• Journal of The Korean Society of Clinical Toxicology
• /
• v.16 no.2
• /
• pp.116-123
• /
• 2018

Purpose: The social environment of easy access to medicines and arbitrary personal decisions leading to overdose aggravate unintentional medicine poisoning. This study aimed to investigate the characteristics of patients who visited emergency departments with unintentional medicine poisoning and reasons for poisoning based on age group. Methods: We retrospectively collected patients who experienced unintentional medicine poisoning based on data from the national injury surveillance system between 2013 and 2016. Subjects were classified into three groups based on age (0-14 years, 15-64 years, and ${\geq}65\;years$). We identified sex, insurance, time of poisoning, place, alcohol co-ingestion, hospitalization, death, and reason for poisoning in each age group. Results: A total of 27,472 patients visited an emergency department with poisoning during the study period; 1,958 patients who experienced unintentional poisoning were enrolled in this study. Respiratory medicine was the most frequent medicine in those younger than 15 years of age, and sedatives and antipsychotic drugs were the most common in patients older than 15 years of age. In total, 35.1% of patients older than 65 years were hospitalized. The most common reasons for poisoning were careless storage of medicine in those younger than 15 years of age and overdose due to arbitrary decisions in those older than 15 years of age. Conclusion: Unintentional medicine poisoning has distinct characteristics based on age group, and strategies to prevent poisoning should be approached differently based on age.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.4
• /
• pp.1540-1546
• /
• 2010

In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.

• Quality Improvement in Health Care
• /
• v.15 no.1
• /
• pp.101-111
• /
• 2009

문제: 병동 처치수가 산정 부정확 및 누락으로 인한 부적절한 재고관리로 진료차질, 불필요한 업무발생 및 수익이 감소한다. 목적: 병동 처치수가 산정 정확화를 위한 업무 표준화 도구 및 시스템을 개발하여 적정 재고관리를 통한 수익증대 및 직무만족도를 향상시킨다. 의료기관: 서울시 종로구에 소재한 대학병원 질 향상 활동: 병동중심의 처치 산정지침 개발 및 수가물품의 적정재고 관리방안을 모색하였다. 개선효과: 병동중심의 처치수가 산정 지침서를 제작하여 업무표준화를 기하였음. 응급청구 품목 및 수량이 '07년 대비 71%감소하고 타 병동 차용품목이 활동 전에 비해 61% 감소, 수량은 77% 감소함. 응급청구 총소요시간이 활동 전에 비해 '07년 대비 77% 감소하고 타 병동 차용 총 소요시간이 61% 감소함. 전년 동기간 대비 수익이 4% 증가하였으며 또한 54병동과 보험 심사팀에서 직원들의 직무만족도가 향상되었다.

• Journal of Chest Surgery
• /
• v.34 no.5
• /
• pp.414-417
• /
• 2001

흉부 대동맥의 비 외상성 자연 파열은 매우 드물지만, 발생시 응급수술이 요하는 위중한 질환이다. 본원에서는 전산화 단층 촬영과 경식도 초음파로 진단하고 부분 대동맥궁 치환술로 성공적으로 치료된 후 흉부 대동맥의 비 외상성 지연 파열 1례를 체험하였기에 문헌고찰과 더불어 보고하는 바이다.

• Journal of Industrial Technology
• /
• v.32 no.A
• /
• pp.15-20
• /
• 2012

For emergency patients as heart disease, fast treatment is very important. This paper describes a smart phone software to detect emergency circumstance and request rescue. Detection of emergency condition of heart disease patients is based on physical motion and biological heart signals as electrocardiogram. Most smart phones have three axis acceleration sensor. On emergency condition, patients remain stationary. Thus the software detect stationary condition by using acceleration sensor data. For more precise detection, it combines electrocardiogram of patients. To request rescue, it sends help messages to designated persons. In addition, it generates emergency sound to surrounding people and plays a video of emergency measure that any person on the place can help the patient temporarily.

• Proceedings of the Korea Information Processing Society Conference
• /
• 2008.11a
• /
• pp.1071-1074
• /
• 2008

본 논문에서는 센서 네트워크를 이용해서 환자 모니터링 시스템(PVMS : Patient Vital Sign Monitoring System)을 구현하였다. 최근 의료 서비스에 유비쿼터스 컴퓨팅 기술을 적용한 사례들이 늘고 있다. 기존 사례에서는 센서 전지 수명, 이동 통신비, 응급상황 대처 등 개선할 부분이 존재한다. 본 연구에서는 이런 점들을 해결하기 위해 환자의 체온 및 맥박 생체신호를 측정하기 위해 소형센서를 사용하였다. 또한 생체신호 전달을 위해 초저전력 무선통신 노드를 사용하여 언제 어디서나 환자 모니터링이 가능하고 의료진에게 응급상황을 신속하게 전달할 수 있는 웹기반 시스템을 개발하였다. 본 연구의 결과는 병동환자뿐만 아니라 활력증후를 상시로 모니터해야하는 원거리 환자를 위한 의료시스템 구축에도 활용될 수 있을 것이다.

• Clinical and Experimental Pediatrics
• /
• v.49 no.7
• /
• pp.757-762
• /
• 2006

Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.

• The Korean Society of Law and Medicine
• /
• v.25 no.1
• /
• pp.87-115
• /
• 2024

In Korea, exposure to stress has been accompanied by mental pain in the process of achieving many growth along with rapid development, various social problems, and the frequency of emergency hospitalization is increasing.. In the case of mentally ill patients, "unwanted hospitalization" is a problem, and police and 119 paramedics try to suppress the body of mentally ill patients, and many problems are exposed This is because the constituent requirements of the provisions of emergency hospitalization under the Mental Health and Welfare Act do not reflect reality, and each institution has a different position on one mentally ill person, and emergency hospitalization does not proceed smoothly or leads to friction between related organizations, and the safety of the mentally ill or others is not secured. Emergency hospitalization is defined as "a person who finds a person who is presumed to be mentally ill and is at high risk of harming his or her health or safety or others," and if the situation is so urgent that he or she cannot afford time to go through the hospitalization procedure to decide on his or her own hospitalization, he or she can request emergency hospitalization with the consent of a doctor and a police officer. In this case, 119 paramedics are escorted to a psychiatric institution. This provision of emergency hospitalization poses many problems in the process of transferring to psychiatric institutions. If a police officer or 119 paramedics in charge of practice use "physical force" during the emergency hospitalization process, side effects will inevitably occur, and professional negligence can be a problem. Specifically, when exercising physical force, the minimum necessary physical restraint based on laws and regulations and proportional principles is required, and the lack of the duty of care of 119 paramedics or police officers under the laws and regulations will eventually be resolved by applying other laws and regulations. Accordingly, it will be an opportunity for mentally ill patients to be transferred to psychiatric institutions in a safe environment by changing the subject of emergency hospitalization provisions under the Mental Health Welfare Act, defining and prescribing the use of physical protection guards as the enforcement regulations of the Mental Health Act, setting the duty of care for 119 paramedics and police officers, and creating an environment for transportation so that mentally ill patients can be treated safely.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1061-1067
• /
• 2005

Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.

• Quality Improvement in Health Care
• /
• v.7 no.2
• /
• pp.138-155
• /
• 2000

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.