• 제목/요약/키워드: Patient fall

검색결과 239건 처리시간 0.032초

6미터 이하 저고도 추락 환자의 안전성 여부 (Are Falls of Less Than 6 Meters Safe?)

  • 서영우;홍정석;김우연;안력;홍은석
    • Journal of Trauma and Injury
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    • 제19권1호
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    • pp.54-58
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    • 2006
  • Purpose: The committee on trauma of the american college of surgeons, in its manual resources for optimal care of the injured patients involved in falls from less than 20 feet need not be taken to trauma centers. Because triage criteria dictate less urgency for low-level falls, this classification scheme has demerits for early detection and treatment of serious problems in the emergency room. Methods: A prospective analysis was conducted of 182 patients treated for fall-related trauma from June 2003 to March 2004. Falls were classified as group A (<3 m), group B (${\geq}3m$, <6 m), and group C (${\geq}6m$). Collected data included the patient's age, gender, site and height of fall, surface fallen upon, body area of first impact, body regions of injuries, Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), and Injury Severity Score (ISS). Results: The 182 patients were classified as group A (105) 57.7%, group B (61) 33.5%, and group C (16) 8.8%. There was a weak positive correlation between the height of fall and the patients' ISS in the three groups (p<0.001). There were significant differences in GCS (p=0.017), RTS (p=0.034), and ISS (p=0.007) between group A and B. In cases that the head was the initial impact area of the body, the GCS (p<0.001) and the RTS (p=0.002) were lower, but the ISS (p<0.001) was higher than it was for other type of injuries. Hard surfaces as an impact surface type, had an influence on the GCS (p<0.001) and the ISS (p=0.025). Conclusion: To simply categorize patients who fall over 6 meters as severely injured patients doesn't have much meaning, and though patients may have fallen less than 6 meters, they should be categorized by using the dynamics (impact surface type, initial body - impact area) of their fall.

라이프케어 증진을 위한 전신진동운동이 낙상위험 뇌졸중 환자의 균형 및 보행능력에 미치는 영향 (The Effect of Whole-Body Vibration Exercise for Life Care on Balance and Walking Ability in the Stroke Patient with Risk of Fall)

  • 한상우;박웅식;문경임;고대식
    • 한국엔터테인먼트산업학회논문지
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    • 제14권8호
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    • pp.437-445
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    • 2020
  • 본 연구는 라이프케어 증진을 위한 전신진동운동이 낙상위험 뇌졸중 환자의 균형 및 보행능력에 미치는 영향을 알아보았다. 본 연구의 대상자는 뇌졸중 환자 30명을 대상으로 전신진동운동군과 오타고운동군으로 15명씩 할당하여 균형능력은 버그균형척도(BBS)와 일어서서 걷기 검사(TUG), 보행능력은 10m 보행속도검사와 Tinetti 운동성 검사를 측정하여 운동 전과 운동 후, 군 간을 비교·분석하였다. 집단 내 운동 전·후의 차이를 비교하기 위해 대응표본 t-검정을 사용하였고, 집단 간의 차이를 비교하기 위하여 독립표본 t-검정을 실시하였다. 실험결과 두 군 모두 운동 전후 BBS와 Tinetti 운동성 검사는 유의하게 증가하였고, TUG와 10m 보행속도는 유의하게 감소하였다. 군 간 비교에서는 BBS, TUG, 10m 보행속도, Tinetti 운동성 검사 모두 유의한 차이가 있었다. 본 연구결과를 통해 라이프케어 증진을 위한 전신진동운동은 낙상위험 뇌졸중 환자의 균형능력과 보행능력을 개선하는데 영향을 미치는 것으로 사료된다. 따라서 낙상위험 뇌졸중 환자의 균형능력과 보행 능력을 향상을 통한 라이프케어 증진을 위해 전신진동운동 프로그램을 권장한다.

