• Journal of Trauma and Injury
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• v.34 no.1
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• pp.31-38
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• 2021

Purpose: Traumatic vertebral injuries have a prevalence of 4-5% at level I centers. Studies have demonstrated that isolated thoracolumbar transverse process fractures (iTPF) rarely require brace or surgical interventions. We hypothesized that similarly isolated thoracolumbar spinous process fractures (iSPF) would have less need for bracing and operative interventions than SPFs with associated vertebral body (VB) fractures (SPF+VB). We performed a similar analysis for iTPF compared to transverse process fractures associated with VB injury (TPF+VB). Methods: In this single-center, retrospective study from 2012 to 2016, patients were classified into iSPF, SPF+VB, iTPF, and TPF+VB groups. Data including the fracture pattern, neurologic deficits, and operative intervention were obtained. The primary outcome studied was the need for bracing and/or surgery. A statistical analysis was conducted. Results: Of 98 patients with spinous process fractures, 21 had iSPF and 77 had SPF+VB. No iSPF patients underwent surgery, whereas 24 (31.17%) SPF+VB patients did undergo surgery (p=0.012). In the iSPF group, three patients (15%) received braces only for comfort, whereas 37 (48.68%) of the SPF+VB group required bracing (p=0.058). Of 474 patients with transverse process fractures, 335 had iTPF and 139 had TPF+VB. No iTPF patients underwent surgery, whereas 28 (20.14%) TPF+VB patients did (p≤0.001). Of the iTPF patients, six (1.86%) were recommended to receive braces only for comfort, while 68 (50.75%) of the TPF+VB patients required bracing (p<0.001). Conclusions: No patients with iSPF or iTPF required surgical intervention, and bracing was recommended to patients in these groups for comfort only. It appears that these injures may be safely managed without interventions, calling into question the need for spine consultation.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.68-74
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• 2018

Purpose: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. Methods: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cut-off values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over '100-treatment line'. Results: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (${\chi}^2$ test for trend, ${\chi}^2=22.66$, p-value<0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. Conclusion: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.

• Journal of the Society of Disaster Information
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• v.10 no.4
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• pp.548-558
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• 2014

The purpose of this study was to examine the influence of social support provided for fire officers on their job satisfaction and burnout. The subjects in this study were 251 male and female fire officers in the 119 fire centers located in Gangwon, Gyeonggi Province and Seoul. A survey was conducted from April 15 to May 12, 2013. As for data analysis, frequency analysis, correlation analysis and multiple regression analysis were made, and the level of statistical significance was all set at p<.05. The findings of the study were as follows: The social support provided for the fire officers had a significant correlation with their job satisfaction and burnout. The factors that affected their job satisfaction were social support from supervisors(${\beta}=-.469$) and social support from colleagues(${\beta}=.934$), which were the subfactors of social support. The factors that exercised an influence on burnout were social support from supervisors(${\beta}=-2.081$) and social support from colleagues(${\beta}=3.117$) as well, which were the subfactors of social support. The overall explain ability percentage of the two variables respectively stood at 31.1 and 21.1 percent. Given the findings of the study, it's required to grasp influential factors for the job satisfaction and burnout of fire officers in more detail, and the development of programs geared toward boosting their job satisfaction is necessary.

• Health Policy and Management
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• v.19 no.3
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• pp.71-91
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• 2009

To assess comparatively the administrative behavior of vaccination and satisfaction of physicians by the provision method according to the National Expanded Programme on Immunization (NEPI) between 2005 and 2006 Demonstration Project in Korea. A questionnaire was performed at 582 and 64 physicians in Daegu metropolitan city and Gunpo city on 2005 (a response rate of 39.3%, 45.3%, respectively). Also, we sampled 31, 56, and 28 physicians in Gangneung city, Yangsan city, and Yeongi county on 2006 (a response rate of 35.5%, 98.2%, and 60.7%, respectively). We analyzed these data set using descriptive analysis and $\chi^2$-test through SPSS for Windows (12.0). Most question categories in Daegu metropolitan city and Gunpo city on 2005 were higher than those in the 2006 Demonstration Project regions. These were 'preparing and signing informed consent to vaccination', 'doing physical examination before periodic immunization', 'searching past shot history and inputting the current shot record through the immunization registry management program by physician', 'filing a medical record', 'satisfying the impact of 2005 and 2006 Demonstration Project and achieving the expectation of this Project', and 'improving the immunization coverage rate', et al. In conclusion, we show that the attitudes and practices of physician should be more sensitive to free vaccination services by private clinics and hospitals than public health centers. In the near future, the government must consider the opinion of physicians in implementing the NEPI by the affordable method of the public-private dynamics.

