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Traumatic Liver Injury: Factors Associated with Mortality
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Youn Suk Chai, Jae Kwang Lee, Seok Jin Heo, Yeong Ki Lee, Yong Woo Lee, Young Hwa Jo, Seong Soo Park, Hyun Jin Kim, In Gu Kang
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Korean J Crit Care Med. 2014;29(4):320-327. Published online November 30, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.4.320
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Abstract
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- BACKGROUND
We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients.
METHODS
From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study.
RESULTS
Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170).
The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006).
CONCLUSIONS
In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
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Assessment and Training of Teamwork and Leadership for Critical Care Nurses: A Pilot Study
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Hyun Jin Kim, Sang Mo Je, Hyun Soo Chung, Sung Phil Chung, Hahn Shick Lee
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Korean J Crit Care Med. 2012;27(2):75-81.
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DOI: https://doi.org/10.4266/kjccm.2012.27.2.75
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Abstract
PDF
- BACKGROUND
Teamwork and leadership training have been shown to improve subsequent resuscitation performance in a variety of clinical situations. Critical care nurses, in addition to those who may be part of resuscitation team leaders and members, have also the need for such training. This study examines the teamwork and leadership skills of critical care nurses and their perceptions of the need for teamwork and leadership training.
METHODS
We developed a pilot, interactive 3-hour teamwork, and the leadership training program based on the objectives and teaching methods of the Advanced Life Support (ACLS) course. Participants completed a 1-hour lecture, and discussion for team roles and obstacles, 30 min of script-based role play in resuscitation team training, and finally, a 2-hour simulation-based team training program.
Before the completion of the course, participants were anonymously surveyed on the perceived educational value of the teamwork and leadership program. Expert raters reviewed videos of simulated resuscitation events in the course, and scored each video by two existing checklist for the team dynamic.
RESULTS
Fifty-one nurses voluntarily participated and six videotaped simulation were rated by an expert rater. Most of the students believed the course was delivered at an appropriate level for them, and that it is a necessary training in their continuing professional education. The video rated average scores were from 68.5 to 72.9 according to the checklists.
CONCLUSIONS
Critical care nurses can learn teamwork and leadership skills from appropriately designed programs, and believe it is a necessity in their training.