Usefulness of Blood Cultures in the Emergency Department

PURPOSE: This study was conducted to derive and validate a clinical prediction rule for blood cultures obtained in the emergency department. METHODS: We conducted a retrospective chart review of patients with a fever who underwent blood cultures from August 2002 through July 2003. The student t-test, coefficient of correlation, ROC (receiver operatics characteristic) curve, and Chi-square statistics were used for the analyses. RESULTS: Included in the study were 108 patients, of whom 47 were men and 61 were women. The mean age was 45.30+/-26.21 years old. The most common diagnoses were pneumonia and acute gastroenteritis. The usefulness of blood cultures in the emergency department was statistically significant in patients with fever or with higher levels of band form. CONCLUSION: We determined that blood cultures are uncommonly useful for febrile patients and that a need rule is needed for the use of blood cutures in the emergency department

Assessment of the Propriety of Separating the Pediatric Emergency Room from the Emergency Department

PURPOSE: Recently, the emergency departments of most general hospitals have been overcrowded, and one of the major causes is the increased number of pediatric patients. Therefore, our hospital separated the pediatric emergency room from the emergency department, and we assessed the effect of that separation. METHODS: Pediatric patients below 15 years of age who visited the emergency department from March 1998 to February 1999, which was before the separation, and from March 1999 to February 2000, which was after the separation, were included in this study. RESULTS: The average lengths of stay of pediatric and nonpediatric patients at emergency department before separation were 1.9+/-3.5 and 2.6+/-5 hours, respectively, and declined to 1.6+/-2.4 and 2.3+/-4.7 after separation (p<0.05). The waiting time until admission declined notably from 3.6+/-2.5 hours to 3.3+/-5.6 hours for pediatric patients, in spite of the fact that the number of pediatric admissions increased (p<0.05). In non-pediatric patients, it declined from 3.1+/-3.3 to 2.6+/-3.5 hours (p<0.05). CONCLUSION: The separation of the emergency department into pediatric and non-pediatric departments reduced emergency-department crowding, the length of stay at the emergency department, and, the waiting time until admission. A fundamental solution to the problem of emergency-department crowding requires an independent pediatric emergency department, an increased number of emergency physicians, increased paramedic coverage, and more efficient hospital policies regarding laboratory, radiology, and admission procedures.

The Analysis of Emergency Department Costs

PURPOSE: To report the distribution of emergency department costs by category of expense and level of patient urgency. METHODS: We retrospectively analyzed the cases of 36,329 patients who visited the emergency department of Pundang CHA hospital during the recent 1year. the patients were divided into two groups : urgent group and non urgent group. Physician, facility, supply, pharmacy, laboratory, and radiology costs were considered. RESULTS: The average costs were urgent visits, 96,124 won; nonurgent visits, 87,028 won. For all patients, the average costs were radiology, 29%; facility, 26%; laboratory, 21%; physician, 12%; pharmacy, 8%; supply, 4%. CONCLUSION: The distribution of ED costs were similiar to regardless of the urgency of the medical condition. Overall improved cost efficiency can be achieved through reductions in the Variable costs of ED.

Comparative Analysis of Cerebral Infarction patients treated with Western and Oriental Therapies; a Proposition for a Western-Oriental Cooperative Therapeutic Standard

PURPOSE: Korea has a parallel system of western and oriental medicine. Therefore doctors of each department have distrust of the other, which in turn confuses the patients and cause discontentment with medical standards. To upgrade the satisfaction of patients that want oriental therapy, we have studied the western-oriental cooperative therapy system to identify its flaw, if any, and tried to find a standard of therapy. METHODS: The 105 Patients included in this study were diagnosed as having a cerebral infarction and were admitted to the neurology department or the oriental medicine department via the emergency department from January to July 2002. We retrospectively analyzed sex, age, severity, admission periods, therapeutic methods and result, and frequency of consulting other departments. RESULTS: At times of admission, the scale of severity showed that there were more severe patients in the western-therapy group. There was no difference in the total prognosis between two groups. In mild patients (GCS>12), western therapeutic results were more favorable than those of the oriental group. In the western-therapy group, 32 (55.2%) patients also received oriental treatment, and 38 (80.9%) patients in the oriental-therapy group received combination of western and oriental therapy. CONCLUSION: From the above study, we propose that patients with unstable vital signs or with acute cerebral infarction should be treated with weatern therapy primarily, with oriental therapy after stabilization, and that mild or longstanding cerebral infarction patients can be admitted to whichever department they want.

Study of Early Development of Hypocalciuria in Patient of Preeclampsia and its Diagnostic Strategy / 대한산부인과학회잡지

Many researchers report that the measurement of urine calcium concentration during antenatal period is helpful in prediction of having preeclampsia,but some don`t. The purpose of this clinical study is to evaluate the relationship of low calcium level in urine and the develpoment of preeclampsia, and effects of other variables. 24hour urine were collected and measured for the concentration of calcium and creatinine from 769 pregnant women who visited our department of obstetrics at Young-Dong Severeance hospital, Yonsei university medical college for antenatal care from March 1, 1993 to May 31, 1996. One group of 41 women developed preeclampsia and the other didn`t. There were no diffrences in ages and gestational age at urine collection between two groups, but a group with preeclampsia had an increased mean arterial blood pressure. There were signiificant difference in calcium concentration in urine and ratios of concentration of calcium and creatinine from urine collected between gestational ages of 25 weeks and 32 weeks and also in those women younger than 25 years old and their first pregnancy. Our study suggests that the measure ment of calcium level and ratios of urine calcium concentration and creatinine concentration at gestational ages between 25 weeks and 32 weeks in women younger than 25 year old with their first pregnancy is quite helpful inpredicting the develpoment of preeclampsia.

Extracorporeal shock-wave lithotripsy of gallstones

No abstract available.

Prospective study for prevention of thrombophlebitis of indwelling central venous catheters

No abstract available.