• Title/Summary/Keyword: patient safety accident

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Clinical aspects of injury and acute poisoning in Korean pediatric patients (소아의 응급질환 - 우리나라 소아 및 청소년의 손상과 급성 중독을 중심으로 -)

  • Lee, Mi Jin;Park, Joon Seok
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.116-121
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    • 2008
  • Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.

Endovascular Stenting of a Traumatic Pseudoaneurysm on C5 Portion of the Internal Carotic Artery - A Case Report - (내경동맥에 발생한 외상성 가성동맥류에 대한 혈관내 스텐트 치료)

  • Jung, Hyun Ho;Kim, Hun Joo;Lee, Myeung Sub;Whang, Kum;Cho, Sung Min;Hu, Chul;Pyen, Jhin Soo;Hong, Soon Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.332-336
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    • 2001
  • This 18-year-old male patient had a massive epistaxis after motorcycle traffic accident on 1st day of admission. There were no other significant brain parenchymal lesion on initial brain CT exam, except multiple pneumocephalus and basal skull fracture lines. We treated epistaxis conservatively till vital signs were corrected, and then conventional cerebral angiogram was followed. On angiogram, there was traumatic pseudoaneurysm on C5 portion(by Fischer) of ICA, so we treated it only by endovascular stenting. For the purpose of sparing parent arterial patency, endovascular stenting on pseudoaneurysm may play a role with safety and good results.

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Comparative Effect of Interventions for Fall Prevention in Hospitals: Network Meta-analysis (병원 입원 환자를 위한 낙상예방중재 효과의 비교우위: 네트워크 메타분석)

  • Kang, Hyunwook;Ko, Ji Woon
    • Journal of muscle and joint health
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    • v.30 no.3
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    • pp.218-229
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    • 2023
  • Purpose: This study aimed to assess and compare the effectiveness of various fall prevention interventions in hospitals through a network meta-analysis. Methods: A network meta-analysis was conducted using the "netmeta" package in R software (v4.1), employing a frequency method. Odds ratios of fall rates and injurious fall rates were utilized to confirm the effects of interventions for fall prevention. Comparative rankings of these interventions were determined using cumulative probability (P-score). Results: Comparative rankings via cumulative probability (P-scores) revealed individualized education as the most effective intervention for fall incidence (P-Score 87.8%). Followed by fall-preventing sensors (60.9%), multicomponent interventions (47.4%), usual care (33.2%), and environmental modification (20.7%). For fall-related injuries, individualized education ranked highest (P-Score 97.1%), followed by multicomponent interventions (76.0%), usual care (47.6%), environmental modification (24.2%), and fall-preventing sensors (5.1%). Conclusion: This study provides valuable insights into the relative effectiveness of diverse interventions in preventing fall incidence through network meta-analysis. The findings aim to support nurses in making informed decisions when implementing fall prevention strategies in clinical practice.

Development of a 2-DOF Ankle Mechanism for Gait Rehabilitation Robots (보행 재활 로봇을 위한 2자유도 족관절 기구 개발)

  • Heo, Geun Sub;Kang, Oh Hyun;Lee, Sang Ryong;Lee, Choon-Young
    • Journal of Institute of Control, Robotics and Systems
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    • v.21 no.6
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    • pp.503-509
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    • 2015
  • In this paper, we designed and tested an ankle joint mechanism for a gait rehabilitation robot. Gait rehabilitation programs are designed to improve the natural leg motion of patients who have lost their walking capabilities by accident or disease. Strengthening the muscles of the lower-limbs and stimulation of the nervous system corresponding to walking helps patients to walk again using gait assistive devices. It is an obvious requirement that the rehabilitation system's motion should be similar to and as natural as the normal gait. However, the system being used for gait rehabilitation does not pay much attention to ankle joints, which play an important role in correct walking as the motion of the ankle should reflect the movement of the center of gravity (COG) of the body. Consequently, we have designed an ankle mechanism that ensures the safety of the patient as well as efficient gait training. Also, even patients with low leg muscle strength are able to operate the ankle joint due to the direct-drive mechanism without a reducer. This safety feature prevents any possible adverse load on the human ankle. The additional degree of freedom for the roll motion achieves a gait pattern which is similar to the normal gait and with a greater degree of comfort.

