외상 환자 관리에서 Critical Pathway의 적용
분야
의약학 > 외과학
저자
심홍진 ( Hong Jin Shim ) , 장지영 ( Ji Yong Jang ) , 이재길 ( Jae Gil Lee ) , 김승환 ( Seong Hwan Kim ) , 김민정 ( Min Joung Kim ) , 박유석 ( You Seok Park ) , 박인철 ( In Chel Park ) , 김승호 ( Seung Ho Kim )
발행기관
대한외상학회
간행물정보
대한외상학회지 2012년, 제25권 제4호, 159~165페이지(총7페이지)
파일형식
19400643.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    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. (J Trauma Inj 2012;25:159-165)
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