• Journal of Trauma and Injury
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• 제23권2호
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• pp.180-187
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• 2010

Purpose: The "golden hour" concept in trauma is pervasive despite little evidence to support it. This study addressed the association between prehospital time and in-hospital mortality in seriously injured abdominal trauma victims. Methods: A retrospective study was conducted over a three-year period from 2006 to 2008. We analyzed trauma victims with abdominal injuries who underwent an emergency laparotomy in a local emergency center located in a city with a population of 2,500,000. According to the 'golden hour' oncept, we separated the trauma victims into two groups (Gourp 1: prehospital time ${\leq}$ 1 hour, Group 2: prehospital time > 1hour) and investigated several factors, such as time, process, and outcome. Results: During the period from January 2006 to December 2008 139 trauma victims underwent an emergency laparotomy, and 89 of them were enrolled in this study. Between the two groups, emergency department (ED) access, transportation, and injury mechanism showed statistically meaningful differences, but no statistically meaningful differences were observed in various measures of the outcome, such as length of hospital stay, length of Intensive Care Unit stay, and mortality. In a univariate logistic regression study, age (odds ratio [OR]: 1.101; 95% confidence interval [CI]: 1.026 to 1.182), Revised Trauma Score (RTS) (OR: 0.444; 95% CI 0.278 to 0.710), hemoglobin (OR: 0.749; 95% CI: 0.585 to 0.960), and creatinine (OR: 24.584; 95% CI: 2.019 to 299.364) were significant prognostic factors, but prehospital time was not. In a multivariate logistic regression study, age and RTS were significant associated with mortality. Conclusion: In this study, we found no association between prehospital time and mortality among abdominal trauma patient who underwent an emergency laparotomy. We suggest that in our current out-of-hospital and emergency care system, until arrival at the hospital time may be less crucial for trauma victims than once thought.

• Journal of Platform Technology
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• 제9권3호
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• pp.44-51
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• 2021

일반적으로 골든 타임은 인명 구조나 화재 진압 등의 사고 초기대응에 있어서 가장 중요한 시간을 의미한다. 골든 타임은 재난 상황별로 다르지만 화재나 구급에 있어서는 5분을 목표로 하고 있다. 하지만 실제 현장의 경우 구급차의 평균 출동 시간은 9분, 평균 이송 시간은 17.6분으로 골든 타임과 비교하여 상당히 큰 지연시간이 존재한다. 이러한 지연시간에는 다양한 원인이 존재하지만 가장 큰 원인은 교통체증이다. 해당 문제를 해결하기 위해 정부에서는 긴급 자동차 양보의무법 제정, 사고 발생률이 가장 높은 장소에 구급차 우선 배치 등을 골든 타임을 확보하고 있지만, 교통량이 빠른 속도로 증가하는 출퇴근 상황에서는 해결책이 되지 못하고 있다. 따라서 본 논문에서는 신호등에 사운드 센서를 설치하여 수집된 소리 데이터를 활용한 딥러닝 기반 긴급차량 우선 신호 시스템을 제안하고 긴급차량의 주파수 대역을 추출하고 거리에 따라 다르게 나타나는 진폭 신호를 분류하는 실험을 진행하였다.

• 대한간호학회지
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• 제46권6호
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• pp.804-812
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• 2016

Purpose: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). Methods: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. Results: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. Conclusion: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center directly should be implemented for patients and/or caregivers.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.25-30
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• 2011

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

• 한국응용곤충학회지
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• 제43권2호
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• pp.163-168
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• 2004

