• 제목/요약/키워드: Respiratory Assessment

검색결과 390건 처리시간 0.027초

심폐소생술 방법 변화에 따른 quality 비교 - 30:2와 2:30 비교분석실험 - (Comparison of quality of 30:2 vs. 2:30 CPR in manikins)

  • 엄태환;유순규;최혜경;정지연
    • 한국응급구조학회지
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    • 제14권3호
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    • pp.71-81
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    • 2010
  • Purpose: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended the ratio of chest compression to ventilation ratio to 30:2 from 2005 CPR guideline to 2010 CPR guideline. However, current studies have shown that the hands-off time was > 10 seconds with that method. For this reason, we devised new CPR method that a ventilation to chest compression ratio of 2:30 to reduce pt assessment time and skipped the assessment step of carotid artery pulse would be a more effective way to reduce the hands-off time & the time to set the CPR. According to the more detailed purpose are listed below. 1) We would like to confirm efficiency of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 to reduce the hands-off time & the time to set the CPR. 2) We would like to evaluate possibility of increasing for chest compression accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 3) We would like to evaluate possibility of increasing for ventilation accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 Methods: According to 2005 American Heart Association Guidelines, 60 paramedic students(20 students X freshmen, sophomore, junior) performed 5 cycles of 3~ chest compressions : 2 ventilations after A, B, C evaluation with Laerdal Resusci R Anne SkillReporters. After 5 minutes rest, the 60 students performed 5 cycles of 2 ventilations : 30 chest compressions after A, B evaluation with the manikins between 13 and 17 September 2010. The short reports including speed & accuracy of chest compression, respiratory, CPR cycle were gained from the manikins. Hands-off times were measured by assistants. Results: Recently, the importance of high quality CPR was emphasized in order to perform the CPR faster and more accurate. To find out improving the conventional CPR method, we switch the procedure of the compression and the ventilation. By switching the procedure back and forth, we are able to compare the effectiveness of CPR between two type of CPR method which are 2:30 and 30:2 methods. 2:30 is that the breaths is delivered twice, first and perform 30 compressions while 30:2 perform 30 compressions first and give 2 breaths followed by the ABC method. Also, we verify the effectiveness of the hands off time, compression accuracy of the compression through the comparison of the two procedure as mentioned earlier. Consequently research verified that 2:30 is the efficient by providing faster set up delivering more accurate chest compression. Conclusion: 2:30 can minimize a time delay from cardiac standstill until starting the chest compression. In addition, hands-off time which is an interruption in chest compression can be shortened by 2:30 method, which result to effective oxygenation of coronary artery & maintenance of the bloodstream. Once again, performing the 2:30 method provide lessen hands off time and increase the accuracy of the chest compression.

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생활권 수목에 살포된 살충제 Fenitrothion의 이용자 노출 및 위해성 평가 (Visitor Exposure and Risk Assessment of Insecticide Fenitrothion Applied to Tree in Public Living Space)

  • 권건형;문준관;정윤미;이민섭;이진흥;이근섭;권영대
    • 한국산림과학회지
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    • 제107권2호
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    • pp.229-236
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    • 2018
  • 도시림, 생활림, 가로수, 도시공원 등 국민들의 일상생활을 하는 구역이나 장소에 위치한 생활권 수목 식재지에서의 농약 살포는 농약 살포자의 농약 노출 문제뿐만 아니라 농약의 살포 후 생활권 수목과 접촉하는 불특정 시민들도 지속적인 농약 노출이 문제가 될 수 있다. 본 연구에서는 생활권 수목의 관리를 위해 관행적으로 가장 많이 살포되는 살충제인 Fenitrothion을 회양목에 살포하고 일정시간별로 손 노출량, 잎 잔류량, 호흡 노출량을 측정한 뒤, 위해성 평가 수식(MOS: margin of safety)을 이용하여 체중별 안전 노출시간을 분석하였다. 그 결과, 살포된 Fenitrothion의 손을 통한 전이량이 급격하게 떨어지고 호흡노출량이 측정되지 않는 48시간 이전까지는 농약노출에 대한 주의가 필요할 것으로 판단되었다.

