• 제목/요약/키워드: purpose of using ambulance

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지역 응급의료기관의 아동 간호중재 분석 -4차 개정 Nursing Intervention Classification을 적용하여- (Analysis of the Characteristics and the Nursing Interventions for Children in Regional Emergency Departments -Using the Nursing Intervention Classification-)

  • 김영혜;이내영;하재현
    • Child Health Nursing Research
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    • 제16권4호
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    • pp.277-286
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    • 2010
  • Purpose: The purpose of this study was to provide descriptive data about the characteristics of pediatric patients and nursing interventions in Regional Emergency Medical Centers (REMC). Methods: A retrospective design was used to examine the medical records of 4,310 children. The clinical data and nursing terminologies of REMC were analyzed using the Nursing Intervention Classification (NIC). Results: Male toddlers dominated the sample. The mean age of the children was 3.51 yr. In more than half of the visits, patients arrived between from 7 a.m. to 3 p.m., on a weekday. There were only 189 ambulance transports to REMC, (4.4% of visits). The most frequent injuries were due to falls (28.0%) and contusions (27.3%), but the most common reasons for visits were non-injury (73.4%): fever, cough/shortness of breath, seizures, and abdominal pain. Of the 4,310 visits, 27.8% spent 6-24 hours in the REMC, while 33% resulted in hospital admission and 2.1% in transfer to another hospital. Of the 17,929 nursing interventions, 17,909 elements (99.9%) were classified under NIC. All the listed NIC interventions, however, were not reflected in the level of practice demonstrated by REMC nurses. Conclusion: These results can enhance the understanding of pediatric emergency nursing interventions and can make NIC more applicable.

병원 전 환경의 외상성 응급환자를 위한 전문기도관리 (Advanced airway management for the prehospital traumatic patient)

  • 심규식;김은미
    • 한국산학기술학회논문지
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    • 제14권5호
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    • pp.2360-2367
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    • 2013
  • 본 연구의 목적은 주행 중인 구급차에서 기관내 삽관과 후두마스크(LMA) 삽입의 신속성과 성공률을 비교하여 구급대원의 전문기도관리 능력을 향상시키는 데 있다. 연구방법은 C 지역 구급대원 중 1급 응급구조사 60명(대조군 30명, 실험군 30명)을 편의추출 하여 마네킹을 대상으로 측정을 하였다. 자료 분석은 SPSS WIN 14.0 Version을 사용하였다. 연구결과 기관내 삽관이 냄새맡기 자세에서 신속성이 좋은 것으로 나타났고(t=-4.038, p<.001), 중립자세에서 그룹 간 신속성 차이는 없었으나 기관내 삽관 시 16명(53.3%)에게 치아파절이 발생했다. 또한, 그룹 간 성공률 차이는 없었고 두 그룹 모두 실험 후 자신감이 향상된 것으로 나타났다. 결론적으로 냄새맡기 자세가 불가능한 외상성 환자는 후두마스크(LMA)의 사용이 효과적이고 구급대원의 기도관리 능력을 향상시키기 위하여 지속적인 교육이 필요할 것으로 사료된다.

벌독에 의한 아나필락시스 쇼크 발생의 예측 인자 (Predictors of Anaphylactic Shock in Patients with Anaphylaxis after Exposure to Bee Venom)

  • 김형주;김선휴;박형도;김우연;홍은석
    • 대한임상독성학회지
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    • 제8권1호
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    • pp.30-36
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    • 2010
  • Purpose: The purpose of this study is to analyze the clinical characteristics of anaphylaxis and anaphylactic shock caused by bee venom. Methods: We retrospectively collected the data of the patients who experienced anaphylaxis caused by natural bee sting or acupuncture using bee venom from January 1999 to December 2008. Seventy subjects were divided into the shock and non-shock groups. The clinical characteristics, sources of bee venom, treatments and outcomes were compared between the two groups. Results: The mean age of the subjects was $45.5{\pm}16.3$ years old and the number of males was 44 (62.9%). There were 25 patients in the shock group and 45 in the non-shock group. The age was older (p=0.001) and females (p=0.003) were more frequent in the shock group. Transportation to the hospital via ambulance was more frequent in the shock group (p<0.001). No difference was found in species of bee between the two groups. The cephalic area, including the face, was the most common area of bee venom in both groups. Anaphylaxis caused by bee sting commonly occurred between July and October. Cutaneous and respiratory symptoms were the most frequent symptoms related to anaphylaxis. Cardiovascular and neurologic symptoms were more frequent in the shock group. The amount of intravenously administered fluid and subcutaneous injection of epinephrine were much more in the shock group than that in the non-shock group. Conclusion: Older age was the factors related to anaphylactic shock caused by bee venom. Further validation is needed to evaluate the gender factor associated with shock.

