• Title/Summary/Keyword: patient room

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Clinical Experience with Continuous Renal Replacement Therapy as a Method of Extracorporeal Elimination and as performed by Emergency Room Physicians for Patients with Poisoning (체외제거가 필요한 중독환자에서 응급의학과 의사에 의해 시행된 지속적신대체요법에 대한 임상적 고찰)

  • Ahn, Jung-Hwan;Choi, Sang-Cheon;Jung, Yoon-Seok;Min, Young-Gi
    • Journal of The Korean Society of Clinical Toxicology
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    • v.7 no.2
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    • pp.150-155
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    • 2009
  • Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

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Non-Operative Management with Angioembolization of Grade IV and V Renal Injuries in a Hybrid Emergency Room System

  • Ahn, So Ra;Seo, Sang Hyun;Lee, Joo Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.191-197
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    • 2021
  • Renal injuries occur in more than 10% of patients who sustain blunt abdominal injuries. Non-operative management (NOM) is the established treatment strategy for lowgrade (I-III) renal injuries. However, despite some evidence that NOM can be successfully applied to high-grade (IV, V) renal injuries, it remains unclear whether NOM is appropriate in such cases. The authors report two cases of high-grade renal injuries that underwent NOM after embolization in a hybrid emergency room (ER) system with a 24/7 in-house interventional radiology (IR) team. A 29-year-old male visited Wonkwang University Hospital Regional Trauma Center complaining of right abdominal pain after being hit by a rope. Computed tomography (CT) was performed 16 minutes after arrival, and the CT scan indicated a grade V right renal injury. Arterial embolization was initiated within 31 minutes of presentation. A 56-year-old male was transferred to Wonkwang University Hospital Regional Trauma Center with a complaint of right flank pain. He had initially presented to a nearby hospital after falling from a 3-m height. Thanks to the key CT images sent from the previous hospital prior to the patient's arrival, angiography was performed within 8 minutes of the patient's arrival and arterial embolization was completed within 25 minutes. Both patients were treated successfully through NOM with angioembolization and preserved kidneys. Hematoma in the first patient and urinoma in the second patient resolved with percutaneous catheter drainage. The authors believe that the hybrid ER system with an in-house IR team could contribute to NOM and kidney preservation even in high-grade renal injuries.

A Study on the Architectural Planning of a Maternity Ward Focused on Rooming-in System (모자동실 개념을 중심으로 한 산과 병동의 건축계획에 관한 연구)

  • Kim, Eon-Hwa;Yu, Young-Min
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.8 no.2
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    • pp.25-33
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    • 2002
  • The effects and necessity of the breast milk are well known, but the breast-feeding rate in our country is very low. One of the reason is due to the separation policy of mother and baby after delivery. The mother is in the inpatient-room and the baby is in the new-born baby room. This isolation operation of hospital get increased according to the decreasing ratio of breast feeding in Korea. Only a few hospital operates and provides the space for a new-born baby in the mother's room. The system of baby and mother in one room is adopted and operated due to the breast feeding campaign. It is very encouraging, but the space for the baby and the mother is not enough in multi-bed rooms. We should reconsider the relationship between the new-born baby unit and the obstetric ward, and design the patient's room for the baby and the mother.

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Analysis of the Bacteria in Nuclear Medicine (핵의학 검사실내 세균 분석)

  • Shin, Seong-Gyu;Lee, Hyo-Yeong
    • Journal of the Korea Safety Management & Science
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    • v.19 no.2
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    • pp.95-100
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    • 2017
  • In this study, the bacterial contamination level of equipments and devices in the nuclear medicine department of a university hospital was investigated. CNS was detected from the sample collected from the door opening button of the nuclear medicine department. Bacillus sp. was detected from the table and CNS with Bacillus sp. were detected from the control button at the PET-CT room no.1. Also, CNS was detected from the table and the control button at the PET-CT room no.2. In the distribution room no.1, CNS and Bacillus sp. were detected while CNS being detected from the distribution room no.2 and CNS with Bacillus sp. being detected from the distribution room no.3. In the injection room, Enterrococcus faecium and Pontoea sp. were detected. On the table of the ecsomatics room, Pontoea sp. was detected. Bacillus sp. was detected from the inside of the syringe Pb shield and CNS was detected from the outside. Enterrococcus faecium was detected from the Gamma camera table and Bacillus sp. was detected from the door grip. On the chair at the patient waiting room, Pseudomonas aeruginosa abd Bacillus sp. were detected. Therefore, it was understood that infection should be prevented by securely sterilizing examination devices after each examination, maintaining cleanliness by regular sterilization of waiting chairs and such objects with a number of direct contacts with patients, and infection education for the features of nuclear department.

Emergency Treatment of Penetrating Cardiac Injury (관통성 심장 자상 환자의 응급수술)

  • 신윤곤
    • Journal of Chest Surgery
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    • v.27 no.6
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    • pp.483-485
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    • 1994
  • Recently, we experienced one case of penetrating cardiac injury patient by the knife.This patient was treated by emergency operation through left anterolateral thoracotomy under local anesthesia at emergency room. But, the patient was brought about the brain death inspite of normalized function of heart and lung. Now we have a conclusion that was able to recover of heart and lung functions by doctor`s exactly judgement and practice, at least.

