• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.22-32
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• 2012

Purpose: The purpose of this study was to examine the occurrence of toxic exposure cases in Korean emergency centers using a toxic exposure surveillance system-based report form and to provide guidelines for the prevention and treatment of toxic exposures. Methods: We retrospectively reviewed the medical records of toxic exposure patients who had visited emergency centers from January 2009 to December 2009. Epidemiology data points for the toxic exposure cases included age, gender, type of exposure, number and kind of substances involved, reason and route of poison exposure, management of the patients in the emergency departments, and the clinical outcome. Results: A total of 3,501 patients from 12 emergency departments were enrolled in the study. 50.0% of the total exposure patients were male and 63.0% of the total cases were fatal. Acute intoxication occurred in 91.3% of the total patients and suicidal intent was the most common (43.3%) reason for exposure. The most common route of exposure was ingestion (75.9%). Of the total cases, pesticides were involved in 26.3%, sedatives/hypnotics/antipsychotics were involved in 22.0%, and bites and envenomations were involved in 15.7%. Conclusion: We provided a database of patients who were admitted to emergency departments after poisoning incidents. We recommend that toxicology professionals develop a classification scheme for toxicants which is adequate for Korean domestic circumstances and initiate a toxic surveillance system for all types of exposures. With support of a psychiatric surveillance system for suicidal patients and establishment of social mediation for pesticide poisoning, major reductions in poison exposures can be achieved.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.104-112
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• 2022

Purpose: The purpose of this study was to investigate the levels and the relationship of emergency nurses' organizational culture and fatigue for infection control, and infection control compliance of COVID-19. Methods: Data was collected from 114 nurses caring for patients suspected of COVID-19 at two emergency medical centers in Gyeonggi-do and Seoul June 18-July 23, 2021. Results: Emergency nurses caring for patients suspected of COVID-19 suffered from high fatigue for infection control. The mean scores of the organizational culture and fatigue for infection control, and infection control compliance of COVID-19 were 51.80 ± 8.37 of 70 points, 78.46± 12.28 of 100 points and 71.02± 7.84 of 80 points, respectively. The higher infection control compliance of COVID-19 is significantly related to the higher organizational culture for infection control (r= .42, p< .001). Conclusion: In the COVID-19 pandemic, the formation of a positive organizational culture for infection control may be a priority as a major strategy to improve the infection control compliance of emergency nurses. It is also necessary to manage the high level of fatigue for infection control among emergency nurses.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.25-32
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• 2018

Purpose: Methamphetamine is an ongoing illegal drug problem worldwide, and its use in South Korea has spread over the last few years. In this study, a clinical review of patients who visited emergency medical centers with positive methamphetamine tests was conducted. Methods: Patients underwent methamphetamine screening based on physician suspicion over a period of 13 years. Their patient characteristics, clinical features, and drug administration properties were described. Results: A total of 297 patients were included, with 19 positive methamphetamine results. Patient age ranged from 21 to 84, with a mean of 37.52. Additionally, 13 were male and 6 were female. The mean BP, PR, RR were 131/82 mmHg, 94/min, 20/min. Saturation levels were all over 95%. Five patients had a psychiatric history. Patient showed varied symptoms ranging from mental changes to chest discomfort. In addition, seven showed abnormal electrocardiography findings and one showed elevated cardiac enzyme levels. Other laboratory results revealed no significantly abnormal results. Six patients also suffered from related trauma. The majority of patients consumed the methamphetamine orally, with unknown motivation at unknown locations. Most were transported by 119 and six patients co-ingested other drugs. Conclusion: Patients who showed positive results to a methamphetamine screening test in Korea visited the emergency medical center mostly by 119 and were unaware of or reluctant to reveal the fact that they had ingested methamphetamine. Emergency physicians should be more aware of the possibility that a patient may have consumed methamphetamine.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.77-90
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• 2009

Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.624-632
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• 2011

Purpose: This study was performed to determine the perception and attitude of emergency medical staff by the presence of family members while performing Cardiopulmonary Resuscitation (CPR). Methods: Data were collected from June and August in 2010 using questionnaire. The participants were 187 doctors and nurses who were working at emergency medical centers located at eight hospitals. Results: Approximately half of the medical emergency staff had previous experience of having requests from a patient's family members to remain present at the time of performing CPR. Most of the subjects did not know that the 2005 American Heart Association (AHA) guideline recommended including willing family members' during CPR. Doctors were more likely than nurses to recognize that the positive effects of family members being present during CPR. Conclusion: This study indicates that health professionals are not aware of the AHA guidelines for including family members during CPR of a patient and further that more doctors than nurses recognized the value of including willing family members during CPR.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.42 no.2
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• pp.9-17
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• 2019

