• Title/Summary/Keyword: EKG

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Effects of Endotracheal Suction and Position Change on Blood Pressure of Patients with Head and Intracranial Surgery (기관내 흡인과 체위변경이 두부 및 두 개내 수술을 받은 환자의 혈압에 미치는 영향)

  • Jo, Eun Hee;Jung, Yoo Jung;Kim, Eun Jin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.3
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    • pp.226-234
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    • 2014
  • Purpose: This study was done to present guidelines for deciding appropriate times for measuring blood pressure (BP) in patients with neurological disorders who had surgery due to brain damage. Method: It was a repeated measures-experimental research on time variants in BP after nursing care. SBP (Systolic BP) and DBP (Diastolic) were measured every 2 minutes up to 5 times using an EKG patient monitor. Measured data were analyzed using repeated measures ANOVA and paired t-test. Results: For suctioning, there were significantly higher differences for SBP averages after 2 min. (138mmHg, p<0.01) and 4 min. (133mmHg, p<0.01) compared to before suctioning (120mmHg). For position change, there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01) and 4 min. (130mmHg, p=0.01) compared to before changing position (121mmHg). For position change followed by suctioning there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01), 4 min. (136mmHg, p<0.01) and 6 min. (125mmHg, p=0.003) compared to before the interventions (121mmHg). Conclusions: Results indicate that there are significant differences in SBP and DBP over time during nursing interventions, suggesting clinical measurement of BP after 6 min. or 8 min. be done for patients with neurological disorders in neurosurgery clinics.

Development and Implementation of a Self-directed Critical Care Nursing e-Learning Program (자기주도형 중환자간호 이러닝 프로그램 개발 및 적용)

  • Kim, Keum Soon;Kim, Jin-A;Ahn, Jung Won
    • Perspectives in Nursing Science
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    • v.9 no.1
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    • pp.51-60
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    • 2012
  • Purpose: The purpose of this study was to develop a self-directed e-learning program for ICU nurses and to evaluate how the proposed e-learning program affects the level of knowledge, nursing performance and job satisfaction of ICU nurses. Methods: The e-learning program was developed with the Computer Assisted Instruction Design Model using sources of self-efficacy which included the inactive attainment, vicarious experience, and verbal persuasion of ICU nurses. The program was evaluated by experts. Following the revision of the program, it was applied to a total of 59 ICU nurses (experimental group n=29, control group n=30) from three hospitals. Four weeks later, we measured the level of knowledge, nursing performance and job satisfaction. Results: The level of knowledge significantly improved in the experimental group (t=5.691, p<.001). Moreover, the level of nursing performance significantly increased in the areas of circulatory diagnostic test (t=2.143, p=.039), EKG (t=2.911, p=.006), aortic balloon pump (t=2.491, p=.017), and nebulizer therapy (t=2.085, p=.044). Overall, job satisfaction did not significantly increase (t=1.664, p=.105); however, job satisfaction in terms of relationships with coworkers (t=2.371, p=.023) and the needs of nursing performance (t=2.940, p=.006) were significantly increased. Conclusion: The results showed that the proposed e-learning program using sources of self-efficacy from ICU nurses was an effective learning method to increase the level of knowledge and nursing performance. The propose de-learning program would be a useful teaching tool for ICU nurses improving the quality of ICU patient care.

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The Research on the Sasang Constitutional Characteristics of Stroke Inpatients (뇌졸중(腦卒中) 환자(患者)의 사상체질별(四象體質別) 특성(特性)에 관(關)한 연구(硏究))

