응급실 내원 자살시도자의 정신과 진료 연계 관련 특성

박한나 ( Han Na Park ),전성숙 ( Seong Sook Jun ),변은경 ( Eun Kyung Byun ) 경희대학교 동서의학연구소 2014 동서간호학연구지 Vol.20 No.2

Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, χ²-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters’ refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was “I’m not mad. I don’t need the psychiatric treatment.” Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

야전부대 의무병이 인식한 응급처치 수행능력

박영숙(중령) ( Young Sook Park ),정은비(대위) ( Eun Bi Jeong ),정재은(대위) ( Jae Eun Jeong ),이지영(소령) ( Ji Young Lee ) 국군간호사관학교 군건강정책연구소 2016 군진간호연구 Vol.34 No.1

Purpose: The purpose of this research is to comprehend the level of emergency treatment performance abilities of the field unit medics the differences in emergency treatment performance capabilities depending on the characteristics and training contents. Method: Survey was conducted for 490 soldiers in 8 units. Out of 490 participants, 469 were used in the analysis. The reliability of measurement tool was confirmed through a coefficient. The analysis included frequency, percentage rate, mean, standard deviation, t-test, ANOVA. Result: Emergency treatment self-evaluation results demonstrated that there was a notable difference in self-evaluation scores depending on licenses and service echelons. The Self-evaluation scores of those who had received emergency treatment training were significantly higher than that of those that did not. Conclusion: There needs to be training reinforcements on parts that demonstrate differences in performance capabilities depending on the types of emergency treatment. Conscription of superb soldiers as medics by reinforcing the standard of licenses or their specialties is also worth considering. And regular and formal education is very important in having confidence and knowledge.

제주 지역 간호사의 구강 악안면 영역 손상에 대한 응급 처치 인식도

이병진(Byoung-Jin Lee),송효정(Hyo-Jeong Song),임길채(Gil-Chai Lim),감세훈(Se-Hoon Kahm),김성준(Sung-Joon Kim) 대한치과의사협회 2012 대한치과의사협회지 Vol.50 No.12

The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question "education time on dentistry in formal education" that marked "0 hour" and "1-3 hours" were 73.3% and 20.0%, respectively. The question "refresher training class on dentistry" that marked "0 hour" and "1-3 hours" were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question "reduction of temporo-mandibular joint(TMJ)"(1.67±0.857), "fixation of dislocated TMJ"(1.70±0.853) and "post-avulsed tooth treatment"(1.78±0.774) by 5-point Likert scale. Likewise, the scores were 2.02±0.806 in the question "treatment of maxillofacial trauma", 2.76±1.061 in the question "emergent care of avulsed tooth", 2.70±1.095 in the question "treatment time of avulsed tooth" and 2.79±1.056 in the question "mouth guard", respectively. Compared to EMT, results of RN showed a statistically lower figure(ph0.05) in all items compared except the question "medicine control", and the question "doctor care in emergency room" was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.

한국, 미국, 유럽의 코로나19 백신 및 치료제 허가·승인 현황 비교

이영빈(Yeongbin Lee),이의경(Eui-Kyung Lee) 대한약학회 2023 약학회지 Vol.67 No.3

As demand for COVID-19 vaccines and treatments has soared, each country has applied appropriate approval/authorization system according to circumstances, such as emergency use authorization, conditional marketing approval, or other rapid procedures to introduce COVID-19 related items quickly. This study compared and analyzed the approval/authorization status of COVID-19 vaccines and treatments in Korea, the United States, and Europe. There were differences in the number and types of approved vaccines and treatments and also in the approval procedures used across countries. The United States adopted the emergency use authorization system, and Europe utilized the conditional marketing authorisation system, while Korea mainly applied conditional approval for vaccines and emergency use authorization for treatments. After initial approval in the US, Europe, most vaccines and treatments were introduced with delay in Korea. For instance, the average of Drug lag time for vaccines was about two months(61.5days). In the case of treatments, the difference between Drug lag time among items was relatively large. Considering that Korea's review period for drug approval is similar to that of the United States or Europe, it is necessary to proceed more quickly with approval applications and emergency authorization reviews in the event of other public health emergencies in the future.

