• Title/Summary/Keyword: Patient circulation

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부산 경남 지역의 주요 종합병원 병동부 면적 및 공간 구성 비율의 변화에 관한 연구 (A Study on the Change of Area and Space Organization Ratio of General Hospital Wards in Busan and Gyeongnam)

  • 박병준;이장민
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제18권4호
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    • pp.7-16
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    • 2012
  • Purpose : The purpose of this study is to look into the change of area and space organization percentage of wards in main general hospitals in Busan and Gyeongnam. Method : Patient area, nursing area, service area, training area, common area were classified for functional space organization. Patient area was reclassified to bedroom and comfort area, and common area was reclassified into vertical circulation, horizontal circulation and facility area. Also, method of area calculation was chosen standard to wall center-lines following building act 911 and functional space area of each hospital was estimated and comparatively analyzed. Result : For hospitals completed before 2000, area ratio by functional space for patient area, nursing area, service area and common area showed 53.6%, 10.2%, 0.8%, and 35.3% respectively. For hospitals completed after 2000, area ratio by functional space for patient area, nursing area, service space, and common area showed 49.2%, 12.6%, 1.1%, and 37.2% respectively. Implications : Through this study, change of percentage of space organization of main general hospitals in Busan Gyeongnam can be understood. Also because most studies on area organization of general hospital wards were focused on the capital area, this study provides basic material for future studies related to area of general hospital wards in Busan Gyeongnam.

돌봄상황에서 신체적 접촉의 특성에 관한 연구 (The Study on the Characteristic of Physical Touch in Caring Situation)

  • 장성옥
    • 기본간호학회지
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    • 제2권2호
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    • pp.183-197
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    • 1995
  • This study was performed to investigate the characteristic of physical touch in caring situation. The subjects of this study were adults in caring situation, therefore they were composed of 7 patients, 6 nurses, 3 doctors, 3 pharmacologists, 3 men in paramedicine area, 3 nursing educators and 13 normal general adults. The datas were gathered through nonstructured questionaire from June, 20th to September, 15th in 1995. The datas were subjects' descriptions about the intention, perception, and form of physical touch in caring situation and analysed by content analysis. The results as follow : The datas were divided into four areas. There were the situation being necessiated the physical touch, meaning of physical touch, form of physical touch and perception about physical touch in caring situation. The situation being necessiated physical touch were the situation that required physical treatment, to deliver the active expression of concern about the patients, to determine the treatment due to the identification of physical condition of patients and to induce the psychological eqilibrium into patient's mind. The meanings of physical touch in caring situation were - Good meanings that intention is to encourage, to be have hope about health and to deliver the affection willing to help patient. - therapeutic methods that were to facillitate the circulation of blood, to reduce the pain perception and to facillitate the circulation of qi. - interpersonal affectionate relation that the intentions were to deliver the understanding of patient's pain, were to delivery the meaning to the patient not be alone. The forms of physical touch in caring situation were none invasive forms just like laying hands on hand, head, shoulder, gentle knocking on the shoulder or back, massage of legs and back and finger pressure on acupuncture points. The perception of physical touch in caring situation divided into two parts. In family, the perceptions of physical touch in caring situation were to promote health status because physical touch induce the psychological peace, and to evoke the importance of relationship among family members. In relation with care giver, perception of physical touch in caring situation were inevitable process in treatment, and to deliver the trust and concern about patients.

