• Title/Summary/Keyword: Fire cause

Search Result 814, Processing Time 0.036 seconds

The Relationship between Yellow Turban Rebellion and Displaced Persons: The Entangled Influence of the Economy, Natural Disasters, Civil Wars, and Refugees (후한 영제(靈帝) 시기 민중 봉기와 그 배경 -재정·자연재해·내란의 상호영향-)

  • Choi Jin-yeoul
    • Journal of the Daesoon Academy of Sciences
    • /
    • v.48
    • /
    • pp.407-443
    • /
    • 2024
  • The relationship between finance, natural disasters and epidemics, the Liang Province Rebellion of mostly Qiang ethnic groups, and the occurrence of displaced persons in the Later Han Dynasty, is examined in this article. Also explored is the financial crisis that had started accumulating in the Later Han Dynasty, as well as the Yellow Turban Rebellion and the displacement of the people. It is argued in this research that the financial crisis had an influence on the occurrence. The Yellow Turban Rebellion began in 184, seventeenth year of Lingdi's reign. The rebellion was an incident that occurred due to a complex combination of natural calamities and man-made disasters. Various natural disasters during the Lingdi period, poor measures for immigration, and Lingdi's refusal to accept Yangci and Liu Tao's advice that the immigrants should return home were the direct causes of the Yellow Turban Rebellion. In short, the increase in military spending due to natural disasters and the Liang Province Rebellion caused financial deterioration were the direct causes of the Yellow turban rebellion. The Yellow Turban Rebellion was suppressed in less than a year. Therefore, the Yellow Turban Rebellion itself was not the cause of the collapse of the Later Han Dynasty. It was rather case that the great fire in South Palace in Luoyang, the capital of Later Han Dynasty, in 185, the increase in taxes of 10 qian per mu (畝) to rebuild the palace, the open and compulsory encouragement of the trafficking of official posts, and the exploitation of civil servants, which destabilized the population. Thereupon, rebellions broke out among the people in various places. Therefore, unlike the Yellow Turban Rebellion, the collapse of the Later Han Dynasty should be viewed as primarily the result of man-made calamities rather than natural disasters.

Treatment of Skin Diseases in Hyungsang Medicine (피부병의 형상의학적 치료)

  • Suk Min He;Hwang Won Duek;Jung Haeng Gyu;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.18 no.3
    • /
    • pp.646-669
    • /
    • 2004
  • By treating skin diseases with Hyungsang medicine and reviewing the clinical cases of them through classifying skin diseases into general care and into Hyungsang medical care, the writer came to the conclusion as followings. The skin is a house of Kyungnak, and it' s a place which Ki comes in and out, which human body controls conditions of his physiological function and which doctors can make a diagnosis from seeing it. The skin is subject to lung and large intestine in the point of organ, but in the point of movement, to spleen and stomach. Skin diseases come from unbalance of Ki and Hyul, mostly from fever in blood and also from Dam, Wind, Dampness and Dryness because of including fire. Generally skin diseases are treated according to classifying into distinctive symptoms, region, cause or time being occurred, and concomitant symptoms. After being divided into man and woman, age and youth, fatness and leanness, Jung Ki Shin Hyul type, visceral figures, Yukkyung shapes on Hyungsang medicine method, the remedy of skin diseases which is combined common meditation with Hyungsang medical method is efficacious. In distinguishing into man and woman, age and youth, man gets sick mainly by drinking liquor and exhausting Jung, woman is taken ill generally by indigestion and Damwha, especially by drinking liquor. Young child gets ill mostly from inherent weakness, but in many cases he is occurred by disturbed digestion, so he must be taken care of ingesting food. The aged becomes ill from weakening, so he must be treated according to reasons of diseases. To fatness and leanness, skin diseases are showed symptoms by weakened Yang, insufficient Yin or excess fever on the theory of upper and lower parts, by unbalance of Ki and Hyul on the theory of left and right, by Dryness and Dampness on the theory of front and rear and by insufficiency of vitality and combined fever on the theory of inside and outside. Therefore doctors must cure the symptoms according to the theory of upper and lower, left and right, front and rear and inside and outside. In type of Jung Ki Shin Hyul, the balances between Jung-Hyul and Shin-Ki are important points. Concretely Jung type comes to easily shortage of Jung or gathering abnormally Dampness and Dam, Ki type is easy to make a mass with Ki or to be deficient of Ki, Shin type comes to press seven emotions togather or to be insufficient of Yin and fever inside, and Hyul type is inclined to be deficient of Hyul and to become feverish or to be deficient of Ki. Therefore on the ground of the above reasons skin diseases come into existence. Inclusively in Jung-Hyul type , Ki must be moved on the base of full Jung-Hyul, so Wukmijiwhangtang or Samultang is prescribed basically. In Shin-Ki type , Jung-Hyul is saved on the base of moving Ki, so Hyangsosan or Yijintang is the proper prescription. Considering the visceral figures, doctors judge for diagnosis and remedy by putting together the elements, that is, great and small sizes of a set of features (eye, ear, mouth, nose), color and temper. The yukkyung types are classified according to many or few of Ki-Hyul, and then skin diseases appear by being inclined toward one side between Ki and hyul, or among the six atmospheric elements(wind, cold, heat, dampness, dryness, and fire). Especially because Yangmyung type is full of much Ki and Hyul, and also has much fever in stomach, he gets skin symptoms frequently. So his prescription is based on taking off fever in stomach, and also he must be careful about regimen certainly.

