• Journal of The Korean Society of Clinical Toxicology
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• v.21 no.2
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• pp.92-107
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• 2023

Purpose: This study investigated the characteristics and treatment outcomes of patients who visited the emergency department due to intoxication and analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on their visits. Methods: A retrospective study was conducted using data from the National Emergency Department Information System (NEDIS) on patients who visited the emergency department due to intoxication between January 2014 and December 2020. In total, 277,791 patients were included in the study, and their demographic and clinical data were analyzed. A model was created from 2014 to 2019 and applied to 2020 (i.e., during the COVID-19 pandemic) to conduct a time series analysis distinguishing between unexpected accidents and suicide/self-harm among patients who visited the emergency department. Results: The most common reason for visiting the emergency department was unintentional accidents (48.5%), followed by self-harm/suicide attempts (43.8%). Unexpected accident patients and self-harm/suicide patients showed statistically significant differences in terms of sex, age group, hospitalization rate, and mortality rate. The time series analysis showed a decrease in patients with unexpected accidents during the COVID-19 pandemic, but no change in patients with suicide/self-harm. Conclusion: Depending on the intentionality of the intoxication, significant differences were found in the age group, the substance of intoxication, and the mortality rate. Therefore, future analyses of patients with intoxication should be stratified according to intentionality. In addition, the time series analysis of intentional self-harm/suicide did not show a decrease in 2010 in the number of patients, whereas a decrease was found for unintentional accidents.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.108-114
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• 2015

Purpose: To improve outcome of severe trauma patient, the shortening of transport time is needed. Although helicopter emergency medical services (HEMS) is still a subject of debate, it must also be considered for trauma system. The aim of this study is to assess whether transport method (HEMS versus ground EMS) is associated with outcome among inter-hospital transport. Methods: All trauma patients transported to regional emergency center by either HEMS or ground EMS from September 2011 to September 2014. We have classified patients according to two groups by transport method. Age younger than 15 years and self-discharged patients were excluded. Results: A total of 427 patients were available for analysis during this period. 60 patients were transported by HEMS and 367 patients were transported by ground EMS. HEMS group had higher mortality than ground EMS group (23.3% vs 3.5%; p<0.001), and included more patients with excess mortality ratio adjusted injury severity score (EMR-ISS) above 25 (91.7% vs 48.8%; p<0.001). In the multivariable regression analysis, HEMS was not associated with improved outcome compared with ground EMS, but only EMR-ISS was associated with a mortality of patients (odds ratio, 1.06; 95% confidence interval, 1.04-1.09). Conclusion: In this study, helicopter emergency medical services transport was not associated with a decreased of mortality among the trauma patients who inter-hospital transported to the regional emergency center.

• The Korean Journal of Emergency Medical Services
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• v.20 no.1
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• pp.57-70
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• 2016

Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.92-98
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• 2002

Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.72-76
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• 2007

Purpose: The purpose of this clinical trial was to evaluate the fixation method for treating alveolar fractures in an emergency department. Methods: The efficiency of using the fixation method was judged on the basis of clinical criteria. Stability, occlusion state, bleeding amount after fixation, operation time, and difficulties during procedural operation were recorded. Results: Eight patients were enrolled in this study. In all instances, the fixation method was effective in bleeding control. Each patient had a noticeable decrement in bleeding. A wire was used for four of the eight patients, and nylon strings was used for the others. The average operation time was 6.3 minutes for the wire patients and 2.8 minutes for the Nylon string patients. No specific problem was identified during the procedural operation. However, the difference in the fixation material influenced the effectiveness of the procedure, the operation time, and the satisfaction of the doctor. Conclusion: In the emergency department, the fixation method using wire or nylon string in the treatment of alveolar fractures is effective in bleeding control

• Journal of Medicine and Life Science
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• v.19 no.1
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• pp.8-13
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• 2022

Jeju is the largest island in Korea and one of its key tourist attractions. As the number of foreign tourists steadily increases, so does the number of injuries incurred there. Accordingly, this study aimed to describe and compare the characteristics of injuries suffered by foreign tourists versus those of domestic tourists. As a cross-sectional study of a retrospective medical record survey, the study was conducted with reference to the Jeju Injury Surveillance System from the 11-year period of January 2008 to December 2018. The following factors were investigated: demographic data, mechanism of injury, place of occurrence, activity when injured, patient outcome, and mortality. A total of 92,095 injured Jeju Island visitors was recorded during this time, a number that included 88,050 Koreans and 4,045 foreigners. The gender ratio showed similar patterns between the two groups and there were no significant age differences. In both groups, the most common mechanism of injury was collisions/cuts. Also, more foreigners experienced falls than Koreans. Regarding the location, Koreans had the most road accidents, while foreigners were most likely to be injured at outdoor locations, such as seas and rivers. Furthermore, more foreigners experienced severe injuries requiring hospitalization. Notably, this study showed the differences in injury between foreign and Korean tourists visiting Jeju Island and its findings lend support to targeted safety promotion programs.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.6-15
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• 2010

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.500-511
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• 2014

Purpose: The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department. Methods: Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires. Results: Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours. Conclusion: Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.3-12
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• 2021

Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.148-163
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• 2002

Background : The personnel of emergency department have been under tremendous pressure to manage unexpected emergency situations and excited patients. And interpersonal conflict has existed always, because emergency department was consisted of various personnel of their own specialty. The patient's satisfaction has to come from the personnel's satisfaction. The purpose of this study was to evaluate emergency department personnel's job satisfaction and its related factors and to improve quality of emergency medical service Methods : A self-administered questionnaire survey to the emergency department personnel was conducted between September 1 and October 31, 2001. The response rate was 90.2%. Using SAS program (Version 6.12), the collected data was analyzed by frequency, ANOVA, multiple comparison, Pearson correlation procedure, and stepwise multiple regression analysis. Result : The analysis of related factors of job satisfaction showed high score of interpersonal interaction (3.246), professional prestige (3.095), autonomy (2.916), task requirements (2.701), organizational requirements (2.444), and pay (1.953) in order of item mean. Professional prestige (0.498), task requirements (0.464), and organizational requirements (0.408) were highly positive correlated with overall level of job satisfaction. The factors influencing the job satisfaction were professional prestige and task requirements which explaining efficacy were 37.6% and 32.2% respectively. The total explaining efficacy was 33.6%. Conclusion : It was found out that emergency department personnel's job satisfaction can be raised by promoting professional prestige and task requirements. The personnel of emergency department have to be satisfied through their job, and the administration of the hospital has to pay more attention to their employees' job satisfaction and it related factors.