• 제목/요약/키워드: Patient falls

검색결과 114건 처리시간 0.019초

저체온 체외순환시 혈액가스분석의 판독과 체온과의 상관관계 (Interpretation of Blood Gas Analysis During Hypothermic Cardiopulmonary Bypass)

  • 송선옥
    • Journal of Yeungnam Medical Science
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    • 제6권1호
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    • pp.121-131
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    • 1989
  • 건강한 성인 83명을 무작위로 선정하여 실시한 신경전도속도 검사에서 다음과 같은 결과를 얻었다. 1) 상지의 정중신경에서는 운동신경의 TL이 3.0-4.2msec 이고, MNCV는 각각 52.1-70.3m/sec(W-E), 44.6-71.0m/sec(E-Ax), 56.6-70.8m/sec(W-E), 50.5-75.1m/sec(E-Ax)이며, CNAP의 진폭은 $6.5-46.1{\mu}V$였다. 2) 척골신경에서는 운동신경의 TL이 2.4-3.4msec이고, MNCV는 각각 54.6-72.8m/sec(W-E), 41.1-64.9m/sec(E-Ax)1987년 3월부터 동년 12월까지 영남대학교 의과대학 부속병원에서 시행된 개심술마취 40례를 대상으로 저체온 체외순환시 저체온상태의 동맥혈과 정맥혈을 동시에 각각 채혈하여 $37^{\circ}C$ 혈액가스분석기로 측정한 비보정치와 환자의 실제 저체온으로 보정한 보정치를 각각 얻어 이를 비교하여 보았던 바 보정치가 비보정치에 비하여 pH는 높았고 이산화탄소분압과 산소분압은 낮았으며 $HCO_{3^-}$, 염기과잉, 이산화탄소분압 및 산소포화도는 온도보정에 영향을 받지 않았다. 이상의 결과로 미루어 보아 저체온상태의 혈액가스분석시 pH와 이산화탄소분압에 대한 온도보정의 영향은 크며, 저온상태에서의 pH 중심점이동과 산염기가 환자상태에 미치는 영향을 고려한다면 환자실제 저체온으로의 온도보정은 필요치 않을 것 같으며 오히려 $37^{\circ}C$ 비보정치로 판독하여 환자상태를 판정하는 것이 임상적으로는 더 타당한 방법이라 사료된다.

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세라밴드를 이용한 PNF 기법 적용이 65세 이상 여성노인의 균형과 보행에 미치는 영향 (The Effect of PNF Technique application Using Thera-Band on the Balance and Gait of Females over 65 years old)

  • 강달원;강미경;강은실;고유리;김다운;김대용;김정은;김원황;김자연;김환;정대인;김명훈;김상엽;이동진;김찬규;김현진
    • 대한물리치료과학회지
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    • 제18권1호
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    • pp.1-10
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    • 2011
  • Purpose: Study on the effect of the use of Proprioceptive Neuromuscular Facilitation(PNF) method by use of the direction and charge regulation which is the advantage of the Thera-band therapy on the walks and balances in old people and comparison with the result after applying the general PNF technique. Method: The study has been performed on 30 females over 65 years old. The study has been done by dividing the object group in 3 patterns, which are number 1, the comparison group of 10, two ones that are applied the PNF technique using Thera-band and third, the ones that are applied only the PNF technique. For the PNF and the Thera-band using PNF, we have divided the group into Combination of Isotonic technique and the Rhythmical stabilization technique according to the patient's acquaintance pattern and applied them to the patient's body. Evaluation was the balancing ability which was calculated by using the BIODEX Balance system / FRT and for the evaluation of walking ability, we have used the speed of walking for 10M / TUG. Result: In the comparison group of 10, the balancing ability and the walking ability did not change much before and after the experiment, which made it possible to compare the group with the other two easily(p>0.05). For the other two groups, we have recognized the enhancement both in the balancing ability and the walking ability, but they did not know much difference between themselves(p<0.05). Conclusion: Though there were not a big difference in the sense of improvement between the Thera-band using PNF and the PNF technique only, we could infer that these two therapy has enhanced much in the walking and balancing ability for people over 65 and through these result we can foresee that not only using the method shown in this study but also by using many advantages of Thera-band, we could diminish the tiredness of healer, enhance the efficiency of exercise in them and also by forming self training program for older people we could help them build the prevention program from falls.

