• Journal of Trauma and Injury
• /
• v.34 no.4
• /
• pp.233-241
• /
• 2021

Purpose: The medical community has been heavily impacted by the coronavirus disease 2019 pandemic. The management of facial trauma patients has been affected by the patient capacity of emergency rooms. In this study, we share our experiences of facial trauma management during the social lockdown period and investigate the epidemiological changes in facial bone fractures. Methods: A total of 997 patients who presented to Ajou University Hospital Emergency Center and were evaluated by plastic or maxillofacial surgeons for facial trauma were included in this retrospective study. Our study design was a comparative study of two groups: the 2019 group (control) and the 2020 group (the experimental group that experienced social lockdown). Results: The total number of emergency room inpatients reflected the national pandemic trends with three peaks in patient numbers. According to these trends, facial bone fractures had two different low points in August 2020 and December 2020. A comparison of the 2019 and 2020 facial bone fractures did not show a statistically significant difference in the total number of patients. An analysis of the causes of trauma showed that domestic accidents increased in 2020 (30.92%; p<0.001). Among the anatomical sites of facial injury in surgical patients, the frontozygomatic complex fracture increased the most in 2020 (p=0.018). Facial injuries with two separate sites of injury or with three or more involved sites also showed a significant increase in 2020 (p<0.001). Conclusions: We demonstrated that the incidence of facial trauma patients correlated with the incidence of patients presenting to the emergency department and that facial trauma is inextricably related to multi-trauma cases. Domestic accidents and facial trauma with multiple anatomically involved sites are increasing trends that need more attention.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.5 no.2
• /
• pp.112-118
• /
• 2007

Purpose: There have been relatively few reports of chlorophenoxy herbicide poisoning. The purpose of this study is to analyze the general characteristics and clinical aspects of the chlorophenoxy herbicide intoxicated patients in Korea. Methods: We prospectively evaluated the chlorophenoxy herbicide intoxicated patients visiting to the 38 emergency medical centers in Korea from the 1 August 2005 to the 31 July 2006. Results: 24 patients were enrolled during the study periods. Their mean age was 55.7 years old. The median amount of the chlorophenoxy herbicide intoxicated is 150 mL. The most frequent location where the patients obtained and took the chlorophenoxy herbicide was their home. Frequent compounds involving chlorophenoxy herbicide poisoning were dicamba(66.7%), MCPP(16.7%), and 2,4-D(12.5%). The most common symptom of the patients was confusion and vomiting. 16 patients(66.7%) intended to suicide. 3 patients out of 24 patients(13.0%) were died. Conclusion: There were 24 patients intoxicated by the chlorophenoxy herbicide during the study periods. The mortality rate was 13.0%. The suicidal attempts and the numbers of death involving chlorophenoxy herbicide were high in Korea.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.18 no.2
• /
• pp.85-93
• /
• 2020

Purpose: The annual statistics for poisoning are reported based on the data from poison control centers in many advanced countries. In 2016 a study was conducted to analyze the 2016 Korea Poisoning status. This study was conducted to make a better annual report for poisoning statistics in Korea from a 2017-2018 national representative database. Methods: This study was a retrospective analysis of poisoning patients based on the data from an emergency department (ED) based injury in-depth surveillance project by the Korea Centers for Disease Control and Prevention in 2017-2018. Bite or sting injuries were not included. Results: A total of 17714 patients presented to 23 EDs because of poisoning. Adults above 20 years old age accounted for 84.6% of the population, while the proportion of intentional poisoning was 60.8%. The poisoning substance presented in the ED were therapeutic drugs (51.2%), gas (20.3%), pesticides (16.4%), and artificial substances (11.4%). Overall, 35% of patients were admitted for further treatment. The mortality was 2.4% (422 cases), and the most common fatal substances in order were carbon monoxide, other herbicides, and paraquat. Conclusion: This study showed the 2017-2018 status of poisoning in Korea. The prognosis is different from the cause of poisoning and the initial mental state of the patient. Therefore, appropriate methods for preventing poisoning and therapeutic plans in specific situations are needed.

• Health Policy and Management
• /
• v.28 no.4
• /
• pp.411-422
• /
• 2018

Background: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. Methods: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ${\geq}15years$. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). Results: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. Conclusion: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.

• Research in Community and Public Health Nursing
• /
• v.14 no.3
• /
• pp.520-532
• /
• 2003

Purpose: The purpose of this study was to identify the health status and request of community residents. This study is part of development of efficient health life enhancement programs. Methods: The subjects of this study were 586 households in a rural community and well-trained interviewers visited every household in the designated area and individually interviewed heads of households for general information and health service utilization. The data were collected using a questionnaire for seven months from March 25 to September 24, 2002. The data were analyzed using frequency. percentage by SPSSWIN (v 10.0). Results: 1. 58.9% of subjects were above sixty, and 60.8% of them were women. 2. The most serious problems they identified were health problems (45.6%), and the second was(##-was+were) economic problems(22.0%). 3. Almost half of the study population regarded themselves as healthy (46.2%). The types of illness they had were neuralgia, arthritis, hypertension, diabetes, and heart disease. 4. Most of the study population answered that they didn't do anything special for health enhancement. 5. Among medical facilities, hospitals or medical clinics (55.3%) were most commonly utilized when they were sick. 6. The highest request of the subjects was 'Home visiting service (45.4%)', and 'free treatment connected to the service of hospitals' was the second. What they needed most regarding health enhancement programs in health life enhancement centers was 'free health examination (58.2%), and heath education programs (57.7%). 7. As a result of investigating the subjects' demand for nursing services in health life enhancement center, 'the clinical examination' was the most requested, and next was 'blood pressure check', 'emergency treatment', and 'rehabilitation service', in that order.

