폐동맥협착의 외과적 치료는 더욱 줄어드는 추세이다. 본 증례는 정상심실중격의 위기적 폐동맥협착증으로 진단받은 생후 2일된 남자 신생아로 심한 청색증과 저산소증을 보여 응급실로 내원하였다. 환아는 산소공급 및 Prostaglandin E$_1$을 투여 후 동맥혈 산소 분압이 19 mmHg에서 54mmHg로 증가하였다. 경피적 풍선 판막성형술을 시도하였으나 유도도관(Guide wire)이 판막의 개구부를 통과하지 못하였고 시술도중 심낭내로 조영제가 고이는 소견을 보여 우심실 천공이 의심되었으므로 응급으로 정상체온의 체외순환하에서 폐동맥 절개후 폐동맥 판막절개술을 시행하였다. 수술 후 중환자실에서의 수술경과는 양호하였고 현재 수술 6개월째 외래 추적관찰중이다.

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Clinical Analysis of the Suicidal Attempters to Change Who Visited Emergency Medical Center (응급의료센터에 내원한 자살기도자의 임상적 변화 분석)

  • Choi, Jeong Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.12
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    • pp.8728-8737
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    • 2015
  • The purpose of this study compared the clinical features of suicidal attempters who visit in the past and present of an emergency medical center, used as a basic data for clinical severity and suicide prevention research of future patients. The author conducted a retrospective analysis of the changed characteristics of suicidal attempters who visit an emergency medical center of Wonkwang University Hospital between from January $1^{st}$, 1998 to December $31^{th}$, 1998 and from August $1^{st}$, 2013 to July $31^{th}$, 2015. Factors related to increased occurrence was changed from male(1.1:1) in 1998 to female(1.3:1) in 2013-2015, from age of $2^{nd}$, $3^{rd}$, and above $6^{th}$ decade in 1998 to $3^{rd}-5^{th}$ decade in 2013-2015. Poisoning was the most common method of suicidal attempt(90.8%;1998, 72.7%;2013-2015), Mortality rate was changed from 16.9%(male 23.1%, female 10.0%) in 1998 to 13.8%(male 18.1%, female 10.5%) in 2013-2015. Among the suicidal attempters(total=516), 37 patients has recurred. But consultant of neuropsychiatric department was 48.3%, All suicidal attempters in future were necessarily neuropsychiatric consultant and continuously follow-up because all patients had recurrent suicide attempt, psychologic disorder, suicide rates are higher than in the general population.

Factors Related to the Disability of Stroke Patients in Gyeongju, Korea (경주지역 뇌졸중 환자들의 장애정도와 관련요인)

  • Kang, Min-Soo;Jo, Min-Woo;Lim, Hyun-Sul;Kim, Sang-Kyu
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.405-416
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    • 2010
  • Objectives: This study was conducted to evaluate factors related to the degree of disability of stroke patients in a rural community. Methods: The study subjects included 641 patients selected from 975 stroke patients over the age of 50 with brain lesion-related disabilities living in Gyeongju, Korea, an urban-rural consolidated community. The data were obtained by interviews from July to October 2008. The subjects were divided into a seriously disabled group (1st and 2nd disability grade) and mildly disabled group (3th, 4th, 5th and 6th disability grade) by degree of disability according to registered disability grade. The collected data were analyzed using the SPSS 14.0 statistical package. Results: The study subjects included 379 males (59.1%) and 262 females (40.9%), and most patients were in their 70s (256 cases, 39.9%). The seriously disabled group included 287 patients (44.8%) and the mildly disabled group included 354 persons (55.2%). Age, prehospital delayed time and number of related chronic diseases were risk factors for serious disability (p<0.05). Conclusions: Our results indicate that the degree of disability can be reduced by decreasing prehospital delayed time. We suggest that education of high risk groups and establishment of emergency services as well as a transport system for stroke patients are required to reduce the degree of disability due to stroke.

