• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.423-429
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• 2018

Objective: Falling is a common cause of head injury in preschool aged children. We investigated the characteristics of mild head injuries caused by falling and the association between body weight and occurrence of traumatic brain injuries (TBI). Methods: This retrospective observational study was conducted on head-injured preschool-aged children that visited the emergency department from January 2012 to December 2015. Characteristics such as age, sex, weight, free fall height, floor type, and presence of TBI, as defined as cerebral hemorrhage or skull fracture, were investigated. We calculated body weight percentiles by calibrating age and weight and categorized them into four quartile ranges. We grouped all included cases into two groups according to the presence of TBI. The characteristics of the two groups were compared by using chi-square test, and the association with TBI was investigated by using binomial logistic regression. Results: A total of 701 children were included, and TBI was observed in 95 children. Children with TBI were younger. The proportion of children with TBI was higher in the third and fourth quartiles of the body weight group as well as according to soft floor and fall from high height (${\geq}1m$). The odds of soft floor being associated with TBI was higher than the odds for hard floor (odds ratio, 2.734; 95% confidence interval [CI], 1.597-4.680). The odds of high height (${\geq}1m$) being associated with TBI was higher than that for low height (odds ratio, 2.306; 95% CI, 1.155-4.601), and the odds ratio for the weight percentile group was 1.228 (95% CI, 1.005-1.499). Conclusion: Prevalence of TBI after falling in preschool-aged children might be associated with high fall-height and body weight quartiles.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.671-678
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• 2018

Objective: This study examined the predictive factors for prolonged length of stays of adult patients with acute appendicitis (AA) in an emergency department (ED). Methods: This was a retrospectively clinical study including patients in an ED. All patients were diagnosed from the clinical symptoms and a typical physical examination, and had undergone a computed tomography (CT) evaluation on the ED visiting date. All data were collected from the electrical medical records. The clinical parameters analyzed were the laboratory data, including the white blood cell count with differential values, C-reactive protein (CRP) level, initial vital signs, duration of admission, coexisting perforation of the appendix in the CT findings. The relationship between the clinical parameters and length of stay was assessed. Results: A total of 547 patients with AA were enrolled in this study. Among them, there were 270 male patients with a mean age of $40.7{\pm}15.8years$. The baseline characteristics, initial clinical features, laboratory, and imaging studies results of 129 patients in the prolonged length of stay (pLOS) group, and 418 patients of the non-pLOS group in AA were compared. Multivariable logistic regression analysis revealed the predictive factors related to pLOS in AA to be as follows: age 40 years or older, body temperature over $37.3^{\circ}C$, CRP level greater than 5.0 mg/dL, and evidence of perforation in CT findings (P<0.001). Conclusion: If we check age, fever, CRP level and find evidence of perforation, it might be helpful for predicting the increasing period of length of hospital stay for patients with AA in ED.

• Clinical and Experimental Pediatrics
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• v.54 no.12
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• pp.477-480
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• 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

• Child Health Nursing Research
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• v.7 no.2
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• pp.191-202
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• 2001

This study was attempted to help in explore new direction about classification of the severity of the pediatric patients visiting emergency center. Data were collected from 276 patients who visited emergency center of E University Hospital during 3 months period from March 1, to May 31,1999. The results were as follows: 1. The degree of severity of the pediatric patients visiting emergency center shown ranged 0-18 and averaged .87. 2. With the respect to the severity of the pediatric patients visiting emergency center, there were statiscally significant difference in patients' visiting time(F=2.607, p=.025), disease classification(F=9.606, p=.000), consciousness level(F=71.499, p=.000), period of symptom manifestation (F=2.262, p=.030), pediatric patients protector's thinking about pediatric patients state (F=16.833, p=.000), treatment outcome (t=5.362, p=.000), duration of stay at emergency center(F=23.944, p=.000).

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.9
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• pp.4075-4082
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• 2011

In the event of the emergency patient care, cabin crew must take the charge of the first responder quickly. The basic emergency treatment knowledge of the cabin crew consisted of 80.5%~97.8% when the emergency scene showed up in the passenger and the types of emergency care with that the cabin crew could cope were bleeding control, fever, seizures, myocardial infarction, airway management, and partial airway obstruction management. Considering these cares, the improper emergency types revealed approximately 3.2%~20.0%. In airway obstruction there was followed by loss of consciousness and this led to cardiac arrest. In case of cardiac arrest, the cabin crew must know how to check breathing and to use the automated external defibrillator(AED). The life-threatening cardiac arrest can happen to any passenger in any time, so the cabin crew should meet with the emergency accident and apply the AED to the cardiac arrest victim.

• The Korean Journal of Emergency Medical Services
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• v.1 no.1
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• pp.11-19
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• 1997

We have reviewed 2.876 patients who visited the emergency room from May, 1996 to september, 1996 in order to look for a more appropriate management of the emergency medical system. The result were summarized as followings; 1. Considering sexual distribution, male patients were 59.6% more than female patients 40.4% and according to age categories, first decade of life was most frequent. 2. Distribution according to ca use is most common for the disease 79.8%, and next injury and traffic accident is 11.6%, 6.8%, respectively. 3. According to the department distribution, pediatrics accounted for 37.4%, internal medicine 21.1%, and emergency medicine 10.0%, and these three departments was 66.3% of total number of patients. 4. 67.0% of patients visited emergency room were discharged. Arrived time in emergency room, patients of 41.9% was visited from 17 to 1 hours. 5. Among 196 patients of traffic accident, 160 were male(81.5%) and 36 were female (18.5%). Distribution of the age is most common in 3rd and 4th decade for 63.2%, and region of injury were face 33.3%, head 22.2%, and chest 22.2% and follow-up measures after visiting emergency room is most common transfer hospital 40.8%.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.119-127
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• 2010

Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.

• Korean Chemical Engineering Research
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• v.55 no.2
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• pp.195-200
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• 2017

Emergency response guidelines play an important role which reduce consequence of accident. For development of useful emergency response guidelines, engineering methodology should be applied to the development procedures. In this study accident propagation model, bow-tie methods, emergency response decision methods were applied to existing emergency response guideline develop procedure. In this way, this study suggest generalized emergency response guideline develop procedures. Also a sheet was developed using suggested procedures to make sample guidelines for a case.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.99-111
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• 2008

Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.159-169
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• 2018

Purpose: The purpose of this study was to investigate the reality of workplace violence experienced by emergency nurses and the relationship of violence response to professional quality of life. Methods: The participants in this study were 899 emergency nurses from Korea nationwide. Data were obtained through an online survey done during October, 2017. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient. Results: Of the emergency nurses, 72.1% recognized that workplace violence is serious. Experience with workplace violence correlated positively with violence reaction (r=.32, p<.001), burnout (r-.20, p<.001) and secondary trauma (r=.22, p<.001). Also, reaction to violence was positively correlated with burnout (r=.28, p<.001) and secondary trauma (r=.56, p<.001). Conclusion: Findings indicate that the diverse workplace violence experienced by emergency nurses decreases their professional quality of life. Further study is needed to develop solutions to the problem of workplace violence in emergency settings.