지역약국에서 보고된 전문의약품과 일반의약품의 이상사례 보고현황 비교 분석 (Comparative Analysis of Ethical-the-counter Drugs and Over-the-counter Drugs for the Adverse Events from the Community Pharmacy)

  • 이모세;박소희;김나영;오인선;이정민;이의경;신주영
    • 한국임상약학회지
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    • 제28권3호
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    • pp.230-237
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    • 2018
  • Objective: To compare adverse event reporting patterns between ethical-the-counter and over-the-counter drugs from community pharmacies and outpatient settings. Methods: We conducted a descriptive study using the adverse event reporting database, wherein data were collected from the regional pharmacovigilance centers of the Korean Pharmaceutical Association between January 1, 2016 and December 31, 2016. The reported drugs were classified into either ethical-the-counter or over-the-counter drugs, and we compared the distribution of patient age and gender, frequent adverse events and medications, serious adverse events, and causality assessment results, where causality assessments were performed according to the World Health Organization-The Uppsala Monitoring Centre's system. Results: We included 17,570 reports (75,451 drug-adverse event pairs). Ethical-the-counter and over-the-counter drugs accounted for 81.4% and 18.6% of the total adverse event reports, respectively. The use of over-the-counter drugs was higher in females and patients aged <18 years, whereas the use of ethical-the-counter drugs was higher in those aged >65 years. Alimentary tract and metabolism drugs, and respiratory system drugs were the most frequent ethical-the-counter and over-the-counter drugs, respectively. From causality assessment results, "possible" (75.4%) was the most commonly assigned category for ethical-the-counter drugs, while "possible" (44.0%) and "unlikely" (47.7%) were the most common categories for over-the-counter drugs. The distribution of serious adverse events were similar for both ethical-the-counter and over-the-counter drugs. Conclusion: Differences were observed in age, gender, reported medications, and symptoms for both ethical-the-counter and over-the-counter drugs. Further pharmacovigilance activities considering the adverse event characteristics of over-the-counter drugs, which are comparable to ethical-the-counter drugs, should be performed.

Prospective phase II trial of regional hyperthermia and whole liver irradiation for numerous chemorefractory liver metastases from colorectal cancer

  • Yu, Jeong Il;Park, Hee Chul;Choi, Doo Ho;Noh, Jae Myoung;Oh, Dongryul;Park, Jun Su;Chang, Ji Hyun;Kim, Seung Tae;Lee, Jeeyun;Park, Se Hoon;Park, Joon Oh;Park, Young Suk;Lim, Ho Yeong;Kang, Won Ki
    • Radiation Oncology Journal
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    • 제34권1호
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    • pp.34-44
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    • 2016
  • Purpose: A prospective phase II trial was conducted to evaluate the effectiveness and toxicity of regional hyperthermia and whole liver irradiation (WLI) for numerous chemorefractory liver metastases from colorectal cancer. Materials and Methods: Enrolled patients had numerous chemorefractory hepatic metastases from colorectal cancer. Five sessions of hyperthermia and seven fractions of 3-gray WLI were planned. Health-related quality of life (HRQoL) was determined using the Korean version of the European Organization for Research and Treatment of Cancer quality of life questionnaire C-30 and the Functional Assessment of Cancer Therapy-Hepatobiliary version 4.0. Objective and pain response was evaluated. Results: A total of 12 patients consented to the study and the 10 who received WLI and hyperthermia were analyzed. WLI was completed as planned in nine patients and hyperthermia in eight. Pain response was partial in four patients and stable in four. Partial objective response was achieved in three patients (30.0%) and stable disease was seen in four patients at the 1-month follow-up. One patient died 1 month after treatment because of respiratory failure related to pleural metastasis progression. Other grade III or higher toxicities were detected in three patients; however, all severe toxicities were related to disease progression rather than treatment. No significant difference in HRQoL was noted at the time of assessment for patients who were available for questionnaires. Conclusion: Combined WLI and hyperthermia were well tolerated without severe treatment-related toxicity with a promising response from numerous chemorefractory hepatic metastases from colorectal cancer.

