The purpose of Emergency Medical System(EMS) is what a patient returns to society with recovering mental tone in the shortest time as giving prompt and proper medical treatment to patient in emergency situation, and the Correctional Administration(CA) is purposed for the convict to return and settle down to society after release from prison in success as executing schooling, enlightenment activity, vocational training to convict who was quarantined from the society for the term of imprisonment. The EMS and CA will coincide each other which is reverting people to society in safety. This study aims to suggest the developmental program of EMS in correctional facilities through the cause of emergency situation, system, human resources, establishment, medical equipments, state of budget and the point issue for safety of victim who has many chances that is exposed to physical damage and disease because of particularity of lower culture in correctional facilities and the staff who works there. First, in the view of the correctional facility security system, a proper number of the emergency rescuers should be employed. Second, the effective transportation system along with some emergency medical equipment needs to be established. Third, the correctional officers and the prisoners should be learned the first-aid training which is realistic, practical and systematic. Fourth, the cooperative system should be established such as 1339 emergency medical information center in society. Fifth, the Ministry of Health and Welfare must increase EMS budget for correctional facilities.
Gil-Sun Hong;Choong Wook Lee;Ju Hee Lee;Bona Kim;Jung Bok Lee
Korean Journal of Radiology
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v.23
no.9
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pp.878-888
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2022
Objective: To investigate the clinical impact of a quality improvement program including dedicated emergency radiology personnel (QIP-DERP) on the management of emergency surgical patients in the emergency department (ED). Materials and Methods: This retrospective study identified all adult patients (n = 3667) who underwent preoperative body CT, for which written radiology reports were generated, and who subsequently underwent non-elective surgery between 2007 and 2018 in the ED of a single urban academic tertiary medical institution. The study cohort was divided into periods before and after the initiation of QIP-DERP. We matched the control group patients (i.e., before QIP-DERP) to the QIP-DERP group patients using propensity score (PS), with a 1:2 matching ratio for the main analysis and a 1:1 ratio for sub-analyses separately for daytime (8:00 AM to 5:00 PM on weekdays) and after-hours. The primary outcome was timing of emergency surgery (TES), which was defined as the time from ED arrival to surgical intervention. The secondary outcomes included ED length of stay (LOS) and intensive care unit (ICU) admission rate. Results: According to the PS-matched analysis, compared with the control group, QIP-DERP significantly decreased the median TES from 16.7 hours (interquartile range, 9.4-27.5 hours) to 11.6 hours (6.6-21.9 hours) (p < 0.001) and the ICU admission rate from 33.3% (205/616) to 23.9% (295/1232) (p < 0.001). During after-hours, the QIP-DERP significantly reduced median TES from 19.9 hours (12.5-30.1 hours) to 9.6 hours (5.7-19.1 hours) (p < 0.001), median ED LOS from 9.1 hours (5.6-16.5 hours) to 6.7 hours (4.9-11.3 hours) (p < 0.001), and ICU admission rate from 35.5% (108/304) to 22.0% (67/304) (p < 0.001). Conclusion: QIP-DERP implementation improved the quality of emergency surgical management in the ED by reducing TES, ED LOS, and ICU admission rate, particularly during after-hours.
In this study, the disaster management and disaster medical improvement was described in underground space(specifically underground shopping center) in case of fire disaster occurred. Firstly, statue and system was discussed concerning building law, safety, fire services, refuge. The underground in Seoul management is classified as to space and form and management agent is different according to the type form. Because the difficulty of emergency rescue arises due to individual management system unified system needs to be established and improvement of facility management agent is necessary. For the patient to be transfer on the ground, corporation between command head quarter and emergency rescue team are essential. And disaster information and emergency medical information are also need to be considered. Therefore, effective countermeasures for emergency saving is urgent considering distribution of medical institution and medical treatment.
Journal of the Korea Academia-Industrial cooperation Society
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v.14
no.2
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pp.768-777
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2013
The purpose of this study is to be conducive to work improvement through analyzing turnover intention and organizational commitment of EMT within medical institution. The subjects of this study were randomly extracted 188 EMT. The survey period was conducted from May 3, 2011 to May 19 (May 3rd-4th in G Province, May 14th in B Metropolitan City, May 18th-19th in D Metropolitan City). An analytical method was made with SPSS WIN program(Version 12.0). As a result of research, the turnover intention was high in women(p<.001), in under 30 years old(about 4.9 times, p<.001), in the unmarried(about 4.3 times, p<.001), and in junior college graduate(about 4 times, p<.001). Also, the turnover intention was high in income with under 1,500,000 won(about 3.3 times, p<.001), in working career with under 5 years(about 3.2 times, p<.001), in feeling the legal work limit(about 1.8 times, p<.05), and in group with low job satisfaction(p<.001). In correlation between organizational commitment and job variable, the variables in age, marriage, academic background, turnover intention, income, career, and legal work limit except gender and job satisfaction showed positive correlation with organizational commitment(p<.01). As for the factors affected on the organizational commitment, the turnover intention(p<.01), the legal work limit(p<.01), and the job satisfaction(p<.001) had significant effect on organizational commitment.
