• 성인간호학회지
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• 제26권1호
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• pp.107-116
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• 2014

Purpose: The purpose of this study was to identify the effects of multi-mode simulation learning on critical thinking disposition, on the problem solving process and on clinical competence of nursing students. Methods: A non-equivalent control group with pre-posttest was designed. The participants in this study were 65 students who were enrolled in an emergency and critical nursing course at N university. The treatment group consisted of 33 juniors in 2010 and the control group 32 juniors in 2011. Collected data were analyzed using chi-square, independent t-test, and ANCOVA with the SPSS/WIN 18.0 for Window Program. Results: There were significant increases in problem solving process and clinical competence in the treatment group who participated in the multi-mode simulation learning compared to the control group who did not (t=-2.39, p=.020; F=12.76, p=.001). However, there were no significant differences in critical thinking disposition between the treatment and control group (t=0.40, p=.692). Conclusion: Multi-mode simulation is an effective teaching and learning method to enhance the problem solving process and clinical competence of nursing students. Further exploration is needed to develop and utilize multi-mode simulation for diverse scenarios, depending on emergency nursing educational goals and environments and to develop a universal method to measure outcomes.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.159-165
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• 2012

Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was $6.4{\pm}2.0$. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.

• Journal of Korean Neurosurgical Society
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• 제39권1호
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• pp.72-74
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• 2006

We report a case of fatal aortic tumor embolism presenting as acute paraplegia. A four-year-old girl was referred from a local hospital with sudden paraplegia and a poor medical condition. A neighbor had noticed her fall from a bike, and she could not walk. She had no previous illness. Emergency spine MRI revealed no remarkable findings. During the process of evaluation, her general condition deteriorated progressively. Chest and abdominal CT showed a large mass in the left lung field, and a diagnosis of aortic occlusion was made. An emergency transfemoral embolectomy was attempted. However, the patency of the aorta was not recovered. On pathological examination of tissues taken from the embolectomy, a pleuro-pulmonary blastoma was found. The patient died 22 hours after the onset of her symptoms. We describe a possible mechanism for the tumor embolism. To the best of our knowledge, this is the first case report of aortic occlusion caused by an embolic malignancy, presenting as acute paraplegia.

• 한국응급구조학회지
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• 제28권1호
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• pp.97-112
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• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• 한국지반신소재학회논문집
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• 제17권2호
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• pp.19-31
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• 2018

최근 도시의 안전을 심각하게 저해시키는 지반함몰현상이 증가하는 추세에 있어 대책이 필요한 상황이다. 지반함몰 발생 시 긴급복구공법에 사용될 산업부산물을 활용한 뒤채움재를 개발하는 것이 본 연구의 목적이다. 이를 위해 유동성 채움재 설계기준에 의거하여 목표성능을 도출하였고, 플로우값, 일축압축강도, 초기응결시간, pH시험 등 실내시험평가를 통해 개발된 재료의 적용성을 검토하였다. 또한 현장실험을 통해 고유동성 채움재의 조기강도에 대한 성능검증과 긴급복구를 위한 시공성을 확인하였다. 평가결과 시멘트의 비율이 4% 이상일 경우 재 굴착이 가능한 장기강도보다 크게 측정되어 긴급복구목적에 적합지 않은 것으로 나타났다. 최적배합비는 저회와 석고의 비율이 약 50:50, 시멘트의 비율이 2%로 나타났다.

• Child Health Nursing Research
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• 제15권3호
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• pp.271-281
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• 2009

