• 대한한방소아과학회지
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• 제21권2호
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• pp.35-50
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• 2007

Objectives The purpose of this study was to revitalize pediatric emergency care in oriental medical hospital. Methods The study was composed of 281 pediatric patients who visited emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital, from March 2006 to February 2007. Results The age distribution showed that 1 to 3 year's patients(40.6%) are the most New pediatric patients(59.1%) were more than who received medical treatment in this place. The seasonal distribution of between month's section and the 24 solar terms's section made no differences and pediatric patients who visited in emergency room was most in spring, least in autumn. Moreover the changes of season's patients were more than others. Pediatric patients who visited during the weekends and holidays(50.9%) were more than during the weekdays(49.1%). Systemic division of the major problems were the digestive symptoms(44.5%) and nervous symptoms(30.6%), respiratory symptoms(12.5%), musculoskeletal symptoms(5.3%), dermatological symptoms(1.8%), cardiovascular symptoms(0.7%) and others(4.6%) followed. The time interval between arrival and onset : within 6 hours were the most(54.5%). Pediatric patients who had digestive, nervous, musculoskeletal diseases within 6 hours were the most, but in the case of patients who had respiratory diseases, most of them were visited within 48 hours. Acting and herb-med treatment(77.9%) were the most in medical treatments. Pediatric patients(69.0%) who didn't revisit in this hospital after treatment in emergency room were more than who revisited(29.9%). Conclusions Pediatric patients who visited in emergency room of oriental medical hospital were most not acute form of a serious diseases, patients most visited in disease prefer to oriental medicine; such as dyspepsia, convulsions, crying, ankle sprain. Further studies will be needed for the actual circumstance's reflecion from this hospital and other oriental hospitals nearby or other western emergency rooms for the accurate studies.

• 대한한방소아과학회지
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• 제24권3호
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• pp.1-15
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• 2010

Objectives: By analyzing data of pediatric patients who had visited the emergency room of an oriental medical hospital, we can understand their characteristics and diseases. The purpose of this study was to introduce the excellence of Oriental medicine, to develop various treatments and to revitalize pediatric emergency care at oriental medical hospital. Methods: The study was composed of 371 pediatric patients who had visited the emergency room of the $\bigcirc\bigcirc$ university oriental hospital from January 2008 to December 2009. Results: 1. Average age of the pediatric patients was 4.28 years old, and it has showed that 1 to 3 years old patients (36.7%) were the most common age. 2. The number of pediatric patients was increased in June. According to the weekly distribution data, the number of pediatric patients who had visited on Sunday was the most (29.1%). Also, the number of pediatric patients who had visited ER for 18 to 21 hours(35.6%) were the most common. 3. The major problems of hospitalization were digestive symptoms and nervous symptoms. The nervous symptoms were the most at infancy. The musculoskeletal symptoms were the most common in adolescence. The digestive symptoms were common in other stages of development. 4. The time interval between arrival and onset; within 6 hours were the most(48.0%). Acupuncture and herbal medication treatment(75.2%) were the most common medical treatments. Most of the pediatric patients(97.3%) were discharged after medical treatments. Conclusions: Pediatric patients who had visited emergency room at the oriental medical hospital were mostly not due to acute form of serious diseases. The most common disease states that have preferred to treat with oriental medicine were dyspepsia, crying, febrile fit, and ankle sprain. We have to introduce the excellence of oriental medicine, and we need to try to develop other treatments such as magnetic acupuncture, moxa therapy, aroma therapy and revitalize pediatric emergency care at oriental medical hospital.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.277-282
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• 1999