마황복용 후 사상체질별 이상반응에 관한 임상연구 : 무작위배정 이중맹검시험 (Adverse Effects of Ephedra According to Sasang Typology in Healthy Adults : A Double-Blind Randomized Controlled Trial)

  • 이태호;형례창;양창섭;김락형;서의석;장인수
    • 대한한방내과학회지
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    • 제30권1호
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    • pp.144-152
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    • 2009
  • Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.

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5-11세 소아에서 코로나19 백신의 효능 및 안전성에 대한 체계적 문헌고찰 (Efficacy and Safety of COVID-19 Vaccines in Children Aged 5 to 11 Years: A Systematic Review)

  • 최미영;유수연;정채림;최영준;최수한
    • Pediatric Infection and Vaccine
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    • 제29권1호
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    • pp.28-36
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    • 2022
  • 목적: 5-11세 소아에서 코로나19 백신의 효능과 안전성을 평가하기 위해서 체계적 문헌고찰을 시행하였다. 방법: 2022년 1월 4일까지 Ovid-MEDLINE 및 medRxiv를 검색하여 문헌을 선정하고 자료를 추출하였다. 근거 수준을 평가하기 위해 GRADE 도구를 사용하였다. 결과: 총 1,675 건의 연구가 일차적으로 검색되었고 최종적으로 5편의 연구가 포함되었다. 서로 다른 4개의 코로나19 백신(BNT162b2, mRNA-1273, CoronaVac, BBIBP-CorV)에 대한 무작위 대조군 연구 결과들은 5-11세 연령에서 각 백신의 양호한 면역원성과 안전성을 보여주었다. 미국에서 5-11세 소아 연령에서 BNT162b2 백신 접종 후 이상사례 모니터링 연구에서는 승인 전 임상시험을 통해 예상되었던 국소반응 및 전신반응이 보고되었으나 중대한 이상사례는 거의 보고되지 않았다. 결론: 5-11세 연령에서 코로나19 백신 접종에 대한 데이터는 제한적이다. 이 연령에서 코로나19 백신의 안전성과 효과에 대한 체계적인 평가를 위해 지속적이고 포괄적인 모니터링이 필요할 것으로 보인다.

인공호흡기 중앙감시시스템 소프트웨어의 사용적합성 총괄평가 (Summative Usability Assessment of Software for Ventilator Central Monitoring System)

  • 정지용;김유림;장원석
    • 대한의용생체공학회:의공학회지
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    • 제44권6호
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    • pp.363-376
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    • 2023
  • According to the COVID-19, development of various medical software based on IoT(Internet of Things) was accelerated. Especially, interest in a central software system that can remotely monitor and control ventilators is increasing to solve problems related to the continuous increase in severe COVID-19 patients. Since medical device software is closely related to human life, this study aims to develop central monitoring system that can remotely monitor and control multiple ventilators in compliance with medical device software development standards and to verify performance of system. In addition, to ensure the safety and reliability of this central monitoring system, this study also specifies risk management requirements that can identify hazardous situations and evaluate potential hazards and confirms the implementation of cybersecurity to protect against potential cyber threats, which can have serious consequences for patient safety. As a result, we obtained medical device software manufacturing certificates from MFDS(Ministry of Food and Drug Safety) through technical documents about performance verification, risk management and cybersecurity application.The purpose of this study is to conduct a usability assessment to ensure that ergonomic design has been applied so that the ventilator central monitoring system can improve user satisfaction, efficiency, and safety. The rapid spread of COVID-19, which began in 2019, caused significant damage global medical system. In this situation, the need for a system to monitor multiple patients with ventilators was highlighted as a solution for various problems. Since medical device software is closely related to human life, ensuring their safety and satisfaction is important before their actual deployment in the field. In this study, a total of 21 participants consisting of respiratory staffs conducted usability test according to the use scenarios in the simulated use environment. Nine use scenarios were conducted to derive an average task success rate and opinions on user interface were collected through five-point Likert scale satisfaction evaluation and questionnaire. Participants conducted a total of nine use scenario tasks with an average success rate of 93% and five-point Likert scale satisfaction survey showed a high satisfaction result of 4.7 points on average. Users evaluated that the device would be useful for effectively managing multiple patients with ventilators. However, improvements are required for interfaces associated with task that do not exceed the threshold for task success rate. In addition, even medical devices with sufficient safety and efficiency cannot guarantee absolute safety, so it is suggested to continuously evaluate user feedback even after introducing them to the actual site.

