• 한국병원경영학회지
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• 제7권3호
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• pp.44-62
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• 2002

Advanced surgical technology demands more precise, meticulous, and time-consuming procedures. In addition, the patient's preference of tertiary health providers makes over crowding of the University Hospitals. Therefore, it has been necessary to maximize utilization of the operating room of such hospitals to accommodate these requirements. This study, targeting 1,302 surgical cases performed in 22 operating rooms at a university hospital in Seoul from October 8 to November 1, 2001, analyzed reasons for delay, and factors that caused delayed use of operating rooms. This study also assessed that the rate of operating room use would increase if the sources for possible reform were improved. 1. Among total of 1,302 cases of surgery, the incidence of surgeries in which there were no time delays and no factors for delay were discovered is 71.4% or 930 cases: the incidence in which surgeries were delayed was 28.6% or 372 cases. 2. As results of logistic regression for delay, procedures involving women were delayed 1.4 times more frequently than those of men. Compared to Department A, Department B was 1.8 times more likely to be delayed, and Department H was 0.4 times less likely to be delayed. Regional anesthesia was 2.4 times more likely to be delayed than general anesthesia, and surgeries that PCA was applied were 0.6 times less likely to be delayed than those when it was not. Surgeries performed on the Thursday were 1.7 times more likely to be delayed than those performed on the Monday. Compared to surgeries performed between 07:00-07:59, those performed between 08:00-08:29 were 4.3 times higher. 3. The reasons for delay were related to surgeon, surgical department, patient, anesthesia, administrative system, sick ward, and support services. Among these, 5,755 minutes for 276 delayed cases could be resolved easily, and resolving delays of 3,320 minutes for 131 cases would be more difficult. Among the causes for delay that could be improved, delays due to patient's transfer and surgeon's factor were the most common, 21.6% and 17.4% respectively. 4. If resolvable delays are improved, pre-anesthesia room is administered, and regional anesthesia and PCA are done ahead of time, use of emergency operating rooms will increase, we can increase overall utilization by 4.09%, we will save 744 minutes a day, we can reduce the time the operation room is used after 4 PM by 35%, and we can resolve the operation cancellations due to insufficient operating rooms. For the increase in the use of operating rooms, we need to maximally decrease the delays that could be improved, by allocating block time based on used totals hours of elective cases, giving accurate information on surgery schedule, voluntary cooperation by staff participating in surgeries in reducing delay time, and the hospital management's will to improve delay.

• 한국원자력학회:학술대회논문집
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• 한국원자력학회 1995년도 추계학술발표회논문집(1)
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• pp.191-196
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• 1995

The intelligent human-machine interface (HMI) has been developed to enhance the safety and availability of a nuclear power plant by improving operational reliability The key elements of the HMI are the large display panels which present synopsis of the plant status and the compact, digital work stations for the primary operator control and monitoring functions. The work station consists of four consoles such as a dynamic alarm console (DAC), a system information console (SIC), a computerized operating-procedure console (COC), and a safety related information console (SRIC). The DAC provides clean alarm pictures, in which information overlapping is excluded and alarm impacts are discriminated, for quick situation awareness. The SIC covers a normal operation by offering all necessary plant information and control functions. In addition, it is closely linked with the DAC and the COC to automatically display related system information under the request of these consoles. The COC aids the operator with proper emergency operation guidelines so as to shutdown the plant safely, and it also reduces his physical/mental burden by automating the operating procedures. The SRIC continuously displays safety related information to allow the operator to assess the plant status focusing on plant safety. The proposed HMI has been validated and demonstrated with on-line data obtained from the full-scope simulator for Yonggwang Units 1,2.

