Clinical analysis of pediatric patients who visited a general hospital emergency center / 소아과

PURPOSE: Through a clinical and retrospective analysis of pediatric patients who visited the Regional Emergency Medical Center of Masan Samsung Hospital from January 2007 to December 2008, we characterized pediatric and adolescent emergency patients to improve emergency care in future. METHODS: We reviewed the medical records of 14,065 pediatric patients below 19 years of age. RESULTS: The male to female ratio was 1.5:1, and the most common age group was less than 3 years (49.6%). The peak month was May (10.0%), the peak day of the week was Sunday (24.7%), and the peak time of day was 20:00.20:59 (8.5%). There was no difference in the number of visits per day based on weather (sunny, rain [below 10 mm per day], snow, and fog) or daily temperature difference; however, visits increased on sandy, dusty days and decreased on rainy days with more than 10 mm of rain per day. Based on the international classification of disease (ICD)-10 system, the most common disease code was code R (symptoms, sign, and abnormal clinical laboratory finding) (31.5%), and the most common symptom was fever (13.1%). Final outcomes were discharged (73.8%), admitted (25.7%), transferred (0.4%), and expired (0.1%). In adolescent patients aged 15.19 years, the most common disease code was Injury & Poisoning (code S&T, 36.9%); the most common symptom was abdominal pain (9.6%). CONCLUSION: Pediatric patients visiting the emergency center were most likely to be male and under 3 years of age and to visit between 20:00 and 21:00 on Sundays and in May, and the most common symptom was fever. Differences between adolescents and pediatric patients showed that adolescents had a higher visiting rate with abdominal pain and a larger temperature difference.

The Clinical Analysis of the Homeless Visiting Emergency Medical Centers

PURPOSE: The homeless patients in our country get their medical services in government facilities. Supposedly, they have clinical characteristics different from those of general population, but most published papers dealing with the homeless have focused on sociologic problems. With the necessity for epidemiologic data, we decided to find clinical patterns for the homeless who visited our emergency medical center. METHODS: Between December 1999 and July 2001, 3,905 homeless patients visited the Seoul Municipal Boramae Hospital. Based on their medical records and radiologic images, we categorized and compared their complaints, medical needs, and clinical findings. RESULTS: The number of male patients dominated over female patients (M:F=13.7:1), 70.9% were in their thirties, forties, and fifties, and 47% of the patients had been brought to the center by police while the others had been referred from institutions for the homeless, smaller hospitals, or mental health institutions. The common reason for visit was altered mentality due to acute alcohol intoxication (18.6%), followed by medical follow-up (15.4%), gastrointestinal symptoms (12.3%), and neurologic problems (10.6%). Of the patients 36.1% were sent to institutions, but 31.8% were returned to the streets, 9.7% were admitted to a ward, and 2.6% died. The main causes of death were pneumonia and intracranial hemorrhage. CONCLUSION: Most homeless patients were relatively young men. Alcohol-related symptoms and gastrointestinal troubles overwhelmingly led the homeless to the hospital. Many homeless patients returned to the streets or other institutions. Later, more sophisticated studies are expected for homeless-patients management.

Experience after the Opening of the Gwangju Wide Regional Emergency Medical Center

PURPOSE: As Gwangju Wide Regional Emergency Medical Center was newly opened during February 2001, a comparative analysis was performed of patients who had visited the emergency department before and after the opening in order to measure the difference and to provide basic data for its management. METHODS: The 9,995 patients who had visited between February 1, 1999, and July 31, 1999, before the opening and the 12,457 patients who visited between February 1, 2001, and July 31, 2001, after its opening were compared according to sex, age, non-trauma or trauma, means and form of visit, attending department, length of stay in the emergency department, form of discharge, and time of death verification (dead-on-arrival (D.O.A) versus deadafter-arrival (D.A.A)). RESULTS: The total number of patients increased by 24%. The admission rate was 31.8% before the opening and 40.6% after the opening; the mean length of stay in the emergency department was 15.7 hours before the opening and 12.2 hours after the opening. The mean length of stay of admitted patients decreased from 26.6 hours before the opening to 18.3 hours after the opening. CONCLUSION: The decrease in the mean length of stay in the emergency department from 15.7 hours before the opening to 12.2 hours after the opening is viewed as a positive result, but is still not satisfactory. Accordingly, it is considered urgent that every clinical department take an active part in improving circulation of patients both in the Emergency Intensive Care Unit (EICU) on the second floor and in the emergency ward on the fifth floor, as well as in providing rapid medical care and decisions on treatment strategies in the emergency department on the first floor.

Clinical Evaluation of the Eye Patients Visiting Emergency Medical Center in Sungnam

To examine the clinical characteristics of ocular emergency in Sungnam, we analyzed 3784 of the eye patients who visited emergency medical center of Inha university hospital during 3 years from January 1, 1995 to December 31, 1997 The ambulation rate of eye patients was 3.97% of total patients visiting emergency medical center and the admission rate was 8.30%. Male was more common than female about 2-fold and the patients in the age of 3rd decade(30.8%) and 4th decade(23.7%) were common Regarding the eye in trouble, there was no significant difference between right eye and left eye. September and autumn were most common month and season and visit rate of Sunday(27.7%) was highest in a week. According to the arrival time at emergency medical center, largest group was between 9 PM and 12 AM and within 1 hour from the onset of disease most patients visit emergency medical center. Most frequent cause of visit was beating by fist and common ocular diseases were conjunctivitis(20.4%), orbital contusion(17.9%) and eyelid laceration(13.9%).