광대노린재(P lewisi)의 실내 계대사육법을 확립하기 위해 먼저 실내에서의 생식행동을 구명하였다. 고온장일조건($25^{\circ}C$, 16Lㆍ8D)의 사육실에서 사육하면서 교미행동과 다중교미가 산란성에 미치는 영향에 대해 조사하였는데 광대노린재 성충의 교미는 성충 일령별로 9일째부터 시작되어 17일 이후는 교미율이 증가(60% 이상)하여 성충 21일째 84.5%로 피크를 이루였다. 광대노린재의 교미행동과정은 탐색배회, 접근, 더듬이접촉, 올라타기, 복부말단접근, 교미(끝에 끝 자세)를 취하는 것으로 조사되었다. 수컷은 교미행동 전 과정에서 능동적이었으며 또한 암컷에게 올라타기를 하기 전까지 마찰음을 내였으나 대부분의 암컷은 교미에 수동적이었다. 교미가 이루어지는 시간은 조명 후 1시간 내에 69% ,2시간 8% ,3시간 6% ,4시간 16% ,5시간 1%로 거의 4시간 내에는 교미가 이루어지는 것으로 관찰되었다. 암컷의 재교미는 첫 교미 후7일 동안 20% 정도 이루어졌으나 수컷의 재교미율은 암컷보다 월등히 높았다. 한편 암컷은 1회 교미 후 시간이 경과함에 따라 산란된 알의 부화율이 감소하였으나 재교미를 함으로서 산란된 알의 부화율이 향상되었고 수컷은 교미횟수가 증가할수록 산란된 알의 부화율이 감소하였다.

• 한국의학물리학회지:의학물리
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• 제15권3호
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• pp.161-166
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• 2004

쐐기형태의 선량분포를 만드는 데 이용되는 선형가속기에 장착된 동적쐐기(EDW; Enhanced Dynamic Wedge)의 품질관리를 위한 간단한 방법을 고안하였다. 선량 프로파일의 품질관리를 위해서는 필름 선량측정 장비와 필름 스캐너, 고 에너지 선량 측정용 필름, 필름 농도계, 삼차원 치료 계획 장치가 사용되었다. 역방향 60$^{\circ}$ 동적쐐기를 각각 한 필름에 조사(이하 60$^{\circ}$REWP; 60$^{\circ}$ Reversed Wedge Pair)하고, 이를 통해 얻어진 선량 프로파일의 선량 대칭도를 정량적으로 분석하였으며, 동적쐐기 구동이 중간에 멈춘 경우 이를 보상하는 부분 보상조사(Partial treatment mode)도 비교하였다. 또한 측정 된 자료들을 구간선량표(Golden STT； Segmented Treatment Table) 로 구현한 삼차원 치료 계획 장치의 계산치와 비교하였다 60$^{\circ}$REWP의 실험을 통해 역방향 쐐기의 효과가 1% 이내에서 잘 상쇄되었음을 알 수 있었으며 이 자료를 기준으로 한 품질관리의 타당성을 확보할 수 있었다. 실효쐐기인자의 품질관리를 위해서는 쐐기 각도 $10^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$, 60$^{\circ}$에 대해 실측하였고, 구간선량표에서 보정인자를 유도하여 동적쐐기 조사 시 자동으로 생성되는 로그 파일을 참조하여 실효 쐐기인자 계산치를 얻어내어 비교하였다. 이 방법을 통해 별도의 측정 장비 없이 용이하게 쐐기인자의 이상 유무를 파악할 수 있었다. 기존의 복잡한 품질관리의 방법을 단순화하고 효율을 극대화시킴으로써 측정에서 분석까지 1시간 내에 동적 쐐기의 품질관리를 수행할 수 있었다. 동적쐐기는 금속쐐기와 달리 선량률과 Y축 콜리메이터의 움직임에 따라 부정확도의 잠재가능성을 갖고 있으므로 수시 품질관리가 필수적인데 본 연구방법을 이용하면 단순하면서도 효율을 극대화할 수 있어 동적쐐기를 이용한 방사선치료의 안전도를 높일 수 있었다.

