본 연구는 응급실 간호사의 폭력경험, 자아탄력성과 직무스트레스정도를 확인하고 관계를 확인하기 위한 서술적 조사연구이다. 본 연구대상은 D시 소재의 4곳과 C시 소재 2곳의 500병상 이상의 응급실에서 근무 중인 경력 1년 이상의 간호사 143명을 대상으로 하였으며, 자료수집기간은 2018년 11월 6일 부터 15일까지이었다. 대상자의 폭력경험은 4점 만점에 평균평점 1.26±1.31점이었고, 자아탄력성은 4점 만점에 2.50±0.55점, 직무스트레스 정도는 5점 만점에 3.62±0.49점이었다. 폭력경험과 직무스트레스 하위영역별 상관관계에서 언어적 폭력 경험은 간호업무(r=.194, p=.010), 역할갈등(r=.158, p=.030) 스트레스와 유의한 양의 상관관계가 있었고, 신체적 위협 경험은 간호업무(r=.200, p=.008), 역할갈등(r=.162, p=.027), 의사와의 갈등(r=.145, p=.042) 스트레스와 양의 상관관계가 있었다. 자아탄력성과 직무스트레스 하위영역별 상관관계에서 간호업무 스트레스는 자아탄력성의 강인함(r=-.189, p=.012), 인내력(r=-.165, p=.025), 낙관성(r=-.186, p=.013) 영역과 음의 상관관계가 있었으며 전문지식 스트레스는 강인함 (r=-.230, p=.003), 인내력(r=-.195, p=.010), 낙관성(r=-.194, p=.010) 영역과 음의 상관관계가 있었고, 간호사 대우 스트레스는 영성(r=.154, p=.033) 영역과 양의 상관관계가 있었다. 폭력경험과 자아탄력성과의 하위영역별 상관관계에서 강인함은 신체적 위협(r=-.150, p=.037) 경험과 음의 상관관계가 있었으며, 인내력은 신체적 위협(r=-.138, p=.050) 경험과 음의 상관관계가 있었고, 낙관성은 신체적 폭력(r=-.151, p=.036) 경험과 음의 상관관계가 있었다. 이상의 결과로 볼 때 응급실 간호사의 직무스트레스 감소를 위해 폭력이 발생하지 않는 안전한 근무 환경을 조성하고, 폭력상황 발생 시의 대처방법에 관한 지속적인 교육 및 스트레스 대처방법, 자아탄력성을 높이기 위한 프로그램개발 및 중재가 필요하다.

Purpose: This study aimed to further understand the experience related to emotional labor among the emergency room (ER) nurses Methods: Data for the study were collected via in-depth, semi-structured interviews with 8 nurses working at ER in tertiary-hospital settings. Conventional content analysis method was adopted. Results: Data analysis revealed 3 categories and 8 major topics on the participants’ experience of emotional labor at ER. The first category ‘the nature of nursing at emergency room’ involves three topics: ‘making quick, smooth interactions with people around ER’, ‘heavy, demanding workloads for ER nurses’, and ‘difficulties embedded in working environment’. The second category ‘rules of emotional expression and management’ includes two topics: ‘norms of emotional expression required for ER nurses’ and ‘work-centered emotional management.’ The last category ‘exhaustion, adaptation, and the sense of reward’ has three topics: ‘burn-out’, ‘recharging and withstanding’, and ‘reeling rewarded’ While experiencing ‘burn-out’ due to the negative effect of emotional labor, participating nurses reported that they also felt the sense of rewarding by restoring positive emotions through proper self-management, positive feedback and social support. Conclusion: The findings show that the nature of ER care required intensive emotional labor from nurses. Thus, it is imperative to provide interventions that assist ER nurses to reduce the negative impact of emotional labor and reinforce its positive influence on their lives, with systemic approaches to reduce the intensity of emotional labor and improve working conditions in ER settings.

