• Title/Summary/Keyword: One-day admission patient

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Safety and Availability of Monitored-Anesthesia Care using Propofol during Implant Surgery of the One-day Admission Patients (당일 입원 환자의 치과 수술 시 Propofol을 이용한 Monitored-Aesthesia Care (MAC)의 안정성 및 유용성에 관한 연구)

  • Kim, Bum-Soo;Kim, Young-Kyun;Yun, Pil-Young;Lee, Yong-In
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.2
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    • pp.120-125
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    • 2007
  • Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.

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Medications at the End of Life Care for Terminal Cancer Patients during Their Last Admission (말기 암 환자의 마지막 입원 동안 임종돌봄시의 약제들)

  • Kim, Do-Yeun
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.7-12
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    • 2010
  • Purpose: To evaluate medications at the end of life care for terminal cancer patients during their last admission. Methods: Medical records of terminal cancer patients during their last admission from July 2003 to April 2008 at a district academic hospital were evaluated. Patient's characteristics, therapeutic drug classification during their last admission and on the patient's day of death, and the administrated route and number of medications on the patient's day of death were analyzed. Results: Total 81 patients were included. The median patient age was 63 years. The median length of admission was 18 days (range: 1~101). 54% of the patients had more than one comorbidities. The most frequently prescribed drugs during the last admission were opioid analgesics (63%), followed by antibiotics (58%) and antacids (53%). On the day of death, common medications were antibiotics (59%), antacids (58%), and opioid analgesics (46%). Intravenous injection was given to 81% of the patients and intramuscular injection was given to 16% of the patients on the day of patient's death. Number of medications prescribed to patients was between 0 and 11 (median: 3) and 12% (10/81) of the patients took over 8 medications including intravenous and oral drugs on the day of death. 6% (5/81) of the patients took potentially futile medications, like multivitamin or statin until the day of death. Conclusion: This study suggests that potentially futile medications and uncomfortable care were given to terminal cancer patients. Multicenter-based studies are necessary to diminish futile medications by essential medication at the end of life care for terminal cancer patients.

Hematoma in Neck after Stellate Ganglion Block (성상신경절 차단후에 발생한 경부혈종)

  • Han, Young-Jin;Choi, Huhn
    • The Korean Journal of Pain
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    • v.7 no.2
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    • pp.270-272
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    • 1994
  • A 43 year old male patient injured in a traffic accident was admitted to the department of general surgery for the treatment of spleen rupture and multiple rib fractures. After subphrenic abscess occurred after splenectomy was treated. After 50 days of admission, left facial palsy occurred with sensory neural hearing loss, and tinnitus by longitudinal fracture of left temporal bone. The patients was consulted to pain clinic for further evaluation and treatment. The patient was treated with stellate ganglion block with 1% lidocaine 6ml one time daily. On 19th day, stellate ganglion block was given as usual, and the patient complained of pain in the neck and headache the next day. Two days later, mild fever elevation and hematoma in the neck were found. Hematoma was drained with hemovac. Ruptured muscular branch of vertebral artery was ligated surgically but the ligation was released in the next day and the hematoma was removed and the artery religated. Five units of packed RBC were transfused during the period and the patient was discharged without any sequelae.

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A Clinical Study of a Stroke Patient with a Worsened Gait Pattern after Discontinuing Rehabilitation (재활치료 중단 후 보행 양상이 다시 악화된 뇌졸중 환자 1례에 관한 고찰)

  • Kim, Cheol-hyun;Moon, Yeon-ju
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.118-124
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    • 2017
  • Objective: This study describes the case of a patient with a left basal ganglia (BG) infarct who had made almost a complete recovery upon discharge from the hospital in 2014 but who was re-admitted after 31 months with a worsened hemiplegic gait. Methods: The patient had undergone no rehabilitation treatment in the 31 months since his discharge. When the patient was re-admitted to our hospital in 2017, stance and gait data were collected on the patient using a treadmill gait analysis system. In addition, the patient underwent a manual muscle test (MMT) evaluation, and his Motricity index (MI) and modified Barthel index (MBI) scores were recorded. After rehabilitation for one month, the patient was reassessed, and the results were compared to those on the day of re-admission and those recorded in 2014. Results: Compared to the 2014 evaluation results, the patient's stance parameters and gait parameters had worsened at re-admission. However, there was no significant change in the patient's MMT grade or MI and MBI scores in comparison to the results of the 2014 evaluation. After one month of rehabilitation, the patient was re-evaluated again, but there was no significant change in comparison to the evaluation results at re-admission. Conclusion: Some of the stroke patients who have passed six months since the onset of their stroke may require ongoing rehabilitation although the functions of them is almost recovered. Because there is a possibility that recovered functions get worse again without any rehabilitation for a long time. And once the recovered functions get worse, re-recovery of them is not easy.