• 안보군사학연구
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• 통권5호
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• pp.131-172
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• 2007

Government duties in the cases of crisis are aimed at supporting efficient military operations in the fields of non-military affairs and resource mobilization, maintenance of government functions, and search for the public security of living during the war. In crisis, the government must change its functions into the total-war system with all resources available for the efficient performance of military operations, war economy, public safety and security as well as government continuance. The main contents of "Chung-Mu Plan" include the alternative measures to control the circulation of life necessities, emergency electricity, water and gas; recover public facilities from the disaster; and accommodate the wounded and refugees. Governments have practiced Ul-chi and ChungMoo exercises to improve government's management capabilities and master standard operating procedures including systematic distribution plans in the national and local level. However, such plans have not yet sufficient enough for the maintenance of public security of living. In addition to the conceptual ambiguity, major problems are the inappropriate system of the war economy, legal institutions, and administrative SOPs for the efficient maintenance of it. Thus, for the betterment of national crisis management system, the government should have the manual stated from every step and level dealing with crisis to the legal institutions. It is important to empower the National Emergency Planning Commission for the policy consistency and efficient/effective implementation. The comprehensive plans must have an integrated cooperative system of the central/local governments, military and civil society with actual practices and exercises for the maintenance of the public security of living.

• 환경영향평가
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• 제21권6호
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• pp.823-839
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• 2012

Environmental Specimen Banks (ESBs) are playing pivotal role in monitoring the effect of environmental pollution on the ecosystem based on the retrospective analysis of the representative samples collected regularly and stored in cryogenic condition. In Korea, National Environmental Specimen Bank (NESB) was established in 2009 and the standard operating procedures (SOPs) for sampling, and cryogenic milling and storage had been prepared during 2007-2010. Since then, the tentative SOPs for the seven kinds of specimens (shoots of Red Pine (Pinus densiflora) and Korean Pine (Pinus koraiensis), leaves of Mongolian Oak (Quercus mongolica) and Zelkova Tree (Zelkova serrata), eggs of Feral Pigeon (Columba livia var. domestica), muscles and organs of Common Carp (Cyprinus carpio), and Freshwater Bivalve (Unio (Nodularia) douglasiae)) have been put to test in the field and laboratory as well against the practicality and feasibility. The SOPs were improved by reflecting the findings from the research and the following discussion regarding the selection of specimen (Feral Pigeon suffering from a control management), sample size (a problem of decreasing number of sampling trees related to increasing sampling time) and period (a problem related to a bud growth), and sampling methods etc.. In addition, barcoding system for the management of the specimen information, and monitoring system of the cryogenic storage to regulate the optimum temperature and the liquid nitrogen level were also developed for the efficient and effective control of the samples. Lastly, the safety guide and emergency protocol were augmented to guarantee a safe work environment with the cryogenic facility. These improvements of the SOPs are expected to contribute to more stable operation of the NESB.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.

• Nuclear Engineering and Technology
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• 제44권3호
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• pp.225-236
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• 2012

The Fukushima-Daiichi accident shook the world, as a well-known plant design, the General Electric BWR Mark I, was heavily damaged in the tsunami, which followed the Great Japanese Earthquake of 11 March 2011. Plant safety functions were lost and, as both AC and DC failed, manoeuvrability of the plants at the site virtually came to a full stop. The traditional system of Emergency Operating Procedures (EOPs) and Severe Accident Management Guidelines (SAMG) failed to protect core and containment, and severe core damage resulted, followed by devastating hydrogen explosions and, finally, considerable radioactive releases. The root cause may not only have been that the design against tsunamis was incorrect, but that the defence against accidents in most power plants is based on traditional assumptions, such as Large Break LOCA as the limiting event, whereas there is no engineered design against severe accidents in most plants. Accidents beyond the licensed design basis have hardly been considered in the various designs, and if they were included, they often were not classified for their safety role, as most system safety classifications considered only design basis accidents. It is, hence, time to again consider the Design Basis Accident, and ask ourselves whether the time has not come to consider engineered safety functions to mitigate core damage accidents. Associated is a proper classification of those systems that do the job. Also associated are safety criteria, which so far are only related to 'public health and safety'; in reality, nuclear accidents cause few casualties, but create immense economical and societal effects-for which there are no criteria to be met. Severe accidents create an environment far surpassing the imagination of those who developed EOPs and SAMG, most of which was developed after Three Mile Island - an accident where all was still in place, except the insight in the event was lost. It requires fundamental changes in our present safety approach and safety thinking and, hence, also in our EOPs and SAMG, in order to prevent future 'Fukushimas'.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.1-7
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• 2008