1998년 4월 1일부터 7일까지 1주일간 영남대학교 의과대학 부속병원 응급의료센터를 방문하는 환자 464명을 대상으로 응급 환자 조사 대장을 작성하여 환자의 일반적인 정보 내용과 현황에 대하여 전향적으로 조사 분석한 결과를 요약하면 다음과 같다. 1. 조사 기간중 내원 환자수는 일 평균 66.3명이었으며, 대기 환자수는 평균 17.3명으로 당일 총진료 환자수는 83.6명이었다. 2. 내원 방법은 걸어서 내원한 환자가 57.3%로 가장 많았고, 교통편은 자가용이 58.0%, 구급차가 26.3%였으며, 발생 장소는 거주지가 85.3%로 가장 많았고, 지역별로는 대구 지역이 81.5%였다. 타 병원을 경유하여 내원한 환자는 2.6%, 직접 내원한 환자는 97.4%였다. 3. 내원 원인 분류상 질환이 74.6%로 가장 많았고, 사고 환자가 71명(15.3%)이었으며 이중 교통 사고가 49명(10.6%)을 차지하였다. 4. 진료를 의뢰한 임상과는 내과가 26.6%로 가장 많았고, 다음이 소아과 16.8%, 정형외과 8.6%, 신경과 8.2%, 신경외과 7.8% 순으로 많았으며 응급의학과를 포함한 기타 과는 8.2%를 차지하였다. 5. 진료 결과 입원이 38.4%, 퇴원이 61.0%, 도착시 사망 환차가 0.6%였으며 타 병원으로의 전원은 1례도 없었다. 결론적으로 3차 의료기관의 응급의료센터에서의 진료는 질병 환자 중심의 진료와 당일 진료후 퇴원가능한 경한 환자 중심의 "fast tracking"을 이용한 신속한 진료 및 외상 환자 및 중환자 중심의 진료 등의 다원적인 진료 형태가 요구되며 이러한 진료형태의 개발과 확립이 필요할 것으로 사료된다.

• 핵의학기술
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• 제25권2호
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• pp.29-34
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• 2021

핵의학과 검체 접수 환경시스템은 20년 전과 비교하여 보았을 때 크게 달라지지 않은 채 동일한 시스템으로 검체 접수 업무가 이루어지고 있다. 핵의학과 검사 특성상 진단검사의 학과와 달리 검체 용기 자체로 검사가 시행되는 것이 아니라 모검체에서 자검체를 생성하여 검사를 시행하는 시스템이기 때문에 지금까지 큰 변화 없이 이어져 온 것으로 보인다. 본원에서는 이러한 검체 접수 환경시스템을 개선하고자 검체의 뚜껑을 자동으로 제거해 주고 동시에 자동접수가 가능한 decapper 자동화 장비를 도입한 사례와 가접수 시스템 적용 사례에 대해서 소개해 보고자 한다. 본원에서는 2019년 환자의 검체 뚜껑을 자동으로 제거해 주는 장비를 도입하고자 진단검사의학과 응급검사실에서 사용하는 Vacuette ® Unicap Belt Decapper(Greiner bio-one, Austria) 제품을 벤치마킹하여 구매를 시도하였으나 5 ml SST, 8 ml SST 튜브를 사용하는 핵의학과 검체를 처리하려면 2대의 장비가 필요하여 예산과 공간 문제에 부딪혀 구매가 지연되었다. 2020년 1월 국산 decapper 자동화 장비를 대여 받아 검체 검사실 접수 실정에 맞게 지속적인 아이디어 제공과 테스트로 수정 보완하여 2020년 10월 검체 뚜껑을 자동으로 제거해 주는 동시에 자동접수 해주는 decapper 자동화 장비를 도입하게 되었다. 또한 검체 접수 전 단계에서 가접수 시스템을 도입하여 병동과 응급실, 건강증진센터 이송사원이 검체를 갖고 검사실에 도착하면 검체를 셀프로 가접수 하여 빠른 시간 내에 검체 도착 여부를 알릴 수 있도록 개선하였다. Decapper 자동화 장비가 도입되면서 자동으로 검체 뚜껑이 제거되고 접수되는 순간에 다른 업무를 수행할 수 있게 되어 검사자의 업무 효율성을 크게 증대 시킬 수 있었고 검사 소요시간에 영향을 미칠 수 있는 검체 접수 마감시간이 단축되어 검사시작을 10분~20분 정도 단축시킬 수 있는 효과를 볼 수 있었다. 또한 반복된 손목 사용으로 인하여 발생되는 근골격계 질환의 감소로 검사자의 건강장해를 예방할 수 있었다. 가접수 시스템을 설치한 후 병동에서는 빠른 퇴원이 가능해졌고 검체 도착 여부를 묻는 불필요한 전화문의 횟수도 감소하게 되었다. 대부분의 핵의학과 검체 검사실은 소규모의 인력으로 운영되고 있는 것이 현실이다. 최소 인력으로 검체 검사와 검체 접수 업무를 동시에 수행해야 되는 소규모 기관에서는 decapper 자동화 장비와 가접수 시스템을 도입 시 업무를 보다 원활히 수행하는데 도움이 될 수 있을 것으로 사료된다.

