• The Korean Journal of Health Service Management
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• v.1 no.1
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• pp.110-124
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• 2007

Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.47-50
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• 2017

Nitrogen is an inert gas that is harmless to humans under normal conditions. While it is not inherently toxic, nitrogen gas becomes dangerous when it displaces oxygen, resulting in suffocation. Herein, we report a case of a 34-year-old man who attempted suicide by nitrogen asphyxiation who presenting with decreased mental function and agitation. Lactic acidosis and hyperammonemia were observed on presentation at the emergency department, but these improved after a few hours. After 2 days, the patient regained full consciousness, and was discharged without any complications. Survival after asphyxiation due to nitrogen gas is very rare, and these patients are more likely to have poorer outcomes. There is a potential for the increasing use of nitrogen gas as a method of committing suicide because of the ease of access to this gas.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.41-45
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• 2012

Recently, some patients have visited the emergency department for treatment of different symptoms of acute poisoning after intake of unidentified herbs, which can be mistaken for wild edible greens, because wild edible greens are good for health and contain vitamins, enzymes, minerals, fibers, and anticancer materials. Winter or early spring, is extremely high, with rapid onset of severe symptoms of poisoning. There have been no reports of poisoning by SymplocarpusRenifolius in Korea, however, we report on three severe cases involving patients who experienced cardiogenic shock with nausea, vomiting, abdominal pain, chest discomfort, dizziness, numbness, and general weakness.

• Journal of The Korean Society of Clinical Toxicology
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• v.14 no.1
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• pp.33-36
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• 2016

Purpose: This study was conducted to identify the characteristics associated with sulfuric acid injury in the emergency department. Methods: Data were collected retrospectively from January 2007 to December 2015 on all sulfuric acid injuries presenting to the emergency department in Gu-mi Soonchunhyung University Hospital. Patients injured by sulfuric acid were recorded over a nine year study period and collected data included demographics, injury mechanism, injured body part, hospital care and final diagnosis. Results: A total of 26 cases were identified. Most patients were male (88.5%) and the face was the most commonly injured body part. The most common mechanism of injury was splashing injury. A total of 16 (61.5%) patients were identified as having lesions worse than second degree burns. Conclusion: Sulfuric acid can cause severe and fatal skin burn. When working with sulfuric acid, acid proof protect clothing, goggles and glove should be worn. Furthermore, safety education and workplace environment improvement are necessary to reduce sulfuric acid injury.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.7-27
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• 2020

Purpose: The purpose of this study is to identify the compliance with the first standardization of the paramedic curriculum and suggest a second standardization to cultivate competent paramedics. Methods: This study was conducted by collecting 38 curricula, and responses to questionnaires, including those on the current status of prehospital field practice, from departments of emergency medical technology of 36 institutions. Data were collected between September 1 and November 30, 2019 via e-mail. Data were analyzed using SPSS v24.0 and NVivo 12.0. Results: Compliance with the first standardization of the paramedic curriculum was over 70% in only 11 on the 26 major subjects. The second standardization of the paramedic curriculum consists of 27 subjects requiring 76~79 credits for the 3-year course and 78~82 credits for the 4-year course. Conclusion: We suggested a minimum number of essential subjects to cultivate competent paramedics following the second standardization of the paramedic curriculum, and we hope colleges comply with this curriculum. Twenty to twenty-five percent of major subjects can be determined by the discretion of the college to maximize competency of paramedic students.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.145-156
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• 2021

Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.22-26
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• 2005

The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.90-95
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• 2004

Purpose: The purpose of this study is to compare the toxicologic characteristics of two groups of patients with acute intoxication for two different time periods and to make recommendations based on the results of this study. Methods: We reviewed retrospectively the medical records of patients with acute intoxication in our emergency center from June 1997 to May 1998 (group A) and from June 2000 to May 2003 (group B), and we evaluated differences in the epidemiologic and the toxicologic characteristics between the two groups. Results: The ratios of the number of patients with acute intoxication to the total numbers of patients who visited our emergency department were $0.49\%$ and $0.52\%$ for groups A and B, respectively. In both groups many poisoned patients visited our emergency center from 4:00 pm to midnight. The interval between the time of intoxication and arrival at the hospital was significantly shorter in group B. The number of patients transferred to our emergency center was larger in group B. Attempted suicide was the major cause of acute intoxication in both groups. Major toxic substances in both groups were centrally active drugs and insecticides. The number of comatose and mechanically ventilated patients was larger in group B. However, there was no statistically significant difference in the mortality rates. Conclusion: Emergency physicians who manage intoxicated patients should recognize regional characteristics and differences in the toxicologic characteristics of poisoning. In addition, the establishment of a poisoning control center in the regional emergency center is necessary to integrate data control and to enhance specialized management of intoxicated patients.

• Nuclear Engineering and Technology
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• v.38 no.3
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• pp.231-238
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• 2006

Whole-body exposure to high-dose radiation causes injury involving multiple organs that depends on their sensitivity to radiation. This acute radiation syndrome (ARS) is caused by a brief exposure of a major part of the body to radiation at a relatively high dose rate. ARS is characterized by an initial prodromal stage, a latent symptom-free period, a critical or manifestation phase that usually takes one of four forms (three forms): hematologic, gastrointestinal, or cardiovascular and neurological (neurovascular), depending upon the exposure dose, and a recovery phase or death. One of the most important factors in treating victims exposed to radiation is the estimation of the exposure dose. When high-dose exposure is considered, initial dose estimation must be performed in order to make strategy decisions for treatment as soon as possible. Dose estimation can be based on onset and severity of prodromal symptoms, decline in absolute lymphocyte count post exposure, and chromosomal analysis of peripheral blood lymphocytes. Moreover, dose assessment on the basis of calculation from reconstruction of the radiation event may be required. Experience of a criticality accident occurring in 1999 at Tokai-mura, Japan, showed that ARS led to multiple organ failure (MOF). This article will review ARS and discuss the possible mechanisms of MOF developing from ARS.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.240-248
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• 2018

Objective Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. Methods Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. Results Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. Conclusion Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.