Study on the Consequence Effect Analysis & Process Hazard Review at Gas Release from Hydrogen Fluoride Storage Tank (최근 불산 저장탱크에서의 가스 누출시 공정위험 및 결과영향 분석)

  • Ko, JaeSun
    • Journal of the Society of Disaster Information
    • /
    • v.9 no.4
    • /
    • pp.449-461
    • /
    • 2013
  • As the hydrofluoric acid leak in Gumi-si, Gyeongsangbuk-do or hydrochloric acid leak in Ulsan, Gyeongsangnam-do demonstrated, chemical related accidents are mostly caused by large amounts of volatile toxic substances leaking due to the damages of storage tank or pipe lines of transporter. Safety assessment is the most important concern because such toxic material accidents cause human and material damages to the environment and atmosphere of the surrounding area. Therefore, in this study, a hydrofluoric acid leaked from a storage tank was selected as the study example to simulate the leaked substance diffusing into the atmosphere and result analysis was performed through the numerical Analysis and diffusion simulation of ALOHA(Areal Location of Hazardous Atmospheres). the results of a qualitative evaluation of HAZOP (Hazard Operability)was looked at to find that the flange leak, operation delay due to leakage of the valve and the hose, and toxic gas leak were danger factors. Possibility of fire from temperature, pressure and corrosion, nitrogen supply overpressure and toxic leak from internal corrosion of tank or pipe joints were also found to be high. ALOHA resulting effects were a little different depending on the input data of Dense Gas Model, however, the wind direction and speed, rather than atmospheric stability, played bigger role. Higher wind speed affected the diffusion of contaminant. In term of the diffusion concentration, both liquid and gas leaks resulted in almost the same $LC_{50}$ and ALOHA AEGL-3(Acute Exposure Guidline Level) values. Each scenarios showed almost identical results in ALOHA model. Therefore, a buffer distance of toxic gas can be determined by comparing the numerical analysis and the diffusion concentration to the IDLH(Immediately Dangerous to Life and Health). Such study will help perform the risk assessment of toxic leak more efficiently and be utilized in establishing community emergency response system properly.

