• 보건행정학회지
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• 제31권4호
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• pp.399-408
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• 2021

The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.

• 한국방재학회 논문집
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• 제7권2호통권25호
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• pp.25-33
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• 2007

선진국에서는 폭염이 발생하면 폭염경고시스템을 바탕으로 경보가 발령되며 이에 따른 지방자치단체(지자체)별 행동요령이나 대응 시나리오가 구축되어 있다. 우리나라도 소방방재청에서 수립한 폭염종합대책을 토대로 지자체별로 계획을 세우고 있으나, 폭염경고시스템이나 폭염취약계층에 대한 정의 및 구체적인 대응 시나리오가 마련되어 있지 않다. 이에 본 연구에서 예방 및 대비, 대응, 복구의 재해관리 단계로 나누어 외국의 선진 사례를 분석하고, 우리나라 폭염종합대책의 현황과 문제점을 살펴보았으며 나아가 폭염종합대책의 위상강화와 내용을 보완하는 운영방안을 도출하였다.

• 한국ITS학회 논문지
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• 제22권1호
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• pp.143-160
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• 2023

화재, 구조, 구급 등 재난상황에서 신속한 대응을 위해 긴급차량의 골든타임 확보가 중요하다. 본 연구에서는 긴급차량의 골든타임 확보와 운행 안전성 증대를 위하여 긴급차량 운행현황 분석에 기반한 긴급차량 우선신호 운영방안 연구를 수행하였다. 이를 위하여 본 연구에서는 긴급차량 출동 통계자료와 교통사고 통계를 이용하여 긴급차량 운영 현황을 분석하고 설문조사 분석을 통해 긴급차량 우선신호 도입 및 운영에 관한 세부기준을 제시하였다. 분석 결과, 긴급차량의 출동빈도와 교통사고가 점차적으로 증가하고 있으나, 긴급차량의 골든타임 확보율이 절반 수준인 것으로 나타나 이에 대한 개선방안 도출이 시급함을 확인하였다. 긴급차량 우선신호 도입에 관한 설문조사를 통해 우선신호 도입의 필요성에 대해 대다수의 시민이 공감하고 있고, 긴급차량 우선신호 제공 가능한 차량 범위와 신호 대기 허용 가능 시간에 대한 기준을 도출하였다. 이를 통해 긴급차량 우선신호 운영 전략과 세부 기준을 마련하는데 본 연구의 결과가 활용될 수 있으며, 긴급차량 우선신호의 신속한 확대를 통한 긴급차량 운행 안전성 개선과 골든타임 확보율 증대에 기여할 것으로 기대된다.

• 한국수자원학회:학술대회논문집
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• 한국수자원학회 2006년도 학술발표회 논문집
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• pp.1726-1731
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• 2006

본 연구에서는 임하다목적댐의 비상여수로 설계를 위하여 수리모형실험과 수치모형실험을 수행하였다. 수치모의에는 3차원 수치모형인 FLOW-3D를 사용하였다. 비상여수로 설계를 위하여 접근수로부, 월류웨어부, 천이부 및 도류부, 그리고 감세부로 나누어 수리모형실험과 수치모형실험의 수리현상 결과를 비교하였다. 최적의 비상여수로 설계를 위하여 기본계획안에 대하여 모의하고 이에 대한 보완점과 문제점들을 찾아내고 해결책을 제시하였다. 수치모의를 통하여 수리모형실험에서 쉽게 수행하기 어려운 다양한 조건을 모의하고 최적의 결과에 찾아 이를 수리모형실험으로 검증함으로써 비상여수로 기본설계안을 도출하였다.

• 한국응급구조학회지
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• 제13권3호
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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.

• 한국의료질향상학회지
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• 제5권2호
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• pp.216-223
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• 1998

We surveyed the discordance rate of principal diagnosis made at emergency room(ER) & made at ward on discharge of the patients. Subjects were four hundred eighty cases who came to the ER of one third-line hospital from January 1, 1998 to January 31, 1998. The discordance rate was higher in patients admitted to medical department(8.2%) than surgical department(1.5%). If the patients were transferred to other department during hospital stay, discordance rate increased from 3.3% to 6.3%. In conclusion, discordance rate of principal diagnosis made at ER and made at ward was higher in patients with complicated problems. Medical record department should keep these findings in mind if it has a plan to support the management of ER record.