최근 5년간 응급실을 내원한 구강악안면외과 환자에 대한 임상적 연구 (A CLINICAL STUDY ON THE EMERGENCY PATIENTS OF ORAL AND MAXILLOFACIAL SURGERY DURING RECENT 5 YEARS)

  • 김종렬;정인교;양동규;박봉욱
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권2호
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    • pp.155-162
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    • 2001
  • This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

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코뼈 골절 환자 452례에 대한 임상 통계학적 분석 (Clinical and Statistical Analysis in 452 Cases of Nasal Bone Fracture Patients)

  • 강재훈;방유현;이용해;최창용
    • Archives of Plastic Surgery
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    • 제38권6호
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    • pp.775-782
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    • 2011
  • Purpose: Nasal bone fracture is most common facial bone fracture. The cause of fractures is mainly trauma such as fighting, automobile accident and fall down, and it commonly involves young males. Very frequently nasal bone fractures are associated with other facial injuries such as orbital bone fracture, maxillary bone fracture and nasal septal deformities. Because of various dynamic directions of power are involved, phenomenon of fractures are also various and treatment cannot be simple. Methods: We studied and analyzed retrospectively 452 cases nasal bone fractures from January 2008 to December 2010. Diagnosis were made with physical examination, Nasal bone X-rays, Facial bone CT and 3D facial bone CT. Four surgeons are involved in treatments of these patients and applied different procedure along patient's condition and deformity. We analyzed the cause of nasal bone fractures, deformities, associate injuries and applied surgical technique, and patient's satisfaction rate. In this study, old nasal bone fractures were excluded. Results: Young male group was most commonly sustained nasal bone fracture and physical violence was most common cause of injury. 64 of 452 patient was involved associate injuries of face. Closed reduction were applied 246 cases and C-arm quide reduction were 167 cases and in 20 cases lateral osteotomy were applied. Approximately, more than 80% of the Patients were satisfied with the outcomes. Conclusion: Diagnosis and treatment of nasal bone fractures are considered simple but because of various deformity and associate injuries, treatment is not always simple and universal. Time to time, we face unsatisfied patient after treatment of nasal bone fractures. For obtaining satisfactory result, cause of injury and state of deformities and associate injuries such as nasal septal deformity should be evaluated properly and proper treatment should be applied.

Thoracoscopy in Management of Chest Trauma: Our Three-year Jeju Experience

  • Lee, Sung Hyun;Yie, Kilsoo;Lee, Jong Hyun;Kang, Jae Gul;Lee, Min Koo;Kwon, Oh Sang;Chon, Soon-Ho
    • Journal of Trauma and Injury
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    • 제30권2호
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    • pp.33-40
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    • 2017
  • Purpose: The role for minimally invasive surgery in chest trauma is vague, one that recently is more frequently performed, and one attractive option to be considered. Thoracoscopic surgery may improve morbidity, mortality, hasten recovery and shorten hospital stay. Methods: A total of 31 patients underwent video assisted thoracoscopic surgery for the treatment of blunt and penetrating chest trauma from June 9th, 2013 to March 21st, 2016 in Jeju, South Korea. Results: Twenty-three patients were males and eight patients were females. Their ages ranged from 23 to 81 years. The cause of injury was due to traffic accident in 17 patients, fall down in 5 patients, bicycle accident in 2 patients, battery in 2 patients, crushing injury in 2 patients, and slip down, kicked by horse, and stab wound in one patient each. Video assisted thoracoscopic exploration was performed in the 18 patients with flail chest or greater than 3 displaced ribs. The thoracoscopic procedures done were hematoma evacuation in 13 patients, partial rib fragment excision in 9 patients, lung suture in 5 patients, bleeding control (ligation or electrocautery) in 3 patients with massive hemothorax, diaphragmatic repair in two patients, wedge resection in two patients and decortication in 1 patient. There was only one patient with conversion to open thoracotomy. Conclusion: There is a broad range of procedures that can be done by thoracoscopic surgery and a painful thoracotomy incision can be avoided. Thoracoscopic surgery can be done safely and swiftly in the trauma patient.