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Bilateral anterior dislocation in the hips: a case report

  • Dheeraj Makkar;Ravi Sauhta
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.70-73
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    • 2023
  • The hip is a stable ball-and-socket joint. Bilateral anterior dislocations of the native hip joints account for fewer than 1% of all dislocations. We present a unique case of a bilateral anterior dislocation in a patient who presented to our institution within 6 hours of trauma. The dislocations were promptly reduced under propofol anesthesia in the operating room. The patient did not suffer a concurrent fracture. After the procedure, we performed regular X-ray examinations for 2 years to rule out the development of avascular necrosis of the head of the femur. The course of the patient was unremarkable.

A Study of Nursing Manpower Requirements based on the Nursing Times spent in Operating Room of an University Hospital (수술실 간호인력의 수요측정 및 간호제공량분석 - 수술대기시간과 수술시간을 중심으로 -)

  • YooN Ke Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.45-61
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    • 1987
  • This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

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A Study of Gender Differences in Inpatients' Privacy Concerns in Multi-bed Hospital Room (다인병실 입원환자의 성별에 따른 프라이버시 특성 연구)

  • Shin, Eun-Gyeong;Park, Soo-Been
    • Korean Institute of Interior Design Journal
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    • v.27 no.1
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    • pp.80-87
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    • 2018
  • This study aims to find gender differences in inpatients' privacy and stress concerns in multi-bed hospital room. In the literature review, we consider the characteristics of multi-bed hospital room and patients' privacy as a psychological environment factor. In the survey research, the questionnaires were used to understand the inpatients' general characteristics and privacy requirements. A total of 109 copies were analyzed through a cross-tabulations and T-test using the SPSS 18.0. Results and conclusions are as follows: (1) In the case of multi-bed room patients, there were some gender differences in privacy and stress, but the differences were limited. (2) There is a difference in the patient 's preference of the hospital room according to gender, and this is related to the privacy characteristic. (3) The social communication and strolling are commonly effective stress relief methods for both men and women, so space is needed to do this methods. The meaning of this study is to specify the privacy and stress of the inpatients in multi-bed patients' room.

A Study on the Effect of Supportive Nursing Care to Anxiety Reduction of the Patient Immediately Before Surgery in the Operating Room (수술실에서의 지지간호가 수술직전 환자의 불안감소에 미치는 영향)

  • Cho, Mi-Ja;Hong, Mi-Soon
    • Korean Journal of Adult Nursing
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    • v.13 no.4
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    • pp.632-640
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    • 2001
  • Purpose: This study was to examine the effects of supportive nursing care on surgical patients in the operating room. Method: This study was nonequivalent control group none-synchronized design. The data were collected during the period of July 26 through October 8, 1999 at K hospital in Kwangju. The subjects for the study were selected from those patients who were admitted to K hospital for abdominal surgery. Forty-eight adult subjects were selected and evenly divided into two groups: 24 for the experimental group and the other 24 for the control group, respectively. The tool used for measuring state and trait anxiety was the one originally worked out by Spilberger(1976), and translated by Kim Jung- Taek and Shin Dong-Kyun(1978) for suitable application for Koreans. Data were analyzed by $\chi^2$- test, t-test, Chronbach's ${\alpha}$ coefficient using SAS/PC+. Result: Results were as follows : 1. The degree of State anxiety was found to be lower in the experimental group who received supportive nursing care in the operating room immediately before an operation than the control group who did not."(p<.001). 2. There was no significant difference on the post-test blood pressure and pulse rate immediately before operation between the two groups(p>.05). Conclusion: Results of the above study reveals that the supportive nursing care in the operating room is effective in alleviating the anxiety of patients. I suggest that it is highly desirable to apply supportive nursing care for those patients who are waiting for immediate surgery.

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Changes in the characteristics of patients transferred to the emergency room through private institutions during inter-hospital transport after the COVID-19 outbreak : A retrospective study (COVID-19 발현 이후 병원간 이송 시 민간 이송업체를 통해 응급실로 전원된 환자들의 특성 변화 : 후향적 연구)

  • Kim, Seong-Ju;Ji, Jae-Gu;Jang, Yun-Deok;Lee, Si-Weon;Yu, Jae-Kwang;Kang, Ji-Hun
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.125-134
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    • 2021
  • Purpose: The purposes of this study were to determine the changes in the pattern of patients who were transferred to the emergency room through inter-hospital private institutions and to determine how long transport takes following the COVID-19 outbreak. Methods: This retrospective observational study analyzed the emergency medical services reports of private institutions following the COVID-19 outbreak in South Korea. The study was conducted in Busan between January 19, 2019 and January 18, 2020, and between January 19, 2020 and January 18, 2021. Results: Upon comparing the patient transport times during the "Pre-COVID-19 period" and "COVID-19 period," a significant delay was noticed in the preparation for transfer of patients during the "COVID-19 period" (p<.05). There were significantly more patients with respiratory infections and patients who complained of general symptoms during the "COVID-19 period." Moreover, there was a higher frequency of patients who were transferred to a 'Level I' emergency room during the "COVID-19 period" compared to during the "Pre-COVID-19 period" (p<.05). Conclusion: Following the COVID-19 outbreak, there is a delay in patient transport to the emergency room through private institution inter-hospital transport and an increase in the number of patients complaining of respiratory infection symptoms. Thus, emergency medical services need additional administrative and economic support to transport infected patients.