  • Hwang, Min-Woo;Lee, Soo-Kyung;Choe, Bong-Keun;Song, Il-Byung;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.17 no.1
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    • pp.103-119
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    • 2005
  • 1. Objectives The purpose of this research is to find out the Constitutional characters of Stroke inpatients. 2. Methods Stroke inpatients admitted into KyungHee Oriental Medical Center from January 2000 to April 2004, were divided into 2 group, cerebral infarction 493 inpatients and cerebral hemorrhage 83 inpatients. This research investigated the distribution of Sasasng Constitution, the gender, the age decade, the period of admission, the elapse of the time after onset, the course of admission, the frequency of Sasang Constitutional Herb-medicine, the past history of hypertension and diabetes mellitus, the obesity, the prevalence rate of hypertension and diabetes mellitus, EKG abnormality and hyperlipidemia. 3. Results & Conclusions The Sasang Constitutional distribution of cerebral infarction 493 inpatients was 0.4% of Taeyangin, Soyangin 34.1%, Taeurnin 56.4%, Soeumin 9.1%. The Sasang Constitutional distribution of cerebral hemorrhage 83 inpatients was Taeyangin 1.2%, Soyangin 47.9%, Taeurnin 43.4%, Soeumin 9.6%. Stroke incidence rate of Taeumin and Soyangin inpatients was high. Sasang Constitution had significant relations with the prevalence of the obesity and hypertension in cerebral infarction inpatients, the prevalence of obesity, diabetes mellitus and ECG abnormality in cerebral hemorrhage inpatients.

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Severity-Adjusted Mortality Rates : The Case of CABG Surgery (관상동맥우회술 수술환자의 수술 후 사망률 예측모형의 개발)

  • Park, Hyeung-Keun;Kwon, Young-Dae;Shin, You-Cheol;Lee, Jin-Seok;Kim, Hae-Joon;Sohn, Moon-Jun;Ahn, Hyeong-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.21-27
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    • 2001
  • Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

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A Clinical Study of Patent Ductus Arteriosus (동맥관 개존증의 임상적 고찰)

  • Jo, Jung-Gu;Park, Geon-Ju;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.574-581
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    • 1985
  • Surgical treatment for PDA has been pivotal in historical development of surgery for congenital heart disease. A clinical study on 36 cases of operated PDA were performed during period from Aug. 1981 to Jul. 1985 at the Department of Thoracic & Cardiovascular Surgery in Chonbuk University. The following results are obtained. 1. The 8 males and 28 females ranged in age from 2 yrs, to 24 yrs, [mean 11 yrs.] 2. Chief complaints of the patients were dyspnea on exertion in 61%, palpitation in 39%, frequent URI in 12%, and no subjective symptoms in 11%. 3. On auscultation, continuous machinery murmur heard in 94% and systolic in 14%. 4. Radiologic findings of chest P-A showed increased density of pulmonary vascularity in 94%, cardiomegaly in 69%, and within normal limits in 5% of the patients. 5. EKG findings of the patients revealed LVH in 69%, RVH in 6%, BVH in 6%, and within normal limits in 17%. 6. Of the 36 patients, cardiac catheterization was performed in 34 patients. The results showed mean Qp/Qs = 2.25, mean Pp/Ps=0.42, and mean systolic pulmonary arterial pressure=53mmHg. 7. Surgical methods were as followed: The 32 case of ductal ligation and one case of division & suture technique for PDA through the left posterolateral thoracotomy were done. And 2 cases of ductal ligation one suture closure through the pulmonary artery were performed under the cardiopulmonary bypass. 8. Intraoperative complication was ductal rupture with division 8< suture for PDA and transient hoarseness in 1, recanalization in 1, and urethral stricture in 1 case postoperatively. 9. One patient died due to ductal rupture intraoperatively and operative mortality was 2.8%.

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Research and Developement of Herbal Medicine(Taeumbiman-tang) on Obesity (복합한약물(가칭; 태음비만탕)을 이용한 비만치료약물 개발을 위한 연구)