도인승기탕(桃仁承氣湯)을 투여한 흉요추 압박골절 치험 1례 (A Case Report of Prescribing Doinseunggi-tang (Taorenchenqi-tang) for the Patient with Thoraco-Lumbar Compression Fracture)

  • 조희근;추민규;박수곤;양미성;안가영;강성인;이유진;최진봉
    • 한방재활의학과학회지
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    • 제19권3호
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    • pp.111-121
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    • 2009
  • Objectives : The Purpose of this study was to investigate the clinical application of traditional Korean herbal therapy to a patient with thoraco-lumbar compression fracture. Methods : The patient who had sudden low back pain, back pain and ambulation disorder due to pain caused by an accidental fall, we prescribed Doinseunggi-tang (Taorenchenqi-tang) for her with acupuncture therapy. And we adopted several scales to estimate to progress of her symptoms. Results : Soon after taking herbal medication with other treatments, the patients pain was controlled and was able to ambulation without pain. Conclusions : In this case, we assume that Doinseunggi-tang(Taorenchenqi-tang) play an important role in improvement of the patient's symptoms. So, the present results suggest that traditional Korean herbal therapy has the positive effect to reduce the pain and shortening the period of treatment.

기관지 내시경 검사에 따른 산소 포화도, 폐기능 및 동맥혈 가스의 변화 (The Change of $SaO_2$, PFT and ABGA During the Bronchofiberscopy)

  • 김종선;신정은;김태희;장종현;천선희
    • Tuberculosis and Respiratory Diseases
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    • 제45권3호
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    • pp.574-582
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    • 1998
  • 연구배경: 기관지 내시경은 기도를 통하여 내시경을 삽입한 후 약 10-30분 가량의 시술을 포함하기 때문에 호흡기계에 병태 생리학적 변화를 동반할 가능성이 있다. 이에 저자들은 기관지내시경 검사에 따른 경피적 산소 포화도의 변화와 검사 전후 동맥혈 가스 및 폐기능의 변화를 보고자 하였다. 방 법: 144명의 환자를 대상으로 기관지 내시경을 입으로 삽입하여 실시하였으며 내시경 전과정을 통하여 pulse oximetry를 사용하여 왼쪽 검지 손가락 끝에서 l 분 간격으로 산소 포화도를 측정하였다. 16명의 환자를 대상으로 내시경 시행전과 직후에 폐기능과 동맥혈 가스검사를 시행하였다. 결 과: 기관지내시경의 평균 시술시간은 14.5분이었고, $SaO_2$는 평균 8.4분후에 최저로 떨어져 $89.0{\pm}5.54%$로 기저치보다 8% 저하되었으나 종결시 회복되었다. 산소 공급군과 비공급군에서 시술시간은 산소공급군에서 유의하게 길었으나, $SaO_2$의 감소는 산소비공급군에서 8.4%로, 산소 공급군의 6.4%보다 컸으나 통계적 유의성은 없었다. 산소 비공급군에서 Biopsy군와 BAL군이 Washing군에 비하여 $SaO_2$ 저하가 더 큰 경향을 보였으나 종결시에는 유사하게 회복되었다. 기관지내시경 시행전 $PaO_2$$FEV_1$의 정도는 기관지내시경중의 $SaO_2$ 감소정도에 큰 영향을 미치지 않았다. 기관지내시경을 전후하여 시행한 ABG상 경미한 $PaO_2$의 감소와 $PaCO_2$의 증가를 보였으며, vP기능 검사상 $FEV_1$의 감소(P<0.05)와 RV의 증가를 보였으나 기도 저항과 폐확산능의 변화는 없었다. 기관지내시경을 전후하여 비교하였을 때 Washing군은 폐기능의 큰 변화가 없었으나, Biopsy군과 BAL군은 기관지내시경후 $FEV_1$이 감소하고 RV가 증가하였으며, 통계적으로 유의하진 않았으나 BAL군에서 더욱 두드러졌다.

