급성약물중독환자의 간호실무표준 개발 : 응급의료센터 내원환자 중심으로

이은경(Eun Kyung Lee),김희정(Hee Jung Kim),박선영(Sun Young Park) 대한여성건강학회 2008 여성건강 Vol.9 No.2

The purpose of this study is to present the desirable level of emergency nursing care of acute drug intoxication by identifying the roles and activities of nurse of emergency medical center as well as to raise the quality of nursing care of acute drug intoxication. The 143 activities of nurse of emergency medical center were identified through a review of literature and a state-of-the-practice survey. The 143 activities were classified into roles and tasks. The roles and tasks were developed to standards and criteria. To verify the content validity of the draft standards and criteria, emergency nursing experts were asked to rate each item of standards and criteria. The data analysis was conducted using the Content Validity Index(CVI). The final 8 standards and 38 criteria of acute drug intoxication care were developed through two rounds of content validity verification. The nursing care standards of acute drug intoxication can present the ideal nursing care and be used as a tool for the quality of nursing care of acute drug intoxication.

Clinical Characteristics of Acute Drug Intoxication in Emergency Department

Kim In Byung,Chun Sung Pil,Kim Seung Whan 대한의생명과학회 2004 Biomedical Science Letters Vol.10 No.3

The number of acute drug intoxication who visiting to emergency department which is located near urban and rural area concomitantly is inclined to increase slightly, The purpose of this study was the investigation of methods and strategies of management of acute drug intoxication in emergency department Clinical trials were done on 92 cases of acute drug intoxication visiting to Emergency Department of Chungnam National University Hospital during 4 months from April to July 2003. 1. The total number of acute drug intoxication during this period was 92 patients, which presented 0.95% of all the emergency department visiting patients during the study. The intentional ingestions were observed in 84 cases (91.3%). 2. The maximal point of age distribution was 4th decade. The number of that was 21 cases (22.8%). 3. The number of patients who had ingested benzodiazepines and doxylamine succinates was 26 cases (28.2%), organophosphorus was 20 (21.7%), paraquat was 10 (10.8%), others were 36 (39.3%). 4. Five kinds of po1ydrug ingestion was observed in 3 cases, four kinds was observed in 3, three kinds was observed in 5 and co-ingestion of alcohol was observed in 28 cases (30.4%). 5. The mortality was occurred in 4 cases, 2 of them were caused by paraquat, 1 of them was caused by organophosphorus (OP), 1 of them was caused by acetic acid. 6. The gastric larvage as a mean of treatment modality was done in 57 cases (61.9%). The use of activated charcoal was done in 8 (8.69%). The maintenance of tracheal intubation was done in 6 (6.52%). 7. The mean observational period in emergency department was 8 hours 42 minutes in benzodiazepine and doxylamine succinate group, 21 hours 46 minutes in OP, 20 hours 39 minutes in other germicidal except OP, 23 hours 9 minutes in paraquat group. Without a drug information and intoxication center in Korea, We should minimize the exhaustion of medical resources by establishment of determinant criteria which can be seen in relatively less-complicated cases of acute drug intoxication. Thus, we should consider the introduction of simple toxicology treatment protocol and toxicologic observation unit in emergency department as possible means to reduce economical and social burdens.

응급실로 내원한 급성 약물중독 환자들의 임상적 특징

이경호,김경환 대한응급의학회 1996 대한응급의학회지 Vol.7 No.3

The initial treatment of acute drug intoxication must start as soon as possible. The treatment has been started mostly in emergency department . We have reviewed 353 patients who visited to emergency department of Sanggye Paik Hospital from 1, January to 31. December in 1994 to look for clinical characteristics of acute drug intoxication. It was 0.66% of total emergency department patients. Male to female ratio was 1:1.9 and the age distribution revealed a high incidence in third decade(29.5%). The motives of intoxication were suicidal attempts in 68.9% and accidental intoxication in 31.1 %. The drug used in acute intoxication were sedatives, NSAID, insecticide, rodenticide, in order. Admission rate was 18.4% and mean hospital day 7.1 days. ICU admission rate was 67.7% and mean staying time was 4.6 days. Overall mortality rate of total cases was 1.98 % and prominent in herbicide intoxication.