응급실에서 소아외상환자의 치과적 처치를 위한 케타민 진정법의 사용 현황

차윤선,김지훈 大韓小兒齒科學會 2015 大韓小兒齒科學會誌 Vol.42 No.1

어린이는 쉽게 넘어지거나 부딪혀 구강안면부의 손상을 흔히 경험하며, 응급치료를 필요로 한다. 이러한 환자들에서는 공포와 불안으로 인해 협조도가 불량해지게 된다. 케타민은 일반 응급실에서 어린 환자의 치료와 검사를 위한 진정제로 잘 알려져 있다. 본 연구에서는 원주 세브란스 기독병원 응급실에서 케타민을 이용한 진정법을 시행한 현황에 대해 알아보았다. 2010년 1월에서 2014년 5월까지 치과적 응급처치를 위해 의뢰된 만 18세 이하의 환자들의 기록이 수집되었으며, 연령, 성별, 시행된 치과적 치료, 케타민 진정법 시행 여부에 대한 자료를 분석하였다. 총 659명의 소아 환자가 치과적 응급처치를 필요로 하였으며, 이중 118명이 케타민 진정법이 시행되었다. 조사 결과 열상의 봉합을 시행한 환자에서 진정법이 더 많이 시행되었고, 연령이 어릴수록 진정법이 시행되었던 상관성이 확인되었다. 케타민 진정법은 치과의사 단독으로 사용하지 않아야하지만, 응급실에서 1차 진료를 담당하는 치과의사는 케타민 진정법이 적용된 환자들을 쉽게 접할 수 있다. 따라서, 응급실에서 근무하는 치과의사는 케타민의 임상적 효과, 고려사항, 그리고 발생 가능한 합병증 및 대처 방안에 대해 숙지하고 있어야 할 것으로 사료된다. Children commonly experience orofacial injuries and often need emergency treatment. Due to fear and anxiety,children tend to be uncooperative in emergency rooms. Ketamine hydrochloride is a well-known sedative agentat medical-based emergency rooms which has been used for procedural sedation. In this paper, we will discussthe sedation of uncooperative young patients, who needed dental treatments in the emergency room at WonjuSeverance Christian Hospital, using ketamine. We collected the records of patients under 18-years-old whovisited the emergency room for dental treatment from January 2010 to May 2014. The data was categorized byage, sex, required dental treatments and application of ketamine sedation. Among 659 pediatric patients whovisited for emergency dental treatments, 118 patients were treated under sedation using ketamine. Majority ofpatients were under the age of 6 (110 patients), and the most frequent cause of sedation was suture of orallaceration (105 patients). Though ketamine should not be used by dentists alone, dentists in emergency roomscan easily meet the patients under deep sedation using ketamine. Hence, dentists in emergency rooms need tobe aware of the clinical effects, considerations, and potential adverse effects of ketamine.