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Trigger point를 이용(利用)한 구안와사 환자(患者) 10례(例)에 대한 임상적(臨床的) 고찰(考察) (Clinical investigation studies on 10 cases of patient with Bell' palsy using Trigger point treatment)

  • 정영돈;이준구;김영일;박태균;신영일;황재연;이현;이병렬
    • 혜화의학회지
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    • 제10권2호
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    • pp.155-165
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    • 2002
  • From July 1th 2001 to October 31th 2001, the Clinical investigation studies were carried out 10 cases of patient with Bell' palsy using Trigger point treatment group, who had been treated in Han-seung Oriental Medical Clinic. The results were like below: 1. The distribution of sex : Male were 4cases. female were 6case and the female to male ratio was 1.5 : 1. 2. The distribution of contributing factor : Unknown reason was most predominant 4 cases, and then were revealed to labor too hard. mental stress(3 cases), trauma common cold(1 case) in turn. 3. The distribution of perid to fall ill : Under a week was the most number 6cases, and then were revealed a week under two weeks(3 cases), over two weeks(1 case) in turn. 4. About period of treatment : The Trigger Point treatment group is shorter than the Acupuncture treatment group. 5. The distribution of grade on admission in descending order : Gr I was the most number and then GrII, GrIII in turn. 6. The distribution of clinical symptoms on admission : Mastoid pain was the most number 9 cases and then lacrimal gland disorder 8 cases, dysgeusia 4cases, hyperacusis 2 cases, the others 2 cases in turn. 7. About effect of treatment : The Trigger point treatment group is more excellent than the Acupuncture treatment group. 8. The more patient age is young, the more effect of treatment was excellent, had nothing to do with both groups. 9. The more perid to fall ill is short, the more effect of treatment was excellent. had nothing to do with both groups. 10. About period of improved frontal belly : The Trigger point treatment group is more excellent than the Acupuncture treatment group.

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환자안전보고학습시스템 자료를 활용한 의료정보기술 및 전자의무기록시스템 관련 환자안전사건 분석 (Analyzing Health Information Technology and Electronic Medical Record System-Related Patient Safety Incidents Using Data from the Korea Patient Safety Reporting and Learning System)

  • 조단비;이유라;이원;이의선;이재호
    • 한국의료질향상학회지
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    • 제27권2호
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    • pp.57-72
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    • 2021
  • Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

외상성 기도 손상의 임상적 고찰 (Clinical Aanalysis of Airway Trauma)

  • 조현민;김영진;류한영;황정주
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.7-11
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    • 2011
  • Purpose: Traumatic airway injuries have high rates of mortality and morbidity. Thus, we evaluated the clinical results of trauma-related airway-injury patients. Methods: A clinical analysis was performed for patients with airway trauma who were admitted and treated at the Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital from Dec. 2002 to Dec. 2009. Results: Sixteen patients were admitted and treated. Fourteen patients were male, and the ages of the patients ranged from 16 to 75 years. Six cases were penetrating injuries, 4 were traffic-accident injuries. 3 were fall injuries, and. 3 were other blunt trauma injuries. Anato- mic injuries included 14 trachea cases (87.5%), 1 Rt. main bronchus (6.25%), and 1 Lt. main bronchus cases (6.25%). Diagnosis was made by using computed tomography and bronchoscopy. Five patients were treated with an explothoracotomy, and 7 underwent neck exploration with primary repair. Three patients simply needed conservative management, and 1 patient was treated with a closed thoracostomy. The post-operative mortality rate was 6.25 % (1 patient). Conclusion: Airway trauma is dangerous and should be treated as an emergency, so a high index of suspicion is essential for rapid diagnosis and successful surgical intervention in patients with airway injuries.