• Journal of Trauma and Injury
• /
• v.36 no.1
• /
• pp.22-31
• /
• 2023

Purpose: Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI. Methods: The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study. Results: On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center. Conclusions: The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.

• Health Policy and Management
• /
• v.2 no.2
• /
• pp.152-178
• /
• 1992

This study focuses on making recommendations for the improvement of poor emergency medical services or EMS in Korea. Problems of the current EMS system is widely reviewed. As an alternative of the current system, a franchises system is introduced to EMS. A feasibility study of the new system is carried out as follows. 1) The current EMS system shows such problem as; - Inadequacy of emergency medical fee schedule, - Shortage of emergency medical resources, - Concentration of emergency medical facilities in metropolitan area, - Unestablishment of training program for emergency personnel, - Inappropriateness of patients' behvaviro pattern in emergency care system. 2) Recommendations for the improvement of EMS are as follows: - Well organized communication and transportation system needs to be established by utilizing all the availabl EMS is to be devised for the provision of appropriate emergency care. - A franchises system can be widly adopted so that private organizations are willing to establish a free standing emergency center. - Emergency care fee schedule of the franchises system needs to be appropriate for the system to provide high standard medical services.

• Spatial Information Research
• /
• v.12 no.2
• /
• pp.193-209
• /
• 2004

The purpose of this study is to analyze the service area of emergency medical centers using GIS-based spatial analysis methods in Seoul, focusing on the behaviour of patients on the choosing of emergency centers. For this analysis, six emergency centers were selected to collect data for the information on the addresses of patients from September to November hi 2003. Analysis on the service area, which was carried out by measuring the distribution of patients in terms of distance from emergency medical centers, clearly reveals that the majority of patients was located within or adjacent districts at the emergency medical center. However, the size of the primary service area f3r six emergency medical centers was much different, implying that the decision to visit specific emergency medical center by patients was closely related to the size, perception, and preference of the emergency medical center. Based on the results of the spatial characteristics of emergency medical service area, this research tries to construct the surface map of the emergency medical service level supplied by 32 regional emergency medical centers located in Seoul. Considering the levels of infrastructure for emergency medical centers, the coverage for the degree of supply of emergency medical service by each emergency medical center was constructed in terms of a distance decaying in the distribution of patients from emergency medical center imposing different weights on distance bands. Spatial overlay utilizing map algebra function was performed in order to calculate total supply level of emergency service. The results clearly show that spatial inequality exists in the supply levels of the emergency medical service among local areas of Seoul.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.14 no.2
• /
• pp.129-135
• /
• 2016

Purpose: This study was conducted to compare demographic and characteristic differences in self-poisoned patients by age groups using a comprehensive trauma database. Methods: This study included 1,823 patients who were admitted to the emergency room following self-poisoning. Three age groups were defined: young patients (less than 19 years), adult patients (19 to 64 years) and elderly patients (65 years and old). From January 2011 to December 2015, data were obtained from in a single emergency medical center. We investigated the materials of poisoning, ingestion time, GCS, systolic blood pressure, heart rate, and outcomes of patients. Results: A total of 1,823 self-poisoned patients visited the hospital during 5 years. Among these, 130 (7.1%) were categorized as young, 1,460 (80.1%) were adults and 233 (12.8%) were elderly. The most common drug of self-poisoning substances was antipyretics (50.0%) for those in the young group, sedative drugs (45.0%) for adults, and pesticides (41.2%) for the elderly. Mortality was 2.7% in the adult group and 14.6% in the elderly group. After adjusting for all factors related to mortality, the odds ratio (OR) of mortality was 2.63 in the elderly group (95% confidence interval [CI]: 1.44-4.81). Conclusion: There were definite differences in the characteristics of three groups. The younger patients used drugs that could be easily obtained while older patients used more lethal drugs.

• Journal of Trauma and Injury
• /
• v.26 no.3
• /
• pp.175-182
• /
• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• Journal of Convergence for Information Technology
• /
• v.11 no.6
• /
• pp.154-161
• /
• 2021

This study analyzed the characteristics of the presence of multiple chronic diseases (MCDs) in older adults who transferred from long-term care hospitals (LTCHs) to emergency departments (EDs). According to the data from the national emergency department information system from January 1, to December 31, 2019, the number of older adults transferred from LTCHs to the ED due to chronic diseases was 13,608. Among those who MCDs, 79.9% were over 75 years old, and 74.0% were hospitalized for MCDs. The length of stay in the ED differed according to the presence of MCDs (P<0.001). As for the prevalence of MCDs, the odds ratio (OR) of the ED and in the hospitalized patients was high in Gwangju (OR 8.899 vs. 8.142) and Jeonbuk (OR 13.865 vs. 10.676). As described above, the characteristics of patients regarding the presence of MCDs varied according to age and region.

• Journal of Trauma and Injury
• /
• v.18 no.2
• /
• pp.119-126
• /
• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

• Child Health Nursing Research
• /
• v.18 no.4
• /
• pp.214-221
• /
• 2012

Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

• Child Health Nursing Research
• /
• v.8 no.2
• /
• pp.174-182
• /
• 2002

The purpose of this study was to investigate the experiences of accident and visiting emergency center, and the experiences of education about emergency care for parents. The subjects of this study were 117 mothers whose children are attending 9 different nursery schools or kindergartens. The instrument used in this study was developed by researchers and validated by nursing professor, first aid doctor and the president of nursery school, and consisted of 'most important thing in child rearing' ,'experiences of accident and visiting emergency center', 'type of trauma' and 'need for parent education program' the result of this study were as followed ; 1.There were 70.09％ of the experience of visiting emergency center among the subjects. The cause of visiting emergency center were high fever and convulsion(42.86％), and trauma by accident(28.04％) 2. The most common type of the indoor accident were fall down and slipping(76.92％), the common type of trauma were contusion (76.92％), abrasion(47.01％), laceration(29.06％), dislocation or fracture(12.82％), burn(10.26％), piercing(8.55％). 3.47.01％ of subjects had the experience of education about emergency care for parents. They were educated by child rearing journals (32.72％), small books which were published by hospitals or community health center (25.45％), mass media(21.8％), parent seminar (12.72％), nursery school or kindergarten (5.45％). In conclusion, the need of emergency care for children was strongly found. Therefore, on the basis of above results, the parent education program which fits their cognitive level and their health care needs So, it must be directed on the further study of parents' knowledge about emergency care for children. To enhance the effectiveness of program and accomplish the children's health promotion, advanced instructional media and demonstration must be included.

• Journal of Korean Academy of Nursing Administration
• /
• v.12 no.3
• /
• pp.444-453
• /
• 2006

Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, IV route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, $O_{2}$ inhalation, suction, fluid infusion, IV bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, $O_{2}$ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.