Reduction of intra-hospital transport time using the easy tube arrange device

주기혁,유인술,이진웅,김승환,유승,유연호,조용철,정원준,안병준,조성욱 대한응급의학회 2016 Clinical and Experimental Emergency Medicine Vol.3 No.2

Objective Critically ill patients sometimes require transport to another location. Longer intra-hospital transport time increases the risk of hemodynamic instability and associated complications. Therefore, reducing intra-hospital transport time is critical. Our objective was to evaluate whether or not a new device the easy tube arrange device (ETAD) has the potential to reduce intra-hospital transport time of critically ill patients. Methods We enrolled volunteers for this prospective randomized controlled study. Each participant arranged four, five, and six fluid tubings, monitoring lines, and therapeutic equipment on a cardiopulmonary resuscitation training mannequin (Resusci Anne). The time required to arrange the fluid tubings for intra-hospital transport using two different methods was evaluated. Results The median time to arrange four, five, and six fluid tubings was 86.00 (76.50 to 98.50), 96.00 (86.00 to 113.00), and 115.50 (93.00 to 130.75) seconds, respectively, using the conventional method and 60.50 (52.50 to 72.75), 69.00 (57.75 to 80.80), and 72.50 (64.75 to 90.50) seconds using the ETAD (all P<0.001). The total duration (for preparing the basic setting and organizing before and after the transport) was 280.00 (268.75 to 293.00), 315.50 (304.75 to 330.75), and 338.00 (319.50 to 360.25) seconds for four, five, and six fluid tubings, respectively, using the conventional method and 274.50 (261.75 to 289.25), 288.00 (271.75 to 298.25), and 301.00 (284.50 to 310.75) seconds, respectively, using the new method (P=0.024, P<0.001, and P<0.001, respectively). Conclusion The ETAD was convenient to use, reduced the time to arrange medical tubings, and is expected to assist medical staff during intra-hospital transport.

Reduction of intra-hospital transport time(IHTT) using Easy Tubing Arrange Device (ETAD)

주기혁,조성욱 대한응급의학회 2015 대한응급의학회 학술대회초록집 Vol.2015 No.2

Introduction: Critically ill patients receive many examinations. Some require the patients to be transported to another location. Longer IHTT increases the risk of hemodynamic instability and impending complications. Therefore, reducing IHTT is critical. This study was designed to evaluate whether or not the newly invented device reduces IHTT of critically ill patients. Material & Methods: This prospective randomized control study was conducted in volunteers. Each participant arranged fluid tubing (4, 5, and 6), monitoring lines and therapeutic equipment setting on the CPR training mannequin. The time it takes to arrange the fluid and tubinging intra-hospital transport using two methods was evaluated. Results: For the conventional method, the total duration was 280.00 [268.75~293.00], 315.50 [304.75~330.75], and 338.00 [319.50~360.25] seconds respective to 4, 5 and 6 fluids, while the new method took 274.50 [261.75~289.25], 288.00 [2271.75~298.25], and 301.00 [284.50~310.75] seconds, respectively. Each showed statistically significant difference (p=0.024, p<0.001, p<0.001). Conclusion: The time to arrange medical tubing was reduced using ETAD and is expected to reduce the side effects that may occur during the intra-hospital transport of critically ill patients.

응급의학과 입원결정권이 응급실 재실시간에 미치는 영향: 역사적 대조군을 이용한 전후 연구

최현수,유승,조용철,정원준,조성욱,안홍준,주기혁 대한응급의학회 2017 대한응급의학회지 Vol.28 No.6

Purpose: This study analyzed the effects of the hospitalization decisions made by emergency physicians (EP) on the emergency department length of stay (ED-LOS). Methods: From March 2016, the hospitalization decisions of six internal medicine departments were made by EP, which has been implemented gradually since 2015. Through a retrospective electronic record review, the ED-LOS between EP hospitalization decision departments (group A) and others (group B) was analyzed and the ED-LOS before and after the hospitalization decision method change was compared (2014 vs. 2016). Results: Compared to 2014, in 2016, the ED-LOS in departments that hospitalization decision made by EP was reduced significantly (median with interquartile range; 478.0 minutes [319.0 to 900.5 minutes] vs. 259.0 minutes [177.0 to 384.0 minutes]; p<0.001). In addition, the ED-LOS in Group A was reduced more than in Group B (219.0 minutes (45.8%) vs. 30.0 minutes (10.2%). Conclusion: ED-LOS can be reduced by the EP hospitalization decisions.