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Effect of pre-hospital BLS simulation training on the paramedic's competency

  • Jung, Jun-Ho;Cho, Byung-Jun
    • 한국컴퓨터정보학회논문지
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    • 제23권1호
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    • pp.103-109
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    • 2018
  • The purpose of the study is to investigate the effect of a simulation training of BLS in paramedics in pre-hospital situation. This a nonequivalence control quasi-experimental study. The study subjects were 8 paramedics of experimental group and 8 paramedics of control group in K fire department. An informed consent was written by the subjects after explaining of the purpose of the study. The study methods consisted of conventional education and practice training. The conventional education was done for 30 minutes and the practice training was taken by four trainees of one group and the instructor demonstrated Basic Iife Support (BLS) performance for three minutes. Each trainer peformed BLS for ten minutes. In the beginning of the course, two paramedics got off from the ambulance and performed BLS including 5 cycles of Cardiopulmonary Resuscitation (CPR). Soon after the BLS, another two paramedics performed pre-hospital BLS survey. The education was guided by two professors of emergency medical technology, two Basic Iife Support instructors, and two emergency rescue directors. Pre-hospital BLS was measured by a 5-point Likert scale. Higher score means higher performance skills. The data were analyzed using SPSS/WIN 22.0 program set at significance level of p<05. The effect of simulation education was much more significant than the conventional education in BLS. The simulation education is very important and effective in improving the clinical performance skills of paramedics than the conventional education. The simulation education can provide the virtual environment of cardiac arrest to the paramedics. In conclusion, the simulation education can provide the effective teaching methods for various practice performance skills and solution by critical thinking in the paramedics and healthcare providers in the future.

The Related Factors to Urgent Disease in Triaging Patients with Acute Abdominal Pain in Emergency Department

  • Lee, Sang Rim;Lee, In Sook;Jung, Eunhee;Kim, Ju Won;Chin, Young Ran;Hong, Hyunsook;Yu, Daewon
    • 지역사회간호학회지
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    • 제30권4호
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    • pp.581-587
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    • 2019
  • Purpose: Abdominal pain is the most common symptom of patients visiting the emergency department (ED). Abdominal pain is caused by a variety of causes, so it is difficult for a triage nurse to determine the urgency of a patient, but it is still a must. The purpose of this study was to identify the related factors to the urgent diseases of patients with abdominal pain visiting ED. Methods: This study was a retrospective descriptive study. The study setting was an ED in a tertiary hospital in Korea. Data were collected from September 1, 2017 to October 15, 2017. During the study period, of a total of 6,181 patients visiting the ED, 731 complained of abdominal pain. Patients with obvious cause of pain and patients who could not express detailed symptoms were excluded. The 573 patients were included in the final analysis. We collected demographics, clinical characteristics, and final diagnosis. We divided final diagnoses into urgent diseases which were more likely to be life-threatening without treatment and non-urgent diseases. We identified the related factors to the urgent diseases of patients with abdominal pain using the logistic regression. Results: 173 (30.2%) patients had urgent diseases. Age (OR=1.02, 95% CI=1.00~1.03), referral from other clinics (OR=2.92, 95% CI=1.86~4.60), ambulance utilization (OR=2.00, 95% CI=1.27~3.15), diarrhea (OR=0.44, 95% CI=0.25~0.76), and tachycardia (OR=2.27, 95% CI=1.44~3.58) were related to urgent diseases. Conclusion: Triage nurse should take into account the patient's age, mode of visiting, and route of visiting ED; and check the symptom of tachycardia or diarrhea.

