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Epidemiologic Analysis of the Trauma Patients Visiting an Urban Specialized-emergency Medical Center (수도권지역 일개 전문 응급의료센터로 내원한 외상환자의 연령군별 특성)

  • Cho, Gyu Chong;Mun, Lee Sang;Kang, Hui Dong;Sohn, You Dong;Oh, Bum Jin;Kim, Won;Lim, Kyoung Soo
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.94-100
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    • 2005
  • Background: Although trauma has been the major cause of death in korea, there are few reports describing the epidemiologic characteristics of trauma victims according to age-group. Thus, this study aimed to describe the epidemiologic characteristics of trauma victims visiting an urban emergency medical center in Korea. Method: This study was conducted with all trauma victims who visited the emergency departments of Asan Medical Center from April 11, 2005 to May 10, 2005. After the subjects were divided into three groups such as child (${\leq}14$ years old), adult(15-64 years old) and elderly(${\geq}65$ years old), the prehospital courses, injury mechanisms, injury severities and clinical results were compared. Result: Among total 5,927 patients who visited the emergency medical center, 896(15.1%) patients were trauma victims. Although child under the age of 15 comprised 28.7% of the total trauma victims, less severe injuries(injury severity score < 9) accounted for 97.7% of the cases. The hospitalization rate for injury among child was 21.5%. however, although elderly aged 65 comprised only 5.9% of the total trauma victims, more severe injuries(injury severity score ${\geq}9$) accounted for 30.2% of the cases. The hospitalization rate for injury among elderly was 56.4%. Conclusion: Patterns of injury and clinical results by age-group were considerably different. less severe and non-hospitalized injuries were more common in child than other age-groups. while severe and hospitalized injuries were common in elderly.

A study on the second standardization of the paramedic curriculum in South Korea (응급구조(학)과 교육과정 2차 표준화 연구)

  • Choi, Eun-Sook;Hong, Sung-Gi;Lee, Kyoung-Youl;Yun, Hyeong-Wan;Han, Seung-Tae;Ju, Jeong-Mi;Jeon, Hyeok-Jin;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.7-27
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    • 2020
  • Purpose: The purpose of this study is to identify the compliance with the first standardization of the paramedic curriculum and suggest a second standardization to cultivate competent paramedics. Methods: This study was conducted by collecting 38 curricula, and responses to questionnaires, including those on the current status of prehospital field practice, from departments of emergency medical technology of 36 institutions. Data were collected between September 1 and November 30, 2019 via e-mail. Data were analyzed using SPSS v24.0 and NVivo 12.0. Results: Compliance with the first standardization of the paramedic curriculum was over 70% in only 11 on the 26 major subjects. The second standardization of the paramedic curriculum consists of 27 subjects requiring 76~79 credits for the 3-year course and 78~82 credits for the 4-year course. Conclusion: We suggested a minimum number of essential subjects to cultivate competent paramedics following the second standardization of the paramedic curriculum, and we hope colleges comply with this curriculum. Twenty to twenty-five percent of major subjects can be determined by the discretion of the college to maximize competency of paramedic students.

A Case of Acute Dapsone Poisoning Complicated with Methylene Blue-induced Hemolytic Anemia (급성 댑손 중독 환자에서 메틸렌블루 치료중 유발된 메트헤모글로빈혈증과 중증 용혈성 빈혈 1례)

  • Lee, Mi-Jin;Park, Kyu-Nam
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.170-174
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    • 2006
  • Methylene blue is a basic thiazine dye frequently used for histologic staining. In clinical toxicology settings, it is also used to treat clinically significant methemoglobinemia. It has dose-dependent oxidation or reduction properties, acting as a reducing agent at lower doses and as an oxidizing agent at higher doses. Hemolytic anemia and hyperbilirubinemia are known toxic effects of methylene blue treatment that have been reported clinically. A 42-year-old woman developed significant methemoglobinemia after acute dapsone overdose; she was treated appropriately with intravenous methylene blue in the therapeutic range. The patient's methemoglobin levels returned to normal. However, 2-4 days later she was noted to have rebound methemoglobinemia, hemolytic anemia, and hyperbilirubinemia. A repeat of Coomb's test and other anemia workups were negative. For management of methylene blue-induced hemolytic anemia, she was administered steroid therapy, N-acetylcysteine, and a blood transfusion. She ultimately recovered, and there were no long-term sequelae from the methylene blue poisoning.

