The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).
de Oliveira Moura, Emmanuella;do Nascimento Rangel, Adriano Henrique;de Melo, Maria Celeste Nunes;Borba, Luiz Henrique Fernandes;de Lima, Dorgival Morais Junior;Novaes, Luciano Patto;Urbano, Stela Antas;de Andrade Neto, Julio Cesar
Asian-Australasian Journal of Animal Sciences
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v.30
no.9
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pp.1340-1349
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2017
Objective: This study aimed to evaluate the microbiological and cellular milk profile for the diagnosis of subclinical mastitis in female buffaloes and to assess risk factors for predisposition of the disease. Methods: Analyses were carried out by standard plate count (SPC), identification of species and antibiotic resistance, somatic cell count (SCC), electrical electrical conductivity of milk (ECM), and lactoferrin content in milk. Teat cups were swabbed to evaluate risk factors, observing hyperkeratosis, milking vacuum pressure and cleanliness of the site. Hence, 30 female buffaloes were randomly selected (15 from a group in early lactation and 15 in late lactation). Results: The most common bacteria in the microbiological examination were Staphylococcus spp., Streptococcus spp. and Corynebacterium sp. In the antibiotic sensitivity test, 10 (58.82%) of the 17 antibiotics tested were sensitive to all isolates, and resistant bacteria were Streptococcus uberis, Streptococcus dysgalactiae, Streptococcus haemolyticus, and Escherichia coli. It was observed that positive samples in the microbiological examination showed total bacterial count between $9.10{\times}10^3$ to $6.94{\times}10^6$ colony forming units/mL, SCC between 42,000 to 4,320,000 cells/mL and ECM ranging from 1.85 to 7.40 mS/cm. It was also found that the teat cups had high microbial counts indicating poor hygiene, and even faults in the cleanliness of the animals' waiting room were observed. It is concluded that values of SCC above 537,000 cells/mL and ECM above 3.0 mS/mL are indications of mammary gland infection for this herd; however, the association of these values with a microbiological analysis is necessary to more accurately evaluate the health status of mammary glands with subclinical mastitis. Conclusion: Through phenotypic characterization of bacteria involved in the samples, the genera Staphylococcus spp., Streptococcus spp., and Corynebacterimum bovis were the most prevalent in this study. Faults in environment and equipment hygienization are factors that are directly associated with mastitis.
The purpose of this study were to find out the practical way to enlarged child-raising knowledge and to enhance their satisfaction with out-patient care by evaluating how effectively the education is done by nurses for mothers with ill-child and how their satisfaction with out-patient care changed. This study was designed as a Nonequivalent Control Group study. The subjects studied were consisted of the experimental and control group. Each consisted of 50 mothers with ill-child in pediatric department at one university hospital in Seoul. The period of this study is from May 20, 1996 to J one 28, 1996. The first data were collected from both of experimental and control groups in which mothers with ill-child come to the hospital for the first time. After this being done, the experimental group had been educated by the planned program and then the second data were collected from them. On the contrary, as for the control group, there had been no education and the second data were col looted on the same method. The data analysis was done by SPSS program. The results of this study are as follow, 1 The child-raising knowledge level of mothers with education was higher than that of with no education. (t=18.84, df=49, p=0.000) 2. The satisfaction with out-patient care level of mothers with education was higher than that of no education. (t=10.51, df=49, p=0.000) Based on these results, I suggest as follow, 1. The research on the patients and their family should be made not only in pediatric department, but in every out-patient department. 2. For more effective education, it is required for all out-patient nurses to research the education demand of patients and their family. 3. To increase the effect of education, there must be the consultation room in out-patient department. 4. The meetings with the mothers with ill-child of the same illness have to be established and periodical education must be executed. 5. Audio-visual education programs like video tapes are needed to make use of waiting time for the medical treatment. 6. On-line consulting programs are needed.
