소아복부둔상시 저혈량성 쇽과 연관된 복부전산화 단층촬영술의 유용성

박광철,조수형,조남수,박진,변주남 대한응급의학회 2000 대한응급의학회지 Vol.11 No.4

Background: We reviewed retrospectively the clinical features and contrast material-enhanced computed tomography(CT) after blunt abdominal trauma demonstrated a characteristic hypoperfusion complex. Our purpose were to evaluate the hypothesis that children with this "hypoperfusion complex" CT finding were associated with a tenuous hemodynamic state, severe injury and a poor outcome. Methods: Between January 1996 and December 1999, 39 consecutive children who sustained blunt trauma and were suspected clinically of having intraabdominal injury underwent CT. Demographic data, blood pressure, indication for CT, pediatric trauma score(PTS) and Glasgow coma score(GCS) were recorded at the time of the initial examination. Results: Three of the 39 children(8%) demonstrated a characteristic finding at CT which was described as the hypoperfusion complex. The "hypoperfusion complex" was present in the 3 of the 39 traumatized children(8%), but was the main radiographic finding in the 3 of the 14 children with a severe pediatric trauma score(PTS<8) and in the 3 of the 6 children with a Glasgow coma score(GCS<8) who were examined with CT. Conclusion: The CT findings in all children with the hypoperfusion complex by definition included marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidney and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava(IVC); and moderate to large peritoneal fluid collection. This "hypoperfusion complex" is a relatively rarely observed in injured children but appears to be associated with severe injury and a poor outcome. The pediatric trauma score provides a useful profile of injury severity in children. Prompt diagnosis of hypovolemic shock is important so that supportive therapy can be instituted to prevent further metabolic abnormalities and their potential cardiotoxic effects. In summary, the intense multiorgan enhancement pattern seen in the hypoperfusion complex indicates tenuous hemodynamic stability and is associated with a poor outcom.

응급의료센터로 내원한 헬기 후송 환자의 현황 및 분석

박진,조남수,조수형 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Our hospital is only emergency medical center that possess the landing zone of helicopter in chon-nam, Korea. An analysis of the present condition of helicopter-transport patient, was performed in order to pursuit and extend the availability of air transport in the future. The result were as follows; 1) The investigated in the present condition by yearly: 2 cases in 1991, 5 cases in 1992, 4 cases in 1993, 9 cases in 1994, 5 cases in 1995. 2) In the proportion of male to female, showed a ratio of three to one [male;72%(18), female;28%(7)] and showed third decade(7 cases), fifth decade(6 cases), sixth decade(4 cases) in comparison of age. 3) The geographical distribution of occurrence showed island areas(64%), inland areas(36%), and 6 cases of inland areas occurred of mountainous region. 4) One cause of events was traumatic causes(52%), which included traffic accident(5 cases) & fall down(4 cases). The other cause was disease(48%). 5) The expended time of helicopter from start to arrive at accident spot within Chon-nam area is from ten minutes to forty-five minutes, as mean expended time is thirty minutes. 6) The expended time from occurrence of patient to admitted hospital was from minimum twenty-five minutes to maximum eight hours and forty minutes, as expended time is one hundred and eighty-six minutes. 7) After arrived at landing zone, via emergency department to admitted patient; 12 cases, performed emergency operation; 4 cases, D.O.A. state; 2 cases, hopeless discharge; 2 cases, transfer to other hospital; 4 cases. Up to now, the present condition of helicopter-transport system was looked upon as petty affairs, and determination of transport was swayed by geographic element rather than severity of injury. And so, it is considered that epochal turning point is necessary for development of helicopter-transport system.