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Scalp injury management by a maxillofacial surgeon in a low-resource hospital

  • Frimpong, Paul;Nguyen, Truc Thi Hoang;Nimatu, Edinam Salia;Amponsah, Emmanuel Kofi;Kim, Soung Min
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.39.1-39.5
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    • 2020
  • Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.

Syndromic Surveillances based on the Emergency Department (응급실 증후군 감시체계의 운영 현황과 활성화 방안)

  • Cho, Joon-Pil;Min, Young-Gi;Choi, Sang-Cheon
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.4
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    • pp.219-224
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    • 2008
  • Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only fur the early detection of bioterrorism but also for more effective public health responses to disease.

Correlation between injury and the injury severity score in geriatric traffic accident patients transported by 119 rescue services (119로 내원한 노인교통사고 환자의 손상과 손상중증도계수의 상관관계 분석)

  • Park, Yu-Jin;Kim, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.3
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    • pp.7-19
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    • 2016
  • Purpose: The purpose of the study was to investigate the correlation between injury and injury severity score (ISS) in geriatric traffic accident patients transported by 119 emergency medical technicians (EMTs). Methods: The subjects were 240 traffic accident patients over 65 years old transported by 119 rescue services emergency departments in Busan from January 1, 2014 to August 31, 2015. Results: ISS increased in motorcycle traffic accidents (p=.026), truck injuries (p=.005), and head and neck injury (p<.001). Vital signs were evaluated by 119 rescue EMT. ISS increased in cases of unresponsive unconsciousness (p<.001), hypotension (p=.001), and bradycardia (p<.001). The need for bleeding control and dressing by the EMTs increased ISS significantly (p=.022). Conclusion: In the initial evaluation of geriatric traffic patients, ISS can increase in motor cycle accidents and truck injuries. Due to high ISS, patients with head and neck injury, chest injury, hypotension, or tachycardia should be transferred to advanced level hospitals.

The Clinical Characteristics of Amusement-park-related Injuries (경기도 지역의 일개 대형 놀이공원에서 발생한 환자를 통한 대형 놀이공원에서의 외상성 손상의 양상)

  • Lee, Jae Hyuk;Sim, Min Seob;Song, Hyoung Gon
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.103-107
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    • 2009
  • Purpose: There are no reports on amusement-park-related injuries in Korea. Thus, the objective of this study was to describe traumatic injury patterns that occurring in an amusement park. Methods: The medical records of an infirmary were retrospectively reviewed. From January 1, 2008, to December 31 2008, patients who were transferred to the nearest emergency departments of hospitals for the purpose of further test and treatment were enrolled. Demographics, injury types and involved parts of the body were analyzed. Results: A total of 3,608 patients visited an infirmary for traumatic injury and about two-thirds had soft issue injuries. Of those, 191 patients (5.3%) were transferred to the emergency department of a hospital. Of the patients who were transferred to a hospital, laceration and contusion were the responsible injuries for about half. Laceration was the most common injury in pediatric patients, and a sprain or a strain was the most common in adult patients. The most commonly injured parts of the body were the extremities in adult patients. However, in pediatric patients, injuries of the head, face and neck were similar to injuries of the extremities. Conclusion: Soft tissue injury was the most common amusement-park-related injury. Laceration was the most common reason to transfer a patient to a hospital. There were differences in injury type and injured part of the body between adult and pediatric patients.