Clinical Characteristics of Acute Drug Intoxication in Emergency Department

In Byung Kim,Sung Pil Chung,Seung Whan Kim 대한의생명과학회 2004 Biomedical Science Letters Vol.10 No.3

The number of acute drug intoxication who visiting to emergency department which is located near urban and rural area concomitantly is inclined to increase slightly. The purpose of this study was the investigation of methods and strategies of management of acute drug intoxication in emergency department. Clinical trials were done on 92 cases of acute drug intoxication visiting to Emergency Department of Chungnam National University Hospital during 4 months from April to July 2003. 1. The total number of acute drug intoxication during this period was 92 patients, which presented 0.95% of all the emergency department visiting patients during the study. The intentional ingestions were observed in 84 cases (91.3%). 2. The maximal point of age distribution was 4th decade. The number of that was 21 cases (22.8%). 3. The number of patients who had ingested benzodiazepines and doxylamine succinates was 26 cases (28.2%), organophosphorus was 20 (21.7%), paraquat was 10 (10.8%), others were 36 (39.3%). 4. Five kinds of polydrug ingestion was observed in 3 cases, four kinds was observed in 3, three kinds was observed in 5 and co-ingestion of alcohol was observed in 28 cases (30.4%). 5. The mortality was occurred in 4 cases, 2 of them were caused by paraquat, 1 of them was caused by organophosphorus (OP), 1 of them was caused by acetic acid. 6. The gastric larvage as a mean of treatment modality was done in 57 cases (61.9%). The use of activated charcoal was done in 8 (8.69%). The maintenance of tracheal intubation was done in 6 (6.52%). 7. The mean observational period in emergency department was 8 hours 42 minutes in benzodiazepine and doxylamine succinate group, 21 hours 46 minutes in OP, 20 hours 39 minutes in other germicidal except OP, 23 hours 9 minutes in paraquat group. Without a drug information and intoxication center in Korea, We should minimize the exhaustion of medical resources by establishment of determinant criteria which can be seen in relatively less-complicated cases of acute drug intoxication. Thus, we should consider the introduction of simple toxicology treatment protocol and toxicologic observation unit in emergency department as possible means to reduce economical and social burdens.

Clinical Characteristics of Acute Drug Intoxication in Emeergency Department

Kim, In Byung,Chung, Sung Pil,Kim, Seung Whan THE KOREAN SOCIETY FOR BIOMEDICAL LABORATORY SCIEN 2004 Journal of biomedical laboratory sciences Vol.10 No.3

The number of acute drug intoxication who visiting to emergency department which is located near urban and rural area concomitantly is inclined to increase slightly. The purpose of this study was the investigation of methods and strategies of management of acute drug intoxication in emergency department. Clinical trials were done on 92 cases of acute drug intoxication visiting to Emergency Department of Chungnam National University Hospital during 4 months from April to July 2003. 1. The total number of acute drug intoxication during this period was 92 patients, which presented 0.95% of all the emergency department visiting patients during the study. The intentional ingestions were observed in 84 cases (91.3%). 2. The maximal point of age distribution was 4th decade. The number of that was 21 cases (22.8%). 3. The number of patients who had ingested benzodiazepines and doxylamine succinates was 26 cases (28.2%), organophosphorus was 20 (21.7%), paraquat was 10 (10.8%), others were 36 (39.3%). 4. Five kinds of polydrug ingestion was observed in 3 cases, four kinds was observed in 3, three kinds was observed in 5 and co-ingestion of alcohol was observed in 28 cases (30.4%). 5. The mortality was occurred in 4 cases, 2 of them were caused by paraquat, 1 of them was caused by organophosphorus (OP), 1 of them was caused by acetic acid. 6. The gastric larvage as a mean of treatment modality was done in 57 cases (61.9%). The use of activated charcoal was done in 8 (8.69%). The maintenance of tracheal intubation was done in 6 (6.52%). 7. The mean observational period in emergency department was 8 hours 42 minutes in benzodiazepine and doxylamine succinate group, 21 hours 46 minutes in OP, 20 hours 39 minutes in other germicidal except OP, 23 hours 9 minutes in paraquat group. Without a drug information and intoxication center in Korea, We should minimize the exhaustion of medical resources by establishment of determinant criteria which can be seen in relatively less-complicated cases of acute drug intoxication. Thus, we should consider the introduction of simple toxicology treatment protocol and toxicologic observation unit in emergency department as possible means to reduce economical and social burdens.

