• Title/Summary/Keyword: Patient circulation

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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.

Effect of advanced life support (ALS) on recovery of spontaneous circulation in out-of-hospital cardiac arrest patients (병원 밖 심정지 환자의 전문소생술이 자발순환 회복에 미치는 영향)

  • Soeun Park;ByoungGil Yoon
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.2
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    • pp.47-62
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    • 2024
  • Purpose: This retrospective study analyzed the effects of advanced life support on the recovery of spontaneous circulation (SC) in patients with out-of-hospital cardiac arrest. Methods: The subjects of this study were out-of-hospital cardiac arrest patients transferred to the hospital by 119 paramedics in Gyeongsangbuk-do from January 1, 2021, to December 31, 2022, amounting to a total of 2,524 patients. Results: The younger the age, the higher the probability of recovery of spontaneous circulation, and it was higher when cardiac arrest occurred in a public place or was witnessed. If the patient's initial electrocardiogram rhythm is defibrillable, the probability of recovery from spontaneous circulation is high. The recovery of the spontaneous circulation rate decreased with time between the time of report and the time of contact with the patient. Recovery of the spontaneous circulation rate was high when mechanical chest compression devices and advanced airways were not used. Additionally, this study had positive effects on defibrillation, peripheral intravenous catheter insertion, and epinephrine infusion. Conclusion: Paramedics should actively perform peripheral intravenous catheter insertion and epinephrine infusion, and it should be possible to clearly determine whether defibrillation should be applied through electrocardiographic education.

Studies of Serum and Urine Potassium Changes During, and after Extracorporeal Circulation in open heart Surgery (체외순환 전후 혈중및 소변에서의 potassium 변화에 관한 관찰)

  • Kim, Yun;Cho, Bum-Koo;Hong, Seung-Nok
    • Journal of Chest Surgery
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    • v.11 no.3
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    • pp.296-302
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    • 1978
  • This experiment was carried out to study the change of potassium before, during, and after extracorporeal circulation. Serum potassium and urinary potassium excretion were examined in 7 cases of patient who were taken open heart surgery using extracorporeal circulation. All of 7 cases were administered 10-25mEq of KC1 during extracorporeal circulation. Serum potassium was not changed significantly during, and after operation, but urinary potassium excretion was declined during extracorporeal circulation and tend to rise after extracorporeal circulation. This result showed no remarkable relation of serum potassium and urinary potassium excretion.

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The Concept of Artificial Liver Support by Using the Extracorporeal Circulation System

  • Cheon, Min-Woo
    • Transactions on Electrical and Electronic Materials
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    • v.16 no.1
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    • pp.25-28
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    • 2015
  • In this study, a basic research on artificial liver was performed for its application to people on the waiting list of liver transplant or patients with hepatic insufficiency. Artificial livers are generally classified into mechanic type, bioartificial type, and hybrid type. An extracorporeal circulation device was examined herein, which is indispensable in the application of an artificial liver, for its effectiveness in supporting the recovery of liver functions. Extracorporeal circulation system is a treatment and life-support system which sends out the patient's blood, removes toxicity by various methods, and then sends the blood back to the interior of the body. This study used an extracorporeal circulation system which enables the Plasma Perfusion by CVVH method, and applied the program of Bioateco corp. Animals with acute hepatic insufficiency were produced to apply the extracorporeal circulation device. As a result, their ammonia, bilirubin, SGOT, SGPT, and bile acid levels rose, confirming the liver function restoration in the experimental animals.

Stroke after percutaneous transhepatic variceal obliteration of esophageal varix in Caroli syndrome

  • Lee, Yoo Min;Lee, Yoon;Choe, Yon Ho
    • Clinical and Experimental Pediatrics
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    • v.56 no.11
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    • pp.500-504
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    • 2013
  • Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

Inhaled iloprost for the treatment of patient with Fontan circulation

  • Kim, Yong Hyun;Chae, Moon Hee;Choi, Deok Young
    • Clinical and Experimental Pediatrics
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    • v.57 no.10
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    • pp.461-463
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    • 2014
  • Decreased exercise capacity after Fontan surgery is relatively common and the failure of the Fontan state gradually increases with age. However, there is no further treatment for patients with Fontan circulation. Pulmonary vasodilation therapy is an effective method to solve this problem because pulmonary vascular resistance is a major factor of the Fontan problem. Inhaled iloprost is a chemically stable prostacyclin analogue and a potent pulmonary vasodilator. We experienced two cases of Fontan patients treated with inhaled iloprost for 12 weeks. The first patient was an 18-year-old female with pulmonary atresia with an intact ventricular septum, and the second patient was a 22-year-old male with a double outlet right ventricle. Fifteen years have passed since both patients received Fontan surgery. While the pulmonary pressure was not decreased significantly, improved exercise capacity and cardiac output were observed without any major side effects in both patients. The iloprost inhalation therapy was well tolerated and effective for the symptomatic treatment of Fontan patients.

