외상 환자의 기록과 분석

Trauma is rapidly becoming one of the most important and serious challenges for the public health in modern societies. In the U.S.A., the trauma is the top ranking cause of death for the age groups younger than 44 and the fourth ranking cause of death for all age groups. In Korea also, trauma is emerging as an exigent social problem due to the significant economic losses caused by the yearly increase in trauma patients and trauma related deaths. Adequate response to the challenge presented by trauma must be based on intensive and scientific analysis of the problem, which require a systemic recording of the data on the trauma patients. Various objective indices designed for the systematic recording and analysis of the trauma data have been developed and are widely in use in the advanced countries; however, not much effort has been made in such area in Korea. In 1985, the Committee on Trauma Research in the U.S.A., proposed the following five areas for trauma: epidemiology, prevention, biomechanics, acute care and rehabilitation. An EMS trauma system includes the facilities, personnel, transportation, communication, education, training and evaluation. An index must be developed for the purpose of accurate recording and effective evaluation of the data. The present article describes an electronic data processing program developed for the purpose of facilitating evaluation of trauma patients by providing a comprehensive system of classification of patient data. Such classification system would exped!te accurate recording and automatic evaluation of data and thereby promote quality assurance and appropriate analysis of data. 1. Classification of data Categories are established for classifying the demographic data, prehospital data, clinical data, laboratory data, trauma outcome data and other data. Demographic data includes patient identification, the date and time of arrival at the emergency room, cause and type of injury, preinjury status of patient and the use of protective gears. Prehospital data includes the time of injury, mode of transportation and emergency care given before the arrival at the hospital. Clinical data includes vital signs, pertinent history, Glasgow Coma scale, results of procedures and clinical impression according to the International Classification of Diseases. Laboratory data includes the results of variable tests; blood alcohol, serum electrolytes, BUN, Creatinine, blood sugar and arterial blood gas analysis. Trauma outcome data inc