• 한국화재소방학회논문지
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• 제27권6호
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• pp.122-128
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• 2013

본 연구는 2010년 1월 1일부터 2011년 12월 31일까지 2년간 119구급대로 이송된 병원 전 제세동 가능한 심정지 환자를 대상으로 연구를 진행하였으며 연구대상자들의 구급활동일지와 구급지령서를 분석하였다. 119구급상황관리센터 상황요원(Dispatcher)이 가장 많이 예측한 지령은 실신으로 74건(33.3%)이었다. 다양하게 예측된 지령 중 실신, 흉통, 전신쇠약, 기타와 같은 지령은 심정지로 예측 불가능한 지령으로 112건(50.5%)을 차지하였으며, 심정지로 예측 가능한 의식장애, 호흡곤란, 무호흡, 심정지, 경련과 같은 지령은 110건(49.5%)을 차지하였다. 이 때 심정지로 예측 가능한 지령에서 목격자의 심폐소생술이 유의하게 높았다. 이와 같이 상황요원은 환자의 의식평가와 호흡평가를 구체적으로 질문하여 심정지를 정확하게 분류해야하며, 이렇게 분류된 심정지 환자는 목격자가 심폐소생술을 할 수 있도록 지도해야 한다. 또한 상황요원에 의해 심정지로 예측 가능한 지령(49.5%)을 받은 구급대원뿐만 아니라 심정지로 예측 불가능한 지령(50.5%)에서도 심정지가 아니라고 정확하게 판단되지 않았다면 현장 구급대원은 심정지 상황에 대비하여 현장출동 준비를 해야 한다.

• 디지털융복합연구
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• 제12권12호
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• pp.449-456
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• 2014

본 연구에서는 관할구역 인구분포와 대비하여 출동건수를 파악하였으며, 출동하여 실제 병원으로 이송한 비율을 파악함으로서, 실제 인구현황과 출동건수와 병원 이송환자의 비율 관계를 분석하였다. 본 연구를 위해, 우리는 2010년 1월부터 2012년 12월까지 3년 동안 대상 지역인 D광역시 소재 5개 소방서별 출동건수를 파악하였으며, 출동현황을 병원 이송과 미 이송으로 데이터를 분석했다. J 소방서에서 출동건수가 가장 높게 나타났으며, 병원 이송건수와 미 이송 건수에서도 가장 높게 나타나는 경향을 볼 수 있었다. 반대로, B 소방서에서 가장 낮게 나타났다. 관할구역 인구수에서는 S소방서 관할구역 인구수가 가장 많았으며, D소방서 관할구역 인구수가 가장 적게 나타났다. 결론적으로 총 출동건수에 의해 병원 이송 건수와 병원 미 이송건수가 유의하게 증감하는 것을 확인하였으며, 인구수에 의한 상관관계는 없는 것으로 나타났다.

• 제어로봇시스템학회논문지
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• 제14권7호
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• pp.720-725
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• 2008

This paper proposes a system architecture for USN with a service robot to provide more active assisted living services for elderly persons by monitoring their mental and physical well-being with USN environments at home, hospital, or silver town. Sensors embedded in USN are used to detect preventive measures for chronic disease. Logged data are transferred to main controller of a service robot via wireless channel in which the analysis of data is performed. For the purpose of handling emergency situations, it needs real-time processing on gathering variety sensor data, routing algorithms for sensor nodes to a moving sink node and processing of logged data. This paper realized multi-hop sensor network to detect user movements with biometric data transmission and performed algorithms on Xenomai, a real-time embedded Linux. To leverage active sensing, a mobile robot is used of which task was implemented with a priority to process urgent data came from the sink-node. This software architecture is anticipated to integrate sensing, communication and computing with real-time manner. In order to verify the usefulness of a proposed system, the performance of data transferring and processing on a real-time OS with non real-time OS is also evaluated.

• 대한영상의학회지
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• 제84권4호
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• pp.923-933
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• 2023

목적 응급실의 급성신산통을 호소하는 환자에서 피질-수질기 요로조영술 컴퓨터 단층촬영(이하 CT)에서 요로결석 발견을 기존의 CT 요로조영술과 비교하였다. 대상과 방법 이 후향적 연구는 한국의 두 삼차 병원의 응급실에서 CT 요로조영술을 촬영한 253명의 요로결석이 의심된 환자를 대상으로 시행하였다. 임상 병력을 알지 못한채로 두 명의 영상의학과 의사가 독립적으로 CT 요로조영술의 피질-수질기를 판독하여 요로결석에 관한 정보를 기록하였다. 판독자들의 요로결석 발견에 대한 민감도를 측정하였다. 초기 평가 후, 임상 정보를 바탕으로 다시 피질-수질기를 판독하였고 민감도를 측정하였다. 결과 253명 중 150명(59%)이 요로결석이 있었고, 요로결석이 응급실 방문의 원인(의미 있는 요로결석)이었던 사람은 138명(92%)이었고, 요로 폐쇄로 인한 변화를 보인 환자는 124명 (82.7%)이었다. 의미 있는 요로결석에 대해서는 두 판독자의 민감도는 98.6% (136/138)이었다. 요로 폐쇄로 인한 변화가 동반되었을 때의 민감도는 판독자 1은 99.2% (123/124)였고 판독자 2는 100% (124/124)였다. 임상 정보를 바탕으로 다시 판독했을 때 의미 있는 요로결석 발견의 민감도는 판독자 1이 98.6%에서 100%, 판독자 2는 98.6%에서 99.3%로 증가하였다. 결론 CT 요로조영술의 피질-수질기는 급성신산통으로 응급실을 내원한 환자에서 요로결석을 진단하는데 민감하다.

