• Title/Summary/Keyword: Emergency medical centers

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Comparison of COVID-19 Vaccines Introduced in Korea

  • Lee, Chang-Gun;Lee, Dongsup
    • Biomedical Science Letters
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    • v.28 no.2
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    • pp.67-82
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    • 2022
  • The prevalence of SARS-CoV-2 led to inconsistent public health policies that resulted in COVID-19 containment failure. These factors resulted in increased hospitalization and death. To prevent viral spread and achieve herd immunity, the only safe and effective measure is to provide to vaccinates. Ever since the release of the SARS-CoV-2 nucleotide sequence in January of 2020, research centers and pharmaceutical companies from many countries have developed different types of vaccines including mRNA, recombinant protein, and viral vector vaccines. Prior to initiating vaccinations, phase 3 clinical trials are necessary. However, no vaccine has yet to complete a phase 3 clinical trial. Many products obtained "emergency use authorization" from governmental agencies such as WHO, FDA etc. The Korean government authorized the use of five different vaccines. The viral vector vaccine of Oxford/AstraZeneca and the Janssen showed effectiveness of 76% and 66.9%, respectively. The mRNA vaccine of Pfizer-BioNTech and Moderna showed effectiveness of 95% and 94.1%, respectively. The protein recombinant vaccine of Novavax showed an effectiveness of 90.4%. In this review, we compared the characteristics, production platform, synthesis principles, authorization, protective effects, immune responses, clinical trials and adverse effects of five different vaccines currently used in Korea. Through this review, we conceptualize the importance of selecting the optimal vaccine to prevent the COVID-19 pandemic.

Trauma Volume and Performance of a Regional Trauma Center in Korea: Initial 5-Year Analysis

  • Yu, Byungchul;Lee, Giljae;Lee, Min A;Choi, Kangkook;Hyun, Sungyoul;Jeon, Yangbin;Yoon, Yong-Cheol;Lee, Jungnam
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.31-37
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    • 2020
  • Purpose: We aimed to evaluate the trauma volume and performance indicators during the first 5-year period of operation in a single regional trauma center. Methods: We analyzed prospectively collected data from the Korean Trauma Data Bank for a single regional trauma center between January 2014 and December 2018. More than 250 variables were analyzed. We calculated the predicted survival rates using the trauma and injury severity score (TRISS) method. Results: In total, there were 16,103 trauma admissions during the first 5 years; trauma activation was performed in 5,105 of these cases. Over 70% of the patients were men, and most of the admitted patients were within the age groups of 55-59 years for men and 75-79 years for women. Analyses were performed considering two patient groups: the total patient group and the group of those with severe trauma (injury severity score [ISS] >15). The median ISS, revised trauma score, and TRISS of the two groups were 5 (interquartile range [IQR] 4-10), 22 (IQR 17-27), and 7.6±0.99 and 6.74±1.9, 0.95±0.13, 0.81±2.67, respectively. Of the total patient group, 801 patients (5%) died in the hospital, whereas of the group of patients with ISS >15, 526 (19.5%) died. The direct transportation of patients to the regional trauma center increased year by year. The emergency room stay time and time to entering the operating room showed a decrease until 2017; however, these parameters increased again in 2018. Conclusions: The trauma volume in the regional trauma center is appropriate, and some improvements could be observed after its establishment. However, performance indicators reveal the prematurity of the trauma center and its potential for further improvements. Moreover, the development of a national trauma system, beyond regional trauma centers, is required.

