• Journal of Trauma and Injury
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• v.33 no.1
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• pp.13-17
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• 2020

Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

• 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.

• The Korean Journal of Emergency Medical Services
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• v.18 no.1
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• pp.43-54
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• 2014

Purpose : The purpose of this study was to provide appropriate direction for triage education by investigating the knowledge level of triage in 119 EMTs before and after the triage education. Methods : The questionnaire was filled out by newly assigned 33 EMTs in the fire service academy in I metropolitan city from November 1, 2013. The data were analyzed using SPSS WIN 21.0 program. Results : The lowest knowledge level by 119 triage was the potential emergency related question, but that by case-based triage was the semi-emergency related questions. The knowledge score by case-based triage before education was 51.14 points. This was lower than knowledge score by 119 triage, that is, 75.70 points. After education, the knowledge level by 119 triage was significantly improved(p =.000). However, there was no significant difference in the knowledge level by case-based triage(p =.236). Conclusion : It is necessary to provide systematic and periodic education and training for 119 EMTs toward triage to improve triage accuracy and efficient circulation of the emergency medical service system. Especially, it is very important to provide case-based triage education for field application.

• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.7-15
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• 2020

The field triage guidelines have been widely implemented in the Korean trauma system. This study aimed to evaluate and validate whether it is reliable to use the field triage guidelines for predicting severe traumatic brain injury (TBI) and traumatic spinal injury (TSI) patients. This study retrospectively analyzed in-hospital cohort registries of all TBI and TSI patients, who visited the emergency department (ED) of the Jeju National University Hospital from 1 January 2013 to 31 December 2015. The primary outcome was defined as TBI and TSI patients with an injury severity score (ISS)>15. Secondary outcomes were defined as cases in which one or more of the following conditions: in-hospital death, ISS>15, admission to the intensive care unit, emergency surgery. We enrolled 14,889 TBI and TSI patients who visited ED, of which 7,966 (53.5%) were triage positive. The overall sensitivity, specificity and area under the curve (AUC) of the full cumulative field triage guidelines step's model (Step 1+3+4 criteria) for primary outcome were 82.8%, 47.0%, and 0.646, respectively. In the results for secondary outcomes, the specificity did not show a significant difference, but the sensitivity decreased to 66.5% and AUC to 0.568. The results of this study suggest that further optimization of the field triage guidelines is needed to identify high-risk TBI and TSI patients.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Journal of KIISE
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• v.44 no.11
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• pp.1156-1164
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• 2017

Existing studies on automatic bug triage were mostly used the method of designing the prediction system based on the machine learning algorithm. Therefore, it can be said that applying a high-performance machine learning model is the core of the performance of the automatic bug triage system. In the related research, machine learning models that have high performance are mainly used, such as SVM and Naïve Bayes. In this paper, we apply Deep Learning, which has recently shown good performance in the field of machine learning, to automatic bug triage and evaluate its performance. Experimental results show that the Deep Learning based Bug Triage system achieves 48% accuracy in active developer experiments, un improvement of up to 69% over than conventional machine learning techniques.

• Journal of muscle and joint health
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• v.25 no.3
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• pp.176-186
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• 2018

Purpose: The purpose of the study was to describe work experiences of triage nurses working at emergency departments in Korea. Methods: A qualitative descriptive research method was used. Twenty-one nurses of emergency department participated in the first interview and 16 of them participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis was utilized to analyze the data. Results: Forty-eight codes, 12 categories, and six themes emerged from the data analysis: caring on the frontline, burden as an initial evaluator, handling things alone, lack of others' understanding, becoming an expert, and needs for improvement. Participating triage nurses faced many challenges and difficult situations in emergency departments. They felt burden and loneliness as initial evaluator. Also, they felt pride in their work and struggled to become a professional. Conclusion: This study is the first qualitative study that has focused on exploring the experiences of triage nurses in emergency departments in Korea. The results provide description and in-depth understanding of working experiences of triage nurses. The results provide valuable fundamental data for regulation, clinical practice, education, and research for triage nurses in Korean emergency departments.

• Journal of Information Processing Systems
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• v.15 no.4
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• pp.967-985
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• 2019

Bug report processing is a key element of bug fixing in modern software maintenance. Bug reports are not processed immediately after submission and involve several processes such as bug report deduplication and bug report triage before bug fixing is initiated; however, this method of bug fixing is very inefficient because all these processes are performed manually. Software engineers have persistently highlighted the need to automate these processes, and as a result, many automation techniques have been proposed for bug report processing; however, the accuracy of the existing methods is not satisfactory. Therefore, this study focuses on surveying to improve the accuracy of existing techniques for bug report processing. Reviews of each method proposed in this study consist of a description, used techniques, experiments, and comparison results. The results of this study indicate that research in the field of bug deduplication still lacks and therefore requires numerous studies that integrate clustering and natural language processing. This study further indicates that although all studies in the field of triage are based on machine learning, results of studies on deep learning are still insufficient.

• Korean Journal of Health Education and Promotion
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• v.21 no.1
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• pp.259-283
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• 2004

This is an quasi experimental study using nonequivalent pre-test post-test control design for the development of the CAI program and an analysis of its effects, for nursing college students to learn emergency patient triage. This program was developed from November, 2000 to middle of September, 2001 with the aid of curriculum design experts. The subjects of this study were 86 randomly sampled freshmen students of C nursing college in Ulsan. They were divided into 45 for the test group and 41 for the control group. The CAI program for the learning of the emergency patient triage has been developed on the basis of Merrill's Component display theory and Keller's ARCS theory and through the curriculum design process of Hannafin ＆ Peck. It has also been done with the use of Tool book 8.0, the multimedia righting tool. The experiment to verify the effect of the CAI program has been carried on from September, 20 to October, 8 2001. There were six hypotheses to accomplish the purpose of the study, and the analysis of the data was done with the use of SPSS/win program. As a result of this study, the author concluded that this CAI program is an effective mediation method to promote the learning accomplishment and learning motive for nursing college students. Therefore in the field of emergency nursing education, it would be possible to use this program as means for widening the possibility of self-learning and to promote individual learning of nursing college students.