A Study on the Development Plan for Promotion of Advanced Disaster-Safety Awareness (선진 재난안전의식의 활성화를 위한 방안 연구)

  • Lee, Jong-hyun;Kim, Mi-ra;Ko, Jae-chul
    • Journal of the Society of Disaster Information
    • /
    • v.17 no.3
    • /
    • pp.415-426
    • /
    • 2021
  • Purpose: The purpose of this study is to create the deveopment plan for promotion of advanced disaster-safety awareness, which is noted as a major factor in the large disaster. Method: This study is to conduct theoretical review with regard to disaster management and safety awareness. Consciousness surveys on safety awareness and previous disaster case was analyzed to derive the cause of the disaster, and the development plan for promotion of advanced disaster-safety awareness was suggested. Result: In the survey on the public's sense of safety on the disaster management evaluation, 'Response' stage was well performed, but the 'Recovery' stage was not. Especially, it was found that disaster safety education at the 'Prevention' stage was very lacking. In the survey on the public's safety awareness, the awareness level of the evacuation facility was very low, information on infectious diseases and collapse accident was insufficient. Especially, it has been found that the awareness on safety regulation in daily life is very insufficient. Through the case study on previous disaster(COVID-19, Fire in Miryang Sejong Hospital, Forest fire in the east coas at 2004'), it was derived that the lack of safety awareness(such as safety insensitivity) was the main factor of the expansion of the damage scale. Conclusion: The development plan for promotion of advanced disaster-safety awareness are as follow. First, it is necessary to spread the safety culture movement through the expansion of safety education and safety promotion. Second, disaster confrontation training for the public should be implemented to improve the effectiveness of disaster response. Finally, it is necessary to change the individual awareness on safety. When these factors are implemented systematically, advanced disaster-safety awareness can be promoted. Ultimately, disaster accidents in our society can be reduced.

A Study of Industrial Patients from Selected General Hospitals in the Kyung Pook and Taegu City Areas (일부지역 산업재해환자 실태 연구 -대구, 경북지역 일부 종합병원 중심으로-)

  • 허춘복;남철현
    • Journal of Environmental Health Sciences
    • /
    • v.17 no.2
    • /
    • pp.78-94
    • /
    • 1991
  • The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure pain. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu Kyung Pook University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as follows: 1. Among the 179 cases, 51.6 % were male and 48.4 % were female. The two largest age groups were 30~39, 31.8 % and 20~29, 27.4 %. Among the 179 cases, 51.6% were married, the largest family number was 2 to 3, 41.1% and 4 to 5, 25.6%. Educationally, graduation from high school was the largest group, 46.4% among the patients, followed by middle school and primary school. The largest group income level was from 40~69만원, 45.2%. The largest group of patients who worked over 50 hrs. a week was 52.0%. The largest group of patients who worked less than 1 year was 44.7%, of the patients in work places of less than 100 people, 60.3% were injured and in work places of 100~299 people, 20.1% were injured. In manufacturing, the lagest group injured was 55.3%, the next group was transport, stroage, communication. The largest group of production workers injured was 40.2%. 2. The cause of injury in the largest group was facility problems, 33.5%. The next group was unsafe habits, 30.2% a lack of safety knowledge, 17.9% and insufficient supervision, 12.3%. The 30~39 year age group was head the highest number of injuries, 40.4% work places with more than 10 yeras of work, 44.4% work palces with more than 1000 people, 56.3% and mining accidents, 80.0%. Among these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries 28.5% as the largest group, followed by falls & falling objects 17.3%, fire & electric 15.1%, struke by an object 14.5%, followed by overaction and vehicular accidents. The accident pattern showed 46.4 % among workers over the 50 year age group, workers in the 5~10 year group, 50.0 % places employing more than 1000 workers, 35.3 % : construction 73.7%, and construction workers 57.1%, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures 54.8%, trauma 14.5%, amputation 11.7%, open wound, and burns. The largest number of fractures occurred in people in the 30~39 year age group, 63.2 % over 10 years of work, 55.6% in work places of 300~400 people, 63.6% construction 63.2% and general workers 57.2 %. 5. The largest group of injuries was upper extremity 45.3%, lower extremity 24.0%, trunk 18.5 % and head or neck 12.2%. Of these groups, upper extremity injuries were the highest in those less 20 years old 75.0%, less than 1 years of work 59.5%, in work places of 500~999 people 60.0%, manufacturing 56.6 % and production workers 55.6%. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 August, 22 people July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work(r=.2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation(r =.4372) p<0.001.