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좌심실 이중유출로를 동반한 교정형 대혈관전위증 -1예보고- (Double-Outlet of Left Ventricle in Corrected Transposition of Great Arteries -One case report-)

  • 권중혁
    • Journal of Chest Surgery
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    • 제12권2호
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    • pp.119-126
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    • 1979
  • This is one case report of the extremely rare congenital cardiac malformation, Double-outlet of left ventricle in corrected transposition of great arteries. 11-year-old boy complained acrocyanosis and exertional dyspnea, the parents noticed cyanosis since birth. Physical examination revealed acrocyanosis, clubbed fingers and toes, G-III pansystolic murmur on 2nd and 3rd ICS, LSB. Right heart catheterization revealed significant $O_2$ jump in ventricular level. Right and left ventriculography showed the both catheters arriving in the same ventricle i.e. anterior chamber, morphological left ventricle was in right and anterior position, simultaneous visualization of aorta and pulmonary artery and aorta locating anterior and right side of pulmonary artery. Echo cardiogram surely disclosed interventricular septum. Conclusively it was clarified that the patient has Double-outlet of left ventricle and corrected transposition of great arteries [S.L.D.]. Operation was performed to correct the anomalies under extracorporeal circulation with intermittent moderate hypothermia. Right-sided ventriculotomy disclosed the following findings. 1. Right-sided ventricle was morphological left ventricle. 2. Left-sided ventricle was morphological right ventricle. 3. Right side atrioventricular valve was bicuspid. 4. Left side atrioventricular valve was tricuspid. 5. Aortic valve was superior, anterior and right side of pulmonary valve. 6. Subpulmonary membranous stenosis. 7. Non-committed ventricular septal defect. We made a tunnel between VSD and aorta with Teflon patch so that arterial blood comes through VSD and the tunnel into aorta. After correction the patient needed assisted circulation for 135 min. to have adequate blood pressure. Postoperatively by any means, adequate blood pressure could not be maintained and expired in the evening of operation day.

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메스암페타민(필로폰) 급성 중독으로 유발된 심정지 후 생존한 1례 (Survival after Cardiac Arrest due to Acute Methamphetamine Poisoning: A Case Report)

  • 문유호;김정호
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.176-180
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    • 2018
  • Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

감염병 전문병원의 병동부 건축계획에 관한 연구 (A Study on the Architectural Planning of the Ward in Infectious Disease Hospitals)

  • 최광석
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제27권1호
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    • pp.7-15
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    • 2021
  • Purpose: This study analyzed the architectural planning factors of the ward in infectious disease hospitals, such as functional unit planning, ward configurations, spatial compositions & circulation, and detailed architectural planning. Through these, the facility guidelines of infectious disease hospitals are summarized, focusing on the differences from the wards of non-infectious hospitals. Methods: This study was conducted by literature review of research reports, papers, design cases, and guidelines, based on the experiences of field surveys for infectious disease hospitals. Results: The result of this study can be summarized into a few points. 1) Infectious disease hospitals need to establish an operation plan with the concept of continuity of care, as an extension of existing facilities. 2) The types of ward configuration for infectious disease hospitals has many variables, so an appropriate type should be selected according to the hospital's operating policy. 3) Various spatial composition types of the ward can be planned by the arrangement of traffic cores and areas of patient groups. At this time, the main planning considerations are safety, efficiency, and comfort. 4) As elements of the detailed plan, It is necessary to consider the types & dimensions of patient rooms, the relationships between nursing stations & sub-stations, and supplementations of medical support functions & convenience facilities. Implications: Since there are many differences in function from the ward of non-infectious hospitals, appropriate facility guidelines for infectious disease hospital are required.

Successful Damage Control Resuscitation with Resuscitative Endovascular Balloon Occlusion of the Aorta in a Pediatric Patient

  • Heo, Yoonjung;Chang, Sung Wook;Kim, Dong Hun
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.170-174
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

개심술시 Activated Clotting Time 을 이용한 Heparin 및 Protamine 양 조절에 관한 임상적 관찰 (Monitoring of Heparin and Protamine Therapy by Activated Clotting Time During Open-Heart Surgery)

