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외상 환자 관리에서 critical pathway의 적용

Other Titles
 Application of Critical Pathway in Trauma Patients. 
Authors
 심홍진  ;  장지영  ;  이재길  ;  김승환  ;  김민정  ;  박유석  ;  박인철  ;  김승호 
Citation
 Journal of Trauma and Injury, Vol.25(4) : 159-165, 2012 
Journal Title
 Journal of Trauma and Injury 
ISSN
 1738-8767 
Issue Date
2012
Abstract
PURPOSE: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. METHODS: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. RESULTS: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was 6.4+/-2.0. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. CONCLUSION: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92302
Files in This Item:
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Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김민정(Kim, Min Joung)
김승호(Kim, Seung Ho)
박유석(Park, Yoo Seok) ORCID logo https://orcid.org/0000-0003-1543-4664
박인철(Park, In Cheol)
심홍진(Shim, Hong Jin)
이재길(Lee, Jae Gil)
장지영(Jang, Ji Young)
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