• 제목/요약/키워드: Emergency Admission

검색결과 320건 처리시간 0.025초

시너(Thinner) 정주로 발생한 급성 폐질환 1례 (Acute Pneumonitis Induced by Intravenous Thinner Injection in a Case of Suicidal Attempt)

  • 이혜지;최병호;김미진;홍정석
    • 대한임상독성학회지
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    • 제13권1호
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    • pp.33-35
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    • 2015
  • A 24 year-old man attempted suicide by injection of 1 cc of thinner into his left antecubital vein; 3 hours later, he visited our emergency room because of left chest pain. We suspected a chemical pneumonitis based on the abnormal findings of his chest X-ray and computed tomography. On the 3rd day after admission, a cellulitis also occurred at the injection area. His symptoms were relieved after supportive care for 2 weeks. There is significant experience with intoxication of thinner inhalation, whereas intoxication of intravenous thinner is rare.

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외래의료 민감 질환으로 응급실을 내원한 환자의 특성 분석: 의료전달체계 중심으로 (Analysis of the Characteristics of Ambulatory Care Sensitive Conditions in Patients Visiting the Emergency Departments: Focused on Health-care Delivery System)

  • 허영진;김지연;이명화;이성민;오미라
    • 융합정보논문지
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    • 제10권10호
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    • pp.253-258
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    • 2020
  • 본 연구는 외래의료 민감 질환(Ambulatory Care Sensitive Conditions, ACSCs)으로 응급실에 내원한 환자들의 특성을 연령(성인 19-64세, 노인 65세 이상)으로 구분하여 그 차이를 비교 분석하였다. 2018년 1월 1일부터 12월 31일까지의 국가응급진료정보망 자료를 이용하여 응급의료기관 종별과 ACSCs의 비율, 응급실 재실시간, 입원일수, 입원율을 살펴보았다. 응급의료기관 종별에서는 지역응급의료센터의 비율이 높았고(P<0.001), ACSCs의 질환 비율에서 성인은 위장염 31.7%와 노인은 폐렴 48.2%로 높게 나타났다(P<0.001). 응급실 재실시간은 울혈성심부전과 당뇨를 제외한 모든 질환에서 노인이 길게 나타났고(P<0.001), 입원일수는 ACSCs 모든 질환에서 노인이 유의하게 길게 나타났으며(P<0.05), 입원율은 당뇨를 제외한 모든 질환에서 노인의 비율이 유의하게 높았다(P<0.01). 이와 같이 ACSCs로 인한 응급실 이용을 파악하여 외래 중심으로 치료를 유도할 수 있도록 의료정책을 강화해야 할 것이다.

Six Sigma 활동을 통한 중증외상환자의 응급실 체류시간 개선 활동 (The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department)

  • 김현수;김옥준;최성욱;김의중;박영태;고대이;조윤경
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.119-127
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    • 2010
  • Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

Initial Management of Radiation Injuries

  • Linnemann Roger E.
    • Journal of Radiation Protection and Research
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    • 제5권1호
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    • pp.11-25
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    • 1980
  • The increasing utilization of radioactive isotopes in industry, medicine and research has raised the question, 'How should hospitals deal with radiation injuries when they occur?' A system for initial management of radiation injuries has been developed by Radiation Management Corporation. Radiation injuries are classified and a treatment plan outlined for each at the emergency and short term medical care phase. This system includes clinical prognosis as well as a detailed plan for quick set up or a Radiation Emergency Area in any hospital. Procedures for patient admission, preparation of the facility, general decontamination, sample taking, and wound decontamination are included.

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중증도 분류체계를 이용한 중증도분류(Triage) (Severity of Emergency Patient classified by Triage System)

  • 배정희;손수경
    • 한국간호교육학회지
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    • 제7권2호
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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안전상비의약품 판매 이후 중독환자 특성 변화 (Changes in Toxicological Characteristics after Sales of Nonprescription Drugs in Convenience Stores)

  • 김창영;이의중;이성우;김수진;한갑수
    • 대한임상독성학회지
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    • 제16권1호
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    • pp.42-48
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    • 2018
  • Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

파마중화제에 의한 비핍뇨성 급성신부전 1례 (A Case of Hair Neutralizer Induced Non-oliguric Acute Renal Failure)

  • 김아진;김경환;박준석;신동운
    • 대한임상독성학회지
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    • 제3권2호
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    • pp.119-121
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    • 2005
  • Sodium bromate or potassium bromate has been used as hair cold neutralizer. Sodium bromate intoxications occurred in children incidentally early days of marketing, but recently in adult suicidally. This chemical intoxication result in renal failure, ototoxicity, neurotoxicity, hemolytic anemia and so on. We experienced a 39-year-old woman of hairdresser with non-oliguric acute renal failure after ingestion hair neutralizer 500 ml. She received hemodialysis 3 times and discharged without complication on 8th admission days.

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Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea

  • Yu Jin Lee;Soon Tak Jeong;Joongsuck Kim;Kwanghee Yeo;Ohsang Kwon;Kyounghwan Kim;Sung Jin Park;Jihun Gwak;Wu Seong Kang
    • Journal of Trauma and Injury
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    • 제37권1호
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    • pp.20-27
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    • 2024
  • Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury

  • Kim, Hee-Yul;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • 제47권6호
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    • pp.467-469
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    • 2010
  • We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/$mm^3$. She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.

배출상수를 이용한 응급구조사 수급전망 (Projection of Demand and Supply for Emergency Medical Technician by Using Produce Constants)

  • 유순규;최혜경;백홍석;엄태환
    • 한국응급구조학회지
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    • 제11권3호
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    • pp.65-79
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    • 2007
  • Purpose : It was to find out demand and supply of EMT from 2007 to 2045 and to expand scope of practice of paramedic in Korea. Methods : This study was conducted by applying a projection formula to the data from admission quota for EMT of the Ministry of Education & Human Resources Development, rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board etc. Results : The number of EMTs were 6,043 paramedics, 5,378 EMT-Bs until 2006 and two produce constants derived from simple estimation were paramedic 0.81, EMT-B 0.86. On the American basis of 5.6 EMTs per 10,000, the number of paramedics under the present act will reach the basis around 2015(5.02), the number of paramedics under the amended act will reach the basis around 2030(5.50). Conclusion : There was relationship between scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic.

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