The Suitability of the CDC Field Triage for Korean Trauma Care

  • Choi, Kang Kook;Jang, Myung Jin;Lee, Min A;Lee, Gil Jae;Yoo, Byungchul;Park, Youngeun;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.13-17
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    • 2020
  • Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Status and Issues on Disaster Preparation Programs in Public Health Center (보건소의 재난관련 대비-대응 사업의 실태와 과제)

  • Cho, Yoo Hyang;Chung, YoungHae;Chie, Nagahiro
    • Journal of agricultural medicine and community health
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    • v.43 no.2
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    • pp.63-73
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    • 2018
  • Objectives: The purpose of this study was to review the disaster preparation and response programs and the status of disaster preparation in public health center. Methods: In depth interview was performed in September 2017 using 5 open questions to the persons who are in charge of disaster response services in 5 public health centers of different levels in Korea. The questions included general characteristics of public health center, disaster programs and future issues. The research hired a quality method. Results: In general, the persons in charge recognized the cooperative agency of local government in disaster management. There were no disaster preparation programs developed by the public health centers. Most of the preparation were passive activities such as emergency support, crisis management on communicable disease and quarantine, participation in biological disaster response training, and education etc. The persons in charge emphasized necessity of disaster preparation programs. Conclusions: Disaster preparation and responsiveness is an evolving issue in public health centers in Korea. Medical support system and communicable disease management system are being set up in the national level. A comprehensive system covering health management, nutritional support, mental health, environment management of shelter, and volunteers supports on public health center level needs to be developed along with a easy-to-follow manual.

A Study on Illness Behavior of Panic Disorder Patients (공황장애 환자의 질환행동에 관한 연구)

  • Kim, Sang-Soo;Je, Young-Myo;Kim, Sang-Yeop;Lee, Dae-Soo;Lee, Sung-Ho;Choi, Eun-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.2
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    • pp.104-119
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    • 1998
  • This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

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Model for the Structural Relationships of Safety Education by a Marine Leisure Sports Experience Center to First-Aid Coping Skills and Experience Satisfaction (해양레저스포츠 체험센터의 안전교육이 응급처치 대처능력 및 체험만족도에 관한 구조적 관계 모형)

  • Choi, Mi-Young;Moon, Tae-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.552-561
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    • 2019
  • The purpose of this study was to verify a model for the structural relationships of safety education provided by a marine leisure sports experience center to first-aid coping skills and experience satisfaction. 307 male and female customers who used a marine leisure sports experience center located in the city of S-si, K-do Province, were investigated from June 15 to August 30, 2017. The collected data were statistically analyzed by SPSS/PC+ 20.0 and Amos 16.0. The findings of the study were as follows: First, the safety education offered by the marine leisure sports experience center was found to have affected first-aid coping skills(t=3.425, p<.001). Second, the safety education by the marine leisure sports experience center was found to have exerted an influence on experience satisfaction(t=3.751, p<.001). Third, the first-aid coping skills of the marine leisure sports experience center was found to have had an impact on experience satisfaction(t=6.781, p<.001). The measurement model for the hypothesis test in this study was found to be appropriate(GFI=.978, NFI=993, CFI=984). Given the findings of the study, more extended safety education is expected to be effective, as customers who use marine leisure sports experience centers will be able to enjoy marine leisure sports more safely and improve their quality of life when they are compulsorily required to receive safety education.

Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty (신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발)

  • Kim, Hee-Ja;Yoo, Jae-Soon;Kim, Hyun-Sook;Tak, Yang-Ju;Bang, Kyung-Sook;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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The Degree of Injury Risk Perception in Preschool Children (학령전기 아동의 사고위험 지각 정도)

  • Kim, Shin-Jeong;Kang, Kyung-Ah;Kim, Sung-Hee;Lee, Jung-Eun
    • Child Health Nursing Research
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    • v.18 no.2
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    • pp.68-75
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    • 2012
  • Purpose: The purpose of this study was to measure (the degree of) injury risk perception in preschool children. Methods: The data were collected from child day care centers and kindergartens located in Seoul, and Gyeonggi and Kwangwon Province. A questionnaire consisted of 28 pictures was administered to 186 preschool children. Results: The mean score for the injury risk perception was 21.83 (${\pm}3.89$), and 77.98 converted into a 100-point scale. According to sub-categories, 'burn prevention' ($.96{\pm}.13$) was the highest, 'interpersonal safety' ($.44{\pm}.31$) was the lowest. There were significant differences in injury risk perception according to gender (t=-2.358, $p$=.019), age (t=-2.101, p=.037), experience of safety education (t=-3.719, $p$ <.001), area of residence (t=-3.445, $p$=.001), injury experience (t=3.212, $p$=.002), and mother's occupation (t=-4.858, $p$ <.001). The highest item in the percentage of correct answer item was 'making jump on the desk', the lowest item in the percentage of correct answer item was 'not wearing safety equipment when rollerblading'. Conclusion: Based on this study, studies should be continued to standardize the instrument. In addition, it is recommended that an injury prevention education program should be developed based on the results of this study to stimulate demand and interest.