Kim, Min-Woo;Oh, Sang-Hoon;Park, Kyu-Nam;Lee, Jung-Min;Lee, Young-Mee;Kim, Han-Joon;Kim, Soo-Hyun;Kang, Dong-Jae
Quality Improvement in Health Care
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v.20
no.1
/
pp.12-24
/
2014
Objectives: The aim of this study was to explore whether emergency bell could shorten door to electrocardiograms (ECG) time in chest pain patients presenting to emergency department (ED) by self-transport. Methods: This was a planned 6-month before-and-after interventional study design. We set up the emergency bell in walk-in patients' waiting room. Prior to the change, patients were triaged before an ECG was obtained. In new process, as soon as patient with chest pain push the emergency bell, emergency physicians examined patient and prioritized performing ECG. We analyzed door to electrocardiograms (DTE) times for patients with chest pain and ST segment elevation myocardial infarction (STEMI) patients between two periods. Results: During the enrollment period, a total of 63 patients called emergency bell. The median DTE time was 6 min (interquartile range: 3.0 - 9.0) and 82.5% received an ECG within 10 minutes, and only three patients were STEMI. DTE time in patient with chest pain was not different between two periods (p=0.980). Before intervention period, 15 walk-in patients admitted in ED for STEMI and 53.8% of STEMI patients received an ECG within 10 minutes. After intervention period, total 19 walk-in patients admitted in ED for STEMI. Of these, 89.5% met the time requirement. Conclusion: Because a small portion of patients with chest pain activated the emergency bell, new strategy for promotion of emergency bell must be needed.
Is trend that treatment that use isotope of radioactive substance increases from 1964 to now steadily. Bursting tube state solidified accordingly. But, do not establish treatment ward in presence at a sickbed by means that present regulation and system escape this as well as possession that exert negative impact in treatment action preferably is and is treating by radioactivity of small quantity, treatment air by that do not detain many sickers without equaling the institution although there is treatment ward keeps fair death anniversary and is in reservation stand-by status. To possess about 10 therapy rooms including existing sickroom in the institute of nuclear energy recently is looked but is waiting for an opportunity for treatment during suitableness time yet indeed even as that operate 57 radiation isotope therapy rooms all in about 28 hospitals in present domestic state is solveded. Therefore, radiation safety supervision by medical treatment action that treat as radioactive substance may need more active effort. Make mandatory to equipment that hospital which correspond to present the third medical examination and treatment must equip, or effort about more active system improvement may have to be about equipment that enforce this.
In this study, we researched the concentration of nitrogen dioxide($NO_{2}$) and sulfur dioxide($SO_{2}$) of indoor(waiting room) and outdoor(place of getting on the bus) at the bus terminals (Kang-Nam, Dong-Seoul and Nam-Bu) in Seoul to recognize the degree of pollution by exhaust gas of the diesel engine vehicles, and examine the factor that might affect air pollution of terminals. The concentration of $NO_{2}$ and $SO_{2}$ were measured in winter and summer, and the results of the analysis are as follows : The mean concentration of $NO_{2}$ was $57.49{\pm}21.86$ ppb and the concentration of outdoor with $64.10{\pm}27.69$ ppb was significantly higher than the indoor with $50.89{\pm}10.92$ ppb (p<0.05), and the highest with $73.54{\pm}25.54$ ppb at Kang-Nam terminal (p<0.01). The mean concentration of $NO_{2}$ was $62.80{\pm}24.74$ ppb in winter and $52.19{\pm}17.50$ ppb in summer, and had a not statistical difference. The mean concentration of $SO_{2}$ was $31.71{\pm}8.73$ ppb and the concentration of outdoor with $31.04{\pm}8.89$ ppb was similar to the indoor $32.29{\pm}8.70$ ppb, and the highest with $32.57{\pm}9.01$ ppb at Dong-Seoul terminal (p<0.05). The mean concentration of $SO_{2}$ in winter with $39.67{\pm}4.10$ ppb was significantly higher than in summer with $23.76{\pm}2.61$ ppb (p<0.01). The concentration of outdoor $NO_{2}$ at Kang-Nam terminal was 104, 84 ppb in winter and 81.20 ppb in summer, and had a statistical difference compared with the concentration of indoor $NO_{2}$ at Dong-Seoul and Nam-Bu terminals. The concentration of indoor $NO_{2}$ and $SO_{2}$ were higher than that of outdoor at Kang-Nam and Dong-Seoul terminals, but on the contrary, lower than that of outdoor at Nam-Bu terminal. The concentration of $NO_{2}$ and $SO_{2}$ at Nam-Bu terminal were lower than those at Kang-Nam and Dong-Seoul terminals. While the concentration of $SO_{2}$ show the large difference between winter and summer, that of $NO_{2}$ dose not.
