• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권4호
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• pp.1049-1065
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• 2023

Recently, with the development of IoT, AI, and mobile terminals, medical information platforms are expanding. The medical information platform can determine a patient's emergency situation, and medical staff can easily access patient information through a mobile terminal. However, in the existing platform, emergency situation decision is delayed, and faster and stronger authentication is required in emergency situations. Therefore, we propose an edge computing-based medical information platform for automatic authentication using patient situations. We design an edge computing-based medical information platform architecture capable of rapid transmission of biometric data of IoT and quick emergency situation decision, and implement the platform data flow in emergency situations. Relying on this platform, we propose the automatic authentication using patient situations. The automatic authentication protects patient information through patient-centered authentication by using the patient's situation as an authentication factor, and enables quick authentication by automatically proceeding with mobile terminal authentication after user authentication in emergencies without user intervention. We compared the proposed platform with existing platforms to show that it can make quick and stable emergency decisions. In addition, comparing the automatic authentication with existing authentication showed that it is fast and protects medical information centered on patient situations in emergency situations.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2007년도 춘계학술대회 논문집
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• pp.543-550
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• 2007

This study is for an effective response as the pre-stage for railway agencies to prepare the rail road kind based emergency response standard operation procedures when the emergency event occurs. Accordingly, I would like to increase the utility in helping the railroad employees to make their decisions. And that is possible through suggesting them to make computerized Emergency situation based activity and Emergency response that is individual based. And of course all of this procedure would be based on the emergency event categorized response scenario.

• 지역사회간호학회지
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• 제28권2호
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• pp.182-195
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• 2017

Purpose: This study explores school nurses' emergency care experiences and their needs for systemic institutional support. Methods: Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data. Results: The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training. Conclusion: The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.

• 대한공간정보학회지
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• 제16권3호
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• pp.87-94
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• 2008

이 연구에서는 복합형 환승센터의 돌발상황 대응을 위한 모니터링 대상의 선정과 돌발상황 모니터링, 검지, 확인, 전파, 처리, 종료까지의 진행 절차에서 관리되는 정보를 도출하고 데이터베이스로 통합관리 하도록 하여 상황진행 단계에 따라 상황처리 의사결정에 필요한 사전정보를 제공하도록 제시하였다. 시설물, 이용자, 교통류로 구성된 환승센터는 모니터링 정보의 한계성을 가지고 있다. 따라서 상황검지 및 상황대응 전략수립 방안에서는 상황대응 전문가의 경험 지식과 과거의 사례를 활용할 수 있는 전문가 시스템의 사례기반 추론을 활용하는 방안으로 접근하였다. 또한 돌발상황 발생 시 공간적 혼잡도 및 피해 최소화를 위해 환승센터에서 운영하고 있는 설비의 통제 방안을 제시하였으며, 대외기관의 서비스 지원 극대화를 위해 실시간으로 상황정보의 공유 서비스 체계가 유지되도록 하였다.

• 한국중재학회지:중재연구
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• 제21권1호
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• pp.239-257
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• 2011

This article examines the requirements of Article 37 of the ICDR International Arbitration Rules and issues that could arise if a party petitions a U.S. Federal Court to enforce an emergency arbitrator's Article 37 decision to grant pre-arbitration provisional relief. On May 1, 2006, ICDR introduced a new procedure for the granting of emergency arbitral relief under its ICDR Rules. The procedure enables a party to apply for emergency interim relief before the appointment of an arbitrator or tribunal to adjudicate the merits of the dispute. Instead, the application for emergency relief is considered by an emergency arbitrator appointed by the ICDR. In short, the ICDR has quickly appointed emergency arbitrator and resolved a challenge to an appointment within 36 hours. In addition, the emergency decisions have been issued within just a couple of weeks. In particular, we looked at what would happen after Article 37 emergency relief is granted. Based on my examination of U.S. cases on the enforceability of interim awards and orders, We conclude that U.S. courts would enforce Article 37 interim measures, whether they are characterized by the emergency arbitrator as an interim order or award. Where the situation warrants, arbitration executives should embrace and use emergency relief procedure of ICDR Rules.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2008년도 춘계학술대회 논문집
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• pp.118-121
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• 2008

Bimodal tram is a transit with no-step floor for wheel-chaired persons, with docking to the station precisely and moving on schedule like train. Because of the automatic traveling of bimodal tram to search and follow the magnet embedded in roadway, bimodal tram should be careful about rainfall, snow and wind like a car driving on roadway in respect to natural disasters. Though response procedures in emergency are different according to the passengers' boarding, emergency mobilization is needed if any emergency situation happens. Emergency mobilization is the act of preparing for major catastrophic events, which may affect public transportation systems or their service areas, by assembling and organizing resources, including people, equipment, facilities, communications systems, expert technical support, and public information systems and protocols. Mobilization is the process that ensures that the right people will deploy appropriate resources at the correct time. Effective mobilization requires a partnership of local and state agencies. Public transportation operators and systems play vital roles in response to and recovery from emergencies and other unexpected catastrophic events. These systems, and their capabilities to mobilize resources, are profoundly affected by the decisions and directives of others during these activities. In this study, we focused on the emergency management for bimodal tram and reviewed the considerations about infrastructures under natural disasters, especially heavy rainfall.