In order to deal with high uncertainty and variability in emergency medical centers, many researchers have developed various models for their operational planning and scheduling. However, most of the models just provide static plans without any risk measures as their results, and thus the users often lose the opportunity to analyze how much risk the patients have, whether the plan is still implementable or how the plan should be changed when an unexpected event happens. In this study, we construct a simulation model combined with a risk-based planning and scheduling module designed by Simio LLC. In addition to static schedules, it provides possibility of treatment delay for each patient as a risk measure, and updates the schedule to avoid the risk when it is needed. By using the simulation model, the users can experiment various scenarios in operations quickly, and also can make a decision not based on their past experience or intuition but based on scientific estimation of risks even in urgent situations. An example of such an operational decision making process is demonstrated for a real mid-size emergency medical center located in Seoul, Republic of Korea. The model is designed for temporal short-term planning especially, but it can be expanded for long-term planning also with some appropriate adjustments.

• Journal of East-West Nursing Research
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• v.24 no.1
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• pp.10-19
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• 2018

Purpose: The purpose of this study was to examine factors affecting the performance of the forensic nursing role among emergency department (ED) nurses. Methods: Data collection was conducted on 125 nurses of EDs in 9 medical centers in U metropolitan city from June 20 to July 20, 2016. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using SPSS Win 21.0 program. Results: There were statistically significant differences in the performance of the forensic nursing role according to the types of emergency medical institutions, perception of the forensic nursing and forensic nurse. Performance of the forensic nursing role had positive relationships with the awareness of the forensic nursing role and forensic nursing competency. Factors affecting the performance of forensic nursing role were forensic nursing role awareness, the types of emergency medical institutions and forensic nursing competency. These factors explained 40.8% of the total variance. Conclusion: The results suggest that awareness of the forensic nursing role, forensic nursing competency and the types of emergency medical institutions have influences on the performance of forensic nursing role. Therefore, it is necessary to design interventions suitable for the types of emergency medical institutions for ED nurses to enhance the awareness of forensic nursing role and to reinforce forensic nursing competency.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.463-473
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• 2020

This study was conducted to provide basic data to find measures to alleviate the job stress of 119 Emergency Medical Technicians by identifying the mediating effect of resilience for life care in the relationship between stress coping and job stress of 119 Emergency Medical Technicians. The data for this study were collected from October 5, 2019, to October 31, 2019. The subject was 205 119 Emergency Medical Technicians working in 119 safety centers located in G Metropolitan City. The collected data were analyzed by independent t-test, ANOVA, Scheffé test, Pearson's correlation coefficients, hierarchical multiple regression analysis, and Sobel test using the SPSS Statistics 21.0 program. As a result oh the study, The mediation effect of resilience was not statistically significant in the relationship between stress coping of seeking social support type and job stress; the mediation effect of resilience was not statistically significant in the relationship between stress coping of seeking positive thinking type and job stress. but, resilience was revealed that resilience completely mediates the relationship between problem-solving type and job stress, and partially mediates the relationship between avoidance type and job stress. The measures to reduce the job stress of 119 Emergency Medical Technicians derived from the above results are as follows. First, among the 119 Emergency Medical Technicians, problem-solving stress coping type 119 Emergency Medical Technicians need to reduce job stress through resilience improvement program. Second, avoidance stress coping type 119 Emergency Medical Technicians should take part in education programs that can reduce job stress in parallel with resilience improvement program.

• Journal of Korean Critical Care Nursing
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• v.14 no.1
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• pp.40-49
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• 2021

Purpose : This study identified the factors affecting the clinical competence of emergency unit nurses caring for foreign patients. Methods : This study utilized a descriptive correlation design. Participants were 112 emergency unit nurses working in different hospitals designated as the government's emergency medical centers and agencies in 2018. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis. Results : Subjects' clinical competence showed positive relationships with cultural competency (r=.45, p<.001) and intercultural communication (r=.53, p<.001). Factors that affect the clinical competence of subjects showed intercultural communication (β=0.38, p=.001). Conclusion : It is necessary to develop programs to improve intercultural communication, factors that influence clinical competence of emergency unit nurses, and apply them to practical fields.