• 한국화재소방학회논문지
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• 제27권4호
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• pp.61-67
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• 2013

이 연구는 병원 전 심정지 환자에게 심폐소생술과 후 72시간 이상 자발순환이 회복된 환자 8례를 대상으로 하였다. 분석 결과 심정지 원인으로는 심장질환이 3례, 응급상황으로 인해 병력을 구하지 못한 경우가 5례를 보였다. 심정지 환자의 6례가 가정에서 발생하였고, 가족이나 동료에 의해 심정지가 목격된 경우가 8례였으며, 가족이나 동료 등 목격자의 의해 시행된 심폐소생술은 5례였다. 구급대원 도착 후 임종 호흡을 보인 환자가 3례로 확인되었다. 심정지 환자의 최초 초기리듬은 심실세동 7례, 무맥성전기활동 1례를 보였다. 출동에서 현장 도착까지 소요시간은 6.1분(${\pm}2.7$), 출동에서 병원 도착까지 소요시간은 23.0분(${\pm}8.8$), 자발순환이 회복되기까지 심폐소생술 지속 시간은 8.7분(${\pm}3.4$)이 소요되었다. 출동한 구급대원의 자격은 1급응급구조사 6례, 2급응급구조사 2례였으며, 3명 출동이 7례를 보였다. 병원 전 심정지 환자의 소생률 향상을 위해서는 무엇보다도 목격자에 의한 심폐소생술이 필요하며, 이를 위해서는 일반인 심폐소생술 교육을 지속적으로 진행하여야 한다.

• 성인간호학회지
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• 제20권1호
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• pp.126-134
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• 2008

Purpose: This study was to explore gender differences on presenting patients with acute myocardial infarction in the emergency department. Methods: The survey was done with 143 emergency medical charts presented to the emergency department and diagnosed with acute myocardial infarction between January 2005 and December 2006. The collected data were analyzed with frequency, chi-square, and t-test. Results: Significant gender differences were apparent in age, route to the emergency department, elapsed time from onset of symptoms to arrival, and initial heart rate. Women were significantly more likely to report hypertension, diabetes, and congestive heart failure than men, but men were significantly more likely to report smoking. Chest pain was the most common initial symptom in both men and women. Women were significantly more likely to report dyspnea and nausea/vomiting than men. Conclusion: Although similarities exist in the associated symptoms of acute myocardial infarction, women might experience different symptoms, compared to men. These findings have implication that patients and health care providers should consider gender difference in presenting symptoms.

