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- 저자 : 송경준 ( Kyoung Jun Song ) (검색결과 4 건)
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학교 손상과 관련된 병원 전단계 응급 의료 실태 및 위해 환경 요인
송경준 ( Kyoung Jun Song ),정성구 ( Sung Goo Jeong ),곽영호 ( Young Ho Kwak ),서길준 ( Gil Joon Suh ),권운용 ( Woon Yong Kwon ),신상도 ( Sang Do Shin ) 대한외상학회 2004 大韓外傷學會誌 Vol.17 No.1
Purpose: This study was designed to evaluate the risk factors of injury and pre-hospital emergency service system in school. Methods: A designed questionnaire was made up by nurse-teachers. We described the frequency and the distribution by types of school, gaining method of information about emergency care, education programs and concerns about injury prevention, transportation methods, and number of injured victim. After all school were divided with two groups such as high and low injury group based on median points of injury count, the adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) of each risk factor were measured using the multivariate logistic regression analysis. Results: 246 female nurse-teachers were responded. Of them, 143 worked at primary school, 50 at middle school, 29 at high school, and 18 at special school, respectively. Injury was the second common cause visiting to nursing room. 43.67% of victims were directly transported by nurse-teacher. Degree of attention about injury prevention was relatively high (63.0%) but education program was not sufficient (83.0%). There were no oxygen devices, ventilatory devices, airway maintenance devices, electrocardiography equipments, and critical drugs except immobilization devices, stretchers, oral antibiotics, and fluids in most schools. Mean number of victim visiting to nursing room due to injury was 2.6 per a day per 1,000 students. Adjusting for related factors, ``disordered shopping and parking area to near school`` (adjusted OR 1.840; 95% CI 1.077~3.143), ``risky window without safety equipment`` (adjusted OR 1.786; 95% CI 1.019~3.131), and ``when number of involved indoor condition was increased by one`` (adjusted OR 1.255 95% CI 1.004~1.568) were significant risk factors on high injury incidence. Conclusion: Injury was one of the most common health problems in school but there was no equipped for emergency care. ``Disordered street near to school`` and ``risky indoor conditions`` were significant risk factors on school injury.
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지역응급의료센터에서 손상구역 운용이 응급실 과밀화 지표에 미치는 영향
강진욱 ( Jin Wook Kang ),신상도 ( Sang Do Shin ),서길준 ( Gil Joon Suh ),유은영 ( Eun Young You ),송경준 ( Kyoung Jun Song ) 대한외상학회 2007 大韓外傷學會誌 Vol.20 No.2
Purposes: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, burns, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. Methods: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients` data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. Results: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). Conclusion: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it`s impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable. (J Korean Soc Traumatol 2007;20:77-82)
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송경준,천성빈,신중호,이중의,서길준,윤여규 대한응급의학회 2003 대한응급의학회지 Vol.14 No.1
Purpose: There is a continuing debate about whether small bowel obstruction (SBO) is best managed operatively or nonoperatively. There is also no definite criteria for physician to decide to operate patient with SBO. This retrospective study was designed to determine the factors influencing the treatment modality of SBO. Methods: A clinical analysis was applied to 95 patients with SBO who were admitted to the emergency department of Seoul National University Hospital from January, 2000 to December, 2001. The patients were divided into the operative and non-operative treatment groups according to the treatment modality. We compared parameters such as age, sex, the etiology of SBO, the history of previous SBO, the history of previous operation due to SBO, time period from onset of symptoms to admission, and symptoms and signs between two groups. Results: Among 95 cases, the operative management was performed in 21 cases and the non-operative treatment in 74 cases. There was no significant difference in the distribution of age and sex between two groups. The most common etiology of SBO was adhesion due to previous operation. In the operative treatment group, 12 (57.1%) cases had the history of previous operation because of SBO, which showed a significant difference compared to the nonoperative treatment group (p<0.001). The major symptoms and signs were abdominal pain, vomiting, abdominal tenderness, hyperperistalsis, leukocytosis, tachycardia, rebound tenderness and fever. Of these symptoms and signs, rebound tenderness was only more common in the operative group than in the non-operative group (p<0.001). Conclusion: At the time of admission to the emergency department, the rebound tenderness in patients with SBO is an important factor to consider the early operative intervention.
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