- Problems with Transferring Major Trauma Patients to Emergency Medical Center of a University Hospital from Another Medical Center
-
Sang Soo Han, Kyoungwon Jung, Junsik Kwon, Jiyoung Kim, Sang Cheon Choi, Kug Jong Lee
-
J Korean Soc Traumatol. 2011;24(2):118-124.
-
-
-
 Abstract
 PDF
- PURPOSE
The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults. Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center.
METHODS
From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed.
RESULTS
Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous.
CONCLUSION
Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers. Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.
-
Summary
- Current State and Problem of the Transfer of Severely Injured Patients in One Regional Emergency Medical Center
-
Won Chul Lee, Choong Hyun Jo, Kyoung Won Jung, Young Gi Min, Sang Cheon Choi, Gi Woon Kim, Jung Hwan Ahn, Yong Sik Jung, Sun Ae Hwang, Ji Yong Kim, Kug Jong Lee, Yoon Seok Jung
-
J Korean Soc Traumatol. 2010;23(1):6-15.
-
-
-
Abstract
PDF
- PURPOSE
Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center.
METHODS
Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggi-do. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer.
RESULTS
Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%).
CONCLUSION
Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.
-
Summary
- Fixation of Open Alveolar Bone Fractures: Easily Applicable Method in the Emergency Department
-
Seung Hwan Seol, Soo Hyun Cha, Sang Cheon Choi, Jung Hwan Ahn, Gi Woon Kim, Hea Kyung Choi, Joon Pil Cho, Yoon Seok Jung
-
J Korean Soc Traumatol. 2007;20(2):72-76.
-
-
-
Abstract
PDF
- PURPOSE
The purpose of this clinical trial was to evaluate the fixation method for treating alveolar fractures in an emergency department.
METHODS
The efficiency of using the fixation method was judged on the basis of clinical criteria. Stability, occlusion state, bleeding amount after fixation, operation time, and difficulties during procedural operation were recorded.
RESULTS
Eight patients were enrolled in this study. In all instances, the fixation method was effective in bleeding control. Each patient had a noticeable decrement in bleeding. A wire was used for four of the eight patients, and nylon strings was used for the others. The average operation time was 6.3 minutes for the wire patients and 2.8 minutes for the Nylon string patients. No specific problem was identified during the procedural operation. However, the difference in the fixation material influenced the effectiveness of the procedure, the operation time, and the satisfaction of the doctor.
CONCLUSION
In the emergency department, the fixation method using wire or nylon string in the treatment of alveolar fractures is effective in bleeding control.
-
Summary
- Current Status of Intraosseous Infusion Technique Use at Emergency Departments in Korea
-
Sang Cheon Choi, Hyun Soo Park, Jae Woo Kim
-
J Korean Soc Traumatol. 2007;20(1):6-11.
-
-
-
Abstract
PDF
- PURPOSE
Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments.
METHODS
We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique.
RESULTS
Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique.
CONCLUSION
The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.
-
Summary
|
KST