Plan for plastic surgeons to participate in trauma teams at regional trauma and emergency centers (권역외상 및 응급센터에서 성형외과의 참여방안)

  • Lim, Nam Kyu;Kang, Dong Hee
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.710-714
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    • 2018
  • A law revised in May 2012 provided support to regional and emergency centers for reducing the risk of preventable deaths. In particular, regional trauma centers have been established throughout the nation, with the goal of ensuring that any trauma patient can reach a trauma center within an hour. As a multidisciplinary approach is particularly important in treating severe trauma patients, activation teams are currently organized at each center to perform multiple simultaneous treatments. Under the present system, only 7 departments can participate in these trauma teams; emergency medicine, cardiothoracic surgery, general surgery, orthopedic surgery, neurosurgery, radiology, and anesthesiology. Plastic surgeons also play an essential role in treating trauma patients, and in fact currently treat many such cases. Especially in reconstruction procedures in patients with head and neck trauma and wide tissue defects, plastic surgeons possess unique expertise. However, since plastic surgeons are excluded from the trauma response teams due to institutional limitations, we describe the role and necessity of plastic surgery for trauma and emergency patients, and urge that the system be improved.

A Study on the Guideline of Spatial Composition and Circulation in Triages and Entrances Area in Emergency Departments for Efficient Infection Control (응급부 진입구역과 환자분류구역의 감염관리를 위한 환자동선과 공간구성 계획에 대한 연구)

  • Kang, Jeeeun;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.1
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    • pp.41-49
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    • 2019
  • Purpose: After Mers breakout in 2015, major hospital in Korea have been renovated the emergency department to make a separate infection control zone for high-risk patient with potential infection and to improve a triage area and an entrance area for efficient patient evaluation. However, there are no specific design standards to reinforce infection control for patients and staffs safety. Therefore, it is important to establish of initial design factors in the triage and entrance area as a guideline. Methods: 5 cases which had been recently renovated are selected to analyze patient circulation and spatial composition in a triage area and an entrance area. The partial floor plans of each case are represented as bubble diagrams to help understanding of different patient circulation flows. Based on this analysis, significant design factors which should be considered in planning stage for infection control have been extracted. Results: 13 design factors are established. Using these design factors, patient circulation diagram is generated to provide an optimized suggestion for efficient infection control. Implications: This suggestion provides basic databases to start to establish design guideline in the triage area and the entrance area to minimize infection spreading in the emergency department.

Factors Influencing Professional Competencies in Triage Nurses Working in Emergency Departments (응급실 간호사의 중증도분류 전문역량에 영향을 미치는 요인)

  • Kim, Myoung Soo;Kang, Minkyeong;Park, Keun Hee
    • Journal of Korean Biological Nursing Science
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    • v.24 no.2
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    • pp.122-130
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    • 2022
  • Purpose: This study was conducted to identify the professional competency of nurses working in emergency medical institutions that use the Korean Triage Acuity Scale (KTAS), and to identify factors that affect them. Methods: This study collected data from 105 nurses working in emergency medical institutions from June to August 2020. For data analysis, descriptive analysis, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression were performed using the SPSS 25.0 program. Results: As for the professional competency in triage, the higher the self-efficacy (β= 0.58, p< .001), the more experience they have in triage-related education (β= 0.30, p< .001), 2-4 years of clinical experience in emergency department (β= 0.19, p= .002), in case of triage alone (β= 0.24, p< .001), the higher the level of education a nurse has (β= 0.19, p= .003), the higher the professional competency in triage. These variables explained professional competency in a total of 64.2% of the participants (F = 38.30, p< .001). Conclusion: To improve nurses' professional competence in triage, introducing manpower expansion, financial support, and the provision of appropriate places is suggested. In addition, it is necessary to repeatedly provide educational opportunities in an environment similar to actual clinical practice by developing various scenarios and introducing simulations and web-based formats.