Coronary Revascularization without Extracorporeal Circulation -Two Case Reports (체외순환을 사용하지 않은 관상동맥 우회술 -2례 보고-)

  • 홍종면;전용선
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1132-1135
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    • 1997
  • We have experienced two cases of coronary revascularization without extracorporeal circulation in a 63 year old female patient and a 75 year old male patient. The first patient had the lesion which was the nearly total occulusion of mid-LAD, about 90% luminal narrowing of second diagonal branch and less than 50% stenosis of proximal RCA. The other male patient had a single vessel disease involving about 95% stenosis of proximal LAD and 1st diagonal branch. PTCA failed in the irst patient because of relatively long sinus pause during procedure In both of the patients, the coronary revascularizations were done at distal LAD and diagonal branch using left internal mammary artery and saphenous vein graft under the beating state, respectively. The postoperative courses were uneventful and the patients were discharged without any complications.

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A Case Report on Posterior Circulation Cerebral Infarction with Early Neurological Deterioration in an Elderly Patient with Chronic Kidney Disease (고령의 만성콩팥병 환자에서 발생한 초기 신경학적 악화가 동반된 후방순환뇌경색 치험 1례)

  • Kim, Jun-seok;Lee, Yoo-na;An, Yu-min;Baek, Kyung-min
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.727-737
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    • 2021
  • Objectives: This study investigated the effect of Korean medicine on an elderly patient with posterior circulation cerebral infarction, chronic kidney disease (CKD), and early neurological deterioration (END). Methods: The patient, who already had CKD, was treated with Korean medicine, comprising herbal medicine, acupuncture, moxa, and cupping combined with Western medicine (antiplatelet, diabetes) and physical therapy. A manual muscle test (MMT) and a modified Barthel index (MBI) were used to observe the treatment effects, and blood tests were performed to check estimated glomerular filtration rate (eGFR), creatinine and blood urea nitrogen (BUN), which represent renal function. Results: After the treatment, MMT, MBI, and renal function scores had increased. Conclusions: This study suggests that Korean medicine can effectively treat posterior circulation cerebral infarction with END in CKD, but further studies should be conducted.

The Effect of Korean Medicine Treatment for Hemorrhagic Transformation after Interventional Reperfusion Therapy of an Anterior Circulation Infarction in a Patient with Hemiplegia and Conscious and Cognitive Disorders: A Case Report (전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례)

  • Chae-eun Kim;Ji-hyeon Kang;Seo-hyun Kim;Jun-seok Kim;Kyung-min Baek
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1274-1288
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    • 2022
  • Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

A study on mobile circulation loop DB systems for patient-centered serbices (환자 중심의 서비스를 위한 모바일 순환 Loop DB 시스템 연구)

  • Lee, Jae-Gwang;Kim, Young-Huyk;Lim, Il-Kwon;Lee, Jae-Pill;Lee, Jae-Kwang
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2012.10a
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    • pp.361-364
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    • 2012
  • Through USN (Ubiquitous Sensor Network) is collected the patient's vital information in real-time, also information collected will be stored in the DB (Date Base), frequent use hospital saved patient's vital information for DB. Stored in the patient's vital medical information stored in the patients with frequent hospital patient to hospital if the patient's vital information is stored in DB. But, stored location is within hospital server or stored in a PC environment, because If utilize other Hospital existing hospitals will need to request. However, Existing hospital have problem for security, authentication, management, cost, manpower, such as, because other hospitals and the exchange of information does not come easily. So, If has the advantage of the patient and the patient's vital information is stored on mobile devices that you can use as DB. It is important to find information quickly and accurately, in this study, Is A study on mobile circulation loop DB systems for patient-centered serbices.

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