• Title/Summary/Keyword: Emergency care education

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Continuous Control of Acetaminophen Poisoning after Implementation of Regulation for Ease Access of Acetaminophen: Cohort Study from Emergency Department Based in-depth Injury Surveillance (아세트아미노펜 사용 편의성 증가 후 중독발생 위험의 지속적 관리 필요성)

  • Jo, Seung Jik;Gang, Hyun Young;Lee, Si Jin;Bae, Gyu Hyun;Lee, Eui Jung;Han, Kap Su;Kim, Su Jin;Lee, Sung Woo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.57-65
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    • 2020
  • Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

Evaluating the Quality of Basic Life Support Information for Primary Korean-Speaking Individuals on the Internet (국내 인터넷 웹 페이지에 나타난 기본심폐소생술 정보의 질 평가)

  • Kang, Hee Do;Moon, Hyung Jun;Lee, Jung Won;Choi, Jae Hyung;Lee, Dong Wook;Kim, Hyun Su;Kang, In Gu;Kim, Doh Eui;Lee, Hyung Jung;Lee, Han You
    • Health Communication
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    • v.13 no.2
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    • pp.125-132
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    • 2018
  • Purpose: The aim of this study is to investigate the quality of basic life support (BLS) information for primary Korean-speaking individuals on the internet. Methods: Using the $Google^{(C)}$ search engine, we searched for the terms 'CPR', 'cardiopulmonary resuscitation (in Korean)' and 'cardiac arrest (in Korean)'. The accuracy, reliability and accessibility of web pages was evaluated based on the 2015 American heart association(AHA) guidelines for CPR & emergency cardiovascular care, the health on the net foundation code of conduct and Korean web content accessibility guidelines 2.1, respectively. Results: Of the 178 web pages screened, 50 met criteria for inclusion. The overall quality of BLS information was not enough (median 5/7, IQR 4.75-6). 23(36%) pages were created in accordance with 2010 AHA guidelines. Only 24(48%) web pages educated on how to use the automated electrical defibrillator. The attribution and transparency of the reliability of pages was relatively low, 20(40%) and 16(32%). The web accessibility score was relatively high. Conclusion: A small of proportion of internet web pages searched by Google have high quality BLS information for a Korean-speaking population. Web pages based on past guideline were still being searched. The notation of the source of CPR information and the transparency of the author should be improved. The verification and evaluation of the quality of BLS information exposed to the Internet are continuously needed.

Remote Medical Equipment Training for Public Health Doctors in Vulnerable Medical Areas Using Smart Glasses (스마트 글래스를 활용한 공중보건의 대상 의료장비 원격교육)

  • Jongmyung Choi;So-Eun Choi;Ji Hyun Moon
    • Journal of Internet of Things and Convergence
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    • v.9 no.3
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    • pp.75-80
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    • 2023
  • In medically vulnerable areas in Korea, public health doctors play a significant role in providing not only general medical care but also emergency medical services to the local residents. However, it has been observed that public health doctors generally lack field experience, resulting in insufficient ability to handle emergency patients and to effectively use medical equipment. This study confirmed the effectiveness of education after conducting remote education using smart glasses on how to use medical equipment necessary for public health doctors. Specifically, real wear was used for smart glasses for medical equipment utilization education, and 10 public health officials in 10 islands in Shinan-gun were targeted. After the training, both the effect of using the equipment and the level of satisfaction were 3 or higher. Therefore, it was confirmed that remote education using smart glasses can be usefully used for public health doctors in medically vulnerable areas.

A Study of Health Promotion Activity in Community Health Nursine Areas (지역사회 간호분야에서의 건강증진행위분석)

  • Kim, Young-Im
    • Research in Community and Public Health Nursing
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    • v.4 no.2
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    • pp.158-169
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    • 1993
  • Health promotions have been identified as foundamental concepts for nursing practice, especially in community health nursing. Nurses have been regarded as having important role's in health promotion activities. According to a review of literature, the concepts of health promotion consist of prevention services, health protection. Health prevention services have three levels : Primary secondary and tertiary. The objectives of this study are (1) to analyze the health promotion activities in school nursing. (2) to analyze health promotion activities in community health nursing posts. (3) to analyze the health promotion activities in industrial nursing while suggesting future direction for health promotion in community health nursing areas. The major results are first, Prevention services are most actively performed rather than health protection, and health education in three areas: School, industries, and community. Health nursing, secondary prevention services follow emergency care, and ordinary diseases control are especially active. Health promotion can ultimately from changing life be accomplished styles, and health behavior. As a consequence, future directions promoting health in community health nursing are desirable areas. Focusing on health protection, and health education that is not activated presently.