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감염병의 예방 및 관리에 관한 법률상 역학조사와 관련된 형사법적 쟁점 (Criminal Law Issues in Epidemiological Investigations Under the INFECTIOUS DISEASE CONTROL AND PREVENTION ACT)

  • 장준혁
    • 의료법학
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    • 제23권3호
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    • pp.3-44
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    • 2022
  • 2020. 2.경 대한민국에서 코로나19 감염증의 대유행이 시작될 당시 문제가 되었던 대구 지역 A종교단체의 역학조사 방해 사건을 중심으로 면밀히 검토한 결과, 역학조사관이 특정 단체에게 명단 제출을 요구하였을 때, 이에 불응하거나 편집된 누락 명단을 제출한 행위에 대하여 역학조사에 해당하지 아니한다는 취지로 선고된 사례가 있는 반면, B열방센터 행사 출입자명단 미제출 사건의 경우 '출입자 명단' 등을 요구받았음에도 정당한 이유 없이 거부한 사실에 대하여 '출입자 명단의 제공은 역학조사에 수반되는 역학조사 간의 연결 과정을 형성하는 핵심적 사실행위로, 이를 거부하는 것도 역학조사 거부, 방해행위에 해당'하므로 적법하게 명단을 요구할 수 있어 처벌이 가능하다는 사례도 있다. 교인명단 제출요구가 역학조사에 해당하는지 여부와 관계없이 교인명단 제출 거부 또는 누락 행위가 곧 역학조사 거부·방해행위에 해당하는 경우도 있는데, 역학조사와 직접 관련성, 역학조사를 위한 것임이 외부적으로 표시되어 인식되었는지 여부, 명단의 역학조사 외의 목적으로 전용될 가능성 등을 종합적으로 고려하여 역학조사에 수반되는 사실행위를 방해함으로써 결과적으로 역학조사가 거부 내지 방해되는 결과가 발생한 경우에는 역학조사 방해가 된다는 하급심 판결의 논리가 설득력이 있다. 역학조사 결과 확인된 각 감염병환자등이나 접촉자 등에 대해 설문조사나 인체검체 채취 및 시험과 같은 역학조사가 실시되지만, 개별적인 사람에 대해 실시되는 역학조사가 서로 독립하여 존재할 수 없으며 역학조사의 연결 과정을 확인하고 추적하는 과정이 역학조사에 필수적으로 수반되며 이러한 연결고리를 확인하는 과정을 누군가 고의로 방해하거나 거부하게 되면, 역학조사가 직접적이고 현실적으로, 광범위하게 방해되는 결과가 발생하기 때문이다. 이 글에서는 주로 ① 감염병예방법상 역학조사와 정보 제공 요청은 차이점이 있으나 정보 제공 요청의 경우에도 역학조사에 해당되는 영역이 있다는 점, ② 코로나19의 의학적 특성과 역학조사의 연속성을 감안하면 역학조사관의 명단요구 행위가 역학조사에 해당할 여지가 있다는 점, ③ 특정한 경우에는 역학조사 방해죄가 위계공무집행방해에 해당할 수 있다는 점, ④ 2020. 9. 29.부터 감염병예법상 정보제공요청을 거부하는 경우에 징역형 또는 벌금형의 처벌규정이 신설되어 운용되고 있다는 점 등을 지적하여, 향후 감염병예방법의 적용 및 역학조사 실무 운용에 있어 도움이 되고자 한다.

간호기록지를 통해서 본 간호과정 적용효과에 관한 연구(간호전문대학을 중심으로) (A Study on Effects of Application of Nursing Process by Nursing Profess notes.(School of nursing))