A Study on Safety and Performance Evaluation of Smart All-in-one Cardiopulmonary Assist Device (스마트올인원 심폐순환보조장치의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Yerim;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.197-205
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    • 2019
  • The existing Extracorporeal membrane oxygenation(ECMO) and Cardiopulmonary bypass system(CPB) have been developed and applied to various devices according to their respective indications. However, due to the complicated configuration and difficult usage method, it causes inconvenience to users and there is a risk of an accident. Therefore, smart all-in-one cardiopulmonary circulation device is being developed recently. The smart all-in-one cardiopulmonary assist device consists of a blood pump for cardiopulmonary bypass, a blood oxidizer for cardiopulmonary bypass, a blood circuit for cardiopulmonary bypass, and an artificial cardiopulmonary device. It is an integrated cardiopulmonary bypass device that can be used for a variety of purposes such as emergency, intraoperative, post-operative intensive care, and long-term cardiopulmonary assist, combined with CPB used in open heart surgery and ECMO used when patient's cardiopulmonary function does not work normally. The smart all-in-one cardiopulmonary assist device does not exist as a standard and international standard applicable to advanced medical devices. Therefore, in this study, we will refer to the International Standard for Blood Components, the International Standard for Blood, the Guideline for Blood Products, and prepare applicable performance and safety guidelines to help quality control of medical devices, and contribute to the improvement of the health of people. The guideline, which is the result of conducted a survey of the method of safety and performance test, is based on the principle of all-in-one cardiopulmonary aiding device, related domestic foreign standards, the status of domestic and foreign patents, related literature, blood pump(ISO 18242), blood oxygenator (ISO 7199), and blood circuit (ISO 15676) for cardiopulmonary bypass.The items on blood safety are as follows: American Society for Testing and Materials ASTM F1841-97R17), and in the 2010 Food and Drug Administration's Safety Assessment Guidelines for Medical Assisted Circulatory Devices. In addition, after reviewing the guidelines drawn up through expert consultation bodies including manufacturers / importers, testing inspectors, academia, etc. the final guideline was established through revision and supplementation process. Therefore, we propose guidelines for evaluating the safety and performance of smart all-in-one cardiopulmonary assist devices in line with growing technology.

Differences in Health Status-related Characteristics Before and After Falls in Adult Hospitalized Patients (성인 입원 환자의 낙상전후 건강상태 관련 특성의 차이)

  • Kim, Myo-Youn;Lee, Mi-Joon;So, Hye-Eun;Youn, Byoung-Sun
    • Journal of Industrial Convergence
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    • v.20 no.10
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    • pp.51-59
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    • 2022
  • This study aims to investigate the changes in health status of inpatients before and after a fall accident, and it is a retrospective study using data from 328 inpatients who fell from January 1, 2016 to December 31, 2020, reported to the patient safety reporting system. The average age of the study subjects was 68.57(±14.13), and those in their 70s accounted for the most at 30.49%. Falls occurred on average 13.86(±25.03) days after hospitalization, and the time when the most falls occurred was between 22:30 and 06:59 with 42.99%. Before and after a fall during hospitalization, bowel problems (x2=314.0, p<.001), urination problems (x2=284.0, p<.001), intravenous fluid therapy (x2=85.16, p<.001), and walking (x2=69.77. p<.001), bedridden state (x2=51.60, p< .001), mental state and performance (x2=17.52, p<.001) patient's attitude (x2=220.17, p<.001), there was a statistically significant difference. It is necessary to develop an appropriate method and education program for fall prevention in hospital by considering the individual characteristics of inpatient.

Epidemiologic Changes of Facial Bone Fracture before and after Coronavirus Disease 2019: A Level 1 Trauma Center in Korea

  • Jeong Ho Kim;Chae Eun Yang;Sug Won Kim;Jiye Kim
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.37-41
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    • 2023
  • Background The coronavirus disease 2019 (COVID-19) outbreak has had a major impact worldwide. Several countries have implemented restrictions on social interaction ("social distancing"). Several studies have reported that the epidemiology of trauma patients, such as those with facial bone fractures, has changed after COVID-19 pandemic. This study aimed to further explore these specific changes. Methods This was a retrospective study of patients who presented to a single institution with facial bone fractures between January 1, 2016, and December 31, 2020. Baseline patient demographics, clinical information, type of fracture, etiology, and operative management were compared before and after COVID-19. Results Of all cases, 3,409 occurred before COVID-19, and 602 occurred after COVID-19. Since the outbreak of COVID-19, the number of patients with facial fractures has not decreased significantly. A significant increase was noted in fractures that occurred outdoors (p < 0.001). However, a decrease was observed in operative management between the groups (p < 0.001). There was no significant difference in the proportion of assault, fall-down, industrial accident, or roll-down. In contrast, the proportion of traffic accidents and slip-down categories increased significantly (p < 0.05). Moreover, a significant decrease was found in the proportion of the sports category (p = 0.001) Conclusions It was confirmed through this study that COVID-19 pandemic also affected epidemiology of facial fractures. Focusing on these changes, it is necessary to develop safety measures to reduce facial fractures.