Purpose: This study was conducted to develop an instrument to measure coping in emergency situations. Methods: The process included construction of a conceptual framework, generation 60 primary items, verification of construct validity and extraction of final items. The.60 preliminary items were reviewed for content validity by seven experts and were tested to evaluate inter-item correlation coefficient by three groups of elementary school students. From November 1 to December 10, 2008, data were collected from 920 elementary school students according to residential characters (major city, small town, rural area). Item analysis, factor analysis with rotation Varimax and Cronbach's alpha were used to analyze the data. Results: 1) There were 45 items in the final instrument categorized into 8 factors. 2) The factors were labeled as "Call for help and check" (8 items), "Care for common symptoms" (6 items), "Appropriate response for the situation" (5 items), "Evacuation" (6 items), "Care for tissue damage" (8 items), "Care for injury by heat, cold or foreign body" (6 items), "Offer help" (4 items) and "Rescue & escape" (2 items). 3) Cumulative percent of variance was 53.10% and eigen values ranged from 1.04 to 13.38. 4) Cronbach's alpha for the total was .943 and ranged from .527 to .869. Conclusion: Validity and reliability of the scale are confirmed in this study showing its utility for measuring coping in emergency situations with elementary school students. Utilization of the scale will also contribute to designing appropriate coping education programs for elementary school students.

• 해양환경안전학회지
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• 제22권5호
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• pp.417-422
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• 2016

항로표지란 해상교통의 안전을 도모하고 선박운항 능률을 향상시키기 위한 해양교통안전시설로 새로운 위험물(New Danger)은 측방표지, 방위표지, 고립장해표지 등을 이용하거나 비상침선표지(Emergency Wreck Marking Buoy)를 사용하여 적절하게 표시하여야 한다. 그러나, 침선표지의 경우 설치의 신속성, 정확성, 부표의 특성 등의 문제로 인해 실질적인 설치 운영상의 문제가 제기 되고 있으며, 선박침몰 사고의 경우 기상악화, 해역의 특성, 사고 위치의 확인이 어려워 신속한 신위험물표지(New Danger Mark) 설치가 어려운 실정이다. 이 연구는 항상 선박 상갑판에 부착된 해양안전설비 중 하나로 Maritime Buoyage System(MBS)에 근거한 자동이탈식 비상침선표지를 개발하였다. 자동이탈식 비상침선표지Auto Releasing Emergency Wreck Marking Buoy)는 총 3개의 세부기술(자동이탈, 자동릴체인, 자동구동등명기)로 구성되며, 선박 상갑판에 부착된 자동이탈식 비상침선표지가 선박의 좌초 전복 침몰 등 해양사고 발생 시 일정수압에 의해 자동으로 이탈(Auto Release) 후 자기 부상(Auto Buoyance)하여 사고 발생 지점에 신속하고 정확하게 설치된다. 이러한 자동이탈식 비상침선표지는 선박의 항해안전을 위협하는 장해물로부터 해당 해역에서의 2차 사고를 방지하고, 신속한 수색 및 구조가 이루어질 수 있도록 한다.

• 한국재난정보학회 논문집
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• 제15권3호
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• pp.440-449
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• 2019

