• 대한임상독성학회지
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• 제11권1호
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• pp.41-45
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• 2013

Following are brief statements about the delayed encephalopathy of a patient who recovered without disturbance of consciousness after acute carbon monoxide poisoning. A 72-year-old male was found without consciousness at home and then visited the ER center. Later we learned that the patient was using briquettes as a household heating source. Blood carbon monoxide hemoglobin level was 17.5%. As carbon monoxide poisoning was uncertain after the first interview with the patient, hyperbaric oxygen therapy was not administered at the early stage. After supplying 100% oxygen, the patient recovered consciousness, however, the strength of the lower limb muscle had decreased to class II. The patient showed continued weakening of the lower limb muscle and an increase of CPK; therefore, he was diagnosed as carbon monoxide intoxication and rhabdomyolysis and then admitted to the intensive care unit (ICU) for conservative treatment. During the hospitalization period, continued weakening of the lower limb muscle was observed and he was diagnosed as myopathy after EMG/MCV. However, he suddenly showed altered mentality on the 20th day of hospitalization, and underwent brain MRI. T2 weighted MRI showed typically high signal intensity of both globus pallidus and periventricular white matter; therefore, he was diagnosed as delayed carbon monoxide encephalopathy. This case showed delayed encephalopathy accompanied by rhabdomyolysis and myopathy of a patient who recovered without disturbance of consciousness.

• 한국응급구조학회지
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• 제12권3호
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• 중환자간호학회지
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• 제6권1호
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• pp.44-56
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• 2013

Purpose: The purpose of this study was to investigate emergency room nurses' recognition of patient safety culture and their performance of safety management activity. Methods: Data were collected from July 1 to August 31, 2012 on 292 emergency room nurses working at 25 general hospitals located in B city in G province. The Hospital Survey on Patient Safety Culture was used to measure patient safety culture, and an 82-item questionnaire was developed to measure safety management activity. Results: the performance of safety management activity were significantly associated with the total career years, whether the nurses had undergone safety training, and whether the nurses has been working in the regional emergency care facility. Of 6 subcategories of the patient safety culture, the perception of a directly commanding senior/manager, frequency of accident reports, and hospital environment were associated with the performance of safety management activity. Conclusion: For improving performance of safety management activity among emergency room nurses, it is necessary to develop an educational program of safety management activity by their level of performance.

• 간호행정학회지
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• 제15권4호
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• pp.491-505
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• 2009

Purpose: This study was to develop an algorithm for emergency nursing care of dyspneic patients. Methods: This methodological study was done through reviews of medical records and literatures, checklists of emergency nursing care for dyspneic patients, interviews with nurses, and experts' validity. Results: Firstly, the initial assessment confirmed the identification of airway patency, accessory muscle usage, RR, $SpO_2$, v/s, skin color, and mental status. Immediate emergency care provided oxygen, checked ABG, EKG, and chest X-ray, established a semi-fowler position, maintained IV routes, administered medication orders, and conducted careful monitoring. Secondly, if the patient exhibited $SpO_2$ of less than 90%, the nurse considered the patient's condition to be aggravated. Thirdly, if the patient showed improvement of more than 90% $SpO_2$, the nurse administered secondary assessment and carried out specific nursing care. However, if the patient continuously showed $SpO_2$ of less than 80%, the nurse assisted the intubation and then executed ventilator therapy. Conclusions: This study suggests that the algorithm is an effective decision tool and utilizing the algorithm is expected to improve the emergency nursing care for dyspneic patients.

• 대한임상독성학회지
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• 제18권1호
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• pp.42-46
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• 2020

Tetramine toxicity due to sea snail ingestion is generally mild and has a good prognosis. Tetramine toxicity acts on the acetylcholine receptor, affecting the neuromuscular junction and autonomic nervous system. A 78-year-old female patient visited the emergency room with vomiting and dyspnea after eating sea snails. At the time of admission, the vital signs recorded were 140/80 mmHg-105/min-24/min-36.5℃, and 90% oxygen saturation. Arterial blood test revealed hypercapnia (pCO₂ 58.2 mmHg) and respiratory acidosis (pH 7.213, HCO₃^- 22.5 mmol/L), whereas other blood tests showed no specific findings. Due to decreased consciousness and hypoxia, endotracheal intubation and mechanical ventilation were administered to the patient. Successful weaning was accomplished after 12 hrs, and the patient was discharged without any further complications. Although tetramine toxicity rarely results in acute respiratory failure due to paralysis of the respiratory muscle, caution is required whilst treating the patient.

• Journal of Chest Surgery
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• 제27권6호
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• pp.483-485
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• 1994

Recently, we experienced one case of penetrating cardiac injury patient by the knife.This patient was treated by emergency operation through left anterolateral thoracotomy under local anesthesia at emergency room. But, the patient was brought about the brain death inspite of normalized function of heart and lung. Now we have a conclusion that was able to recover of heart and lung functions by doctor`s exactly judgement and practice, at least.

• 한국응급구조학회지
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• 제19권3호
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• 한국응급구조학회지
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• 제8권1호
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• pp.189-197
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• 2004

The fate of a emergency patient is decided upon the extent of first aid in one hour after accident. Suitable diagnosis and treatment can raise the possibility of patient's life and reduce the recuperation time. We surveys papers which were The Korean Society Of Sports Medicine(1993-2004 yeas 405papers)and The Korean Society Of Emergency Medicine (1990-2004 yeas 797 papers). This paper got the following results through analyses of problems in emergency medical service system and of injures from sports. First, portable X-RAY equipment is needed to apply it to emergency. Second, it should have small and light structure compared with old equipments and have high voltage generator unit for X-RAY using inverter. Third, it should be able to send the shot data that is digital detector type without film to doctors in emergency center.

• 대한응급의학회지
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• 제29권5호
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• pp.551-556
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• 2018

Cases of repeated acute gastric dilatations after binge eating in one patient are rarely reported. We report here a case of repeated acute gastric dilatations in a 22-year-old woman with bulimia nervosa. Her repeated acute gastric dilatations seem to have been related to superior mesenteric artery syndrome. On her last visit due to acute gastric dilatation, she underwent emergency gastric decompression surgery because of abdominal compartment syndrome; however, she eventually died because of ischemia reperfusion injury. Emergency physicians should be aware of the need to manage acute gastric dilatation in patients with eating disorder and should pay attention to the signs and distinctive clinical features of abdominal compartment syndrome.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제5권8호
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• pp.63-70
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• 1999

The patient characters in medical emergency facilities is in emergent situation and very wide medical area. So, the spatial composition of this facilities should be more efficient than general medical ones. For this reason, patient who visit medical emergency center should be triaged by each property of patient. And then the clinical space is to be composed in response to flow of each patient group that triaged. Therefore this study aims to find method of the spatial composition and architectural details of medical emergency center.