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3차 병원 응급실을 빈번히 이용하는 소아 환자들의 특성
채현석,박관진,김영민,김상철,이지한,김 훈,이석우 대한응급의학회 2022 대한응급의학회지 Vol.33 No.5
Objective: Frequent emergency department (ED) visit is a global public health problem that can delay proper management and reduce the quality of medical services. While many researches were done on adult frequent ED users, studies lack on pediatric patients. This study was designed to identify the characteristics of the frequent pediatric ED users and risk factors related to pediatric frequent ED visits. Methods: This was a retrospective observational study using ED-based data derived from pediatric patients at a tertiary university hospital. The main exposure variable was frequent pediatric ED visits, which were defined as more than 4 visits within a year (January 1-December 31, 2019). Characteristics and risk factors for frequent pediatric ED users were evaluated using forward stepwise regression analysis. Results: During the study period, 10,050 pediatric ED visits (8,313 patients) were identified. Of which, 550 (5.5%) were frequent ED visits (114 patients, 1.4%). The independent risk factors for frequent pediatric ED visits were age <1 year (adjusted odds ratio [AOR], 2.79; 95% confidence interval [CI], 1.32-5.93), visiting during spring and winter (AOR, 5.72; 95% CI, 3.36-9.75) and visiting due to medical problem (AOR, 1.66; 95% CI, 1.02-3.08). Primary diagnosis of unspecified convulsions, acute lower respiratory infection, other specified medical care, and arrhythmia were associated with frequent pediatric ED visits. Conclusion: Age <1 year, visiting ED during spring and winter, visiting ED due to medical problem can increase the risk of frequent ED visit by pediatric patients.
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에피네프린 투여에 따른 아나필락시스 환자의 임상학적 양상 비교
김솔기,박관진,채현석,김영민,김상철,김 훈,이석우 대한응급의학회 2023 대한응급의학회지 Vol.34 No.6
Objective: Epinephrine is a first-line drug for anaphylaxis, but a poor prognosis can occur if not administered properly. This study compared the clinical features of patients with anaphylaxis in the emergency department (ED) according to epinephrine administration. Methods: This was a retrospective cross-sectional study using ED-based data retrieved from a tertiary university hospital. Patients diagnosed with anaphylaxis between 2018 and 2020 were enrolled in this study. The patients with anaphylaxis were classified according to epinephrine administration, and the clinical features were compared. The adjusted odds ratios (AORs) with a 95% confidence interval (CI) were calculated for the main factors associated with epinephrine use. Results: Among 205 eligible patients with anaphylaxis, 157 (76.6%) were treated with epinephrine. The main contributing factors influencing epinephrine use were patients with cardiovascular symptoms (AOR=2.97; 95% CI, 1.26-7.01) and patients transferred from other hospitals (AOR=0.37; 95% CI, 0.16-0.85). Conclusion: The major factors influencing epinephrine use in the ED when patients with anaphylaxis presented with cardiovascular symptoms were identified. It is essential to prevent potentially fatal consequences in patients with anaphylaxis through appropriate epinephrine administration.
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소아응급전담전문의 진료 도입에 따른 소아응급진료 양상 변화
김백현,박관진,김영민,채현석,김상철,김 훈,이석우 대한소아응급의학회 2024 대한소아응급의학회지 Vol.11 No.3
Purpose: We aimed to evaluate whether pediatric emergency practice has improved since the introduction of pediatric specialist care (PSC). Methods: Retrospective observational study was conducted using the data retrieved from the emergency department (ED) of a tertiary university hospital in Cheongju, Korea. Patients younger than 19 years who visited the ED from January 2019 through December 2023 were enrolled in this study. Hospitalization (overall and intensive care unit [ICU]), inhospital mortality, and return visit within 24 hours were compared between the periods before (January 2019-January 2021) and after (June 2021-December 2023) the introduction of PSC. Adjusted odds ratios with 95% confidence intervals were calculated for the outcomes using multivariable logistic regression. Results: During the study period, a total of 36,162 patients visited the ED. The visits increased from 12,196 before to 22,387 after the introduction of PSC (increase by 83.6%). Annual numbers of the visits have increased since 2020 and reached 10,942 in 2023. After the introduction of PSC, decreases were noted in the hospitalization (adjusted odds ratio, 0.67; 95% confidence interval, 0.62-0.72) and return visit within 24 hours (0.73; 0.61-0.88). Hospitalization to the ICU increased (2.90; 2.29-3.69), while there was no significant difference in the in-hospital mortality (1.31; 0.77-2.25). Conclusion: After the introduction of PSC, overall hospitalization and return visit decreased, while hospitalization to the ICU increased without a difference in the in-hospital mortality. Multidisciplinary efforts are needed to continue providing the pediatric specialist-centered emergency practice.
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IEEE 1459-2010 규격의 정의를 이용한 다중 입력 채널을 갖는 전력 감시 시스템
전정채(Jeon, Jeong-Chay),오 훈(Oh, Hun) 한국산학기술학회 2014 한국산학기술학회논문지 Vol.15 No.5
본 논문에서는 전력 시스템의 전원 및 부하 측을 동시에 감시가 가능한 다 채널(전압 8채널,전류 10채널)전력 측정 시스템을 개발하였다.제안된 시스템은 전력품질과 관련된 규정인 IEEE1459-2010의 정의를 사용하여 전력 성분을 계산하는 신호처리 알고리즘을 기반으로 TMS320C42DSP를 이용하여 개발하였다.개발된 시스템은 표준 전원 공급 장치를 이용하여 그 성능 시험을 실시하였고,그 결과 측정오차는 0.2% 이하로 나타났다.또한 제안된 시스템을 3상 4선식 전력시스템에 설치 하여 실증 시험을 실시하여 그 성능을 입증하였다.제안된 시스템은 상업 및 산업용 전력 시스템에 적용하여 동시에 다 채널 로 전력을 측정 및 분석함으로써 전력품질과 관련된 다양한 문제를 줄일 수 있을 것이다. This paper develops power measurement system with multiple sensor input channels (voltage-8 channels and current-10 channels) that simultaneously can monitor power components for both supply and load side of power system. The hardware implementation of the proposed system is based on TMS320C42 DSP and signal processing program algorithm to calculate power components use the definition of IEEE Standard 1459-2010 related power quality. The performance of the developed system is tested by using standard ac power source device, and the test results showed that accuracy of the developed system is less than 0.2 %. Also, field test of the proposed system in the three-phase and four-wire power system was implemented. Simultaneous multiple channel measurement and analysis of power components in commercial and industrial electrical power system using the proposed system will be necessary to reduce power quality problems.
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