서울시(市) 대기오염(大氣汚染)이 시민보건(市民保健)에 미치는 영향(影響)에 관(關)한 조사연구(調査硏究) (Epidemiological Study of Air Pollution and Its Effects on Health of Urban Population)

  • 정규철
    • Journal of Preventive Medicine and Public Health
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    • 제2권1호
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    • pp.5-22
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    • 1969
  • The urban population of our country is rapidly increasing due to many factors of social structure, and sociologists are predicting that the increase rate of the urban population will be over 50% in 1980's. Above all, the population of the capital city of Seoul, is at present more than four millions. Such centring of people in cities, together with the improvement of the standards of living, caused rapid increase in the amount of fuel consumption, and this consumption of fuels became one of the primary sources of the air pollution in cities. Moreover, the heavy traffic, construction of many tall buildings, and the increasing number of new factories due to the industrial development-all these are contributing to make the matter of air pollution worse and worse in the Metropolitan, whose geographical location is quite unfavorable considered from the view point of air pollution. Most homes in Seoul use briquet as fuel, while oils are used in tall buildings. The CO, $SO_2$, and smoke that come from burning of these fuels are a great threat to the health of the urban population. With the purpose of examining the influence of air pollution upon the public health, written inquiries were made upon respiratory diseases, and the carboxyhemoglobin saturation in the blood was measured to determine whether the air pollution may affect the health of the urban population. Method of Health Examination (1) Investigation of Respiratory Diseases Patients' records were examined to figure out the monthly ambulance rate of respiratory patients to the total number of patients treated. On the other hand, by using the questionnaire form approved by the Medical Research Council's Committee on Research into Chronic Bronchitis, investigators interviewed the examinees and inquired into the respiratory symptoms. (2) Measuring of Carboxyhemoglobin Saturation From the ear lobe of the examinees, with the use of the melangeur for the white blood cell counting, blood was taken, and after diluting it ten times with 0.1% $Na{2}CO_{3}$, again diulting it 20 times with 0.5% $Na_{2}\;CO_{3}$, its absorbancy was measured. The following results are obtained from the investigation. (1) It was found out that 7.7% of the total patients under treatment were suffering from upper respiratory infection, acute or chronic bronchitis, bronchial asthma, pulmonary emphysema and bronchiectasis. Of them all, patients with upper respiratory infection numbered the greatest with 4.8% and patients with acute or chronic bronchitis the next with 2.1%, and their monthly ambulance rate was high from December to February during the winter, and from April to May and from September to October during the changeable seasons. (2) The daily ambulance rate of respiratory patients, it was revealed, had a close connection with the concentration of $SO_2$ and CO in the air. (3) It was found out that men were more subject to respiratory disease than women, and both men and women were more liable to the diseases with the advancing of age. (4) People living at Choong-ku with the heavy traffic and in the industrial zones of Yeungdungpo had high frequency of respiratory symptoms. (5) Considered from the view point of occupations, high frequency was found among those without job, with jobs unknown, merchants and intdustrial workers, whose social status was rather low and traffic policemen who were always exposed to the exhaust gas of cars. As for women, the frequency was detected in the order of those from high to low, housewives who were exposed to briquet gas, women with jobs unknown, women without jobs, whose social status was low. (6) Ex-smokers rather than smokers, of both sexes, had higher frequency. As for men, heavy smokers had high frequency, while in women light smokers had rather high frequency which was presumed to be due to their average old age. (7) Men's average of carboxyhemoglobin saturation was 9.48%, while women's was 11.3%, higher than men's. (p<0.05). Age meant no difference in the case of men, but as for women, the saturation was remarkably high between the ages from 20 to 60. (8) No regional difference was detected in the carboxyhemoglobin saturation. (9) The carboxyhemoglobin saturation was found, in the case of men, in the order of office workers, traffic policemen, students, the unemployed, merchants and industrial workers, drivers; and as for women, the order was housewives, office workers, merchants and industrial workers. (10) No significant correlation was found between the carboxyhemoglobin saturation and the concentration of CO detected in kitchens, or between the carhoxyhemoglobin saturation and the passing of time after exposure to briquet gas. No difference of carboxyhemoglobin saturation was detected between smokers and non-smokers, and the degrees of smoking; only, significant negative correlation was found between the passing of time after smoking and the carboxyhemoglobin saturation. It is ture that air pollution causes or aggravates the respiratory diseases, increases the carboxyhemoglobin saturation in the blood, but what seems to be more hazardous to the health is the air polluted by the briquet gas in the kitchens and on-dol rooms rather than the atmospheric air pollution.

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농어촌지역 응급환자 실태조사 - 서남해안 지역을 중심으로 - (Research on Actual Condition of Emergency Patients in Farming and Fishing Villages - In southwest coast district center -)

  • 최길순;권혜란
    • 한국응급구조학회지
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    • 제10권1호
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    • pp.13-21
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    • 2006
  • Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.