• 의료법학
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• 제23권1호
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• pp.37-80
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• 2022

이 논문에서는 현행 응급의료에 관한 법률이 규정하고 있는 응급의료에서의 설명·동의의 원칙과 응급의료거부죄를 검토함으로써 응급의료종사자의 환자에 대한 생명보호 의무가 환자의 자기결정권 보장보다 중요한 경우에 한하여 응급의료거부죄가 성립함을 제시한다. 응급의료에서도 일반 의료상황과 마찬가지로 의료행위 시행 전 환자에게 응급의료의 필요성이나 방법 등에 관하여 설명하고 동의를 받아야 함이 원칙이다. 다만, 설명·동의 절차를 예외적 방법으로 이행하거나 생략할 수 있음에도 그 절차 준수를 이유로 응급의료를 거부·기피한 응급의료종사자는 응급의료거부금지에 따른 행정처분과 행정벌을 부담하게 된다. 즉, 설명·동의 절차 생략 가능성에 관한 판단에 따라 응급의료거부죄가 성립할 수도 있는 것이다. 환자가 미성년이거나 의사결정능력이 없는 경우 그 법정대리인이 환자의 의학적 이익에 반하는 결정을 하더라도 법정대리인의 의견이 무조건적으로 존중되는 것은 아니다. 미성년 환자도 원칙적으로 자신의 신체에 관하여 결정할 권리가 있고, 법정대리인의 결정 역시 환자의 최선의 이익을 위한 것일 때 유효하기 때문이다. 환자가 치료를 거부하는 상황에서도 원칙적으로 응급의료종사자의 생명보호의무가 더 우선한다. 그러나 현행법은 여러 예외 상황에 대해 명문의 규정을 두고 있지 않아 응급의료 현장에서 그 해석에 어려움이 있다. 한편, 우리 대법원 및 하급심 판례는 응급의료종사자의 응급의료의무와 설명의무 사이의 이익형량이 불가피한 상황에서 환자의 생명상실이 문제되는 경우 설명의무보다 응급의료를 시행하여 환자의 생명을 보호하여야 할 의무가 우선이고, 예외적으로 사전에 치료 여부·방법에 대해 환자의 진지한 숙고가 있었던 경우 환자의 자기결정권이 응급의료의무와 대등하게 고려될 수 있다는 취지로 설시하고 있으므로, 이를 체계적으로 정리하고자 한다. 나아가 현행법의 해석만으로 해결이 어려운 부분에 대하여는 1) 미성년자에 대한 응급의료의무 조항 신설, 2) 응급환자의 의사결정능력 판단 기준을 의학적 내용을 중심으로 수정·보완, 3) 응급처치시 의료인의 추가 동의가 불요함을 명시, 4) 복수의 의견 충돌이 있는 경우에 대한 제도적 보완, 5) 응급의료 중단시 벌칙조항 신설 등 입법 과제를 제시한다.

• 의료법학
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• 제14권2호
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• pp.281-313
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• 2013

A physician has to do his best for the better treatment of his patiensts. But, if a physician cannot remedy his patients because of the lack of hospital facilities, the lack of medical knowledge and etc., the physician must transfer his patients to another suitable hospital immediately. This is called the duty of interhospital transfer of patients. The necessity of interhospital transfer of patients is primarily ocurred in emergency medical care situations. The Supreme Court Decision 2010DO7070 delivered on April 29, 2010 is one of the important decisions related to the duty of interhospital transfer of patients. The Supreme Court ruled that there were the physician's medical malpractice and the causation between the physician's medical malpractice and the death of patient, as the physician has left the patient without due observations for 1 hour and 30 minutes after the caesarean operation inspite of mass bleeding during the operation, and has transferred the patient to another suitable hospital later. And the Supreme Court ruled that the transferring physician has to explain the situation of the patient in detail to the physician being transferred. I agree with the Supreme Court Decision. As decided by the Supreme Court, physicians will treat their patients more carefully and in case of necessity for transfer, physicians will transfer their patients with more caustion. However, the study for this issue should be continued hereafter because concrete standards are not given to lawers and physicians just by the Supreme Court Decisions itself.

• 대한간호학회지
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• 제29권4호
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• pp.880-891
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• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• 인터넷정보학회논문지
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• 제21권4호
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• pp.25-34
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• 2020

현 의료정보시스템에서는 환자에게 부착된 IoT 또는 의료기기를 통해 생성된 생체데이터를 의료정보서버에 저장과 동시에 모니터링 할 수 있는 시스템 환경이 구축되고 있다. 또한 의료진의 이동단말기를 통해 ID/PW만을 이용한 간단한 인증 후 환자의 생체데이터 및 의료정보, 개인정보에 쉽게 접근이 용이하다. 그러나 이러한 의료정보 접근방법은 환자 개인정보보호차원에서 개선되어야하며, 응급처치를 위한 신속한 인증시스템이 제공되어야 한다. 이에 본 논문에서는 환자상황기반의 자동인증시스템을 구축 및 성능평가 하였다. 환자상황을 정상상황과 응급상황으로 분류하고, 병동으로부터 들어오는 환자 생체데이터를 이용하여 환자상황을 실시간으로 판별하였다. 환자상황이 응급상황일 경우 의료진의 이동단말기에 응급코드를 포함한 응급메시지가 수신되고, 의료진은 환자 상위의료정보를 확인하기 위해 애플리케이션을 통해 자동인증을 시도한다. 자동인증은 사용자인증(ID/PW, 응급코드)과 이동단말기인증(의료진역할, 근무시간, 근무위치)이 결합된 인증방법으로써 사용자인증 이후 의료진의 추가개입 없이 자동으로 이동단말기인증이 진행된다. 모든 인증을 마친 의료진은 의료진 역할과 환자상황에 따라 접근권한을 부여받고, 애플리케이션을 통해 환자의 등급화 된 의료정보에 접근이 가능하도록 구현하였다. 환자상황에 따른 의료진의 제한적 의료정보접근을 통해 환자의 의료정보를 보호하고, 응급상황 시 추가개입 없는 자동인증을 구현하여 신속한 인증을 제공하였다. 구현된 자동인증시스템의 수행성 검증을 위해 성능평가를 실시하였다.