• Title/Summary/Keyword: Golden hour

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The Meaning of 'Golden Hour' in Prehospital Time for Abdominal Trauma Victims with Emergency Laparotomy (복부외상으로 응급개복술을 시행한 환자에서 병원전단계 황금시간의 의의)

  • Jang, Tae-Chang;Lee, Kyung-Won
    • Journal of Trauma and Injury
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    • v.23 no.2
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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.

Emergency vehicle priority signal system based on deep learning using acoustic data (음향 데이터를 활용한 딥러닝 기반 긴급차량 우선 신호 시스템)

  • Lee, SoYeon;Jang, Jae Won;Kim, Dae-Young
    • Journal of Platform Technology
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    • v.9 no.3
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    • pp.44-51
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    • 2021
  • In general, golden time refers to the most important time in the initial response to accidents such as saving lives or extinguishing fires. The golden time varies from disaster to disaster, but is aimed at five minutes in terms of fire and first aid. However, for the actual site, the average dispatch time for ambulances is 9 minutes and the average transfer time is 17.6 minutes, which is quite large compared to the golden time. There are various causes for this delay, but the main cause is traffic jams. In order to solve the problem, the government has established emergency car concession obligations and secured golden time to prioritize ambulances in places with the highest accident rate, but it is not a solution in rush hour when traffic is increasing rapidly. Therefore, this paper proposed a deep learning-based emergency vehicle priority signal system using collected sound data by installing sound sensors on traffic lights and conducted an experiment to classify frequency signals that differ depending on the distance of the emergency vehicle.

Hospital Arrival Rate within Golden Time and Factors Influencing Prehospital Delays among Patients with Acute Myocardial Infarction (급성심근경색 환자의 증상 발현 후 골든타임내 응급의료센터 도착율 및 지연에 관련된 요인)

  • Ahn, Hye Mi;Kim, Hyeongsu;Lee, Kun Sei;Lee, Jung Hyun;Jeong, Hyo Seon;Chang, Soung Hoon;Lee, Kyeong Ryong;Kim, Sung Hea;Shin, Eun Young
    • Journal of Korean Academy of Nursing
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    • v.46 no.6
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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.

Delayed Transfer of Major Trauma Patients Under the Current Emergency Medical System in Korea (현재의 국내 응급의료체계에서 중증외상환자의 이송 지연)

  • Jung, Kyoung-Won;Jang, Jeong-Moon;Kim, Ji-Young;Baek, Suk-Ja;Song, Seo-Young;Gang, Chan-Suk;Lee, Kug-Jong
    • Journal of Trauma and Injury
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    • v.24 no.1
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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.

Laboratory Studies on the Reproductive Behavior of Red-Striped Golden Stink-Bug, Poecilocoris lewisi Distant (Hemiptera : Scutelleridae) (실내사육에서 광대노린재(Poecilocoris lewisi Distant)의 생식행동)

  • 김남정;설광열
    • