• 제목/요약/키워드: Patient circulation

검색결과 315건 처리시간 0.024초

응급부 진입구역과 환자분류구역의 감염관리를 위한 환자동선과 공간구성 계획에 대한 연구 (A Study on the Guideline of Spatial Composition and Circulation in Triages and Entrances Area in Emergency Departments for Efficient Infection Control)

  • 강지은;권순정
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제25권1호
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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.

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

  • 박소은;윤병길
    • 한국응급구조학회지
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    • 제28권2호
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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.

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

  • 김윤;조범구;홍승록
    • Journal of Chest Surgery
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    • 제11권3호
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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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    • 제16권1호
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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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    • 제56권11호
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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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    • 제57권10호
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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.

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

  • 홍종면;전용선
    • Journal of Chest Surgery
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    • 제30권11호
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    • pp.1132-1135
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    • 1997
  • 충북대학교병원 흉부외과에서는 좌전행지에 99%, 제2대각지에 90%, 우측 관상동맥에 50% 이하의 협착과 경피적 관상동맥 풍선 성형술 시행도중 동정지와 계속적인 서맥, 심방 및 심실조기박동의 부정맥을 보인 63 세의 여자 환자와 좌전행지의 근위부에서 원위부위까지 95% 정도의 협착과 제1대각지의 분지부위에 95% 이상의 협착을 가진 75세의 남자환자를 인공심폐기를 사용하지않고 심장이 박동되는 상태에서 정중 흉골절개를 통해 얻은 좌측 내유동맥과 우측 복재정맥을 이용해 좌전행지와 대각지에 성공적으로 관상동맥우회술을 시행하였다.

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

  • 김준석;이유나;안유민;백경민
    • 대한한방내과학회지
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    • 제42권5호
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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.

전방순환 뇌경색의 중재적 재관류 치료 이후 출혈 변환으로 의식 및 인지장애를 동반한 편마비환자의 한방치험 1례 (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)

  • 김채은;강지현;김서현;김준석;백경민
    • 대한한방내과학회지
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    • 제43권6호
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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.

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

  • 이재광;김영혁;임일권;이재필;이재광
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2012년도 추계학술대회
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    • pp.361-364
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    • 2012
  • USN(Ubiquitous Sensor Network)는 환자의 생체 정보를 실시간으로 수집하고 수집된 정보를 DB(Data Base)에 저장을 한다. DB에 저장된 환자의 생체 정보는 환자가 자주 이용하는 병원에 저장되어 환자가 병원을 이용 할 경우 저장되어 있는 환자의 생체 정보를 가지고 진료를 하게 된다. 하지만 저장되어 있는 위치는 병원 내의 서버나 PC 환경에 저장을 해놓고 있기 때문에 환자가 다른 병원을 이용하게 될 경우 기존 병원의 DB에 요청을 해야 한다. 하지만 기존 병원은 보안, 인증, 관리, 비용, 인력 등의 문제가 있기 때문에 다른 병원과의 정보 교환이 쉽게 이루어지지 않는 문제가 있다. 그래서 환자의 생체 정보가 환자의 모바일 기기에 저장 되어 있는 경우 그대로 사용할 수 있다는 장점이 있다. DB는 정보를 빠르고 정확하게 찾는 것이 중요하다. 본 연구에서는 환자 중심의 서비스를 위한 모바일 순환 Loop DB 시스템을 연구한다.

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