응급 수술에 대한 기술통계학적 고찰 : 한 종합병원의 1개년을 중심으로 This statistical data derived from our hospital for one year

조남수,김용배,소금영 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

경련 발작에 대한 초·중·고교 응급처치교육 모듈 평가

조준필,박남수,안정환 韓國學校保健學會 2009 韓國學校保健學會誌 Vol.22 No.1

Purpose : The purpose of this study was to evaluate the effectiveness of first aid education module on convulsion and seizure for students in elementary, middle and high school. Methods : This study has implemented to 2 types of test groups and control group in each 3rd and 5th grade of elemenary school, 2nd grade of middle school and high school within target school. The data were collected through a self-reported questionnaire to before, after and one month after education from July, 11 to September 4, 2007. Results : The test group who received first aid education possessed greater knowledge about convulsion and seizure relative to the control group not received education. The overall students has satisfied and been understood well with this module. The educators agreed to the practical aspects of this module in school setting. Conclusion : The above results implicated the importance of a continuous and systematic first aid education program among students. For effective first aid education, there needs a development of targeted educational materials for each grade student and training programs for educators.

응급실 내원 환자 14,836례의 통계적 고찰

조수형,조남수,임경준 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

Cases of 14,836 patients who visited the emergency room at the Chosun University Hospital from January 1 to December 31, 1994 were analyzed statistically according to sex, age, department, admission, discharge and used transportations. The results were as follows: 1) Considering sexual distribution, male patients were 52.3% and female patients were 47.7%. 2) According to age categories, 4th decade of life was most frequent. 3) According to the department distribution, internal medicine accounted for 22.7%, orthopedic surgery 15.4%, neurosurgery 12.4% and pediatrics 11.7%. 4) The rate of patients admitted via emergency room was 38.0% of total number of patients visited emergency room. The department distribution was as follows: internal medicine 24.1%, neurosurgery 13.7%, orthopedic surgery 12.1%, general surgery 10.5%. 5) 62.0% of patients visited emergency room were discharged. The department distribution was as follows: internal medicine 21.9%, orthopedic surgery 17.5%, pediatrics 13.3%. 6) The number of DOA patients was 212(14.3%) and it showed highest rate in December. 7) A car and taxi were the most frequently used transportation(70%) but the used rate of hospital, 119 and 129 ambulance tended to increase. 8) Emergency room was visited most frequently from 20 to 24 hours. 9) Consumed time from arrival to emergency care of the relevant department was within one hour(67%).

중심 정맥 도관 348례의 임상적 고찰

조남수,김용배,임경준 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

To evaluate clinical trends, central venous catheterization of 348 in total performed at the Chosun University Hospital from January 1993 through December 1994 were analyzed clinically & statistically according to sex, age, department, used veins and complications. The results are as follows : 1) Considering sexual distribution, male patients were 61.2% and female patients were 38.8%. 2) According to age categories, fourth decade of life was most frequent. 3) According to departmental distribution, general surgery was 38.5%, chest surgery was 21.0% and orthopedic surgery was 12.9%. 4) Subclavian vein used most frequently (74.1%), and femoral vein accounted for 14.9%, extermal jugular vein 7.5% internal jugular vein 3.4%. 5) Complications associated with subclavian vein catheterization using infraclavicular approach occupied 15.1%(39 cases) of total subclavian vein catheterization(258 cases), and among these complications pneumothorax occupied 43.6%, subcutaneous hematoma 28.2%, local infection 15.4%.

