This study aims to enhance the accuracy of severity classification by examining the usage patterns and characteristics of emergency department visits. It focuses on adult and elderly patients who visited a public hospital in Seoul. This descriptive study retrospectively reviewed the electronic medical records of patients who visited the emergency department of a public hospital between November and December 2023. The total number of participants was 1,033, with 46.4% (n=479) being elderly and 53.6% (n=554) being adults. The chief complaints of the participants were as follows: for the elderly, nervous system symptoms at 8.2% (n=85) and digestive symptoms at 7.5% (n=77) were the most common, while for adults, gastrointestinal symptoms at 11.0% (n=114) and trauma at 8.6% (n=89) were more prevalent. In the case of the elderly, patients classified as urgent accounted for the highest percentage at 23.9% (n=247), while for adults, non-emergency were more prevalent at 32.2% (n=333). The initial severity classification error rate for elderly patients in the urgent was 3.8%, indicating that the suitability of KTAS for elderly patients with high severity was low. To minimize severity classification errors and enhance KTAS accuracy, it's essential to address its current limitation of only classifying adults and children separately by developing a KTAS classification system that reflects the diverse characteristics of elderly patients.

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.

Headache is one of most common chief complaints of pediatric patients in emergency departments (ED). In this study, the character, duration, strength and location of headaches, as well as the results of brain imaging studies, were recorded. Seventy-four children (34 boys, 40 girls) visiting the ED of major hospitals in Cheongju were enrolled from October 1, 2013 to September 30, 2014. Ages of the children ranged from 3 to 18 years, with the mean age being 13 years. Four of them (5.4%) had trauma-related headaches. There were 34 migraines (45.9%), 27 tension headaches (36.5%), 3 secondary headaches (4.1%), 2 seizure-related headaches (2.7%), 1 headache with hydrocephalus (1.4%), 1 concussion (1.4%), and 1 headache with subdural hematoma (1.4%). The highest number of patients, 31 (41.9%), had symptoms for less than two hours, while 11 pediatric patients (14.9%) had symptoms for 2-4 hours, and the third-largest group, 10 patients (13.5%), had symptoms between 24 and 72 hours. Twenty-nine patients (39.2%) had one headache per month, 20 patients (27.0%) had 1 to 14 headaches per month, and 4 patients (5.4%) had more than 15 headaches per month. Children with migraine took a nonsteroidal anti-inflammatory drugs (NSAID, 34 patients; 45.9%), acetaminophen (19 patients; 25.7%), and Topiramate (1 patient; 1.4%). Average strength of headache was 7.37 ± 1.79. There were 23 children (31.1%) with headaches in the parieto-temporal area, 16 children (21.6%) in the occipital area, 9 children (12.2%) in the frontal area, 4 children (5.4%) in the global area, and 6 children (8.1%) in an uncertain location. There were 31 children (41.9%) with pulsating headaches, 18 children (24.3%) with squeezing headaches, 5 children (6.8%) with stabbing headaches, and 11 children (14.9%) with headaches of an uncertain nature. Thus, we suspect children visiting the ED had severe headaches.

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 aim of this study is to confirm the importance of a more immediate advanced cardiac life support (ACLS) through a comparative analysis of the results of cardiopulmonary resuscitation (CPR) according to the occurrence place of cardiac arrest in tertiary emergency department. The subjects were 493 patients who had received CPR in Chosun university, Emergency Medical Department, between April 2013 and March 2015. The subjects were categorized into three groups according to the occurrence place of cardiac arrest: pre-hospital, in-emergency room, and in-ward. We conducted a clinical analysis of the results. During the period, 493 cardiac arrest patients underwent CPR, 63 patients (12.8%) were discharged alive and 41 patients (8.3%) got a good score on the cerebral performance category (CPC). Concerned occurrence place of cardiac arrest, 11.3% (16 patients) of the in-emergency room group (total 288 patients) were discharged alive. Also, 9.4% (27 patients) of the In-emergency room group got a good score on the CPC. In the other two-group cases, 7.1% (10 patients) of pre-hospital group (total 141 patients) and 6,2% (4 patients) of in-ward group (total 64 patients) got a good score on the CPC. These results indicate that both the rates of alive discharge and a good CPC score of the in-emergency room group are higher than in out-of-emergency room. This difference might be due to the fact that patients could get the more immediate ACLS by emergency medicine doctors if cardiac arrest occurs in emergency room than other places.

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.