• Journal of Information Processing Systems
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• 제12권1호
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• pp.129-148
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• 2016

Acute myocardial infarction (AMI) is one of the three emergency diseases that require urgent diagnosis and treatment in the golden hour. It is important to identify the status of the coronary artery in AMI due to the nature of disease. Therefore, multi-modal medical images, which can effectively show the status of the coronary artery, have been widely used to diagnose AMI. However, the legacy system has provided multi-modal medical images with flat and unstructured data. It has a lack of semantic information between multi-modal images, which are distributed and stored individually. If we can see the status of the coronary artery all at once by integrating the core information extracted from multi-modal medical images, the time for diagnosis and treatment will be reduced. In this paper, we analyze semantic relations between multi-modal medical images based on coronary anatomy for AMI. First, we selected a coronary arteriogram, coronary angiography, and echocardiography as the representative medical images for AMI and extracted semantic features from them, respectively. We then analyzed the semantic relations between them and defined the convergence data model for AMI. As a result, we show that the data model can present core information from multi-modal medical images and enable to diagnose through the united view of AMI intuitively.

• 대한안전경영과학회지
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• 제17권1호
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• pp.45-52
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• 2015

The purpose of this investigation is to enhance the survival rate of patients by transporting them to the hospital within the golden hour through the operational improvement of emergency dispatch instruction. To this end, problems and improvements of current operating system were derived by carrying out a survey against paramedics of Incheon city in 2012 and analyzing the current emergency dispatch instruction. This study analyzed the emergency activity daily reports for one year from January 1 through December 31, 2012 and researched the consciousness of 119 emergency medical technician. According to the analysis of the survey, there were no meaningful differences in the on-site arrival times per triage. Therefore, the item of 'Emergency Classification' specified in the emergency dispatch instruction needs to be integrated in the scheme of "triage". Also, the feedbacks of the emergency action log and the emergency dispatch instruction are necessary for 'duty for operation' to review the adequacy to the severity after the end of emergency operation. Finally, the improvement of the system for the continuous communication between the paramedics and the command staff is necessary. This improvements as stated above are expected to contribute to raise survival rate of patients.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.321-324
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• 2018

최근 차량과 모든 사물을 연결하는 V2X(Vehicle to Everything) 기술의 진화가 빨라지고 있다. 특히 이동통신망을 활용한 C-V2X(Cellular V2X) 기술과 이와 결합된 서비스가 빠르게 발전하고 있는 추세를 확인할 수 있다. 하지만 우리나라는 교통사고 부상자 긴급 구난(e-Call, emergency Call) 서비스 분야에서 발전한 통신 기술에 비해 상대적으로 미흡하다고 볼 수 있으며, 사고 후 골든아워 내 구조차량의 도착비율도 현저히 낮고, 보행자 사고 비율도 높은 편이다. 따라서 본 논문은 C-V2X 통신과 안드로이드 운영체제를 적용한 통신 아키텍처를 설계하였고, 이를 기반으로 한 V2N(Vehicle to Nomadic Device) 통신을 이용하여 기존 e-Call 서비스의 개선 방안을 제시하였다.

• 대한방사선기술학회지:방사선기술과학
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• 제43권4호
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• pp.289-295
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• 2020

This study investigated the feasibility of establishing a college of medicine in the western region of Chungnam to fill the gap in the medical doctor in charge of essential medical care in the region. Currently, the level of medical services in Chungnam is low compared to provinces across the country and in particular, 7 cities and towns, which account for 760,000 people, one-third of Chungnam's population, are located in the western regions of Chungnam. Because of this, in the event of an emergency patients, it is necessary to travel to Cheonan, Daejeon, Seoul, etc. where the regional emergency medical center is located for more than 1 hour and 30 minutes. In the case of critically ill and emergency patients transfer, it is a situation that misses the golden time and causes valuable loss of life. In order to improve the medical environment in the western region of Chungnam and improve the lives of residents in vulnerable areas of medical services, it is believed that establishing a college of medicine in the western region of Chungnam is essential.