1980년대와 1990년대의 급성약물중독 환자에 대한 비교

한승태,이준희 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

Background : To comparatively analysis the epidemiological changes in the acute drug intoxication between 1980s and 1990s. Methods : We reviewed retrospectively the medical records of the patients with acute drug intoxication in the emergency department of the Inha hospital from June 1986 to April 1987 and from June 1996 to May 1997. And we performed comparative analysis between two results. Results : The ratio of the acute drug intoxication in the emergency medical center was reduced significantly in 1990s against 1980s. Sexual ratio and prevalent age group has no significant interval changes between 1980s and 1990s. The prevalent seasons were Spring in 1980s and Summer in 1990s but has no significance. The most commonly used drugs was rodentides in 1980s and hypnosedatives in 1990s and shown significant interval changes. The most common motive was suicidal attempts in both 1980s and 1990s, but significantly reduced. After emergency treatment the rate of curative-discharge has improved and the rate of admission has decreased significantly in 1990s against 1980s. The most critical agent was agricultural chemicals in both 1980s and 1990s. The mortality rate has no significant interval changes. Conclusion : There were some significant interval changes of the acute drug intoxication in prevalence rate, commonly used drugs, ratio of suicidal attempt and curative-discharge rate between 1980s and 1990s. New education programs for preventing acute drug intoxication and strict legal control of drugs are important and necessary.

급성 약물중독 환자의 응급의학적 고찰

강지훈,이현노,진영호,이재백 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

Background : Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. Methods : Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. Results : 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p. m. and of the time on arrival to emergency center was 8 p. m. - midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. Conclusion : The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p < 0.05).

급성 약물중독에 관한 임상적 고찰

송종오,민미심,조영일,김준호,허원만,주용진 건국대학교 의과학연구소 1994 건국의과학학술지 Vol.4 No.-

A clinical study was made in 234 cases of acute drug intoxications who visited to emergency room of Kon Kuk University Hospital during recent 4 years from January 1990 to december 1993. The following results were obtained. Total number of cases of acute drug intoxications was 234 which comprised 0.46% of total number of patients of the emergency room during the same period. The ratio of male to female was 1:1.07. The highest age incidence was in the third decade(27.8%). The monthly incidence was highest in July. Higher frequency was observed in summer season. The most common drug of the intoxication was pesticides and herbicides(52.6%), the remainders were sedatives and analgesics(24.8%), miscellaneous drugs(13.2%), rodenticides(5.6%) and unknown drugs(3.8%) in orders. The most common cause of drug intoxication was suicide(69.3%) and the others were accident, intention, unknown causes in orders. Main clinical manifestations were the impaired consciousness, nausea, vomiting, dizziness and dyspnea. Physical examination revealed tachycardia, increased blood pressure, miosis of the pupil and sweating. The complications were developed in 15.8% among 234 cases and common complications were respiratory failure, cardiovascular collapse, pneumonia, renal failure, pulmonary edema, brain edema in orders. Overall mortality rate was 8.1% of total cases and the mortality rate was highest in herbicide intoxication(29.4%).

부산 지방의 급성 약물 중독에 관한 임상적 관찰

이재동,송갑영,강창일,정정명,최하진 인제대학교 1981 仁濟醫學 Vol.2 No.2

개원 이래 1년 1개월간 본원에 내원하였던 급성 약물 중독 환자 240례를 임상적으로 관찰하였다. We did clinical evaluation with the 240 acute drug intoxication cases which occurred from June 1979. to Jull 1980 (13 months) in Busan with her surrounding rural area and following results were obtained. 1) Acute drug intoxication was 3.4% of total emergency visits and incidence leas highest in July, Summer season and 3rd. decade age group. 2) The motive of intoxication was suicidal attempt 78.3%, and the remainder was accidental poisoning. Male to Female ratio was 1: 1.2. The order of causative agent frequency was pesticides which was predominantly in rural area, various kinds of drugs, hyponotics & rodenticides which was predominantly in inner city area. 3) Overall fatality rate was 9.6%, most of them was pesticidal case and 77. 1% close was completely recovered.

급성 약물 중독환자에서 발생된 폐렴의 임상양상 및 위험인자에 대한 고찰

윤현주 ( Hyun Ju Yoon ),손지웅 ( Ji Woong Son ),최유진 ( Eu Gene Choi ) 대한결핵 및 호흡기학회 2005 Tuberculosis and Respiratory Diseases Vol.59 No.4