Lee Won Jae;Park Kyu Nam;Choi Seung Pil;Lee Mi Jin
Journal of The Korean Society of Clinical Toxicology
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v.3
no.1
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pp.33-39
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2005
Purpose: Nowadays the Korean society is in the center of time of the social change. Because of dissociation of traditional family, IMF (International Monetary Fund) crisis and economic recession, the mortality rate of suicidal attempts are increasing annually. The majority of suicidal attempts were by poisoning considering the characteristics of korean society. Therefore we studied to find out the characteristics of suicidal poisoning before and after social economic stress, and to suggest the direction for the proper management. Methods: We reviewed medical records of 547 patients of suicide by poisoning who visited the emergency medical centers of St. Mary's hospitals from 1997 to 2004. For the annual trends analysis, we analyzed the demographic and toxicologic data of these patients compared with before and after IMF crisis (1998) and the economic recession ($2003\~2004$). Results: At the time of IMF and the economic recession, the number of suicidal poisoning increased, especially in fifth decade. The refusal rate of toxicological emergency treatment increased. Also the mortality rate and the admission rate to ICU (Intensive Care Unit) increased during the same period. In the result of the comparison analysis, clinical severity and mortality of social problem group were higher. However they couldn't be treated appropriately because of financial problem and the family indifference. Conclusion: At the economic recession period, the severity of suicidal poisoned patients was high. But the refusal rate of toxicologic treatment also increased, so the patients had lost the chance for proper toxicologic treatment. Therefore they would be supported by medical institution and public health.
Journal of agricultural medicine and community health
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v.34
no.3
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pp.346-358
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2009
Objectives: A study was conducted by analysing the contents and frequency of emergency treatment practiced by emergency medical technicians(EMTs) in emergency situations and contains related factors. Methods: The study subjects included 80 EMTs who participated in ongoing education classes during the period from June 25th to June 26th, 2008. the survey included 53 EMTs employed within 119 first aid teams in fire stations in both a metropolitan city and a medium-sized city. From the survey results relation between frequency of emergency treatment and subjects characteristics explored statistically including t-test, X2 test, Pearson correlation and finally stepwise multiple regression. Results: The most frequent procedure by EMTs checking vital signs. The statistically significant related factors overall of the 23 items of emergency treatment frequency was the working area and the grading of EMT certification. In contrast, significant related factors with frequency of IV linkage were found to be the subjects gender, institution employed and the importance of recognizing the item. The statistically significant related factors of that of ECG monitoring was the gender of respondents. Conclusions: To keep the appropriate frequency of emergency treatment by EMT, active efforts to promote their individual importance and confidence cognition are necessary, especially towards males and persons who have 2nd class certification. Moreover, EMTs who work in small cities must be supported.
Objective : An effective intervention has not yet been established for patients with acute occlusion of the internal carotid artery (ICA). The aim of our study was to investigate the feasibility, safety, and efficacy of emergent stent placement of carotid artery to improve neurologic symptoms and clinical outcome. Methods : Of 84 consecutive patients with severe ICA stenosis who were admitted to our institution from March 2006 to May 2009, 10 patients with acute ICA occlusion (11.9%) underwent emergency carotid artery stent placement. We reviewed their records for neurologic outcome using the National Institutes of Health Stroke Scale (NIHSS) score, before and at 7 days after stent placement; clinical outcome using the modified Rankin Scale score (mRS) and Glasgow Outcome Scale (GOS); frequency of procedure-related complications; and recurrence rate of ipsilateral ischemic stroke within 90 days. Results : Carotid lesions were dilated completely in all patients. Median NIHSS scores before emergency stent placement and at 7 days were 16.6 and 6, respectively, showing significant improvement. Eight patients (80%) had favorable outcomes (mRS score 0-2 and GOS 4-5). Complications occurred in two patients (20%): stent insertion failed in one and an intracerebral hemorrhage occurred in the other. Ipsilateral ischemic stroke did not recur within 3 months. Conclusion : Emergency carotid artery stent placement can improve the 7-day neurologic outcome and the 90-day clinical outcome in selected patients with acute cerebral infarction.
Journal of The Korean Society of Clinical Toxicology
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v.17
no.1
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pp.7-13
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2019
Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.
Journal of the Korea Institute of Information and Communication Engineering
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v.23
no.2
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pp.149-155
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2019
In this paper, we propose an emergency call system which makes a call to an institution or a guardian when an urgent case occurs to a user based on the indoor location service. In addition, it establishes indoor location service infrastructure assuming welfare institutions and hospitals. The proposed system receives the sensor value from the device that is in the form of a clock on the wrist and determines the emergency situation and delivers emergency information to the terminal. The location terminal transmits location and emergency information to the server, and the server accesses the database and stores the data. This enables the caregiver to communicate with the server through the application, monitor the user's status, receive notifications, and respond to emergency situations by using the emergency call function. If the proposed system is applied to the fields requiring urgent action such as medical field and welfare field, it will provide more stable and prompt emergency service to users and carers.
Man pursues health as his basic right. Therefore, the government should try to preserve the right of the people's health and carry out the policy of medical treatment for that. But the system of our medical care is advantageous to the medical institutions, which produce medical goods each people buys and sells freely, more than to the maintenance and improvement of their health. That is to say, the first aim of the institution is not the healthy preservation of the people but their accumulation of riches. The medical conflicts are the social situation which is happening between those who produce medical treatment and the patients who consume it. Its behinning comes from the lack of belief by the inhuman relationship between patients and doctors. According to thelatest investigation, the patients of oriental clinics look more content than those who go to common hospitals. The reasons are as follows; fitness to one's physical constitution, the kind altitude of doctors and the view of oriental medicine toward human body. Though the content degreee is higher than western medicine, such conclusions result from the present condition the number of the patients is less. In short, the first, since the right of patients is higher and the fields make more variors and popular, the conflicts and mistakes go on increasing. The second, in their activity of treatment, the legal importance of atlention and explanatory obligation should be considered seriously so as not to break out medical mistakes. The third, in the center of technical books which are accepted by the academic world, the clinical exertion doing treatment is needful. The fourth, as the direct order of medical justification the self-determination of patients should be respected. The fifth, because the process and record of treatment become important in the time of emergency legally, the conversations and movements as well as the details of treatment must be recorded. The sixth, the academic effort about the settlement institution or the legal system is necessary.
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