• KSII Transactions on Internet and Information Systems (TIIS)
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• 제8권2호
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• pp.406-423
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• 2014

The recent advances in wireless communication systems and semiconductor technologies are paving the way for new applications over wireless sensor networks. Health-monitoring application (HMA) is one such emerging technology that is focused on sensing and reporting human vital signs through the communication network comprising sensor devices in the vicinity of the human body. The sensed vital signs can be divided into two categories based on the importance and the frequency of occurrence: occasional emergency signs and regular normal signs. The occasional emergency signs are critical, so they have to be delivered by the specified deadlines, whereas the regular normal signs are non-critical and are only required to be delivered with best effort. Handling the occasional emergency sign is one of the most important attributes in HMA because a human life may depend on correct handling of the situation. That is why the underlying network protocol suite for HMA should ensure that the emergency signs will be reported in a timely manner. However, HMA based on IEEE 802.15.4 might not be able to do so owing to the lack of an appropriate emergency-handling mechanism. Hence, in this paper, we propose a new emergency-handling mechanism to reduce the emergency reporting delay in IEEE 802.15.4 through the modified superframe structure. A fraction of an inactive period is modified into three new periods called the emergency reporting period, emergency beacon period, and emergency transmission period, which are used opportunistically only for immediate emergency reporting and reliable data transmission. Extensive simulation is performed to evaluate the performance of the proposed scheme. The results reveal that the proposed scheme achieves improved latency and higher emergency packets delivery ratio compared with the conventional IEEE 802.15.4 MAC.

• 보건행정학회지
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• 제16권4호
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• pp.128-146
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• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• 한국응급구조학회지
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• 제18권3호
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• pp.63-75
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• 2014

Purpose: The purpose of this study was to investigate the image about emergency medical technology (EMT) jobs and to identify factors influencing the image of EMT jobs among students of this department. Methods: A self-reported questionnaire was administered to 532 paramedic students in the cities of D, G, and J between May 28 and June 19, 2013. Data were analyzed by using the SPSS version 21.0 program. Results: The image about EMT jobs was positively related to self-esteem. However, the image about EMT jobs was negatively related to grade and hospital practice experience. In the multiple regression analysis, the adjusted $R^2$ value was .220 (p < .001). Conclusion: The importance of enhancing the self-esteem of paramedic students should be emphasized. Further research on the image about EMT jobs in the hospital practice setting is needed.

• 대한임상독성학회지
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• 제14권2호
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• pp.115-121
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• 2016

Purpose: Because carbon monoxide (CO)-intoxicated patients with an alert mental status and only mild cognitive dysfunction may be inadequately assessed by traditional bedside neurologic examination in the emergency department (ED), they may not receive appropriate treatment. Methods: We retrospectively investigated the incidence and features of cognitive dysfunction using the Korean version of the Mini-Mental State Examination (MMSE-K) in ED patients with CO poisoning with alert mental status. We conducted a retrospective review of 43 consecutive mild CO poisoned patients with a Glasgow Coma Scale score of 15 based on documentation by the treating emergency physician in the ED between July 2014 and August 2015. Results: Cognitive dysfunction, defined as a score of less than 24 in the MMSE-K, was diagnosed in six patients (14%) in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed greater impairments. The mean age was significantly older in the cognitive dysfunction group than the non-cognitive dysfunction group (45.3 yrs vs. 66.5 yrs, p<0.001). Among the initial symptoms, experience of a transient change in mental status before ED arrival was significantly more common in the cognitive dysfunction group (32.4% vs. 100%, p=0.003). Conclusion: Patients with CO poisoning and an alert mental status may experience cognitive dysfunction as assessed using the MMSE-K during the early stages of evaluation in the ED. In the MMSE-K, orientation to time, memory recall, and concentration/calculation showed the greatest impairment.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.142-147
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• 2009

Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn' be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn' be found on CXR to be verified, which helped us to could accurately evaluate patients.

• 대한임상독성학회지
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• 제16권2호
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• pp.141-148
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• 2018

Purpose: The Korean government approved selected nonprescription drugs (Over-The-Counter drug; OTC drug) to be distributed in convenience stores from 15. Nov. 2012. This study examined the changes in the incidence and the clinical outcome of acute pharmaceutical drug poisoning after the deregulation of OTC drug sales. Methods: This study analyzed the data of Emergency Department based Injury In-depth Injury Surveillance (EDIIS), Korea Centers for Disease Control and Prevention, from 2011 to 2014. The following items were examined: age, gender, intention, alcohol association, pharmaceutical drugs resulting acute poisoning, the clinical outcomes in emergency department, and the admission rate of intensive care unit (ICU). This is a retrospective cross section observational study. Results: A total of 10,162 patients were subject to pharmaceutical drug poisoning. Acute poisoning by acetaminophen and other drugs were 1,015 (10.0%) and 9,147 (90.0%) patients, respectively. After the deregulation of OTC drug sales, acute poisoning by other drugs increased from 4,385 to 4,762 patients but acute poisoning by acetaminophen decreased from 538 to 477 patients (p<0.05). The rate of admission of acetaminophen poisoning increased from 36.1% (194/538) to 46.8% (223/477). The admission rate to the ICU by acetaminophen poisoning increased from 4.6% (25/538) to 11.3% (54/477) after the deregulation of OTC drug sales (p<0.05). Conclusion: Since the deregulation of OTC drugs sales, pharmaceutical drug poisoning has increased but acetaminophen poisoning has decreased. The rate of hospitalization and ICU admission by pharmaceutical drug poisoning with or without acetaminophen has also increased.

• 한국응급구조학회지
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• 제25권1호
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• pp.73-84
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• 2021

Purpose: The purpose of this study was to investigate the educational satisfaction of trainees in implementing violence prevention education by workers in the emergency room and insufficient education. Methods: The participants of the study were 65 emergency room employees in S area. Results: First, education was helpful if you actively participated in education, and if you did not actively participate in education, education was shown to be of little or no help (χ²(p)= .000 p-value<.05). Second, formal education (53.3%) was identified as the problem of preventive education currently in place of education, and statistics show that the biggest problem with applying emergency room violence prevention education at worksites is a lack of active support (41.7%) from the police and hospitals. Third, 48.3 percent of the respondents thought that the education methods invited experts were appropriate for emergency room violence prevention education. Conclusion: The problem with the current emergency room violence prevention education is that it is necessary to establish a connection program between hospitals and police stations and give lectures by experts in violence prevention education to apply the contents of the educational curriculum in the workplace with one time and formal education.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.119-126
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• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.48-51
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• 2011

Powered by compressed air, a nail gun is an essential alternative tool to a hammer on any construction site. This useful machine launches nails at high speed, automatically embedding them in a piece of wood in only a fraction of a second. In spite of its convenience, life-threatening and fatal nail gun injuries can occur when a nail gun is misused, such as in a suicide attempt, or when the operator has insufficient training because combustion nail guns are capable of firing projectiles at velocities higher than 150 m per second. Although injuries by nail guns are rarely reported, there have been reports of nail gun injuries to the head and the trachea in Korea. In the emergency room, the authors experienced a patient injured by an accidental shooting of a nail gun while working in construction. In that accident, a nail penetrated the patient's cervical vertebra through the left cheek. This report is aimed at studying medical treatment for patients with penetrating injuries caused by nail guns.

• 대한임상독성학회지
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• 제13권2호
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• pp.71-77
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• 2015

Purpose: Acute endosulfan poisoning is rare but causes significant morbidity and mortality. The aim of our study is to describe complications and features of seizure and determine factors associated with mortality in acute endosulfan poisoning. Methods: Twenty-eight adult patients with acute endosulfan poisoning admitted to our emergency department during a 15-year period were studied retrospectively. The clinical features of seizure, use of antiepileptic drugs during seizure, and hospital courses were evaluated. Clinical factors between survived group and non-survived group were compared for identification of factors associated with mortality. Results: Of the 28 patients with endosulfan poisoning, 4 patients (14.3%) died and 15 (53.6%) patients developed generalized tonic-clonic seizure. Thirteen patients (46.4%) and 5 patients (17.9%) progressed to status epilepticus (SE) and refractory status epilepticus (RSE), respectively. SE and RSE were associated with mortality. Almost all significant complications including shock, acute renal failure, hepatic toxicity, rhabdomyolysis, and cardiac injury developed in SE and RSE patients. Conclusion: SE and RSE were important contributors to death in endosulfan poisoning. Emergency physicians treating endosulfan poisoning should make an effort not to progress seizure following endosulfan poisoning to SE and RSE using a rapid and aggressive antiepileptic drug.