  • PDF

A Study of Industrial Patients from Selected General in the Kyung Pook and Taegu City areas (일부지역 산업재해환자 실태 조사 연구 -대구${\cdot}$경북지역 일부 종합병원 중심으로-)

  • Huh, Choon-Bok
    • The Journal of Korean Physical Therapy
    • /
    • v.3 no.1
    • /
    • pp.151-174
    • /
    • 1991
  • The purpose of this study is to research the actual conditions of industrial accident patients and to produce worker satisfaction and a rational and effective counter measure plan. Direct interviews with 179 cases (in and out patients) were carried out during a three month period from April to July 1990, at six hospitals : two general hospitals Sun Lin and Sung Mo in Po Hang, and four general hospitals in Taegu : Kyung pooh University Hospital, Dong San Medical Center, Young Nam Medical Center and Catholic Hospital. The results of this study are summarized as fellows : 1. Among the 179 cases, $51.6\%$ were male and $48.4\%$ were female. The two largest age groups were 30-39, $31.8\%$ and 20-29, $27.4\%$. Among the 179 cases, $51.6\%$ were married, the largest family number was 2 to 3, $41.1\%$ and 4 to 5, $25.6\%$. Educationally, graduation from high school was the largest group, $46.4\%$ among ,the patients, followed by middle school and primary school. The largest group income level was from 40-69 만원, $45.2\%$. The largest group of patients who worked over 50 hrs. a week was $52.0\%$. The largest group of patients who worked less than 1 year was $44.7\%$, of the patients in work places of less than 100 people, $60.3\%$ were injured and in work places of 100-299 people, $20.1\%$ were injured. In manufacturing, the largest group injured was $55.3\%$, the next group was transport, storage, communication. The largest group of production workers injured was $40.2\%$. 2. The cause of injury in the largest group was facility problems, $33.5\%$. The next group was unsafe habits, $30.2\%$ ; a lack of safety knowledge, $17.9\%$ ; and insufficient supervision, $12.3\%$. The 30-39 year age group head the highest number of injuries, $40.4\%$ ; work places with more than 10 years of work, $44.4\%$ ; work places with more than 1000 people, $56.3\%$ and mining accidents, $80.0\%$. Among. these groups the highest cause of injury was due to facility problems. 3. The accident pattern showed machinery injuries $28.5\%$ as the largest group, followed by falls & falling objects $17.3\%$, fire & electric $15.1\%$, strucke by an object $14.5\%$, followed by overaction and vehicular accidents. The accident pattern showed $46.4\%$ among workers over the 50 year age group, workers in the 5-10 year group, $50.0\%$ ; places employing more than 1000 workers, $35.3\%$ ; construction $73.7\%$, and construction workers $57.1\%$, among these fall & falling objects caused the greatest number of injuries. 4. The largest group of injuries was fractures $54.8\%$, trauma $14.5\%$, amputation $11.7\%$, open wound, and burns. The largest number of fractures occurred in people in the 30-39 year age group, $63.2\%$ : over 10 years of work, $55.0\%$ ; in work places of 300-490 people, $63.6\%$ ; construction $63.2\%$ and general workers $57.2\%$. 5. The largest group of injuries was upper extremity $45.3\%$, lower extremity $24.0\%$, trunk $18.5\%$ and head or neck $12.2\%$. Of these groups, upper extremity injuries were the highest in those less than 20 years old $75.0\%$, less than 1 year or work $59.5\%$, in work places of 500-999 people $60.0\%$, manufacturing $56.6\%$ and production workers $55.6\%$. 6. Periods of injury showed 34 people injured in September, to be the largest followed by October, 32 ; August, 22 people : July, 19 people and the lowest December, 2 people. During the week, Friday had the largest group injured, 35 people ; followed by Saturday, 26 people and the lowest was Wednesday, 17 people, During the day 1400 hours had the largest group injured, 38 people ; followed by 800 hours, 31 people. 7. On a basis of 5 as the highest mark, the average, according to worker satisfaction showed facility safety 3.55, work environment 3.47, income 3.44, job 3.21 and treatment 2.98. 8. The correlation between general characteristics and injury showed that age was directly correlated to the duration of work (r=2591) p<0.01, age was directly correlated to industry (r=2311) p<0.01, and the duration was directly correlated to occupation (r=4372) p<0.001.