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Improvement for Work Status of Community Health Practitioners in Island Areas (전남 도서지역 보건진료원 업무환경 개선방안)

  • Kim, Ok
    • Journal of Korean Academy of Rural Health Nursing
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    • v.7 no.2
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    • pp.59-66
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    • 2012
  • Purpose: The purpose of this study was to assess the work status of community health practitioners in island areas. Methods: Participants in this study were 59 community health practitioners in primary health care posts located on islands in J Province. Data were collected during December, 2011 and analyzed using SPSS 17.0 program. Results: Characteristics of the majority of community health practitioners in the island areas was that they were over 50 years old, married, and had 10 years job experience, The population under their jurisdiction was less than 200 and they had an average of 6-10 patients/day and worked less than 10 hours/day. Health education and practice were the most common of task, and they had various types of paperwork to complete. They visited senior citizens living alone, managed medications, gathered health data for research, waited for night treatment of emergency patients, carried out health promotion programs, and visited seriously ill patients at home after work hours. Conclusion: Results of the study indicate that in order to improve the role and function of the primary health care posts and to boost morale, the practitioners' opinions should be actively accepted by the community health practitioner association and competent government agencies.

New Graduate Nurses' Satisfaction with Transition Programs and Experiences in Role Transition (신규간호사의 실무적응지원 교육 만족도 및 역할 이행 경험에 관한 조사)

  • Kwon, In Gak;Cho, Yong Ae;Cho, Myung Sook;Yi, Young Hee;Kim, Mi Soon;Kim, Kyeong Sug;Choi, Ae Seon
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.237-250
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    • 2019
  • Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

Awareness of good death, perception of life-sustaining treatment decision, and changes in nursing activities after decision to discontinue life-sustaining treatment among nurses in intensive care units at tertiary general hospitals (상급종합병원 중환자실 간호사의 좋은 죽음인식, 연명의료결정 인식 및 연명의료중단 결정 후 간호활동의 중요도 변화)

  • Cho, Gyoo Yeong;Bae, Hye Ri
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.109-122
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    • 2023
  • Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.

Relationship of Mean Arterial Pressure with the Adverse Outcomes in Adult Blunt Trauma Patients: Cross-sectional Study (성인둔상환자에서 평균동맥압과 위해사건발생의 관련성:단면 조사 연구)

  • Cha, Seung Yong;Kim, Yong Hwan;Hong, Chong Kun;Lee, Jun Ho;Cho, Kwang Won;Hwang, Seong Youn;Lee, Kyoung Yul;Lee, Younghwan;Choi, Seong Hee
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.39-46
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    • 2013
  • Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.

A Comparative Analysis of Disaster-Related Curriculum between Emergency Department and Nursing Department

  • Jung, Ji-Yeon
    • Journal of the Korea Society of Computer and Information
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    • v.24 no.10
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    • pp.183-188
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    • 2019
  • This study is a descriptive research to compare and analyze the current status of disaster-related curriculum between emergency department and nursing department Research and analysis targets were 41 universities which include the emergency department in South Korean by using the universities' internet homepage, finally 30 universities were researched by removing the universities which doesn't upload the curriculum on their homepage, have emergency department or have nursing department. The research data were collected and analyzed by using the universities' internet homepage. The Keyword is 'Disaster', 'Catastrophe', and 'Emergency' to search the name of the subjects. The curriculum calculated as a percentage of frequency by using the status of disaster-related subjects opening, classification of major education, grade, credit, number of class, practical hours, and the total number of subjects. According to the study, 29 universities (96.7%) of emergency department and 19 universities (63.3%) of nursing department has the disaster-related subjects in their curriculum. The current status of the class opening is emergency department at second grade and nursing department as fourth grade. As a subject of major, two credits are the common class credits. Based on the results of the study, knowledge and skills and training courses are necessary to develop the ability to cope with disasters in the disaster field. The curriculum that matches the role of health care resources will be required.

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

  • Yildirim, Birdal;Tanriverdi, Ozgur
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.349-353
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    • 2014
  • Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.