목 적 : 뇌경색 질환은 기온차가 급격한 겨울철에 많이 발생하는데 경기북부 지역에 위치한 본원 응급실에 내원한 환자 중 Brain MRI를 검사한 환자를 대상으로 하절기와 동절기를 비교하여 기온차에 따른 Brain Infarction 환자 분포를 알아보고자 한다. 대상 및 방법 : 하절기(2012년~2014년 6월-8월)와 동절기(2012년~2014년 11월- 1월)에 본원 응급실을 내원한 환자 중 MRI Brain acute stroke, MRI Brain diffusion, MRA Brain + diffusion 검사를 시행한 환자를 대상으로 하였다. 하절기 1001명(남:574명,여:427명), 동절기 1141명(남:586명, 여:555명)을 대상으로 판독 결과가 infarction으로 나온 환자의 성별, 연령별로 분류 하였다. 결 과 : Infarction은 하절기 393명(남:249,여:144), 동절기 455명(남:259,여:196)으로 확인되었다. 하절기 393명 중 20대 4명 (남:3,여:1) 30대 3명(남:1,여:2), 40대 16명(남:10,여:6), 50대 74명(남:60,여:14), 60대 72명(남:55,여:17), 70대 123명(남:73,여:50), 80대 84명(남:37,여:47), 90대 16명(남:10,여:6), 100대 1명(여:1)이었고, 동절기 455명 중, 30대 3명(남:2,여:1), 40대 16명(남:12,여:4), 50대 60명(남:47,여:13), 60대 99명(남:65,여:34), 70대 162명(남:95,여:67) 80대 101명(남:35,여:66), 90대 14명(남3,여11)으로 확인되었다. 결 론 : 응급실에 내원한 Brain MRI 검사환자 중 하절기 보다는 동절기에 뇌경색 질환이 증가하는 것을 알 수 있고, 연령대는 70대에서 뇌경색 질환이 가장 많이 발생하였다.

The rise of medical knowledge and awareness of the importance of dental and stomatognathic system increase the patients who visit dental emergency room. The chief complaints of patients who visited the emergency room varies from a pain, trauma, hemorrhag. The purpose of this study was to classify dental emergency patients by chief complaint and to analyze in indiviual group and to provide more effective emergency dental care. This study was carried out with 1129 patients visiting emergency room of the dankook university dental hospital from 7/2011 to 6/2012. Dental emergency patients was classified trauma, pain, hemorrhage group by chief complaint and studied mothly, the day of the week, time, age distribution and cause of the individual group. The chief complaint of visiting emergency room were trauma 660 people (58.5%), pain 347 people (30.7%), hemorrhage 96 (8.5%), other 26 patients (2.3%). The monthly distribution was observed in May (12.8%), March (10.5%), September (10.2%). The trauma patients were frequent in the spring and early summer but painful patients visited in September (12.7%) and May (11.8%) in March (11.2%). The peak age group was 20 to 29 years(20.9%), followed by 0 to 9 years(19.4%), 40 to 49years (15.2%,). In trauma group the peak age was under the age of 10 (31.7%), followed by 10 to 19 years (18.8%), 20 to 29 years (17.1%) . However, in pain group, peak age was 20 to 29 years (26.8%) followed by 40 to 49 years(21.3%), 30 to 39 years (19.6 %). The most common cause of trauma were subluxation(16.5%), laceration13.7%), uncomplicated crown fracture(12.05%) and in pain group was pulpal origin(46.1%), followed by periodontal origin( 20.7%), post op pain(8.9%). Undefined pain or neuralgia were 7.9%. The most common cause of hemorrhage was post extraction( 66.7%), post operation(16.7%), spontaneous bleeding due to periodontitis(12.5%). In conclusion, the trauma, pain were different in monthly distribution and the peak age of patients. Dental emergeny doctor should understand pattern of indiviual emergency group and perform proper diagnosis and treatment for more effective emergency care.

The purpose of this research is to find the reasons of overcrowding in the emergency department of an hospital, then to shorten the total stay time of patients The fact that main causes of the overcrowding exist in the process of the emergency department

The purpose of this study was to identify vulnerable area of emergency medical care. In the existing method, the emergency medical vulnerable area is set as an area that can not reach the emergency room within 30 minutes. In this study, we set up an area that can not reach within 30 minutes including the accessibility of 119 emergency center. To accomplish this, we obtained information on emergency room and 119 emergency center through Open API and constructed road network using digital map to perform accessibility analysis. As a result, 509 emergency room are located nationwide, 78.0% of them are concentrated in the region, 1,820 emergency center are located, and 61.0% of them are located in rural areas. The average access time from the center of the village to the emergency room was analyzed as 15.3 minutes, and the average access time considering the 119 emergency center was 21.8 minutes, 6.5 minutes more. As a result of considering the accessibility of 119 emergency center, vulnerable areas increased by 2.5 times, vulnerable population increased by 2.0 times, and calculating emergency medical care vulnerable areas, which account for more than 30% of the urban unit population, it was analyzed that it increased from 17 to 34 cities As a further study, it will be necessary to continuously monitor and research the real-time traffic information, medical personnel, medical field, and ambulance information to reflect the reality and to diagnose emergency medical care in the future.