• 한국융합학회논문지
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• 제7권2호
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• pp.85-91
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• 2016

본 연구는 국내 화재피해자의 긴급복구를 위한 민 관 융합형 지원시스템 방안에 대한 것으로, 화재피해자의 긴급복구활동에 대한 현황과 문제점 분석을 통하여 정부와 민간 협력기반의 통합적 지원시스템 구축방안을 제시하였다. 전체적으로 국가는 시스템 운영의 관리 감독기관의 기능을 담당하고 민간에서 실질적 긴급복구 전담기관의 기능을 담당하는 시스템을 의미한다. 결과적으로, 화재피해 긴급복구 지원을 위한 법제도 정비, 지원사업의 민간위탁 시스템 구축, 소요재원의 안정적 조달 및 민 관 긴급복구의 융합기능 강화를 위한 지원시스템 방안을 도출하였다. 특히, 긴급복구 소요재원의 안정적 조달 방안은 긴급복구를 위한 기금의 신설 및 민간 수탁법인의 자체 재원 조성의 세부방안을 논의하였다. 본 연구결과는 향후 국가 소방안전복지와 사회안전망의 강화에 기여할 것이다.

• 한국건설관리학회논문집
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• 제10권5호
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• pp.148-157
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• 2009

When an emergency situation happens in buildings, the top priority is to ensure the occupant from danger as soon as possible. Achieving that goal is a multifaceted and difficult task. However, current evacuation systems have many deficiencies in dealing with the emergency in multi-level structures. The shortage of abilities to continuously update database, predict the future situation and provide the information to users with contextual information is the limit in current systems. Thus, it is very crucial to introduce Evacuation Information System (EIS), which is able to respond quickly to the emergency, and transfer the information to both the administrator and the occupant. The main purpose of this paper is to build EIS on the basis of the indoor Geographical Information System (GIS). When the emergency happens, EIS gives the instruction to Emergency Response Model (ERM) at once. ERM carries out the order and calculates the optimal evacuation routes, then sends the result to EIS. At last, EIS transmits evacuation messages to the occupant who implements evacuation plan. This paper highlights the benefits of EIS in two aspects. One is that EIS can update the data continuously to support evacuation strategy-making. The other is that it can transmit evacuation messages to both the administrator and the occupant.

• 대한임상독성학회지
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• 제19권2호
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• pp.93-99
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• 2021

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

• Nuclear Engineering and Technology
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• 제27권4호
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• pp.571-581
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• 1995

원자력 발전소의 비상운전절차서는 작성단계부터 난점이 많이 있고, 작성된 절차서를 착인 및 검증하는 데에도 많은 어려움이 따른다 캐나다의 원자력 규제기관인 AECB에서도 원자력발전소의 운전 허가를 받는 데 있어 발전소 비상운전 절차서를 하나의 요구조건으로 삼고 있는데, 그 요구조건은 발전소 내외의 비상상황에 대처하기 위한 상세한 계획 및 절차를 개발하는 것이다. 본 보고서에서는 미국의 원자력 발전소 비상운전 계획을 참고하고 있는 캐나다 원자력 발전소용 비상운전절차 표준지침서를 검토하고, 캐나다 비상운전 절차서 들의 현재 경향을 알아보았으며, 캔두형 발전소들의 비상운전 절차를 사고의 범위(개별적인 사고의 종류 지정), 사고진단 방법(사건 대응적, 징후 대응적, 또는 이 두 가지 방법의흔합형), 절차서 형식 등을 중점으로 비교 검토하고, 각 절차서의 내용을 포괄적으로 종합하여 현재 건설중인 월성 원자력 발전소 2, 3, 4호기용 비상운전절차서의 기본방향을 징후 대응적절차서(사고진단이 안될 경우 사용)와 논리도표와 문장이 혼합된 형식의 사건파악적절차서로 이루어진 비상운전절차서로 제시하였다.