A Peripherally Inserted Central Catheter is a Safe and Reliable Alternative to Short-Term Central Venous Catheter for the Treatment of Trauma Patients

  • Ryu, Dong Yeon;Lee, Sang Bong;Kim, Gil Whan;Kim, Jae Hun
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.150-156
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    • 2019
  • Purpose: To determine whether a peripherally inserted central catheter (PICC) meets the goals of a low infection rate and long-term use in trauma patients. Methods: From January 2016 to June 2018, the medical records of patients who underwent central venous catheterization at a level I trauma center were retrospectively reviewed. Data collected included age, sex, injury severity score, site of catheterization, place of catheterization (intensive care unit [ICU], emergency department, or general ward), type of catheter, length of hospital stay during catheterization, types of cultured bacteria, time to development of central line-associated bloodstream infection (CLABSI), and complications. Results: During the study period, 333 central vein catheters (CVC) were inserted with a total of 2,626 catheter-days and 97 PICCs were placed with a total of 2,227 catheter-days. The CLABSI rate was significantly lower in the PICC group when the analysis was limited to patients for whom the catheter was changed for the first time in the ICU after CVC insertion in the ER with similar indication and catheter insertion times (18.6 vs. 10.3/1,000 catheter-days, respectively, p<0.05). The median duration of catheter use was significantly longer in the PICC group than in the CVC group (16 vs. 6 days, respectively, p<0.05). Conclusions: The study results showed that the duration of catheter use was longer and the infection rate were lower in the PICC group than in the CVC group, suggesting that PICC is a safe and reliable alternative to conventional CVC.

Clinical predictors of therapeutic laparotomy in anterior abdominal stab injuries: a multicenter study from low-income institutions in Ethiopia

  • Segni Kejela;Abel Hedato;Yeabsera Mekonnen Duguma;Meklit Solomon Gebremariam
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.140-146
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    • 2024
  • Purpose: Despite the high incidence of abdominal stab injuries, the rate of nontherapeutic laparotomies and the predictors of therapeutic laparotomies have rarely been studied in low-income settings. Methods: This multicenter retrospective study involved three of the largest academic medical centers in central Ethiopia. All patients who sustained an anterior abdominal stab injury and underwent exploratory laparotomy, regardless of the intraoperative findings, were included over the 3-year course of the study. Results: Of the 117 patients who underwent exploratory laparotomy, 35 patients (29.9%) underwent nontherapeutic laparotomies. Three factors predicted therapeutic laparotomy: hollow viscus evisceration (adjusted odds ratio [AOR], 5.77; 95% confidence interval [CI], 1.16-28.64; P=0.032), localized and generalized peritonitis (AOR, 4.77; 95% CI, 1.90-11.93; P=0.001), and white blood cell count ≥11,500/mm3 (AOR, 2.77; 95% CI, 1.002-7.650; P=0.049). The overall positive predictive value of the therapeutic predictors was 80.2%, while the negative predictive value of all predictor-negative patients was 58.1%. The predictors would have prevented 51.4% of the nontherapeutic laparotomies. Conclusions: Close to one-third of the patients had a nontherapeutic laparotomy. The clinical predictors of therapeutic laparotomy were shown to have a high positive predictive value despite a lower negative predictive value. Further prospective studies that involve all patients who sustain anterior abdominal stab injuries are needed to potentially improve on the negative predictive value of the predictors suggested by our study.