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김정애,이은휘,김민영,장은희,김현정,형경선,송혜숙,김은영,홍승희,김경미,이혜련 병원간호사회 2001 임상간호연구 Vol.7 No.2
The purpose of this study is to improve the development and effective management of emergency medical care. The author has analized patients who visit the ED(2nd referral level) by ambulance and evaluated proper transportation according to the level of general conditions. The period of the study is 4 months from May 1 to Aug 31 in 2001. The population of the retrospective study are 1,346 patients. Collected data were reevaluated and classified by the properties of the patients and they were calculated by frequency and percentages. The results were as follows; 1) Of the total 7,358 patients, 1,346 visited ED via ambulance, attributed to 1,246(92.6%) via 119 system, 65(4.8%) via 129 emergency system, and 35(2.6%) via other hospital ambulances. 2) Male and female patients were 761, 585 respectively in number. The peak age was 3rd decade. Residency was limited to YONGSAN-KU. The time of admission was 20-24 hour, 12-16 hour, by orders. The peak day of admission was concentrated on the Sunday(including holiday), Friday, Monday, Wednesday by orders. The places of accident were at home, street, roadways, other hospital, subways by orders. Depts. of admission were medicine, neurosurgery, orthopedics by orders. 3) In aspect of the medical severity, 120(8.9%) patient were classified into emergent, 439(32.6%) into urgent and 787(58.5%) into nonurgent. 4) The distribution of the emergency level according to medical service showed that of the total 1,246 patients, 100(8%) emergent, 396(31.8%) urgent and 750(60.2%) nonurgent used 119 system, total 65 patients, 9(13.8%) emergent, 30(46.2%) urgent and 26(40%) nonurgent used 129 system, total 35 patients, 11(31.4%) emergent, 13(37.2%) urgent and 11(31.4%) nonurgent used other ambulances. 5) The results of the patient management were ward admission 248(18.4%), ICU admission 84(6.2%), transfer 106(7.9%), expire 15(1.1%) and discharge 893(66.4%). 6) The results of the patient management according to medical service showed that of the total 1,246 patients, 194(15.6%) ward admission, 63(5.1%) ICU admission, 98(7.9%) transfer and 877(70.3%) discharge used 119 system, total 65 patients, 32(49.2%) ward admission 12(18.5%) ICU admission, 6(9.2%) transfer, 1(1.5%) expire and 14(21.5%) discharge used 129 system, total 35 patients, 22(62.9%) ward admission, 9(25.7%) ICU admission, 2(5.7%) transfer and 2 (5.7%) discharge used other ambulances. The above results guided us to see that 58.5% of the patients who visited ED were nonurgent conditions, which make the state of 2nd referral level ED crowded by the nonurgent patients. These conditions deteriorate the effective management of emergency medical care. To improve & solve this matter, paramedics who are responsible for the patient distribution by ambulance should recognize the urgent level of the patients so that really urgent patients and people in need of 2nd referral level's help can be provided with proper managements. To accomplish this, efficient communication systems between near hospitals and continuous propaganda to the people are desperately required.
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