Nursing Needs of Parents with Hospitalized Child (입원환아 부모의 간호요구)

  • Seo Young Mi;Kwon In Soo;Cho Myeong Ock;Choi Woon Ju
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.59-69
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    • 1999
  • The main purpose of this study is to identify nursing needs of parents who have hospitalized child. Research design is a descriptive survey. The subjects for the study were 79 parents who have hospitalized child at a pediatric ward of one of the general hospital attached to a university in J city. The data was collected by researchers using a structured questionnaire. The questionnaire was Likert type 5 point scale, composed of 5 categories with 61 items. The data was analyzed by SPSS/PC. The results of the study were as follows ; 1) Mean score of nursing needs of subjects were 3.93 at 2nd day of admission and 3.99 at 7th day of admission. 2) Among the categories, the highest nursing need at the End day and 7th day of admission was ‘dilect nursing’, in desending order, ‘facilities and environment’, ‘education and counseling’, ‘nursing assessment’. The lowest nursing need was ‘reference’. 3) Differences between the nursing needs of subjects at 2nd day and 7th day were as follows : (1) By categories, there was a significant difference only in the ‘reference’ categoly(t=2.74, P=.008). (2) By items, there were significant differences in items of ‘to check necessary materials(t=2.31, P=.024)’, ‘to understand family function and family relationship(t=2.12, P=.041)’, ‘to set up study room(t=2.22, P=.030)’, and ‘to mediate parent's meeting group(t=3.89, P=.000)’. The above result indicated that nursing needs of parents with hospitalized child were above average, especially very high in items about disease process, and items directly associated with treatment and nursing care. So, nurses have to focus on information about the patient's state of disease, treatment, test and procedure, and in efficiently giving direct nursing care to implement mure effective care for the hospitalized children and their parents. And some future researche is needed to identify the difference of degree of nursing needs of parents with hospitalized child according to admission duration using a different sample and a longer sampling interval.

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Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation (살모사 교상 후 발생한 범발성 혈관내 응고장애 2례)

  • Kim, Suk-Hwan;Choi, Se-Min;Oh, Young-Min;Park, Kyu-Nam;Lee, Won-Jae;Choi, Kyung-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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Nutritional Support, Gastric Residual Volume and Nutritional Status during Enteral Nutrition in Intensive Care Unit Patients (중환자실 경장영양 환자의 영양지원, 위 잔여량 및 영양상태)

  • Lee, Minju;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.26 no.6
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    • pp.621-629
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    • 2014
  • Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

Clinical study on the 96 Cases of Stroke patients (뇌졸중환자(腦卒中患者) 96례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Yong, Hyung-Soon;Ko, Seong-Gyu
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.85-96
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    • 1998
  • This study was done with 96 cases of stroke patients who admitted to Department of the circulatory internal medicine Sang-ji University oriental Hospital from January to December in 1997. The purpose of this paper is to predict prognosis in stroke patient and to estimate change of muscle motor power between admission and discharge day in Sasang Constitution. The results are as follows. 1. Motor function of upper extremities was improved one stage at discharge day compare to admission day and the function of lower extremities had no change in muscle motor power. 2. Especially March and April had high morbidity any other months and the time of onset was most frequent on the morning. 3. They had hypertension as first preceding disease, and the next was stroke. Stroke occurred most frequently in resting, and the next was in sleeping. 4. In Sasang constitution, Taeyum-in(太陰人), 47.9%, was most neumorous, the next was Soyum-in(少陰人), 36.5%, and the third was Soyang-in(少陽人), 15.6%.

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Outpatient Day-Care Management of Unruptured Intracranial Aneurysm: A Retrospective Cohort Study

  • Dae Chul Suh;Yun Hyeok Choi;Sang Ik Park;Suyoung Yun;So Yeong Jeong;Soo Jeong;Boseong Kwon;Yunsun Song
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.828-834
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    • 2022
  • Objective: This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods. Materials and Methods: This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage. Results: The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6-53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6-53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes. Conclusion: This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.

Effects of Pain Control Education on Pain Control Barrier, Postoperative Pain and Pain Control Satisfaction in Gynecological Patients (통증조절 개별교육이 부인과 수술환자의 통증조절 방해, 수술 후 통증 및 통증조절 만족도에 미치는 효과)

  • Lee, Bok-Nam;Lee, Ga-Eon
    • Journal of Korean Academy of Nursing
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    • v.36 no.6
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    • pp.968-975
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of preoperative pain control education on the pain control barrier, postoperative pain and pain control satisfaction in gynecological patients. Method: The study was a quasi-experimental research design. There were 58 subjects who were admitted for gynecological surgery to D University Hospital in B city. Pain control education was provided individually to the experimental group one day before their operation day for 20 minutes with the 'Pain Control Guide Book' in the patient's admission room. The education book was made by researchers based on pain management references and patient interviews. For assessing the pain control barrier, a simplified version of Barriers Questionnaire was used, postoperative pain was assessed on a numeric scale(0-10) and satisfaction of pain control was assessed by one question. Results: The pain control barrier(F=15.828, p<.001) and the post pain score of the experimental group was lower than that of the control group. In addition, pain control satisfaction of the experimental group(t=3.612, p<.001) was higher than the control group's. Conclusion: With the above results, preoperative pain control education could be an effective nursing intervention for pain control of surgical patients.