병원 내 심폐소생술에서 흉부압박의 질에 있어 구조자 자세가 미치는 영향: 무작위 교차 마네킨 연구

전가람,조용철,안홍준,정원준,유연호,박정수,주기혁 대한응급의학회 2020 대한응급의학회지 Vol.31 No.6

Objective: This randomized crossover simulation study aimed to compare the effectiveness of chest compressions, performed during 10 minutes of cardiopulmonary resuscitation, in three different compression postures: standing posture (SP), single-leg kneeling posture (SLKP) and both legs kneeling posture (BLKP) on a manikin lying on a bed. Methods: Enrolled participants were doctors, nurses and emergency medical technicians who worked in the emergency department and performed chest compressions (CCs) without ventilation for 5 sessions (10 minutes) in the three compression postures from June to August 2019. The chest compression parameters (CCPs) such as compression depth, compression rate (CR), the accuracy of compression depth (ACD) and accuracy of relaxation (AR) were collected by the Resusci Anne PC skill report system. The statistical differences of CCPs between three postures were analyzed. Results: A total of 32 participants were enrolled in this study. There were no significant differences between SP, SLKP and BLKP on compression depth (52.6 vs. 53.2 vs. 50.9 mm, P>0.05), CR (110.2 vs. 111.8 vs. 111.6 compressions/min, P>0.05), ACD (43.7% vs. 47.0% vs. 46.3%, P>0.05), and AR (99.4% vs. 99.0% vs. 99.3%, P>0.05). There were no significant differences in CCPs according to chest compression time in the three postures. However, there was a significant difference between the SP and BLKP (16.0 vs. 14.0, P=0.023) on the Borg scale of subjective fatigability. Conclusion: In our study, when rescuers performed chest compression on a hospital bed, the parameters of CCs for the three compression postures were similar.

Is it possible to reduce intra-hospital transport time for computed tomography evaluation in critically ill cases using the Easy Tube Arrange Device?

Kyung Hyeok Song,조성욱,이진웅,조용철,정원준,유연호,유승,김승환,유인술,주기혁 대한응급의학회 2018 Clinical and Experimental Emergency Medicine Vol.5 No.1

Objective Patients are often transported within the hospital, especially in cases of critical illness for which computed tomography (CT) is performed. Since increased transport time increases the risks of complications, reducing transport time is important for patient safety. This study aimed to evaluate the ability of our newly invented device, the Easy Tube Arrange Device (ETAD), to reduce transport time for CT evaluation in cases of critical illness. Methods This prospective randomized control study included 60 volunteers. Each participant arranged five or six intravenous fluid lines, monitoring lines (noninvasive blood pressure, electrocardiography, central venous pressure, arterial catheter), and therapeutic equipment (O2 supply device, Foley catheter) on a Resusci Anne mannequin. We measured transport time for the CT evaluation by using conventional and ETAD method. Results The median transport time for CT evaluation was 488.50 seconds (95% confidence interval [CI], 462.75 to 514.75) and, 503.50 seconds (95% CI, 489.50 to 526.75) with 5 and 6 fluid lines using the conventional method and 364.50 seconds (95% CI, 335.00 to 388.75), and 363.50 seconds (95% CI, 331.75 to 377.75) with ETAD (all P<0.001). The time differences were 131.50 (95% CI, 89.25 to 174.50) and 148.00 (95% CI, 116.00 to 177.75) (all P<0.001). Conclusion The transport time for CT evaluation was reduced using the ETAD, which would be expected to reduce the complications that may occur during transport in cases of critical illness.