• 한국정보통신학회논문지
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• 제22권12호
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• pp.1625-1630
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• 2018

응급 상황에서 응급 구조사는 외상 평가와 치료가 주요 업무이다. 하지만 응급 처치를 할 수 있는 범위가 협소하며 병원의 응급실로 이송하는 일을 주로 수행하고 있다. 응급 상황에 맞는 전문의를 연결하여 원격 의료 지도를 통한 응급 처치가 이루어진다면 정확한 진단과 적절한 치료에 도움을 줄 수 있다. 본 논문에서는 응급 의료 서비스를 위한 원격 의료 지도를 지원하기 위한 앱을 개발하였다. 개발된 스마트 앱은 응급 구조사가 원격지에 있는 의사를 호출하여 응급 환자의 상태를 생체 신호와 영상으로 실시간 전송할 수 있다. 이를 통하여 환자의 상태를 정확하게 진단하는데 도움을 줄 수 있다. 또한 응급 치료를 지도할 수 있으며 응급실에서의 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• 한국응급구조학회지
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• 제20권1호
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• pp.57-70
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• 2016

Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.

• 대한임상독성학회지
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• 제9권2호
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• pp.113-116
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• 2011

Superwarfarin, such as brodifacoum, is a highly lethal vitamin K antagonist used as a rodenticide. Brodifacoum has a particularly long half-life in the body, which ranges to several months, and therefore requires prolonged treatment with antidotal vitamin K. We experienced a case whereby an 18-year-old male was presented to the hospital with a severe bleeding disorder. It was discovered that he had ingested brodifacoum rodenticide with intent to commit suicide. Despite continual treatment with vitamin K, the bleeding disorder persisted for several months before he recovered. We report this case with literature review.

• 간호행정학회지
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• 제21권4호
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• pp.386-392
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• 2015

Purpose: The purpose of this study was to identify the job of emergency room (ER) nurses working in small and medium sized hospitals and to explore factors affecting their job. Methods: The survey data were collected between January 2014 and May 2014 and participants were 159 nurses working in Seoul, Kyunggi, Incheon, and Chungnam in hospitals of less than 500 beds. Results: The score for nurses job was 2.12/4.0, and emergency treatment (1.87/4.0) followed basic nursing (3.51/4.0) and counseling (2.32/4.0). The nursing job was significantly different depending on the age, education level, position, resident doctor(emergency medicine specialty or other) and grade of ER (regional ER or local ER). In the multiple regression, education level (${\beta}=.18$), position (${\beta}=.24$), hospital size (${\beta}=.20$), and grade of ER (${\beta}=.21$) explained 17.0% of variance in ER nurses' job in small and medium sized hospitals. Conclusion: The findings indicate that ER nurses in vulnerable areas do more nursing practice including emergency treatment as well as the usual independent nursing practice. Accordingly, a systematic assignment of nursing professionals is needed to reduce loading of ER nurses in small and medium sized hospitals.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2017년도 추계학술대회
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• pp.279-281
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• 2017

최근 시간적, 공간적, 의료기술 적용의 한계를 극복하기 위하여 의료 기술과 IT 기술의 융합을 시도하고 있다. 본 연구에서는 응급 의료 서비스에 적용할 수 있는 구급 정보 서비를 위한 환경을 구축하였다. 이 환경은 응급 환자의 상황 파악 및 응급처치 등을 쉽게 지원하고, 이를 원격지 의료 지도 의사에게 전달하여 응급처치 및 병원 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• 한국응급구조학회지
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• 제9권1호
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• pp.101-109
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• 2005