  • Kwak, Chang-Kyu;Sohn, Eun-Hae;Yoo, Jung-Hee;Koh, Byung-Hee;Song, Il-Byung;Lee, Eui-Ju
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.2
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    • pp.530-535
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    • 2005
  • A Korean traditional herbal formular, Taeumbiman-tang(TBT), was based on Taeumjowi-tang, currently the most widely used herbal formula compound, and which is known to be safe and have a positive effect on adult obesity. TBT was given to obese children for thirty days, and was found to be clinically safe and effective. The subjects were children who had been admitted into the hospital to be treated for obesity, that had more than 20% relative body weight. Originally there were 19 subjects, but 5 dropped out of the experiment. There were 5 girls and 9 boys, whose average ages were $11.00\;{\pm}\;2.60$ years, average weight was $54.01\;{\pm}\;18.59\;kg$. As a pretest, all of the volunteers were examined for height, weight, blood pressure, pulse rate, EKG, and chest radiography. The subjects underwent interview, body measurement tests, blood tests, and safety tests under 8 hour fasting state. After 15 days of TBT intake, the safety tests and the interview were conducted. The interview, body measurement tests, blood tests, and safety tests were conducted again after the 30 day trial was completed. The short term effects of TBT on obese children is weight loss. It did not cause any significant changes in the subject's livers, hearts, and kidneys, and clinically dangerous side effects or withdrawal symptoms were not observed.

A Case of Coronary Vasospasm in a Patient with Esophageal Cancer Receiving Chemotherapy with 5-fluorouracil (5-fluorouracil 사용 중인 식도암 환자에서 발생한 관상동맥연축)

  • Jin Wook Lee;Moo In Park;Seun Ja Park;Won Moon;Sung Eun Kim;Jae Hyun Kim;Kyoungwon Jung
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.58-61
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    • 2017
  • 5-Fluorouracil (5-FU) has been widely used in the treatment of various solid tumors. However, 5-FU cardiotoxicity is being reported with increasing frequency. The main symptom of cardiotoxicity is chest pain at rest with ischemic electrocardiographic changes. Up until now, the underlying mechanism has been suspected to be coronary artery spasm. However, this chest pain associated with 5-FU has several characteristics that are incompatible with coronary artery spasm; eg, inefficacy of calcium-channel blocker and a slow increase in cardiac enzyme levels. We experienced a case of 5-FU-induced cardiotoxicity which showed clinical findings consistent with acute myocardial infarction. Based on the clinical findings, coronary angiography, and no stenosis was noted. However, we concluded that the cardiotoxicity in this case was due to ischemia caused by coronary artery spasm. Because vasodilatator was effective and secondary attack was followed.

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The Effect of Oxygen Therapy on VPB in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자에서 심실 조기수축에 대한 산소치료의 효과)

  • Shin, Kyu-Suck;Ko, Jeong-Seok;Kim, Seo-Jong;So, Kun-Ho;Jin, Gyo-Hyun;Lee, Keun;Lee, Gwi-Lae;Roh, Yong-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.42-49
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    • 1999
  • Background: In patients with chronic obstructive pulmonary disease(COPD). it is well known that hypoxemia increases the frequency of VPB, which is associated with the poor prognosis such as sudden death. The aim of this study is to evaluate the effect of short and long-term low flow oxygen therapy on the development of VPBs in patients with COPD by correcting the hypoxemia. Method: In 19 patients with COPD, oxygen saturation and VPB's were monitored by pulse oxymeter and 24-hour Holter EKG, with room air and oxygen saturation and VPB's were monitored on the 1st and on the 8th day during oxygen therapy with nasal prong (2L/min). Results : The arterial oxygen saturation was significantly higher on the 1st day of oxygen therapy compared with breathing room air, and was also higher on the 8th day of oxygen therapy than on the 1st day. We found that there was significant correlation between the lowest value of the arterial oxygen saturation and the mean value of the arterial oxygen saturation. The number of VPB's per hour was significantly lower on the 1st day of oxygen therapy compared with breathing room air, and also lower on the 8th day of oxygen therapy than on the 1st day. Our results showed positive correlation between the decrease in the frequency of VPB's and the increase in the lowest arterial oxygen saturation, even though correlation was not significant(p=0.056). Conclusion: With oxygen therapy, the arterial oxygen saturation was increased and the number of VPB's was decreased. Long-term oxygen therapy more than 7days, would be helpful to decrease the number of VPB' s in patients with COPD.