• 기본간호학회지
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• 제10권2호
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• pp.154-162
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• 2003

Purpose: The purpose of this study was to investigate factors which can delay hospital arrival for patients with acute stroke. Method: The participants for this study were 102 patients who were admitted to the Department of Neurology in a hospital in Chungnam province. Data were collected from Oct, 2002 to June, 2003. The data were analyzed with frequencies, percentages, and $x^2$ test using the SPSS PC program. Result: The results of this study were as follows: 1. Only 33.8 % of participants arrived at the hospital within 3 hours. 2. Educational level, economic status, people living in same residence, and place of residence were factors which significantly affected prehospital delay time. Also there were significant differences in prehospital delay time according to family history of stroke, day of the week when symptoms began, perception of seriousness of symptoms, type of hospital first used, and transportation. Conclusion: Therefore, to reduce prehospital delay time, educational programs which focus on the above factors need to be developed. Also, a public campaign for utilizing emergency service to reduce transportation time for acute stroke patients need to be facilitated.

• Parasites, Hosts and Diseases
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• 제47권3호
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• pp.269-273
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• 2009

A 57-year old man who was admitted to an emergency room of a tertiary hospital with hemoptysis developed malarial fever 19 days later and then died from severe falciparum malaria 2 days later. He had not traveled outside of Korea for over 30 years. Through intensive interviews and epidemiological surveys, we found that a foreign patient with a recent history of travel to Africa was transferred to the same hospital with severe falciparum malaria. We confirmed through molecular genotyping of the MSP-1 gene that Plasmodium falciparum genotypes of the 2 patients were identical. It is suggested that a breach of standard infection control precautions resulted in this P. falciparum transmission between 2 patients in a hospital environment. This is the first report of a nosocomial transmission of falciparum malaria in Korea.

• 보건행정학회지
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• 제10권1호
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• pp.148-173
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• 2000

This thesis is a kind of case report on the managerial difficulties and strategies to overcome them for the rural hospitals in Korea. We examined environmental situations and SWOT(Strength, Weakness, Opportunity, Threat) of the hospitals, and suggested some strategies to improve the hospital business through analysing secondary data and brief survey to staffs and patients at 3 case hospitals. Among the strategies were included establishment of their identity as community hospitals, positioning towards high-touch services rather than high-tech services to improve their competence. For this positioning, patient satisfaction should be emphasized to make rapport with the residents in the community, and a few service areas should be selected and strengthened. Emergency care and geriatric health services are recommended to be covered strongly, because rural hospitals are usually the one and only hospital in the region and rural communities have aged population structure. In addition to these, networking is necessary among rural hospitals nationwide and with local clinics and tertiary hospitals near urban areas. And also, complementary role division with community health post should be developed to lessen the competitive relationship between public and private sectors. To support these strategies, fresh organizational culture should be built up to make hospital staff creative and enthusiastic on their job. Finally, inducement of governmental assistance will be necessary to make the environment advantageous to the rural hospitals.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.349-353
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• 2014

Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.

• 간호행정학회지
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• 제8권2호
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• pp.309-321
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• 2002

Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

• 성인간호학회지
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• 제29권1호
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• pp.12-21
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• 2017

Purpose: The purpose of this secondary data analysis study was to compare what factors influenced individual's satisfaction with emergency medical services (EMS). Methods: Data were obtained from the Korea Health Panel Survey 2013 with 20,641 participants. A total sample of emergency room (ER) users (n=1,709) aged 20 and over were selected and divided into two age groups, one for 1,046 adults and the other for 663 elderly. Participants' responses were analyzed using descriptive statistics, ${\chi}^2$ test and logistic regression. Results: Among adults and elderly who were transferred to other hospitals instead of being admitted or returned to their homes reported less satisfaction (${\chi}^2=10.18$, p=.006). Further, the adults who perceived their arrival to the ER as not delayed (${\chi}^2=3.74$, p=.049) or visited the ER for treatment for illness (${\chi}^2=5.32$, p=.021) reported more satisfaction than those who perceived their ER service being delayed or visited the ER for accident or poisoning. The elderly who visited ER by non-ambulance reported higher satisfaction than those who arrived by ambulance (${\chi}^2=14.15$, p<.001). Conclusion: In both adults and the elderly, satisfaction of EMS can be increased by avoiding transferring patients to other hospital. For adults to be satisfied with EMS, efficient and rapid EMS might be needed to avoid delay in ER arrival, especially for adults with accidents or poisoning.