• Proceedings of the Safety Management and Science Conference
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• 2009.11a
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• pp.51-60
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• 2009

To investigate acute drug intoxication trends in the elderly visited Emergency Medical Centers, Data was collected from the records of poisoning patients visited Five different Hospitals from January 1. 2007 to December 31. 2007. The analysis was conducted by using 135 cases of 624 cases. When considering only the elderly and making comparisons between the urban areas and the rural areas the following data was produced. In regard to patients with acute drug intoxication, the main substance of choice was pesticides. Cases of acute drug intoxication are definitely higher for those categorized as the rural elderly (75.0%) when compared with those categorized as the urban elderly (44.1%). The male to female ratio, those living together as a family, past suicide attempts, mental state and sobriety condition when they came, monthly distribution etc. between the two groups did not demonstrate a difference between them. In regard to reasons given for acute drug intoxication, suicide was the highest at 60.7% of the cases. When comparing accidental reasons for poisoning, the urban elderly, at 34.2% of their cases, were higher than in the rural elderly, at 23.7%. After first aid was administered, the admission rate was higher for the rural elderly (47.4%) than for the urban elderly (33.9%). This shows that the rural elderly have a more severe acute drug intoxication poisoning problem than the urban elderly do.

• Journal of Preventive Medicine and Public Health
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• v.55 no.4
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• pp.360-370
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• 2022

Objectives: This study evaluated the response in Daegu, Korea to the first wave of the coronavirus disease 2019 (COVID-19) pandemic according to a public health emergency response model. Methods: After an examination of the official data reported by the city of Daegu and the Korea Centers for Disease Control and Prevention, as well as a literature review and advisory meetings, we chose a response model. Daegu's responses were organized into 4 phases and evaluated by applying the response model. Results: In phase 1, efforts were made to block further transmission of the virus through preemptive testing of a religious group. In phase 2, efforts were concentrated on responding to mass infections in high-risk facilities. Phase 3 involved a transition from a high-intensity social distancing campaign to a citizen participation-based quarantine system. The evaluation using the response model revealed insufficient systematic preparation for a medical surge. In addition, an incorporated health-related management system and protection measures for responders were absent. Nevertheless, the city encouraged the participation of private hospitals and developed a severity classification system. Citizens also played active roles in the pandemic response by practicing social distancing. Conclusions: This study employed the response model to evaluate the early response in Daegu to the COVID-19 pandemic and revealed areas in need of improvement or maintenance. Based on the study results, creation of a systematic model is necessary to prepare for and respond to future public health emergencies like the COVID-19 pandemic.

• Journal of Advanced Technology Convergence
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• v.2 no.2
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• pp.15-21
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• 2023

The purpose of this study was to determine the effects of injury experiences (accidents and addictions) on healthcare use type. This study used the KNHANES VIII-2. Of 7,359 respondents, a total of 6,072 were included, with the exception of 1,287 who were in the age groups <20 years, had missing data, or inappropriately completed the questionnaire. Of these 6,072 respondents, data from 5,355 having injury experiences were used. Data were analyzed using an SPSS WIN 20.0 Version program. Younger age groups had injury affected (p<.05); poor perceived health status was significantly more likely to affect injury than good perceived health status (approx. 2.0-fold, p<.05). As for the number of injuries, emergency rooms were about 4-5 times more frequently used than inpatient or outpatient clinics among the injury treatment centers (p<.05). Injury can cause activity restriction and difficulties in daily life and there can be only a few types of healthcare use; therefore, it is necessary to reinforce relevant programs and make relevant policies.

• Journal of agricultural medicine and community health
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• v.38 no.2
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• pp.130-141
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• 2013

Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.560-569
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• 2016

Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

• Journal of Korean Critical Care Nursing
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• v.5 no.2
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• pp.37-48
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• 2012

Purpose: The purpose of the study was to evaluate how advanced practice nurses (APNs) recognized their work by analyzing nursing outcomes. The ultimate goal was to examine the utility of APNs by connecting their work to the outcomes. Methods: Cross-sectional survey was conducted to collect the data from 59 APNs in a tertiary hospital lovated in Seoul, Korea. The questionnaire with 84 outcome indicators for advanced practice nurses was used. Descriptive statistics were used to analyze the data. Results: Among 84 outcome indicators, 11 indicators were associated with the work of APNs. Majority of these findings were included in the categories of clinical results and satisfaction. Items identified to be associated with the work of APNs were different among oncology nursing area, surgical speciality area, emergency care area, and critical care area. Conclusion: The results of the study indicated that the works of APNs were relevant to education/counseling/training and interpersonal relationship with other health professionals. The results of the study could be helpful to delineate the work characteristics of APNs and increase the utility of APNs in Korea where roles of APNs are not yet clearly delineated in most clinical settings.