Application of Vein Infrared Imaging instrument in the treatment of medical patients with difficulty of vein-detaining needle / 中国实用护理杂志

Objective To investigate the application of Vein Infrared Imaging instrument in the treatment of medical patients with difficulty of vein-detaining needle. Methods A total of 116 cases of patients with difficulty of vein-detaining needle were admitted to Peking Union Medical College Hospital International Medical Service Department from June 2015 to May 2016. These participants were divided into vein imaging and conventional puncture group by the punctures method, 58 cases in each group. Vein imaging group applied vein imaging device in the whole process of venous indwelling needle, including vascular assessment before operation, real-time imaging and confirmation, the control group used conventional technology in peripheral venous catheter. The success rate of vein-detaining needle, operation time, puncture tube material cost, the incidence rate of venous indwelling needle complications were compared between two groups of patients. Results One-time success rate of vein imaging group reached 72.4% (42/58), puncture success rate reached 93.1% (54/58), higher than in conventional puncture group, which was 48.3% (28/58), 67.2% (39/58),the difference between the two groups had statistical significance(χ2=7.061, 10.629,P<0.05). Conventional puncture group 's operation time was (8.4±4.2) min,and puncture tube material cost was(123.37±62.20)yuan;vein imaging group respectively were (3.5±1.2) min, (67.50±24.82) yuan, the difference between the two groups had statistical significance (t=5.410, 4.057, P<0.05). Conventional puncture group's rate of complications was 41.4%(24/58), and vein imaging group was 17.2%(10/58), the difference between the two groups had statistical significance (χ2=8.155,P=0.004). Conclusions Application of vein infrared imaging instrument is a practical, safe and rapid method of vein-detaining needle, which can improve the work efficiency of nurses, and have more advantages in the treatment of patients with difficulty of vein-detaining needle.

Analyses of 13 842 emergency patients under observation in emergency room / 中华急诊医学杂志

Objective To analyze the epidemiology of patients with diseases to be treated by internal medicine physicians present in the emergency department.Methods A retrospective analysis of the data of patients under observation in the emergency department of the affiliated hospital of Inner Mongolia Medical University admitted from Jan.1 2014 through Jan.1 2015 was carried out.The records including patients' name,age,gender,type of diseases,time required for complete resolution of the disease and outcome of patients were kept.The data were analyzed with SPSS 17.0 version software,and x2 test was used to compare the difference in incidence.Results There were a total of 13842 patients with 53％ male and (58.21 ± 17.43) years of average age.The highest proportion of patients kept in emergency room for observation was in 60-74 years old group.The number of patients paying a visit to the doctor peaked during 12-24 o'clock and there were two max-peaks at 18,and 22 o'clock.There was a significant increase in number of patients in March,April and Dec.with the highest number in March and the lowest number in July.Respiratory diseases,cardiovascular disease and neurological diseases were the major prevalence diseases in the seasonal spectrum accounting for 64.56％ of the total number.Between July and August,a large number of patients suffering from outbreak of allergic asthma were flocking to hospital after a shower of heavy rain.Conclusion A more attention should be paid to the middle-aged people of this kind.According to the prevalence features of the diseases,the appropriate and reasonable arrangements of medical workers & medical resources should be planned out so as to increase the survival rate of emergency patients.

Prevention of Venous Thromboembolism in Medical Intensive Care Unit: A Multicenter Observational Study in Korea

Patients admitted to medical intensive care unit (MICU) are at increased risk for venous thromboembolism (VTE); and prophylaxis is recommended. However, the actual range and frequency of VTE prophylaxis administered to MICU patients are not well defined. Patients over 40 yr of age and expected MICU stay of more than 48 hr were eligible for this observational cohort study of 23 MICUs in Korea. Patients already on anticoagulation therapy or those requiring anticoagulation for reasons other than VTE were excluded. Among 830 patients, VTE prophylaxis was given to 560 (67.5%) patients. Among 560 patients, 323 (38.9%) received pharmacoprophylaxis, 318 (38.4%) received mechanical prophylaxis and 81 (9.8%) received both forms of prophylaxis. About 74% of patients in the pharmacoprophylaxis group received low molecular weight heparin and 53% of the patients in the mechanical prophylaxis group used intermittent pneumatic compression. Most of the patients (90%) had more than one risk factor for VTE and the most common risk factor was old age, followed by heart and respiratory failure. In this observational cohort study of 23 MICUs in Korea, 67.5% of patients received thromboprophylaxis. Further studies are needed to clarify the role and efficacy of VTE prophylaxis in Korean critically ill patients.

Use of alternative medicines among medical patients at Siriraj Hospital.

Alternative medicine is widely used throughout the world. The objective of this study was to determine the prevalence, patterns and cost of alternative medicine among patients attending the Department of Medicine, Siriraj Hospital. One hundred patients admitted to Department of Medicine and one hundred outpatients in the Department of Medicine in January 2000 were interviewed. Information concerning underlying medical conditions and details of use of alternative medicine including their cost and patient satisfaction were collected. The results revealed 1) 52.5% of the patients used at least one modality of alternative medicine 2) the most common modalities of alternative medicine were folk remedies or herbal medicine (72%) and massage (31%) 3) older patients and those living outside Bangkok, with underlying disease or who had received conventional medicine had a higher rate of use of alternative medicine 4) the main problems leading patients to use alternative medicine were musculoskeletal problem (41%), fever (16%) and fatigue (14%) 5) most of the patients (60%) were satisfied with the alternative medicine they received and 6) the cost of alternative medicine for each patient was 1,434 Baht per month for ex-user and 379 Baht per month for current-user. Based on the information obtained from this study, alternative medicine is commonly used by Thai patients and it is estimated that at least 155 million Baht has been spent on alternative medicine for all patients attending the Department of Medicine, Siriraj Hospital annually, and at least 6 billion Baht has been spent on alternative medicine for all patients in Thailand each year.