• 한국보건간호학회지
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• 제9권1호
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.470-478
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• 2016

본 연구는 긴급상황 및 재난시 미국과 한국의 장애인을 위한 피난 대응체계 및 매뉴얼 실태 비교분석을 통하여, 재난약자인 장애인의 행태를 고려한 피난매뉴얼 구축방안을 제시하는 것을 목적으로 하고 있다. 이상의 연구결과 다음과 같은 결론을 얻었다. 첫째, 건축물 주 이용자/재실부하를 고려하여 건축물 용도에 의한 피난 계획기준을 강화하고, 시설인가 기준(경사로, 수평 출구 수 및 피난거리, 피난발코니 등)을 제시하여 장애인의 피난 안전성을 강화할 필요성이 있다. 둘째, 국가기관 및 장애인 관련단체는 장애유형에 따른 접근성 및 피난특성을 고려한 표준 피난 매뉴얼 제시가 필요하며, 각 시설에서는 재실 장애인의 유형에 따른 피난계획을 수립할 필요성이 있다. 셋째, 재실자의 장애유형에 따라 장애인의 이동특성 및 피난행태가 다르므로 장애 유형별 피난훈련이 필요하며, 피난 보조도구 및 서비스 동물 등 다양한 상황을 고려한 정기적인 피난훈련을 통해 장애인과 관리자의 피난 숙련도 향상이 요구된다.

• 대한수사과학회지
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• 제3권1호
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• pp.60-73
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• 2008

응급의료체계(Emergency Medical System)의 목적은 응급환자에게 신속하고 적절한 응급처치를 제공함으로써, 환자의 생명을 구하고 환자의 상태를 최단 시간 내에 정상상태로 회복시켜서 사회로 복귀시키는 것이며 교정행정(矯正行政)의 목적은 범죄자를 사회로부터 격리하여 이들 수형자에게 형기동안 교육, 교화활동 및 직업훈련 등을 실시함으로써, 이들이 출소 후 사회에 복귀하여 다시는 범죄를 저지르지 않고 성공적으로 사회에 정착하도록 하는 것이다. 이렇듯 교정행정과 응급의료체계의 목적이 국민을 안전하게 사회에 복귀시키는 것으로 상호 부합된다 할 것이다. 따라서 본 연구는 교정시설 내 하위문화의 특수성으로 인한 신체적 손상과 질병에 노출될 기회가 많은 수용자와 그 곳에서 근무하고 있는 직원들의 안전을 위해 교정시설 내 다양한 응급상황 발생요인과 제도, 인력, 시설, 장비, 예산현황 및 문제점 등을 통해 효율적인 교정시설 내 응급의료체계 발전방안을 다음과 같이 제시하고자 한다. 첫째, 각 교정시설 보안근무체계에 맞게 적정인원의 응 급구조사의 채용을 확대하여야 한다. 둘째, 수용자의 중증도분류에 따른 이송체계를 완비하고 응급의료장비를 갖추어야 한다. 셋째, 교정공무원과 수용자에 대해 실습 위주의 현실적이고 체계적인 응급처치교육을 실시하여야 한다. 넷째, 1339응급의료정보센터와 같은 사회 내 응급의료체계와 협력체계를 구축하여야 한다. 다섯째, 보건복지부는 응급의 료기금의 지원을 교정시설로 확대하여야 한다.

• 한국실내디자인학회논문집
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• 제26권6호
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• pp.172-179
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• 2017

The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권4호
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• pp.207-214
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• 2019

Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권3호
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• pp.81-90
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• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.

• Journal of Preventive Medicine and Public Health
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• 제16권1호
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• pp.135-152
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• 1983

Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

• 대한한의학원전학회지
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• 제23권1호
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• pp.31-46
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• 2010

This research is aimed at contriving to expand to its base on the research work Military medicine in East Asia by introducing GunjungUihak(means Military medicine) and adding translations and commentaries to it and propagating to academic circles. GunjungUihak is the only technical book on GunjungUihak which was written for the purpose of treating soldiers in time of war. One of the characteristics shown in its prescription is convenience in medical treatment; the writer of GunjungUihak Wangmyeonghak(王鳴學) edited pills and a powdered medicine to be prescribed in large proportions so that they could be used urgently in the situation of battles at a viewpoint of a general while collecting knowledge of medicine. In addition, this book is compiled with a very short edition with one volume and 18 units. Including only a little amount in the book means that it was compiled by extracting only the contents needed in preparation for the wartime emergency, and such a measure was taken for military surgeons to carry it with facility during the time of war. In addition, much weight of this book was given to the diseases caused by environment with which soldiers came in contact in time of combat, not the wounds by the weapons of war as specified from the beginning of the book, which suggests that the environmental factor of the friendly forces was much more threatening than the arms of enemy troops in the situation of a combat. Like this, GunjungUihak is a material of great value in that it is showing a model of the aspects of Military medicine in East Asia at that time even in its fragmentary writings and it has been preserved by Korea.

• 전기학회논문지
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• 제65권11호
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• pp.1943-1947
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• 2016

Korea Electrical Safety Cooperation(KESCO) have provided the electrical safety speed-call service from 2007 year. Purpose of the service is to reduce discomfort of electricity use and to prevent electrical accident like as electrical fire and shock accident by providing emergency treatment service on fault of the residential electrical facilities notified in the specific house like as a lower-income group and a social welfare facility. But efficiency and economic evaluation of the electrical safety speed-call service is impossible because analysis on the quantitative effect of the service is difficult. This paper presents cost-benefit analysis method and result of the electrical safety speed-call service. The presented cost-benefit analysis method has a two-step process: the first step is to measure quantitative electrical fire prevention effect of the service by using electrical accident statistics and developing outcome analysis logic model of the service effect, and the second step is to analysis cost-benefit(B/C)of the service by calculating quantitative benefit analysis on the measured quantitative electrical fire prevention effect. The results showed that cost-benefit(B/C)of the electrical safety speed-call service is over 4 after 2010 year.

• 한국습지학회지
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• 제23권2호
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• pp.183-188
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• 2021

소규모 하수처리장의 경우 유입수량의 변동폭이 크고 하수관거 노후화로 인한 불명수 유입 등에 의해 하수처리 운영이 어려운 것으로 보고되고 있다. 특히, 동절기 수온저하로 인한 전반적인 운영문제가 많아 본 연구에서는 산악지역에 위치한 소규모 하수처리시설의 운영현황과 온도에 따른 수질변화를 분석하였다. BOD, COD, SS의 경우 온도에 따라 방류수 수질 농도가 크게 변화하는 것으로 나타났으며, 특히 COD가 많은 영향을 받는 것으로 나타났다. 이에 한시적으로 동절기 수온 저하 대책을 적용하고자 생물반응조 수위를 0.4m 상승시켰으며, 생물반응조 덮개를 설치하고 운영하였을 때 결과를 비교 분석한 결과 유의미한 개선효과가 발생하였다. 이외 동절기 생물반응조 처리효율 저하에 대한 개선방안을 생물반응조 체류시간 연장하는 방안으로 생물반응조 규격을 확대하는 방안, 유량조정조를 신설하고 외부반송하는 방안, 무산소에 산기장치를 설치하여 동절기 비상시 호기조로 사용하는 개선방안을 제시하였다. 본 연구결과는 동절기 소규모 하수처리시설 운영방안에 대한 기초자료로 활용될 수 있을 것으로 판단된다.