연구목적 : 소방조직은 재난현장에서 가장 우선적으로 대응하는 기관으로 신속하고 체계적인 대응을 하기 위하여 긴급구조훈련을 실시하고 있다. 하지만 형식적인 훈련, 지역적 특성이나 환경적 특성이 고려되지 않는 훈련 등 긴급구조훈련의 한계점에 대한 변화와 개선의 필요성이 제기되고 있다. 연구방법 : 본 연구에서는 긴급구조훈련과 관련된 이론적 검토를 실시하고 강원지역 소방조직의 의식조사를 통하여 긴급구조훈련 개선방안을 제시하였다. 연구결과 : 긴급구조 활동 시 어려움이 있는 시설은 위험물 저장 및 처리시설이 가장 많았으며 긴급구조 대응업무의 수준은 응급복구가 미흡하다고 응답한 의견이 가장 많았다. 또한 긴급구조훈련의 효과는 도움이 된다고 응답하였지만 시나리오에 의한 훈련, 보여주기식 훈련, 매년 유사한 훈련, 현실감 없는 훈련, 유관기관의 관심 부족 및 형식적 참여 등으로 도움이 되지 않는다고 응답한 부분도 있었다. 그리고 긴급구조훈련 평가의 적절성은 대부분이 만족한다고 응답하였지만 훈련 유형과 상관없는 평가방식, 필요 이상의 훈련 규모를 설정하게 하는 평가방식, 유관기관의 형식적 참여를 유도하는 평가방식 등으로 만족하지 않는다고 응답하였다. 마지막으로 긴급 구조훈련 개선에 대한 요구도는 다양한 피해 상황을 반영한 훈련이 필요하다는 의견이 가장 많았다. 결론 : 긴급구조훈련 개선방안은 다음과 같다. 첫째, 다양한 훈련내용을 설정하고 지역의 주요 발생재난 등을 검토하여 지역적 특성에 맞게 작성해야 한다. 둘째, 소방서별 적절한 훈련계획을 위하여 긴급구조훈련계획 지침 및 매뉴얼 등을 개정하고 실무자를 대상으로 교육하고 이를 위해 긴급구조훈련에 대한 유형부터 전술, 전략까지 실무적으로 활용할 수 있도록 훈련을 정립해야 한다. 셋째, 실제 재난 발생 시 지원기관 및 유관기관의 참여도를 높이기 위하여 훈련계획단계부터 참여를 유도하고 인센티브 혹은 패널티(penalty)를 줄 수 있는 제도 등을 마련해야 한다. 넷째, 동시다발적으로 발생할 수 있는 재난 상황에 대비하여 소방서간, 권역별 훈련으로 기관별 지원태세 확립, 협조체계를 구축해야 한다. 다섯째, 긴급구조훈련 평가는 결과보다 훈련과정에 중점을 둘 수 있도록 하고 재난상황별 보완사항을 도출해내는데 관심을 두고 개선해야 한다. 특히, 세부절차에 수행여부를 평가하기 보다는 훈련의 종류나 형태 등을 고려하여야 하며 훈련 규모 보다는 훈련의 완성도(숙련도), 역할 수행여부 등을 고려할 수 있는 평가방안이 마련되어야 한다. 여섯째, 효율적인 긴급구조훈련을 위하여 실무자의 요구도를 파악하여 훈련 유형 및 방법에 대하여 소방서별 특성에 맞는 훈련으로 개선되어야 한다.

• 한국응급구조학회지
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• 제25권1호
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• pp.135-146
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• 2021

Purpose: This study aimed to evaluate the Citizen-Corps-Active-In-Disaster (CAIND) according to a new viewpoint based on changes in basic theoretical concepts and establish a development plan. Methods: A documentary survey was administered, and the study followed the technical approach method. Detailed information on CAIND was taken from scholarly monographs, specialty publications, and previous studies, including master and doctorate dissertations. Results: CAIND may be defined as legal auxiliary organizations composed of local residents who volunteer to prepare for "all kinds of disasters as well as prevention activities" and instill the ideology of "leading service organizations of safety as a form of community involvement," "resident-friendly organizational activities based on autonomous operation," and "performing activities which supplement their demands according to the realization of social welfare and regional conditions." Conclusion: The newly established basic theoretical concept included the concepts of "professionalism and possibilities," "social expandability," "voluntary participation," and "the realization and complementation of social welfare"

• Journal of Radiation Protection and Research
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• 제39권2호
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• pp.96-102
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• 2014

소변시료 바이오어세이는 분석설비가 비교적 간단하고 시료 채취가 용이하여 내부피폭선량 평가를 위하여 널리 사용되고 있는 대표적인 간접측정법이다. 본 연구에서는 소변시료 바이오어세이 결과에 대해 보다 객관적인 성능검사를 수행하기 위하여 미국 NIST에서 주관한 NRIP (NIST raiochemistry inercomparison pogram)에 참여한 결과를 소개하였다. 60일간의 분석기간 동안 인공합성소변으로 제작된 검사시료의 방사능분석결과를 보고하는 cstomary exercise에서는 12가지 방사성핵종에 대한 측정 결과 ANSI N13.30에서 제시하는 성능검사 기준을 모두 만족하는 것으로 확인되었다. 비상상황에 대비하여 8시간 이내에 방사능분석결과를 신속하게 보고하는 eergency preparedness exercise에서는 9가지 방사성핵종에 대하여 -35 ~ 45%의 차이를 나타내어 확인된 오차범위 내에서 비상시 신속한 내부피폭 분류에 적용하기에 적합한 것으로 확인되었다.