광주·전남 지역 병원간 응급 의료 전달 체계에 대한 연구 : 조선대학교 병원 응급의료센터를 중심으로

조남수,조수영 조선대학교 2001 The Medical Journal of Chosun University Vol.26 No.1

Background: To provide basic data to help construct regional EMSS. Methods: Using a questionnaire, the authors investigated prospectively the data of 766 patients transferred directly to Emergency Medical Center of Chosun University Hospital from other hospitals from April 1 to May 31, 2000. Results: 1) Transfer records; Transfer records of 407(53.1%) patients were faithful, 159(20.7%) patients were unfaithful. 47(6.2%) patients made a phone call to the emergency room or the Department of Emergency Medicine, 9(1.2%) patients to other departments, and 144(18.8%) patients were others. 2) The distribution of the region; A regional distribution of 766 patients transferred to Chosun University Hospital. The transfer took less than 1 hour in 134 patients, it took 1~2 hours in 150 patients, 2~3 hours in 222 patients and 3 hours or more in 260 patients. 3) The mode of transfer; Of the 766 patients, 8(1.1%) patients were transferred by foot, 78(10.2%) patients by a 119 rescue ambulance, 428(55.9%) patients by a hospital ambulance, 31(4.0%) patients by an emergency rescue party, 149(19.5%) patients used private cars, 67(8.8%) patients used public transportation and 5(0.6%) patients were transferred by others means. 4) The reason of transfer; 138(18%) transferred patients from primary hospital or secondary hospital wanted the transfer. 306(39.9%) patients were transferred due to inducement, 162(21.1%) patients due to the absence of specialized departmental doctors, 64(8.4%) patients due to emergency surgery, 46(6%) patients due to bed deficit and 50(6.5%) patients due to other reasons. 5) Diagnosis and treatment in ER; Among all transferred patients, 6 patients were in pericardiocentesis, 103 patients in CT(brain), 61 patients in MRI(brain), 65 patients CT(other part), 10 patients in MRI(other part), 15 patients in closed thoracostomy, 148 patients in central vein catheterization, 5 patients in 4-vessel angiogram and 152 patients in endotracheal intubation. 6) The result of treatment; 458(59.8%) patients were admitted, 148(19.3%) patients to ICU, 15(2%) patients were admitted to a delivery room, 14(1.8%) patients were transferred to an other hospital, 30(3.9%) patients were in a mortuary, 101(13.2%) patients were discharged and 221 patients were admitted for an emergency operation. Conclusion: For effective and well organized EMSS the following are required. Communication prior to the patients transfer. Reinforcement of ambulance equipment and training of emergency staff for long distance transfer of a serious case. A detailed record of early state and treatment of transferred patients. The standardizational the transfer records which contains first aid treatment including fluid treatments, address and early vital signs of patients. Investigation and study for newlydeveloped transfer records.

급성 약물 중독에 대한 임상적 고찰

조수형,조남수,김용배 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

A clinical observation was made on 194 cases of drug intoxication to Chosun University hospital via emergency room during one year from January 1994 to December 1994. The observed results were summarized as follows; 1. The ratio of drug intoxicated patients to total patients of emergency room was 1.3%(194 patients of the total 14,836 patients) 2. Female was slightly more than male (54% : 46%) and the age group of the third decade was of the largest proportion. 3. In monthly distribution, September had the largest propotion(14.4%). The largest proportion of the time interval on arrival to emergency room and of presumed time of poisoning was night(8 p.m. ∼12 p.m.). 4. Suicidal attempt was the most common motive of drug intoxication(82.5%). 5. The most common drug of intoxication was S.H.T.(sedatives, hypnotics, tranquilizer)(24.7%). 6. The abnormal signs on arrival to emergency room were tachycardia, tachypnea, hypertension in order of frequency. 7. The observed abnormal laboratory findings on arrival to emergency room were leukocytosis(97 cases), glucosuria(21 cases), proteinuria(10 cases) in order of frequency. 8. The outcome of the patients were recovery(42.8%), against discharge(35%), hopeless discharge(16%), death(6,2%).

인도네시아 지진해일에 대한 의료지원보고

조수형,김선표,최웅지,김성중,조남수,이준영,문성표 朝鮮大學校 附設 醫學硏究所 2005 The Medical Journal of Chosun University Vol.30 No.2

An unprecedented magnitude of disaster, Tsunami, washed away Southeast Asia, on December 26, 2004. and more than 200,000 peoples were killed by the disaster. Staffs of our hospital visited Indonesia for voluntary medical supports from January 12, to January 21, 2005. We summarize here our 10 days' experiences in Indonesia.

전신마취중 발생한 부적합 수혈 1례 보고 : A case Report

조남수 최신의학사 1988 最新醫學 Vol.31 No.8