  • 김춘동;이성행
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.346-355
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    • 1980
  • It has been proposed that wide individual variation in response to heparin be not considered in the conventional set protocol for the control of heparin and protamine during extracorporeal circulation. In this paper, two protocol of heparin and protamine therapy were compared to assess the role of the Activated Clotting Time [ACT] in relation to heparin, protamine, and postoperative blood loss and transfusion. The study groups consisted of the 31 patients [adults 15 and children 16] anticoagulated with the conventional heparin protocol and the 31 patients [adults 15 and children 16] anticoagulated with ACT protocol during extracorporeal circulation. In the conventional heparin protocol, two mg of heparin per kg was administered initially with an additional 0.75 mg of heparin per kg every 30 minutes of extracorporeal circulation, and reversal was accomplished with protamine in a dose of 1.5 times the total milligram of heparin. In the ACT protocol, two mg of heparin per kg was administered initially with an additional dose of heparin enough to reach an ACT of 480 seconds [within safe zone 300 to 600 seconds] from the patient`s dose response curve every 1 hour of extracorporeal circulation, and reversal was done with protamine in a dose of 1.3 times the milligram of the residual heparin. The results were summarized as follows. After a dose of 2 mg per kg of heparin, the patient`s ACT varied from 240 to 600 seconds in adults and from 240 t~ 660 seconds in children. In the ACT group the total amount of heparin administered was markedly reduced when compared to the conventional group, and less protamine was required to neutralize heparin. The dose of heparin administered decreased from 7.07 [SE 0.42] mg/kg of the conventional group to 4.92 [SE 0.32] mg/k8 of the ACT group in adults and from 10.17 [SE 1.15] mg/kg to 5.23 [SE 0.24] mg/kg in children, which represent 30.4% and 48.6% decrease respectively. The dose of protamine administered for reversal decreased from 10.6 [SE 0.63] mg/kg of the conventional group to 3.35 [SE 0.35] mg/kg of the ACT group in adults and from 15.7 [SE 1.70] mg/kg to 3.26 [SE 0.27] mg/kg in children, which represent 68.4% and 79.2% respectively. The ratio of protamine to heparin administered in the conventional group was 1.50:1 in adults and 1.54:1 in children, but in the ACT group 0.68:1 in adults and 0.62:1 in children. Postoperative blood loss and transfusion revealed no statistically significant difference between the two groups. Although six patients in the conventional group and one in the ACT group needed re-exploration for continuous hemorrhage, no case of generalized oozing was encountered, and in each case a definite bleeding site was identified. Author would like emphasizing the value of the ACT protocol in controlling heparin and protamine administration during extracorporeal circulation.

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체외순환 개심술 환자의 혈청 및 뇨중 Amylase 변동에 관한 연구 (A study on the amylase in serum and urine in open heart surgery under the extracorporeal circulation)

  • 이병우;김근호
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.83-90
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    • 1983
  • During the period of March 1981 to September 1982 a series of survey has been done on the value of amylase in blood and urine of 24 patients who went through the operation of heart surgery, for congenital and acquired heart diseases, with extracorporeal circulation at the Department of Thoracic _ Cardiovascular Surgery, School of Medicine, Hanyang University. In order to analyze the iteration and inter-relation of the value of amylase in blood and urine and the extra corporeal circulation time. The duration of extra-corporeal circulation time up to 60 minutes was classified as Group A while above 60 minutes was classified as Group B. The results are as follow; 1. 3 patients [23.07%] among 13 patients of Group A and 3 patients [27.27%] among 11 patients, showed increased amylase value after the surgery. 2. The average value in blood after operation was 120.3190.71 unit in Group A and 130.90113.15 unit in Group B. It was 11.59 units [9.63%] higher in Group A than in Group B. 3. 1 patient [7.7%] among 13 patients of Group A and 2 patients[18.18%] among 11 patients of Group B, the frequency of Group B was 10.48% higher. 4. The average Value of amylase in urine after the surgery was 111.9254.87 unit in Group A and 151.54111.17 unit in Group B. It was 39.62 unit [32.72%] higher in Group A than in Group B. 5. The longer the duration of extra corporeal circulation time showed the higher the amylase value in blood and urine after the operation. 6. Although the value of amylase in blood and urine was increased after operation, no patients Were found to have developed clinical pancreatitis.

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