The purpose of this research is to compare between past and present resuscitation outcome of cardiac arrest patients in one emergency department. A clinical analysis of 429 cases of CPR performed in one emergency department from April 2013 to March 2015 was conducted. Then we compared this with previous paper that were written in same emergency department in 2004. During the period, 429 patients received resuscitations. Between the two studies, all patients under CPR were increased 2.27 times (94.33 pts/years to 214.5 pts/years). As the cause of cardiac arrest, traumatic cardiac arrest increased to 30.1% form 24.1%. Cardiogenic cardiac arrest showed highest survival rate in two studies, and the ratio was increased from 6.8% to 15.2%. VF/VT showed highest survival rate in two studies, and the ratio was increased from 8.8% to 20.7%. In this study, At least who once became ROSC patients was 260 people (60.6%), permanent surviving patient was 34 people (7.93 %), patients with CPC score 1-2 was 26 people (6.06%). The survival rate of patients with cardiac arrest has increased compared to the past. But in-hospital cardiac arrest survival rate is still low so it is necessary to increase the recovery rate of cardiogenic arrest survival rate to increase the permanent survival rate and good prognosis patients.

This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

한 대학병원 응급실에 방문한 응급환자들이 방사선에 얼마나 피폭되는지를 알아보고자, 2006년 3월 16일 부터 31일까지 15일 동안 방문환자 200명을 임의 추출하여 방사선 피폭선량을 측정한 결과는 다 음과 같다 1. 연구대상자의 분포는 타병원전원환자 50명(25.0%), 교통사고환자 24명(8.3%),기타사고환자 50명 (25.0%), 일반환자 76명(38.0%)이었다. 2. 환자의 방사선 촬영횟수를 보면 환자 1인당 타병원, 전원환자 6.4회, 교통사고환자 14.5회, 사고환 자 2.6회, 일반환자 2.4회로 교통사고환자들이 타환자군에 비해 방사선촬영 건수가 3～4배 많았다 3. 환자의 방사선촬영종류별 피폭선량을 보면 일반촬영 28.9mGy, CT촬영 84.2 mGy, 특수촬영 1.02mGy로 CT촬영피폭이 일반촬영 비해 10배 정도 많았다. 4. 환자의 평균 방사선 피폭선량을 보면 타병원 전원환자는 24.6mGy, 교통사고환자는 55.2 mGy, 사 고환자는 17.1mGy 일반환자는 17.0mGy로 타병원 전원환자와 교통사고환자가 상대적으로 피폭이 많았다. 5. 방사선촬영 부위별로 보면 일반촬영에서는 두부피폭 1.7mGy로 사고환자에서 피폭이 많았고, 흉 부 2.0mGy, 복부 1.6mGy는 일반환자 에게 많았으며, 척추 3.4mGy, 골반부 1.8mGy, 상지부 0.5mGy, 하지부 0.6mGy는 교통사고 환자에게 피폭이 많았으며, 통계적으로 유의한 차이를 보였다 (P<0.001). 6. CT촬영에서는 타병원 및 전원환자가 두부 10.9mGy으로 많았고, 흉부와 복부는 각각 2.9mGy, 3.6mGy로 일반환자에게 많았고, 척추, 골반부 1,9mGy 2.7mGy는 교통사고환자에게 많았다. 특히 복부피폭은 통계적으로 유의한 차이를 보였다.(P<0.05) 결론적으로 한 대학병원 방문한 응급환자 특히 교통사고환자의 방사선 검사시 일반 외래 환자들의 촬영보다는 과다한 검사와 피폭이 노출선량한도가 2배 이상 증가하는 실정이다. 따라서 병원 관리자 및 방사선취급자는 환자 방사선 촬영시 노출을 최소한으로 제한하고, 방사선피폭감소를 위해 병원의 종 사자인 방사선사의 기술적인 연구와 및 보조연구자 및 의료인 등 모두가 예방할 수 있는 대책이 필요할 것으로 생각한다.