혈액투석 환자들이 경험한 건강문제 분석 (An Analysis of Health Problems Experienced by the Clients Receiving Hemodialysis)

  • 신미자
    • 대한간호학회지
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    • 제26권4호
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    • pp.903-916
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    • 1996
  • The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows : 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric keratosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul oder of uremia.

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저작·연하 용이 소불고기 노인식 개발 (Development of Easily Chewable and Swallowable Korean Barbecue Beef for the Aged)

  • 김수정;주나미
    • 한국식품영양학회지
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    • 제27권6호
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    • pp.1175-1181
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    • 2014
  • This study was conducted to develop for the elderly food that is safe, well-shaped, and easy to chew and swallow, using gelification. Gelatin, which has low adhesiveness, thereby lowering the possibility of being swallowed wrongly into the respiratory track, was used as a viscosity agent for the gelification. Water and gelatin amounts were adjusted to facilitate breaking the food with the tongue. Various foods for the elderly with chewing and swallowing difficulties were used for sensory assessment. Sensory panel consisted of 10 dietitians (10 women) in nursing care facilities. The sensory optimal composite recipes were determined by central composite design (CCD). The sensory measurements were significantly different in appearance (p<0.05), saltiness (p<0.05), sweetness (p<0.01), and overall quality (p<0.05). The optimum formulation of the Korean barbecue beef calculated by numerical and graphical method was 3.71 g of sugar and 19.53 g of soy sauce. Moisture content, hardness and adhesiveness of the Korean barbecue beef were 78.85%, 2.40, -1.87, respectively. The result shows that food for the elderly, which is easy to chew and swallow, using gelification will have sufficient competitiveness in terms of safety, taste, and preference. The development of food for the elderly that take into account the difficulties in chewing and swallowing among the elderly, reflects their preference, and has sufficient nutrients, is important to enable the elderly to enjoy their meals. Also, as the Korean society is getting older, it remains one of the biggest social challenges.

피해산정형 전과정평가 기법을 적용한 콘크리트 압축강도별 환경영향 비교 분석 연구 (A Comparative Study on the Environmental Impacts by Concrete Strength Using End-point LCA methodology)

  • 김성희;태성호;채창우
    • 콘크리트학회논문집
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    • 제26권4호
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    • pp.465-474
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    • 2014
  • 콘크리트 구조물이 전생애주기 동안 발생시키는 오염물질의 종류와 발생강도를 정량적으로 분석하고 이로 인한 인간과 생태계, 지구환경 및 자원 고갈 측면에 미치는 피해를 고려하기 위하여 피해산정형 전과정평가 기법을 적용한 콘크리트 구조물의 환경영향평가를 실시하였다. 평가대상은 25층 공동주택의 벽체 구조물이며, 동일한 기능을 수행하기 위한 콘크리트 구조물의 압축강도를 일반강도에서 고강도까지 24 MPa, 40 MPa, 60 MPa로 각각 변화시켜 평가하였다. 평가기간은 50년으로 제한하였고, 생애주기는 원료 채취부터 투입원료의 생산, 구조물의 시공, 사용 및 폐기 단계를 포함시켰다. 피해산정형 전과정평가는 전과정 영향평가(LCIA) 단계 중 정규화와 가중화 단계에서 실시되는데, 특성화 단계에서 산출된 환경영향범주 결과를 인체건강, 생태계의 질, 기후변화 및 자원고갈 관점에서 단일지수화 시킬 수 있는 모델을 제시한다. 평가 결과, 콘크리트 구조물의 환경영향은 여러 영향범주 중 지구온난화, 호흡계 무기물질, 및 비재생 에너지원의 사용으로 인한 영향이 전체 환경부하의 99% 이상을 차지하는 것으로 나타났으며, 압축강도의 변화에 따라 모든 환경영향범주의 값이 일괄적으로 증가 또는 감소하는 것이 아니기 때문에 전체적인 환경영향을 살펴보기 위해서는 종말점 수준의 피해산정형 평가모델을 적용하여 모든 환경영향범주를 종합적으로 고려할 필요가 있다.