선원법상 선원건강증진을 위한 제도개선에 관한 연구

전영우,김재호,서우영,최연희,최순호,박일수,강성홍 한국해사법학회 2013 해사법연구 Vol.25 No.3

This study intends to identify items necessary for strengthening medical as-sistance and health promotion of seafarers, through the questionnaire survey and analyses on the present status of medical care and health conditions of sea-farers, and propose the directions for improving system for promotion of health and medical care conditions on board. It is necessary to make legal base in or-der to achieve policy tasks to be taken for the promotion of seafarers' health identified by this study. To this end the following should be carried forward.Firstly, the quality of emergency medical assistance to ships needs to be enhanced. To do this, it is necessary to cope with the present limitations where emergency medical assistance is given by heavily relying on the audio in-formation through radio medical advice and to strengthen legal system requiring ships to equip with health measurement instrument on board through which the doctor providing medical advice could much better grasp the health conditions of seafarers in emergency.Secondly, it is necessary to improve the medical care system where the med-ical assistance must be available not only in emergency situations but also or-dinary normal times through innovating the present system where it is available only in emergency situations. To realize this, it is essential to amend the legal system relating to the remote medical treatment and care. It must be pro-spectively considered, for special places such as ships, etc. where the avail-ability in utilizing medical institution is limited, to allow the remote medical care for which medical care demander have been longing.Thirdly, it is necessary to enhance the legal system whereby latest emer-gency medical equipment having recently been developing should be carried on board as well as medicines essential for various emergency situations on board should be provided and necessary preventive medicines should be despatched without delay especially upon outbreak of a new infectious disease. To do this, the regulation 52 of enforcement ordinance of Seafarers' Act needs to be re-vised as well as a system needs to be introduced whereby a periodic review on the standards concerning medicines and medical equipment to be carried on board could be conducted.Fourthly, with respect to improving the system of persons in charge of medi-cal care it is necessary to amend the articles 85 and 87 of Seafarers' Act so that shipowners must appoint either master or chief officer as the person in charge of medical care or medical first aid. And it should be tried to introduce a system where the person in charge of medical care or medical first aid could assist remote medical doctors for successful medical treatment in the situations of providing remote medical treatment for seafarers in order to promote the ef-fectiveness of remote medical treatment and care for seafarers.Fifthly, it is also necessary to develop health check-up equipment to be car-ried on board and introduce the preventive health management system for sea-farers where seafarer's health conditions could be checked up by conducting regular medical examination in order to evolve from after cure system to the era of prevention of outbreak of diseases on board. An effective way of realizing this could be the establishment and operation of seafarers' health promotion center. 이 연구는 선원의 의료와 건강실태 현황을 설문조사를 통하여 선원에 대한 의료지원 및 건강증진을 위하여 개선해야 할 점을 찾고 의료사각지대로 되어 있는 선내 의료 및 건강관리 여건을 개선하기 위한 제도개선 방향을 제안하는 것을 목적으로 한다. 이 논문에서 제시한 선원건강증진을 위한 정책 추진과제를 실천하기 위해서는 선원법 등의 법적 뒷받침이 필요하다. 이를 위하여 추진하여야 할 제도개선방향은 다음과 같다.첫째, 선내응급의료지원의 질적 향상을 추진하여야 한다. 이를 위하여 무선전화에 의한 음성 정보에 의존하여 응급의료지원을 하고 있는 한계를 극복하여야 하며, 의료지원을 하는 의사가 응급선원의 건강상태를 파악할 수 있도록 건강측정장비를 선박에 비치할 것을 의무화하는 등 제도를 강화해 나가야 할 것이다. 둘째, 응급 시만 의료지원을 하는 현행 제도를 개선하여, 응급 시 뿐만 아니라 평상시에도 의료지원을 할 수 있도록 제도적 개선이 필요하다. 이를 위해서는 원격의료에 대한 현행 법제에 대한 개선이 필요하다. 선박 등 의료기관 이용이 제한되어 있는 곳에 대해서는 의료 수요자가 절실하게 요청하고 있는 원격의료의 허용을 전향적으로 검토하여야 할 것이다.셋째, 최근 발달하고 있는 최신 응급의료장비의 선내비치와 더불어 각종 해상 응급상황에 맞는 의약품을 갖출 수 있도록 특히, 신종 전염병의 발병 시 지체없이 필요한 예방약품을 갖출 수 있도록 제도적 정비가 필요하다. 이를 위해서는 선원법 시행규칙 제52조에 대한 정비와 선내에 비치할 의약품과 의료장비 비치기준에 대한 주기적인 검토제도가 마련되어야 한다.넷째, 의료관리자 제도에 대한 개선방향으로는 선원법 제85조 및 제87조를 개정하여 선박소유자가 선장 또는 1등항해사 중에서 의료관리자 또는 응급처치담당자를 지정하도록 제도적 보완을 할 필요가 있다. 또한 선원에 대한 원격의료의 효과를 제고하기 위해서는 의료관리자에게 원격의료 상황에서 원격지의사를 보조하여 원만한 의료행위가 가능하도록 하는 제도의 마련도 추진되어야 할 것이다.다섯째, 선원의 건강문제에 대하여 상병 후 치료 중심에서 발병 예방 중심으로 진화할 수 있도록 선박에 비치할 건강측정장비를 개발하고 평소에 선원의 건강상태를 측정하여 건강상태를 확인하는 예방적 선원건강관리제도의 도입이 필요하다. 이를 실현하기 위한 효과적인 방안은 선원건강증진센터를 설치․운영하는 것이다.

Using nasal cannula for sevoflurane deep sedation in emergency dental treatment

Kim, Jongbin,Yoo, Seunghoon,Kim, Jongsoo,Kim, Seungoh The Korean Dental Society of Anesthsiology 2015 Journal of Dental Anesthesia and Pain Medicine Vol.15 No.1

Background: Emergency room doctors run into difficulties in treating injured pediatric patients because usually they fell into panic after trauma. In these situation, deep sedation with sevoflurane is fully recommendable method. The conventional way can interrupt common dental treatment procedure. Methods: In the present study, nasal cannula was used for sevoflurane deep sedation in 11 dental emergency treatment. Age ranged from 0 to 3 years old (average of 1.8 years). Results: Treatment duration was from 10 to 35 minutes (average of 16.7 minutes). Average duration of sedation was 25.5 minutes ranging from 15 to 45 minutes. Conclusions: It has advantages to use nasal cannula for sevoflurane deep sedation rather than conventional intubation; saves time and secures good operation field.

