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      • KCI등재

        2급 응급구조사의 성인외상환자에 대한 처치의 적절성 평가

        장문수,어은경,김상현,김창섭,송근정,박한규,유지영,최동섭 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

        In Korea, EMT have two classified subgroup of first and second degree : EMT-P, and EMT. For the beginning, authorization of the first EMT was made in this year through the EMT educational program. There are 8 items which EMT can perform the treatment without the supervision by a physician. But there was no previous report of pertinent assesment of treatment performed by the EMT. There upon authors have conducted review of assessment done by the EMT in EC setting, and proposed the following treatment application can be used by EMT at the field of accident. The study materials include adult trauma patient older than 15 years, and sustained trauma within 48 hours before visiting Ewha University DongDaeMoon Hospital Emergency Deparment. The duration of study was from Apr. 1 1995 to Aug. 31 1995. the study was conducted by 5 certified EMT. The EMT's performance was evaluated by the attending Emergency Medicine physician. The result were as followings ; 1. Among the total 5532 ED visiting patients during the study period, 1267 were adult trauma patients who recieved treatment within 48 hours of injury. 2. Among 1222 out of 1267 patients have completed performed survey. 3. Male to female ratio was 2.6 : 1, age distribution was from 15 to 87 years old and mean age was 34.6 years old. 4. The MOI showed : MVA (33.1%), blunt trauma (29.9%), slip down (16.8%), penetrating injury(15.4%), and miscellaneous (5.7 %), burn (3.1%), falling down injury(2.9 %), bite injury(1.1%) in order. 5. There were 437 cases of survey completed by the EMT. For assessment of mental status of 3 different method : AVPU, 5 scale mental status and GCS, were correlated with EM physician with 99.1%, 98.6%, 97.7 %, respectively. 6. For 320 out of 437 cases of survey completed, 319 patients recieved treatment by the EMT within 30 minute and 1 patient between 30 to 60 minute of an ED arrival. 7. For those 437 cases of survey completed, 266 patient (60.9%) had adequate treatment and 54 patients (12.4%) had inadequate treatment. 67 patient (15.3%) did not received treatment but it was adequate inway, and 50 patients (11.9%) did not received treatment even though patient required treatment. In cases of adult trauma patients, EMT's mental status assessment was correlated with EM physician's assessment. But treatment done by EMT without the supervision of EM physician was adequate only in 76.2 %. Therefore, continuous education and assessment of treatment performed by EMT in needed to improve field treatment by EMT future.

      • KCI등재

        침술요법 후에 발생한 기흉 2례

        신준섭,어은경,최옥경 대한응급의학회 1996 대한응급의학회지 Vol.7 No.3

        Acupuncture is occasionally used in the treatment of intractable pain in the neck, shoulder, and any other site. Complications seem to be increasing by the frequency of acupuncture. Patients undergoing such therapy should be advised on its potential hazards. During the management of the patient with dyspnea, we experienced two cases of pneumothorax associated with acupuncture. A 53-year-old male and a 44-year-old female were carried into the emergency department in our hospital. They experienced shortness of breath and respiratory difficulty after multiple needle insertion in their back during acupuncture procedure. The chest X-ray was immediately taken and pneumothorax was found. The closed-chest thoracotomy with underwater seal drainage was performed in the emergency department. They were discharged after the chest tubes were removed, confirming the complete reexpansion of the lung.

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