  • PDF

Environmental Interpretation on soil mass movement spot and disaster dangerous site for precautionary measures -in Peong Chang Area- (산사태발생지(山沙汰發生地)와 피해위험지(被害危險地)의 환경학적(環境學的) 해석(解析)과 예방대책(豫防對策) -평창지구(平昌地區)를 중심(中心)으로-)

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
    • /
    • v.45 no.1
    • /
    • pp.11-25
    • /
    • 1979
  • There was much mass movement at many different mountain side of Peong Chang area in Kwangwon province by the influence of heavy rainfall through August/4 5, 1979. This study have done with the fact observed through the field survey and the information of the former researchers. The results are as follows; 1. Heavy rainfall area with more than 200mm per day and more than 60mm per hour as maximum rainfall during past 6 years, are distributed in the western side of the connecting line through Hoeng Seong, Weonju, Yeongdong, Muju, Namweon and Suncheon, and of the southern sea side of KeongsangNam-do. The heavy rain fan reason in the above area seems to be influenced by the mouktam range and moving direction of depression. 2. Peak point of heavy rainfall distribution always happen during the night time and seems to cause directly mass movement and serious damage. 3. Soil mass movement in Peongchang break out from the course sandy loam soil of granite group and the clay soil of lime stone and shale. Earth have moved along the surface of both bedrock or also the hardpan in case of the lime stone area. 4. Infiltration seems to be rapid on the both bedrock soil, the former is by the soil texture and the latter is by the crumb structure, high humus content and dense root system in surface soil. 5. Topographic pattern of mass movement spot is mostly the concave slope at the valley head or at the upper part of middle slope which run-off can easily come together from the surrounding slope. Soil profile of mass movement spot has wet soil in the lime stone area and loose or deep soil in the granite area. 6. Dominant slope degree of the soil mass movement site has steep slope, mostly, more than 25 degree and slope position that start mass movement is mostly in the range of the middle slope line to ridge line. 7. Vegetation status of soil mass movement area are mostly fire field agriculture area, it's abandoned grass land, young plantation made on the fire field poor forest of the erosion control site and non forest land composed mainly grass and shrubs. Very rare earth sliding can be found in the big tree stands but mostly from the thin soil site on the un-weatherd bed rock. 8. Dangerous condition of soil mass movement and land sliding seems to be estimated by the several environmental factors, namely, vegetation cover, slope degree, slope shape and position, bed rock and soil profile characteristics etc. 9. House break down are mostly happen on the following site, namely, colluvial cone and fan, talus, foot area of concave slope and small terrace or colluvial soil between valley and at the small river side Dangerous house from mass movement could be interpreted by the aerial photo with reference of the surrounding site condition of house and village in the mountain area 10. As a counter plan for the prevention of mass movement damage the technics of it's risk diagnosis and the field survey should be done, and the mass movement control of prevention should be started with the goverment support as soon as possible. The precautionary measures of house and village protection from mass movement damage should be made and executed and considered the protecting forest making around the house and village. 11. Dangerous or safety of house and village from mass movement and flood damage will be indentified and informed to the village people of mountain area through the forest extension work. 12. Clear cutting activity on the steep granite site, fire field making on the steep slope, house or village construction on the dangerous site and fuel collection in the eroded forest or the steep forest land should be surely prohibited When making the management plan the mass movement, soil erosion and flood problem will be concidered and also included the prevention method of disaster.