위장관 ; 응급 위장관 수술 후 조기 경장 섭취의 안전성

이형순 ( Hyung Soon Lee ),심홍진 ( Hong Jin Shim ),이호선 ( Ho Sun Lee ),이재길 ( Jae Gil Lee ),김경식 ( Kyung Sik Kim ) 대한소화기학회 2011 대한소화기학회지 Vol.58 No.6

Background/Aims: Postoperative early feeding has many advantages, and current guidelines recommend the early diet or enteral feeding after gastrointestinal surgery. However, there are controversies in emergency situation. The aim of this study was to assess the safety of early enteral feeding in patients underwent emergency gastrointestinal (GI) surgery. Methods: We reviewed the patients underwent emergency GI surgery by single surgeon from March 2008 to December 2010, retrospectively. The early feeding was defined when feeding was started within 72 hours after operation. Results: Fifty-three patients were enrolled. Men were 31, with mean 60.6 (±18.5) years old age. Thirty-three patients were treated in the intensive-care unit after operation. The most common cause of operation was bowel perforation, and followed by intestinal obstruction. Segmental resection with primary anastomosis of small bowel is the most common operation. Thirty-two of them started the diet within 48 hours postoperatively. Twenty-nine patients had post-operative complications. Wound complications were the most common, and followed by the abdominal pain, and ileus. Wound complications were developed in 18 patients, and the post-feeding abdominal pain was in 7 patients. Anastomotic leakage and intraabdominal abscess were developed in 2 patients, and 1 patient required reoperation to treat the anastomotic disruption. One patient developed pneumonia and sepsis, and resolved under conservative treatment. There was no mortality in these patients. Conclusions: Early enteral feeding may be safe in cases of emergency GI surgery. However, it may require further studies to confirm the safety and feasibility of the early feeding in emergency situations. (Korean J Gastroenterol 2011;58:318-322)

광질처리에 따른 벼 유묘 출현, 생육 및 광합성

강진호,전병삼,최진룡,김종수,김영광 韓國作物學會 2003 한국작물학회지 Vol.48 No.6

본 연구는 벼 종자의 파종 후 발아, 유묘출현 및 생육 초기에 가하여지는 광질처리가 유묘 출현, 생장, 형태, 엽록소 함량 및 광합성율에 미치는 영향을 조사하여 벼의 육묘에 이용되고 있는 부직포의 색상을 전환할 필요가 있는가를 검토하고자 실시하였으며 그 결과를 요약하면 다음과 같다. 1. 파종 직후에 가하여지는 광질처리에서 유묘출현율은 조사일 모두 일미벼에서는 광질처리간 차이가 없었다. 그러나 동진벼와 대산벼에서는 원적색광 처리에서 가장 낮았으며, 청색광과 적색광간에는 차이가 거의 없었다. 2. 파종 직후에 가하여지는 광질처리로 인하여 원적색광 처리에서 초장과 엽장이 가장 짧았던 반면, 적색광은 뿌리수를 증대시켰다. 3. 파종 직후에 가하여지는 광질처리로부터 지상부 건물중은 청색광 처리에서, 뿌리의 건물중은 적색광 처리에서 가장 많았던 반면, 지상부 및 뿌리 건물중 모두 원적색광에서 가장 적었다. 4. 엽록소 함량과 광합성율 모두 품종간에는 일정한 경향이 없었으나, 광질처리에서는 이들 모두 적색광에서 가장 높고, 청색광, 원적색광 순으로 감소하였다. White spunbonded fabrics has been utilized toy covering in rice seedling nursery. This study, therefore, was carried out to examine the effect of light quality on seedling emergence, growth, morphology, chlorophyll content and photosynthesis to get the information on the color of the fabrics. Blue, red and far-red lights were treated immediately after sowing seeds of three cultivars, Dongjinbyeo, Ilmibyeo and Daesanbyeo. Seedling emergence, growth and morphology, chlorophyll content and photosynthetic rate were measured. Seedling emergence rate of Dongjinbyeo and Daesanbyeo was low under far-red light treatment compared to those under blue and red light ones. Although the rate of Ilmibyeo was not different from three light treatments. Far-red light treatment showed similar response in plant height and leaf length, but yee light increased number of roots. Shoot and root dry weight was the highest in blue and red light treatments, respectively. Total dry weight, however, was the lowest under far-red light treatment. While chlorophyll content and photosynthetic rate of the three cultivars did not showed consistent response, those were the greatest under red light treatment, and were decreased in order of blue and far-red light treatment.

발아 및 입묘율 향상을 위함 파종전 종자처리 모형설정에 대한 제언

강진호,윤수영 한국약용작물학회 2003 한국약용작물학회지 Vol.11 No.5

Various presowing seed treatments have been used to enhance the rated of germination and afterward seedling emergence. Seeds treated by them occasionally have not shown the same rate in indoor and field. The presowing treatments considering germination mechanism and factors affecting germination should be totally included in indoor experiments so that the results drawn could be reproduced in the field. Seed drying after the treatments and field conditions after sowing especially able to show Phytochrome-mediated responses related to light treatment must be determined prior to force the treatments to seeds. After set up these prerequisites to promote the rates of germination and emergence, many seed treatments proposed so far must be fixed how to be done; alone, sequential and simultaneous.