Reduction of Fall Incidence through Operation of the Staff Nurse-Centered Peer Review Group (낙상 peer review group 운영을 통한 낙상발생률 감소)

  • Sung, Il Soon;Song, Mi Ra;Kim, Hee Sun;Kim, Eun Sook;Jung, Mi A;Lee, Su Mi;Sung, Young Hee;Ha, Kook Hee;Kim, Seong Hwa;Lee, Hye Ran;An, Kyoung Jin;Shim, Mi Ok;Kim, Nag Hee;Sung, Young Hee
    • Quality Improvement in Health Care
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    • v.14 no.1
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    • pp.49-54
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    • 2008
  • Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

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Characteristics of Puffer Fish Poisoning Outbreaks in Korea (1991-2002) (대한민국에서 복어독에 의한 식중독 발생 특성)

  • Kim, Ji-Hoe;Gong, Qing-Li;Mok, Jong-Soo;Min, Jin-Gi;Lee, Tae-Seek;Park, Jeong-Heum
    • Journal of Food Hygiene and Safety
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    • v.18 no.3
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    • pp.133-138
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    • 2003
  • The data on outbreaks of puffer fish poisoning during 1991 to 2002 in Korea were gathered from press reports, and characterized information collected. During the period, a total of 32 outbreaks of puffer fish poisoning was reported. These outbreaks caused 111 persons to become poisoning, among the cases 30 persons were fatal. The mean case fatality rate was 27.0%, and most of deaths (93.3%) were the male of above 29 years old. Patient number of below 4 persons per a poisoning accident occupied 75.0% of total outbreaks; 65.8% of total cases; and 66.7% of total deaths) was occurred in the months, November through January. Most of puffer fish poisoning (75.0% of total outbreaks; 68.5% of total cases; and 73.3% of total deaths) were found along the south coastal area of Korea, including Busan, Gyeongsangnam-do, Jeollanam-do and Jeju-do. Over than 80% of puffer fish poisoning outbreaks occurred at fishing boat and home where privately made food was cause, and outbreaks in restaurants accounted for 15.6%. Most commonly implicated foods were Guk, boiled soup with puffer fish meat and spices.

Severity of grinder injuries and related factors compared with other high-rotation cutting tool injuries: a multicenter retrospective study from 2011 to 2018

  • Juni Song;Yang Bin Jeon;Jae Ho Jang;Jin Seong Cho;Jae Yeon Choi;Woo Sung Choi
    • Journal of Trauma and Injury
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    • v.36 no.1
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    • pp.32-38
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    • 2023
  • Purpose: This study aimed to identify the characteristics of patients injured by high-rotation cutting tools and the factors related to the severity of their injuries. Methods: Adult patients (≥18 years), who presented to the emergency department (ED) after a high-rotation cutting tool injury and who were registered in the Korean Emergency Department-based Injury In-Depth Surveillance (2011-2018) database, were included. Patients' demographic characteristics, injury-related factors, and Injury Severity Scores were collected. All included cases were categorized into two groups according to the tool that caused the injury: grinder versus nongrinder. The characteristics of the two groups were compared, and the factors associated with the severity of injuries were investigated. Results: Among 8,697 ED visits, 4,603 patients had been using a grinder and 4,094 had been using a nongrinder tool. The most frequently injured body part while using a grinder was the hand (46.4%), followed by the head (23.0%). While using a nongrinder tool, the most frequently injured body part was also the hand (64.0%), followed by the lower leg (11.4%). The odds of a severe injury were affected by patient age (odds ratio [OR], 1.024; 95% confidence interval [CI], 1.020-1.028) and using a grinder (OR, 2.073; 95% CI, 1.877-2.290). The odds of a severe injury using a grinder were higher in arm injuries (OR, 1.60; 95% CI, 1.40-1.83) and multiple-part injuries (OR, 1.998; 95% CI, 1.639-2.437). The odds of a severe injury using a grinder were lower for head injuries (OR, 0.481; 95% CI, 0.297-0.781). Conclusions: Injuries from grinders were more likely to affect the head and neck than nongrinder injuries, despite the lower severity. The current lack of regulations on grinders in occupational safety and health standards warrants relevant legislation and the development of applicable safety equipment.