Background: This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. Methods: An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child's temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as "easy," "slow to warm-up," and "difficult." The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. Results: The study included 60 children aged 8-12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety. A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001⁎) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = -0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. Conclusion: A high percentage (70%) of children aged 8-12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.
This paper aims reinterpreting and reflecting on the current status and problems with the various contents that have developed through Jeongeupsa (井邑詞, Jeongeup Lyrics) in order to enhance the local and cultural value of Jeongeupsa within the broader context of classical poetry. The results of this research are as follows: First, I raised the questions by summarizing previous studies on the interpretation of Jeongeupsa. The view of Jeongeupsa as songs about the jealousy and anger of wives is highlighted, and the view of the wives' desire for their husbands' safety is confirmed to be passive portrayals of women. These two interpretations raise questions about the extent to which Jeongeupsa remain relevant to local cultural content of today. Second, it was understood that Jeongeupsa shows a mature attitude that does not indicate spatial separation from the subjects in the poem. This is shown via the absence of those subjects, and further shows an active and subjective attitude of waiting. Therefore, it was deemed that there is room to reconsider to the categorization of Jeongeupsa as lewd songs. Third, the contents generated through Jeongeupsa are buried in feelings of sadness and anger. Thereby, the contents have not guaranteed the health of Jeongeupsa. In order to promote Jeongeupsa as a source of local and cultural content, the positive value of Jeongeupsa must be enhanced.
Kim, Cheol-U;Lee, Chul-Hyung;Yoon, Ja-Yeong;Rhee, Seung-Koo
Journal of the Korean Orthopaedic Association
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v.53
no.6
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pp.513-521
/
2018
Purpose: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. Materials and Methods: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. Results: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5-13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5-40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141-540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. Conclusion: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.
Purpose For nuclear medicine technologists, it is difficult to stay away from or to separate from radiation sources comparing with workers who are using radiation generating devices. Nuclear medicine technologists work is recognized as an optimized way when they are familiar with work practices. The aims of this study are to measure radiation exposure of technologists working in PET and to evaluate the occupational radiation dose after implementation of strategies to lower exposure. Materials and Methods We divided into four working types by QC for PET, injection, scan and etc. in PET scan procedure. In QC of PET, we compared the radiation exposure controlling next to $^{68}Ge$ cylinder phantom directly to controlling the table in console room remotely. In injection, we compared the radiation exposure guiding patient in waiting room before injection to after injection. In scan procedure of PET, we compared the radiation exposure moving the table using the control button located next to the patient to moving the table using the control button located in the far distance. PERSONAL ELECTRONIC DOSEMETER (PED), Tracerco$^{TM}$ was used for measuring exposed radiation doses. Results The average doses of exposed radiation were $0.27{\pm}0.04{\mu}Sv$ when controlling the table directly and $0.13{\pm}0.14{\mu}Sv$ when controlling the table remotely while performing QC. The average doses of exposed radiation were $0.97{\pm}0.36{\mu}Sv$ when guiding patient after injection and $0.62{\pm}0.17{\mu}Sv$ when guiding patient before injection. The average doses of exposed radiation were $1.33{\pm}0.54{\mu}Sv$ when using the control button located next to the patient and $0.94{\pm}0.50{\mu}Sv$ when using the control button located in far distance while acquiring image. As a result, there were statistically significant differences(P<0.05). Conclusion: From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine. Conclusion From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine.
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