The purpose of this study which was done by 250 Prehospital Care Reports(PCRs) survey of some squads in Seoul Metropolitan Fire & Disaster Management Department was to improve prehospital emergency care by means of quality management. The data were collected in 3 squads from Jun. 21 to Jul. 18, 2004 and analyzed by using SPSS Win 12.0 Version. The conclusions from this study were summarized as follows. The mean time of Event to treatment interval was $4.6{\pm}4.3$ minutes and 49.2% arrived at patient within 4 minutes. Platinum minute was observed 61.1% of verbal response, 73.3% of painful response, 77.8% of unresponsive. The great majority of patients couldn't receive advanced life support on account of limited scope of practice and strict direct medical control in the Emergency Medical Services Act. Data from quality improvement activity will be useful to expand indirect medical control which is able to activate prehospital care. To utilize PCR for quality improvement. It has to have data elements, run data, patient data, check boxes, narrative including US DOT's minimum data set.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.278-281
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• 2018

Central retinal artery occlusion (CRAO) is considered an ophthalmologic emergency. The prognosis of this disease is very poor. Currently, there is no generally effective therapy available to treat CRAO. Hyperbaric oxygen therapy (HBOT) can increase the volume of oxygen delivered to the ischemic retinal tissue until spontaneous or assisted reperfusion occurs. We report the case of a patient who experienced sudden visual loss due to CRAO that was treated with HBOT. The patient was an 81-year-old woman who presented with CRAO in her right eye (OD). She exhibited "hand motion" visual acuity before treatment. She underwent three sessions of HBOT at a pressure of 2.8 atmospheres absolute, performed over 3 days. After 4 days in hospital, her visual acuity improved to 0.4 (OD) for far vision and 0.5 (OD) for near vision. Her vision was stable without the supply of oxygen; therefore, she was discharged.

• 대한한방내과학회지
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• 제39권3호
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• pp.350-362
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• 2018

Objectives: By analyzing the characteristics and the distribution of diseases of patients who visited the emergency room of a Korean medical hospital, we sought to determine the methods of activating the Korean emergency medical system and to use this analysis as a basis for future research. Methods: We conducted a retrospective review of 959 patients who visited the emergency department of the Dong-Eui University Korean Medical Hospital from January 2016 to December 2016. The review was conducted using electronic medical records created during the emergency department visit. Results & Conclusions: In distribution of sex, the rate of males was 47.9%, and that of females was 52.1%. In distribution of age, the greatest number of patients were in their 50s (27.5%), followed by those in their 60s (19.9%) and 40s (14.8%). In distribution of residence, most patients were from Busan (84.9%). In distribution of week, more patients visited the emergency room on Sundays and holidays (44.3%). September was the busiest month (12.5%). Visits usually occurred during daytime and nighttime, and there were few visits at dawn. In the analysis of the time interval between onset of symptoms and the emergency room visit, most patients visited within 24 hours (46.5%). In the distribution of diseases, facial palsy was the most common (34.6%). In the systematic distribution of diseases, circulatory diseases were the most common (56.7%), followed by diseases of the musculoskeletal system (28.6%). The rate of first emergency room visit was 52.9%, and the rate of revisit was 47.1%. The rate of hospitalization after emergency room treatment was 27.5%, and the rate of discharge was 72.4%. The rate of revisit was 63.4%. In the distribution of treatment before arrival at the emergency room, direct was the most common (51.0%), and the outpatient department of western medicine was next. In the distribution of treatment in the emergency room, acupuncture was the highest (91.4%), followed by herb-med (43.0%).

• Journal of Trauma and Injury
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• 제23권1호
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• Journal of Chest Surgery
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• 제46권6호
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• pp.467-470
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• 2013

The rupture of a renal artery aneurysm is a rare disease that is difficult to diagnose. Although we usually consider the appropriate treatment to be open laparotomy with aortic aneurysm surgery or stenting with graft insertion through intravascular intervention, thus far, there is no general consensus on the treatment protocol for renal artery aneurysm. Notably, ruptured renal artery aneurysm is a true critical emergency that may result in a fatal outcome. We are reporting two renal artery aneurysm patients who had ruptured and underwent emergency laparotomy.