응급의학과에서의 인공호흡기 처치 = VENTILATOR MANAGEMENT IN EMERGENCY DEPARTMENT

다국어 초록 (Multilingual Abstract)

Study Objectives : To investigate and resolve the problems related with ventilator management in ED(emergency department). At present the ventilator is essential equipment of ED on university hospital and emergency center in Korea.
Design : Retrospective consecutive case series.
Setting : University teaching hospital
Type of participants : All patients admitted and recieved ventilator management in ED of yeungnam university hospital from Jan. 1994 to jul. 1995.
Methods and interventions : Charts of all patients were reviewed to determine the frequency, the types and causes of respiratory failure, the death rate, the mean duration of admission, the complications, and CPR(cardiopulmonary resuscitation) related with ventilator management in ED. We also identified the problems related with ventilator management by ED physicians and nurses through the answers to seven questions that suggested by us about ventilator management in ED.
Measurements and main result : There were 34,751 admissions through ED during the study period. Of these 160 patients managed with ventilator in ED. The frequency of ventilator management in ED is increased at 1995(0.73%) that compared with 1994(0.32%). Non-trauma(113 cases) and hypoxic respiratory failure(83 cases) patients are more common than trauma(37 cases) and ventilatory failure Total CPR rate related with ventilator management are 25.3%. The mean duration of admission are 12.56±20.28 days, and the death rates are 45.3%. The incidence of complications occurred during ventilator management in ED are 37 cases. About seven questions suggested by us to 30 ED staffs(ED physician, nurses and paramedics), most frequent answer is the difficulty of keeping ventilator in ED because other department rent ventilator from ED and lost a part of ventilator.
Conclusion : As the use of ventilator in ED is increased the emergency physician should be well trained for the indications, complications, setting mode and general problems of machine occurred during ventilator management in ED
patients.