Predictive factors for severe infection among febrile infants younger than three months of age (발열을 주소로 내원한 3개월 미만의 영아에서 중증 감염의 예측 인자)

  • Cho, Eun-Young;Song, Hwa;Kim, Ae-Suk;Lee, Sun-Ju;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Lee, Kwan;Park, Byoung-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.898-903
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    • 2009
  • Purpose : This study investigated the predictive factors for identifying infection-prone febrile infants younger than three months. Methods : We conducted a retrospective study of 167 infants younger than three months with an axillary temperature >$38^{\circ}C$ who were hospitalized between 2006 and 2008. If they met any of the following criteria, positive blood culture, CSF WBC ${\geq}11/mm^3$ or positive CSF culture, urinalysis WBC ${\geq}6$/HPF and positive urine culture, WBC ${\geq}6$/HPF on microscopic stool examination or positive stool culture, they were considered at high risk for severe infection. Infants with focal infection, respiratory infection or antibiotic administration prior to admission to the hospital were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and the clinical course between the high risk and low risk groups for severe infection. Results : The high-risk group included 77(46.1%) infants, and the most common diagnosis was urinary tract infection (51.9%). Factors, such as male sex, ESR and CRP were statistically different between the two groups. But, a multilinear regression analysis for severe infection showed that male and ESR factors are significant. Conclusion : We did not find the distinguishing symptoms and laboratory findings for identifying severe infection-prone febrile infants younger than three months. However, the high-risk group was male and ESR-dominated, and these can possibly be used as predictive factors for severe infection.

The Role of Intra-Aortic Balloon Pump in Coronary Artery Bypass Surgery (관상동맥 우회술에서의 대동맥내 풍선 펌프의 역할)

  • 박성식;김기봉
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.282-286
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    • 1997
  • In the era of coronary artery bypass grafting, the intraaortic balloon pump (IABP) is more widely used and its indication has been ex anded. We perf'orbed retrospective clinical analysis on the patients who have received IABP pre andfor postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients (15.5%) were supported by IABP during the course of the operation. The mean age at the time. of the operation was 57.2 years (39∼ 75 years) and the male to female ratio was 33 : 17. The preoperative diagnosis was unstable angina in 33 (66%), stable angina in 7 (14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13 (26%) with class IV angina, 12 (24%) with difficulty in CPB weaning, 6 (12%) with postinfarct angina and 3 (6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low c rdiac output syndrome. All IABPS were introduced via femoral artery and among them 45 cases (90%) percutaneously. The mean postoperative assist time was 22.3 hours (0.5 ∼ 168 hours) and IABP could be removed within 48 hours in most of them (44150). The operative mortality was 6.1% (3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.

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Improvement Devices on the Law and Institution and Current Situation of Health and Medical Treatment for the Aged (노인보건의료의 현황과 법 제도적 개선방안)

  • Noh, Jae-Chul;Ko, Zoon-Ki
    • The Journal of the Korea Contents Association
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    • v.13 no.4
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    • pp.170-186
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    • 2013
  • As the population is getting older, medical expenses amount of the whole is keep increasing. So, the pressure of the finances, Health Insurance, Medical Care Assistance Act and etc, is getting higher. The share of healthcare-expense is increasing due to elderly illness. And it became a social problem; we analysed present state of senior healthcare in South Korea-looked into current laws and policies, and found problems. We tried to suggest improvements that drew from the current state of foreign country senior healthcare of those problems. For the result, we found the problem in relevant-law system of senior healthcare guarantee. In this study, we proposed the ways to qualitatively upgrade of medical standard that considered on elderly' features: the strengthened guarantee for healthcare, financial secure for long-term convalescence benefit, linking and functional reinforcement for elderly welfare and long-term convalescence insurance, the solution for overlapped laws about convalescence in long-term convalescence insurance and elderly welfare, a betterment of grading, and a home service consolidation. We need to secure right amount of emergency medical service budget, and effective management system for the improved level of senior severely emergency medical service. Furthermore, we suggested that South Korea needs to legislate [The Law for Senior Medical Secure] to respond to rapidly increasing senior healthcare fee.

Characteristics and Death Risk Factors of Patients in Long-Term Care Hospital Connected to Special Hospital (일개 특수 요양병원 환자들의 특성 및 사망 위험요인)

  • Park, Un Je
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.12
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    • pp.651-659
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    • 2020
  • The objective of this study is to provide high-quality medical service, by understanding the characteristics and death risk factors of patients at V long-term care hospital, that has established and operated the cooperative treatment system in connection with a public institution, the S veterans hospital. A follow-up survey targeting a total of 850 discharged patients was conducted for the year 2017. Average age of patients was 79.2 years, with 86.4% belonging to the 70 years or over group. The men of national merit were 75.4%, which was more than three times higher than general patients. Hospitalization for 180 days or more was 46.4%, which was higher than general long-term care hospitals (37%). The major death risk factors were age and the number of hospitalized days. Our data indicate that transfer to S veterans hospital results in providing quicker treatment and higher effectiveness of the numerous recovery therapies. We therefore propose that the cooperative treatment system should be expansively operated to increase the quality of happy life, by alleviating the health of patients with chronic diseases in a long-term care hospital.