• 한국응급구조학회지
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• 제27권2호
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• pp.51-63
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• 2023

Purpose: The study aimed to analyze the occurrence and transfer status of emergency patients at Incheon International Airport in Korea. Methods: This study design included 810 patients for eight years, from July 1, 2014 to June 31, 2022. The collected data were analyzed with SPSS statistics version 25.0. Results: For the demographics, 531 (65.6%) were males, 151 (19.5%) were in the highest age group (in their 50s), and 289 (35.9%) were foreigners. The most common place of occurrence was in protected areas in the passenger terminal, with 341 (42.1%) of cases occurring here. The time of arrival at the site (z=-3.444, p=.001), stay duration at the site (z=-8.145, p=. 001), and transfer time (z=-3.623, p=.000) were all significantly longer. Conclusion: It is necessary to consider a rapid emergency transportation plan, such as developing a system that simplifies immigration procedures when emergency patients move from protected areas to general areas. Moreover, in order to quickly respond to foreign emergency patients, detailed characteristics will need to be identified. Lastly, considering the long transfer time, an instructing doctor should accompany an ambulance and actively perform advanced resuscitation.

• Journal of Trauma and Injury
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• 제32권2호
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• pp.101-106
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• 2019

Purpose: The purpose of this study was to determine the essential factors for prompt arrangement of angio-embolization in patients with pelvic ring fractures. Methods: A total of 62 patients with pelvic ring fractures who underwent angio-embolization in Dankook University Hospital from March 2013 to June 2018 were retrospectively reviewed. There were 38 men and 24 women with a mean age of 59.8 years. The types of pelvic ring fractures were categorized according to the Tile classification. Patient variables included sex, initial hemoglobin concentration, initial systolic blood pressure, transfused packed red blood cells within 24 hours, Injury Severity Score (ISS), mortality rate, length of hospital stay, and time to angio-embolization. Results: The most common pelvic fracture pattern was Tile type B (n=34, 54.8%). The mean ISS was $27.3{\pm}10.9$ with 50% having an $ISS{\geq}25$. The mean time to angio-embolization from arrival was $173.6{\pm}89minutes$. Type B ($180.1{\pm}72.3minutes$) and type C fractures ($174.7{\pm}91.3minutes$) required more time to angio-embolization than type A fractures ($156.6{\pm}123minutes$). True arterial bleeding was identified in types A (35.7%), B (64.7%), and C (71.4%). Conclusions: It is important to save time to reach the angio-embolization room in treating patients with pelvic bone fractures. Trauma surgeons need to consider prompt arrangement of angio-embolization when encountering Tile type B or C pelvic fractures due to the high risk of true arterial bleeding.

• 대한임상독성학회지
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• 제17권2호
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• pp.102-107
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• 2019

Purpose: Acute carbon monoxide (CO) poisoning is one of the most common types of poisoning and a major health problem worldwide. Treatment options are limited to normobaric oxygen therapy, administered using a non-rebreather face mask or hyperbaric oxygen. Compared to conventional oxygen therapy, high-flow nasal cannula oxygen (HFNC) creates a positive pressure effect through high-flow rates. The purpose of this human pilot study is to determine the effects of HFNC on the rate of CO clearance from the blood, in patients with mild to moderate CO poisoning. Methods: CO-poisoned patients were administered 100% oxygen from HFNC (flow of 60 L/min). The fraction of COHb (fCOHb) was measured at 30-min intervals until it decreased to under 10%, and the half-life time of fCOHb (fCOHb t_1/2) was subsequently determined. Results: At the time of ED arrival, a total of 10 patients had fCOHb levels ≥10%, with 4 patients ranging between 10% and 50%. The mean rate of fCOHb elimination patterns exhibits logarithmic growth curves that initially increase quickly with time (HFNC equation, Y=0.3388*X+11.67). The mean fCOHbt_1/2 in the HFNC group was determined to be 48.5±12.4 minutes. Conclusion: In patients with mild to moderate CO poisoning, oxygen delivered via high flow nasal cannula is a safe and comfortable method to treat acute CO toxicity, and is effective in reducing the COHb half-life. Our results indicate HFNC to be a promising alternative method of delivering oxygen for CO toxicity. Validating the effectiveness of this method will require larger studies with clinical outcomes.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.