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지역별 응급의료접근성이 노인의 허혈성 심장질환 사망률에 미치는 영향 (Effect of regional emergency medical access on the death rate of elderly individuals with ischemic heart disease)

  • 고은정;조근자
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.19-38
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    • 2021
  • Purpose: This study aimed to investigate the relationship between emergency medical service accessibility in different regions and the sudden death rate in elderly patients with ischemic heart disease using data analysis techniques and suggest improvements in regional emergency medical services. Methods: The study collected data from the NEDIS database and Statistics Korea. Data on a total of 75,867 patients aged ≥65 years were reviewed among patients with ischemic heart disease who visited emergency medical institutions in 2018. Frequency analysis, chi-square test, multiple logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0. Results: With an emergency medical resource per 100km2, there was a concomitant reduction in the risk of death. There was a decrease in the death rate by 0.967, 0.970, 0.997, and 0.391 times with the increase in the presence of a fire department, an ambulance, a paramedic, and a regional medical center, respectively. Furthermore, a decrement in the death rate was witnessed 0.844, 0.825, and 0.975 times with the initiation of a local emergency medical center, a local emergency medical institution, and an angiography device, respectively(p <.001). Conclusion: To improve the accessibility of emergency medical services, the population and geometric area of the region should be considered essential factors when deploying emergency medical resources.

1급 응급구조사의 직무분석에 관한 연구 (A study on the job description of paramedics)

  • 손인아
    • 한국응급구조학회지
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    • 제9권1호
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    • pp.43-53
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    • 2005
  • The purpose of this study was to survey a perception of frequency & importance level of job performance, from 249 paramedics who were working at fire station. The job related activities of 4 duties, 18 tasks and 145 task elements were checked by 4 rating scale. The data were analyzed using a SPSS program for descriptive statistics. The results of the study were as follows ; 1. Some of the most frequent tasks were medical tx, managing people & organization, trauma care, pt assessment, general coping skill 2. Some of the most frequent task elements were preparation of written reports, operation of pt lifting supplies, transportation of patients on stretchers, administration of cervical collar and utilization of scoop stretcher. 3. Some of the highest level of importance in task were resuscitation of circulation, surgical tx, safety & infection control, environmental emergency care, trauma care. 4. Some of the highest level of importance in task elements were administration of cervical collar, adult CPR, infant CPR, child CPR, and AED. 5. The highest level of task elements in perception of frequency & importance were administration of cervical collar, infection control after pt care, utilization of long back board, disinfection of ambulance after ride a long, care of chest pain pt, care of unconscious pt, tx of asthma. 6. A difference between frequent & importance score were due to lack of supplies(41%), structural problems(30%) and medical control system(16%), lack of skills(10%), Suggestion; 1. This paper would be more reliable and confirm through wilder range of survey. 2. It would be necessary of more depth survey through dacom study from paramedic. 3. Development of field oriented protocol & curriculum that based on task elements which have high score of both frequency & importance level is required.

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4종류의 구급장비 및 마루(Floor) 위에서 시행한 가슴압박 에너지(kg)측정 실험에 관한 연구 (Chest Compression Energy(kg) Measurement of 4 Types of Rescue Device on the Floor)

  • 신동민;한용택;김승용;박시은
    • 한국안전학회지
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    • 제29권6호
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    • pp.125-131
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    • 2014
  • The purpose of this study is to investigate the effect of high quality CPR using the 4 types of rescue device equipment and chest compressions energy measurement in pre-hospital settings. So, we used the mode to insert load cell in ALS Skill master Manikin to develop CFMM(Compression Force Measurement Manikin) on main stretcher, CPR board, long spine board, scoop stretcher and floor. And, our research team could know that the main stretcher needed average force of 32.55 (${\pm}1.01$) kg, CPR board of 27.23 (${\pm}1.08$) kg, long spine board of 27.13 (${\pm}1.18$) kg, Scoop Stretcher of 27.38 (${\pm}1.05$) kg and Floor of 27.24 (${\pm}0.93$) kg. CPR board must be necessary in the case of CPR on main stretcher in a moving ambulance. But if the condition of patient's back surface is the removable stretcher and the long spine plate, the patient doesn't have to be spent time to use a CPR board. Furthermore, this research suggests to consider that how to take advantage of the education to students for the equipment to check in real time the energy(kg) requirement of chest compressions.