  • 최상순;조희숙;백승남
    • 대한간호학회지
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    • 제11권2호
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    • pp.55-68
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    • 1981
  • The prime object of the study is to evaluate how much all the students of the Nursing Schools throughout the nation are in comprehension toward the application of nursing process to clinical experience as means of systematic solution of nursing problems. An effort has been made to find out the actual state whether they are in practice of clinical experience in accordance with application of nursing process, over the period of four weeks managing from December 1st to 28th, 1980 and centering on 36 nursing schools, and meanwhile and evaluation, employing the assessment tool used by Bertuccietal, has been made on the nursing process notes recorded by 200 senions out of 21 nursing schools where application of nursing process to clinical experience being in practice. The assessment tool is composed of 5 different criteria in view of patient nursing and authors made an attempt to find out the result of clinical experience on application students in accordance with 5 different scoring criteria and further evaluating all the findings thereof. The findings were disposed of accordance with practice duration and criteria of the specific sudents subject to this finding as to verify the scoring difference in significance and of which the results are as follows: 1) as of now, in 21 (58.2%) out of 36 nursing Schools nursing process in being appliced in clinical experience. 2) Schools that started the application of nursing process to clinical experience amount to - for more than 4 yrs -6 (28.6%) - for 2 to 3 yrs-11s(52.4%) - for 1 yr -4 (19.0%) 3) As for the response upon application of nursing process. To clinical etperience, the largest voice (61.9%) heard was that it is rather difficult beyond the lecturing thereof, to practically apply it outs patients and the second voice (19.1%) turned out to be that it is hard to put in practice owing to uninformed nurses of the process serving in the clinical field. 4) The response. Of the processors assigned to instruction as to the most difficult problem in criteria of nursing process, the largest voice (38.2%) centered on the problem assessment while the second voice (17.7%) on the indirect nursing activity and the objective data respectively and considered to be the easiest was the indirect nursing activity (11.7%). 5) In order for a satisfactory. application of nursing process to clinical experience hence-forth, it has been pointed out that sufficient number of nurses should be supplemented in clinical field (44.1%) and at the same time supplementory education (35.3%) centered around professors be necessary. 6) Of the criteria that record result of nursing process, a significant difference in comprehension of subjective and objective data has been revealed according to the degree of the practice duration of application to clinical experience. For instance, while although poor it may seen, only 74.9% in subjective data and 71.1% in objective data represent the student group in practice for more than 4 years and only 56.3% in subjective data and 66.8% in objective data represent the student group in practice for 2 to 3 years but they still surpass in comprehension over the student group in practice for 1 year attaning only 19.6% in subjective data and 16.8% in objective data (P < 0.005). 7) As for problem assessment, the student group who started application of nursing process for 4 years stand for 37,7% the group for 2 to 3 years started for 25.3% and the group for 1 year started for 5.4%, revealing no significant difference according to duration (P < 0.5) and as poor as to indicate only 22.8% on an overage is in comprehension. 8) On direct and indirect nursing activity, the student group of for more than 4 years in appling nursing process (representing 49.5% in direct nursing activity, 21.4% in indirect nursing activity). Know more about it than the student group of for 2 to 3 years (representing 36.3% in direct nursing activity, 20.8% in indirect nursing activity) but revealed no significant difference. (P < 0.5) 9) The student group applying nursing process for more than 4 years subjective data (74.9%) comprehend were more than objective data (71.1%) but shown no significant difference (P < 0.5). 10) However, the student group applying nursing process for 2 to 3 years comprehend objective data (66.8%) well ever subjective data (55.5%) indicating that 40.9% in average is in comprehension, thereby revealing a significant difference (P < 0.005). 11) On the other hand, the student group applying nursing process to clinical experience for 1 year had revealed themselves as poorly as to comprehend only 11.7% are an average of it, revealing no significant difference (P < 0.5). In consequence of the fore going, I the conductor of the present study, hereby suggest the following points: 1) Application of nursing process to clinical experience be practiced in all the Nursing Schools all over the nation at the earliest possible date in order that scientific nursing be prevailed (as of now only 58.0%), 2) In teaching nursing process, it is desirable to teach specific method of applying to practical clinical situations. 3) In order to meet the end of satisfactory application of nursing process to clinical experience, sufgecient nursing man power be sysplemented in clinical field and at the save time supplementary education by professors is necessary. 4) Sinces the students whose application duration of nursing process to clinical experience is longer comprehend more about it, it is reguired that the schools not yet in practice of the application be promptlyurged to follow. 5) Of the criteria recording nursing process, since it is comparatively hard to comprehend“assessment”and“Direct and indirect nursing activity”, a concentrated instruction is desirable. 6) The students whose duration of application of nursing process to clinical experience falls short of 1 years be put in a concentrated guidance program on individual criterion.

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