• The Korean Journal of Emergency Medical Services
• /
• v.27 no.1
• /
• pp.43-58
• /
• 2023

Purpose: This study explored the values and attitudes toward the death of paramedic students. It comprehensively investigated paramedic students' first encounters with death during their clinical practice. Methods: Between December 2022 and January 2023, in-depth interviews were conducted with seven paramedic students who underwent clinical practice. Their experiences with death and grievances were explored by applying Colaizzi's (1978) phenomenological research method. Results: After exploring and analyzing the collected data, the context and meaning of the phenomenon were integrated. Resultingly, five major categories and 16 subcategories were derived. Conclusion: Universities should introduce a practical curriculum on experiences with death to reduce the negative emotions associated with death that paramedic students experience during their clinical practice and convert them into opportunities for reflection and growth.

• The Korean Journal of Emergency Medical Services
• /
• v.8 no.1
• /
• pp.105-115
• /
• 2004

The nation is turning into aging society, and safety accidents among elderly people are on the rise. When death roll caused by safety accidents was investigated, senior citizens who died from safety accidents outnumbered the other age groups who died for the same reason. The most common cause of death was traffic accidents, followed by suicide and a hurt from a fall, and Korea rated first among OECD member nations in death roll by traffic accidents. Aging brings a lot of physical changes to elderly people, and they are often likely to be involved in accidents such as a hurt from a fall due to degenerated sensory organs like hearing and eyesight and deteriorated motor skills. Unsafe social facilities also have them face a lot of accidents, including fracture and death, and such accidents take place even at home that is usually considered safe, or are triggered by things of daily use. As a result of comparing every age group's death roll by safety accidents, the number of senior citizens who died from safety accidents was far higher than that of the other age groups who died for the same reason in every accident field. In aging society, a sharp increase in the elderly population and ensuing safety accidents are expected to pose a serious threat to national economy, and diverse efforts should be put into tacking this problem. For instance, safety education should be provided to people in general including senior citizens on a regular basis, and more safety facilities should be prepared. Besides, safety equipment should be developed.

• KDI Journal of Economic Policy
• /
• v.36 no.4
• /
• pp.103-133
• /
• 2014

We consider the economic value of emergency medical facilities. An emergency medical facility affects the medical environments in a community, and thus the social demand on the facility increases as the demand of qualified public health service increases. Regarding the increased demand and the limited resources of fiscal budget, it is important to scientifically evaluate the social benefit of the public investment on emergency medical facilities, as the results of evaluation can help make better budgetary decision on each public investment project of emergency medical facilities. In this paper, we try to estimate the economic value of emergency medical facilities based upon the estimated changes in preventable death rate by the facility and the statistical value of life. We hope the results contribute to improve the budgetary decision making on the emergency medical facility projects, thus the public health policies.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.7
• /
• pp.3423-3426
• /
• 2016

Background: Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED). Materials and Methods: This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December $31^{st}$, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death. Results: During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47). Conclusions: Cancer patients have double the risk of mortality if presenting with sepsis at the ED.

• Journal of Preventive Medicine and Public Health
• /
• v.30 no.4 s.59
• /
• pp.884-892
• /
• 1997

Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.18 no.1
• /
• pp.11-17
• /
• 2020

Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion: Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.

• Journal of East-West Nursing Research
• /
• v.22 no.2
• /
• pp.129-137
• /
• 2016

Purpose: The purpose of this study was to identify factors determining the quality of life in nurses in emergency rooms. Methods: Subjects were 131 nurses working in emergency rooms in B metropolitan city, Y and J city. Data were collected from June 5 to July 10, 2015 using structured self-report questionnaires. Data were analyzed using t-test, one-way ANOVA, $Scheff{\acute{e}}$ test, Pearson correlation coefficients, and stepwise multiple regression with SPSS/WIN 21.0 program. Results: Existential well-being (${\beta}$=.59) of nurses in emergency rooms and gender (${\beta}$=.19) were found to be significant predictors of quality of life in nurses in emergency rooms. Conclusion: The results suggest that it is needed to improve existential well-being of nurses in emergency rooms. Ultimately, holistic spiritual program for nurses should be developed the quality of life in nurses in emergency rooms.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.1
• /
• pp.349-353
• /
• 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.

• The Korean Journal of Emergency Medical Services
• /
• v.27 no.1
• /
• pp.91-100
• /
• 2023

Purpose: In patients with major trauma, mortality varies by age. This study aimed to identify predictors of death according to age. Methods: Data from the Community-Based Severe Trauma Survey in Korea were analyzed using a retrospective case-control design. Factors associated with death were identified by age using independent-samples t-tests, Welch's test, and χ² tests. Results: There were statistically significant differences in mortality by sex (p=.006), location (p=.029), mechanism of injury (MOI) (p<.001), intention (p<.001), transportation (p<.001), surgery (p<.001), and Injury Severity Score (ISS) (p<.001) in the ≤44 years age group; by location (p<.001), MOI (p=.004), intention (p<.001), transportation (p<.001), surgery (p<.001), and ISS (p<.001) in the 45-54 years age group; by location (p=.040), MOI (p<.001), transportation (p<.001), transfusion (p<.001), surgery (p<.001), and ISS (p<.001) in the 55-64 years age group; by location (p=.015), intention (p<.001), surgery (p<.001), and ISS (p<.001) in the 65-74 years age group; and by location (p=.002), intention (p<.001), transfusion (p=.020), surgery (p<.001), and ISS (p<.001) in the ≥75 years age group. Conclusion: In patients with major trauma, predictors of mortality varied by age.

• Journal of Medicine and Life Science
• /
• v.16 no.3
• /
• pp.60-63
• /
• 2019

The rate of suicide is the 5th leading cause of death in Korea. Moreover, suicide is the 1st cause of death in from 2nd to 4th decade. In order to treat suicide attempters who have visited the emergency room and to prevent retries, it is necessary to understand the nature of the suicide and to take the right approach. Suicide is more than doubled in women, and retry rates are high among patients with a history of suicide. Suicidal means are throat, fall, gas poisoning, poisoning and drowning. All suicide attempters should suspect and treat cervical spine injury and airway management, and rapid hyperbaric oxygen therapy is recommended for carbon monoxide addicts. Interviewing a suicide attempter requires a sympathetic attitude and examines the underlying depression or adaptation disorders. Interdisciplinary care with mental health departments is necessary, and interventions in emergency roombased suicide attempt management work can be helpful to connect with the community.