응급의료센터 환자의 내원 정보 및 실태 분석

도병수,이삼범 영남대학교 의과대학 1999 Yeungnam University Journal of Medicine Vol.16 No.2

Background: For effective and systematic management of patients in the emergency department(ED), the data on patient arrival and status in ED of Yeungnam University Hospital were evaluated. Materials and Methods: During the seven days from Apr. 1 to Apr. 7, 1998, the general patient information such as onset time and place, factors associated with transportation, causes of admission, cared department and patient disposition were recorded. Results: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3. Male to female ratio was 1:0.71. Daily staying patients were 17.3, and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk(57.3%), transportation by car(58.0%), place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of departments which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred-patient-to-another-hospital was zero. Conclusion: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

응급의학은 어떤 의학분야이며 그 미래는?

도병수,이삼범 영남대학교 의과대학 2002 Yeungnam University Journal of Medicine Vol.19 No.2

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life of limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

동시에 내원한 대량환자의 응급의학과내 처치에 대한 고찰

도병수 대한응급의학회 1995 대한응급의학회지 Vol.6 No.1

A multicasuality incident usually refers to an isolated, geographically focused event which produces a limited number of casualities that tare managed within a community. Our emergency department(ED) was experienced two cases of multicasuality events in Taegu, Korea. And we could gain experience with in-ED-community multicasuality events management. We tried to analyse emergency department disaster management in the review of two community muticasuality events including fall downing accident and food poisoning. The result of ED management survey shows the importance of the hospital's disaster plan to presuppose a large influx of patients, notification of the hospital, mobilization of additional personnel resources including triage and trauma team and preparation of ED space and beds.

대장 및 직장암 환자에서 말초혈, 하장간막정맥혈, 담즙 및 직장 분비물 간의 CEA치의 의의와 상관관계

도병수,정연웅,김상운,김재황,심민철,권굉보 대한대장항문학회 1991 Annals of Coloproctolgy Vol.7 No.2

복강내농양으로 부터 혐기성균 분리 및 동정과 항균제에 대한 감수성

도병수,송괄열,김재황,김흥진,심민철,권굉보,김회선,김성광 대한대장항문학회 1991 Annals of Coloproctolgy Vol.7 No.1

응급의료센터에 내원한 비외상성 흉통환자의 임상 양상

도병수,정준영,이삼범,박종선,신동구,김영조 영남대학교 의과대학 1999 Yeungnam University Journal of Medicine Vol.16 No.2

Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were 1.1±0.9 in non-cardiac diseases, 1.4±1.1 in cardiac diseases and 1.7±1.1 in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

대장암 술전 대장 정결법에서 Golytely(ColonlyteR)의 사용효과

도병수,김재황,심민철,권굉보 대한외과학회 1991 대한외과학회 학술대회 초록집 Vol.1991 No.11

병원전단계 외상지수계 및 현장 중증도분류법

도병수,이삼범 대한외상학회 1997 大韓外傷學會誌 Vol.10 No.1

Trauma scoring system(PhTSS) have been devised to aid in the triage of trauma victims in the prehospital setting and provided the advantage over the judgment of EMT in determining which trauma victims require transportation to emergency or trauma center. This PhTSS requires several characteristics which is simple, accurate, easily accessible and effective, and should have high predictive validity and inter- & intra-observer reliability. So authors will discuss the most commonly used trauma score and illustrate in the accompanying tables; is the GCS, the RTI, the TS, the RTS, the CRAMS score, the TTR and the PTS.

응급의료서비스 이용의 적절성과 대형병원 응급실과밀화에 대한 해결방안

도병수 대한의사협회 2009 대한의사협회지 Vol.52 No.11

Inappropriate use or misuse of EMS (Emergency Medical Service) is a potential waste of resources and diversion of needed service from another in need. One of the most serious consequences of an inappropriate use of EMS is emergency department (ED) overcrowding. ED overcrowding in large hospitals, especially university hospitals, has been a persistent and unsolvable problem worldwide. The issues have drawn the attention of media and have been discussed in many conferences. Currently, various studies have identified the causes and suggested the solutions for these problems. The inappropriate use of EMS are mainly caused by the misguidance of EMS providers and misuse of the public user. In order to solve this problem, the EMS system provider should make an effort to improve and develop the system. The government will also need to step up publicity activity on the awareness for an appropriate use of EMS system through mass media. ED overcrowding are caused by misuse of both EMS and medical transfer system. And inefficiency of hospital operating system is another cause. The hospital and its ED have to respond more rapidly to eliminate the unnecessary wait time of ED patients. Relocation of boarding ED patient to other inpatients area, such as hallways, conference rooms, is the first thing to do. To improve the flow of ED patients, the persons in charge of every department will have to come together to coordinate the early discharge of hospital patients and the scheduling of elective and surgical patients. The suggested solutions must be put in practice immediately.

단순 방사선 사진상 기복강으로 오인할 수 있는 Chilaiditis Syndrome 1례

이창현,이상범,도병수 대한응급의학회 1998 대한응급의학회지 Vol.9 No.2

Chilaiditis syndrome is very rare clinical condition that interposed of the hepatic flexure of large bowels between the liver and diaphragm. Clinically it is characterized by abdominal pain that becomes increasingly worse during the day and is often accentuated by deep breathing. On radiologic studies, it shows gas within the hepatic flexure interposed between the liver and diaphragm, which is simulating a pneumoperitoneum. A case was admitted at emergency care center of Yeungnam university hospital and we report it.