• 한국방재학회:학술대회논문집
• /
• 2011.02a
• /
• pp.112-112
• /
• 2011

오늘날 우리 사회의 생활과 문화의 질이 향상됨에 따라 공공 및 개인의 안전과 건강에 대한 관심이 증대되고 있다. 특히, 재난과 비상사태는 생명에 대한 희생뿐만 아니라 훨씬 더 심각한 경제적인 결과를 초래한다. 이러한 응급사태에 개비하여 적절히 준비되지 않았거나 재난의 예방 및 완화시킬 방법을 가지고 있지 못한다면 도시의 발전적인 프로젝트는 예고 없이 도시를 강타하는 재난 및 비상사태에 의해 무산되고 만다. 이러한 여건 하에 재난과 응급사고를 효율적으로 대처하는 응급처치와 서비스에 대한 급격한 관심과 함께 일정한 결정적 대응시간 내에 각종사고와 재해로부터 방어할 수 있는 공공서비스에 대한 필요성이 크게 증가되었다. 본 연구에서는 신고, 응급구조, 환자이송 등 도시의 병원 전 단계 의료환경에 대해서 조사하였다. 본 연구의 목적은 반응시간과 출동거리를 분석함으로써, 응급사고에 즉시 응급구조서비스를 제공하기 위해 안전센터(119센터)의 최적 입지를 확인하는 것이다. 이를 위해서 사고발생, 반응시간, 출동거리 등을 응급의료 활동과 관련된 연구논문, 대상지 전역의 소방기록물과 출동일지 등의 통계자료를 활용하여 신속한 응급의료 서비스를 위한 패턴을 분석 하였다. 또한 응급구조대의 조직과 활동의 분석을 통해 응급의료시설의 최적 입지설정을 위한 제도적 개선대안을 마련해 보았다. 대상지 연구를 위해, 구조활동 및 소방서비스의 최근 통계자료의 조사를 통해 진주시의 모든 119센터의 입지와 응급의료서비스 및 사고발생 현황을 나타내었다. 자료 분석을 위해서 SPSS14.0을 사용하였으며, 지역의 특성 분포, 안전센터별 대응시간, 이송시간 등을 소방 GPS시스템과 입지할당모형 중 Center Point Model(CPM)을 적용하였다. 결과적으로 본 연구를 통해 대상지역의 119안전센터의 서비스 질이 나쁜 지역을 지리학적인 관점에서 최적 입지/배분 패턴의 설정을 통해 확인할 수 있었으며, 이를 통해 미래 응급의료서비스의 효율적인 입지/배분을 통해 공공 및 개인의 안전과 건강에 기여할 수 있을 것으로 기대된다.

• Journal of agricultural medicine and community health
• /
• v.43 no.3
• /
• pp.158-171
• /
• 2018

This TSIG analysis regarding national actions for marine oil spills could be indicated and suggested improvements in the response system could be made based on the present study.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.30 no.2
• /
• pp.35-46
• /
• 2024

Purpose: It is the responsibility of public healthcare to respond quickly to infectious disease outbreaks and disasters such as MERS, COVID-19, the Syrian earthquake, and the Miryang Sejong Hospital fire accident. It is very important to secure safe medical facilities and protect lives through emergency medical support and disaster response systems. The purpose of this study is to investigate the safety status of regional medical facilities that play a central role in the event of a disaster. Methods: The target was 41 local public hospitals, including 35 regional medical centers and 6 Red Cross hospitals nationwide. We delivered a questionnaire to 41 medical facilities and collected data from 32 regional public hospitals that received responses. Results: In order to respond to safety accidents, a survey was conducted on infections, falls, patient identification, and incorrect connections for medical accidents, and for in-hospital accidents, a survey was conducted on entrapment, collision, water leaks, falling objects, and crime prevention. For natural disasters, we investigated the response environment for typhoons, floods, and snow damage, and for social disasters, we investigated the response environment for fire, power outages, and radiation damage. Implications: We hope that it will be used as basic data for developing standards and creating hospital facilities and environments that are safe for everyone to respond to various disasters and prevent patient safety accidents in the future.

• Health Policy and Management
• /
• v.13 no.4
• /
• pp.115-130
• /
• 2003

Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door­to­needle time was 60.0 minutes, and median door­to­balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6％) of thrombolytic patients and 43 out of 96(44.8％) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.23 no.3
• /
• pp.81-90
• /
• 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.