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An Open-label, Randomized, Comparative Assessment of the Efficacy and Safety between Tofisopam and Lorazepam in Anxiety Disorder (Tofisopam과 lorazepam의 항불안효과와 안전성에 대한 비교 연구)

  • Lee, Min Soo;Kim, Yong-Ku;Kwak, Dong-Il
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.265-271
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    • 1997
  • Objective : A 4-week, single-blind, parallel group study was conducted to evaluate the efficacy and safety of tofisopam and lorazepam in 32 outpatients with anxiety disorder. Methods : Patients were randomized to receive either tofisopam(N=17) or lorazepam(N=15). The starting dose of tofisopam was 50mg t.i.d. daily, which could be increased to a maximum of 100mg t.i.d. according to the patient's clinical response and side effect. The starting dose of lorazepam was 0.75mg b.i.d. daily, which could be increased to a maximum of 1.5mg b.i.d. depending on the patient's clinical response and side effect. Efficacy evaluations at baseline, week 1, 2, and 4 used the 14-item Hamilton Rating Scale for Anxiety(HAM-A) and Clinical Global Impression(CGI). Tolerability was assessed by response to a nonleading question concerning adverse events. Laboratory parameters including vital sign, EKG, hematological, and biochemical values were measured during trial. Results : No significant differences between HAM-A total scores, two HAM-A factors(psychic, somatic) and CGI severity scores were recorded at any point during tofisopam and lorazepam treatments. However, in each group there was a significant decrease in HAM-A total scores, two HAM-A factor s(psychic, somatic), CGI severity scores over time. The pecentages of patients with tofisopam who at least minimally improved increased from 64.7% at week 1 to 94.1% at week 4. The pecentages of patients with lorazepam who at least minimally improved increased from 40.0% at week 1 to 66.7% at week 4. The pecentages of patients with tofisopam who had not any adverse event increased from 58.8% at week 1 to 87.9% at week 4. The pecentages of patients with lorazepam who had not any adverse event were not changed from 46.7% at week 1 to 46.7% at week 4. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial in both groups. Conclusion : These data suggest that tofisopam may be effective in reducing anxiety and is a anti-anxiety drug of identical potency with lorazepam. Tolerability of tofisopam was superior to lorazepam. These findings should be confirmed by using double-blind crossover study with a large member of patients.

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Interim Report about The Effect of Bunsimgi-eum(Fenxinqiyin) on the Chest Discomfort of Hwa-byung's Major Symptom (화병 핵심증상 중 흉민에 대한 분심기음의 효능 : 무작위배정, 이중맹검, 위약대조군연구의 중간보고 - 피험자 특성을 중심으로)

  • Yim, Hyeon-Ju;Kim, Seok-Hwan;Lee, Sang-Ryong;Kang, Wee-Chang;Jung, In-Chul
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.3
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    • pp.169-188
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    • 2009
  • Objectives : The purpose of this research is to examine the effect of Bunsimgi-eum on the chest discomfort of Hwa-byung's major symptom. Methods : In this randomized, double blinded, placebo-controlled study, we planned to give Bunsimgi-eum or controlled medication for major symptoms of Hwa-byung. As preparatory research, 100 mm Visual Analogue Scale(VAS) for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, Korean State-Trait Anger Expression Inventory(STAXI-K), Korean State-Trait Anxiety Inventory(STAI-K), Korean Beck's Depression Inventory(BDI-K) and Heart Rate Variability(HRV) were also measured as the 2nd evaluative instrument at the before treatment. Results : Clinical characteristics-vital signs & demographic characteristics showed no significant difference between both groups. The characteristics of disease-chief complaint, pattern Identification, period, etiological factor, etc, also showed no significant difference between both groups. There were almost no Coincidence between pattern identification & weight of Hwa-byung's major symptoms. The results of Chest PA, EKG and clinicopathologic examination showed no significant difference between both groups. There were no significant difference between both groups in all valuation scales; 100 mm Visual Analogue Scale for chest discomfort, the Hwa-byung' major symptom was measured as the 1st evaluative instrument, and Likert scale for major symptom of Hwa-byung, STAXI-K, STAI-K, BDI-K and HRV. Conclusions : We considered that establishment of experimental group and controlled group was objective and worth conducting this research. And this methodology is expected to be applied to the subsequent research. And also, we hope to make up for this study through various study and discussion.

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