  • PDF

A case study of verifying a suicide by carbon monoxide intoxication committed by burning an ignition charcoal briquette (착화탄 연소에 의한 일산화탄소 중독사에서 자살입증에 관한 사례연구)

  • Sung, Tae-myung;Jo, Ju-ik;Ahn, Phil-sang
    • Analytical Science and Technology
    • /
    • v.28 no.6
    • /
    • pp.398-408
    • /
    • 2015
  • Carbon monoxide (CO) intoxication, arising from CO from an ignited charcoal briquette (ICB), is a popular means of committing suicide in Korea. Most CO intoxications are related to suicide attempts; however, the possibility of a homicide disguised as a suicide cannot be ruled out. Therefore, forensic investigation of the deceased and the crime scene is crucial to confirm that the deceased committed suicide. Detection of the components of an ICB on the objects suspected of being contacted by the deceased, such as the hands, nostrils, and doorknobs, is essential for linking the crime scene to the victim in the case of suicides by ignited ICBs. The traces from an ICB were analyzed by investigating the morphological characteristics and obtaining elemental compositions. The ICBs were completely different from blackened wood, as detected by discriminant analysis with the elements of carbon and oxygen. We analyzed one case of CO intoxication to demonstrate an excellent procedure for verifying whether a suicide occurred with an ICB. We employed SEM-EDX for the analysis of an ICB, microscope-FT/IR and pyrolysis-GC/MS for a partly burnt resin-type substance, GC/MS for diphenhydramine (a sleeping drug), and GC/TCD for the CO-Hb level. We detected traces of an ICB on the hands, nostrils, and doorknobs, which were all discriminated into an ICB group. Detection of ICB traces from the nostrils could indicate that the deceased started the fire themselves to commit suicide. The partially burnt black material was analyzed as an acrylronitrilestyrene polymer, which is normally used to make bags for carrying or wrapping and could be assumed to have been used to transport the ICB. Diphenhydramine, a sleeping drug, was detected at a level of 2.3 mg/L in the blood, which was lower than that in fatal cases (8-31 mg/L; mean 16 mg/L). A CO-Hb level of 79% was found in the blood, which means that the cause of death was CO intoxication. The steps shown here could represent an ideal method for reaching a verdict of suicide by CO intoxication produced by burning an ICB in a sealed room or a car.

A Study on the Estimation Method of the Repair Rates in Finishing Materials of Domestic Office Buildings (국내 업무시설 건축 마감재의 수선율 산정 방안에 관한 연구)

  • Kim, Sun-Nam;Yoo, Hyun-Seok;Kim, Young-Suk
    • Korean Journal of Construction Engineering and Management
    • /
    • v.16 no.1
    • /
    • pp.52-63
    • /
    • 2015
  • Business facilities among domestic architectures have rapidly been constructed along with domestic economic development. It is an important facility taking the second largest proportion next to apartment buildings among current 31 building types of fire department classification of 2012 year for urban architectures. The expected service life of business facilities is 15 years, but 70% of those in urban areas have surpassed the 15 year service life as of the present 2014. Thus, the demand for urgent rehabilitation of such facilities is constantly increasing due to the aging and performance deterioration of the facilities'main finishing materials. Especially, the business facilities are being used for the lease of company office or private office, and such problems as aging and performance deterioration of the facilities could cause less competitive edge for leasing and real estate value depreciation for the O&M (Operation & Management) agent and the owner, respectively. Therefore, an effective planned rehabilitation as a preventive measure according to the standardized repair rate by the number of years after the construction is in need in order to prevent the aging and performance deterioration of the facilities(La et al. 2001). Nonetheless, domestic repair/rehabilitation standards based on the repair rate are mainly limited to apartment buildings and pubic institutions, resulting in impractical application of such standards to business facilities. It has been investigated and analyzed that annual repair rate data for each finishing material are required for examination of the applicability of the repair rate standard for the purpose of establishment of a repair plan. Hence, this study aimed at developing a repair rate computation model for finishing materials of the facilities and verifying the appropriateness of the annual repair rate for each finishing material through a case study after collecting and analyzing the repair history data of six business facilities. The results of this study are expected to contribute to the planning and implementation of more efficient repair/rehabilitation budget by preventing the waste of unpredicted repair cost and opportunity cost for the sake of the business facilities' owners and O&M agents.

Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
    • /
    • v.9 no.2
    • /
    • pp.111-128
    • /
    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

  • PDF