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

• Environmental Engineering Research
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• 제20권4호
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• pp.356-362
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• 2015

Many burial sites were constructed in a short time to prevent the rapid spread of foot and mouth disease in infected livestock carcasses in Korea. More than 4,700 carcass burial sites were constructed in 2011. Approximately seven million poultry and 3.5 million livestock, including cattle and swine, were buried on farmland. Some burial sites were suspected of leachate leakage and were excavated and carcasses redisposed in a bioaugmentation process. This study performed interviews in order to understand the economic issues related to carcass burial and redisposal. The internal data from local government and the assumption data from online sites were analyzed to evaluate the costs; the focus was on burial site construction. The results showed that the local government paid $4.7 and $10.9 per carcass for traditional burial and redisposal. The comparable costs shown online were $4.5. This study found that the standard operating procedures should be carried out to reduce environmental impact and avoid additional costs. We estimated that the cost could be reduced by the advance preparations of materials against the emergency situations such as catastrophe of epidemics. In addition, the innovative technology for the stabilization of carcasses should be established through a future study.

• 한국산업보건학회지
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• 제29권4호
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• pp.562-570
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• 2019

Objectives: Rapid Intervention Crews (RIC) are indispensable for rescuing firefighters who are lost or trapped. They are included in Disaster Scene Standard Operating Procedures. This study was conducted to examine the use of RIC at emergency scenes in South Korea. Methods: We conducted a nationwide survey of 4,913 firefighters in South Korea. The firefighters' experiences of use of RICs were assessed by asking, "How often are RICs available at fires?" Results: A full 40.8% of firefighters answered that they 'never' have RICs available at fires. Another 8.4% responded that they 'always' have RICs available, which is much lower than the rate among US firefighters (19.9%). RICs are available more often for firefighters in the capital area than for firefighters outside the capital area (13.4% vs. 5.1%, p<0.001). The larger the jurisdiction served, the more likely the firefighters were to have RICs available (p<0.001). Conclusions: These results imply that firefighters in South Korea are at risk. It is necessary to recruit personnel to improve the use of RICs and to explicitly include RICs in SOPs, training, and business plans.

• 시스템엔지니어링학술지
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• 제19권2호
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• pp.32-45
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• 2023

Implementing Severe Accident Management (SAM) strategies is crucial for enhancing a nuclear power plant's resilience and safety against severe accidents conditions represented in the analysis of Station Blackout (SBO) event. Among these critical approaches, the In-Vessel Retention (IVR) through External Reactor Vessel Cooling (IVR-ERVC) strategy plays a key role in preventing vessel failure. This work is designed to evaluate the efficacy of the IVR strategy for a high-power density reactor APR1400. The APR1400's plant is represented and simulated under steady-state and transient conditions for a station blackout (SBO) accident scenario using the computer code, ASYST. The APR1400's thermal-hydraulic response is analyzed to assess its performance as it progresses toward a severe accident scenario during an extended SBO. The effectiveness of emergency operating procedures (EOPs) and severe accident management guidelines (SAMGs) are systematically examined to assess their ability to mitigate the accident. A group of associated key phenomena selected based on Phenomenon Identification and Ranking Tables (PIRT) and uncertain parameters are identified accordingly and then propagated within DAKOTA Uncertainty Quantification (UQ) framework until a statistically representative sample is obtained and hence determine the uncertainty bands of key system parameters. The Systems Engineering methodology is applied to direct the progression of work, ensuring systematic and efficient execution.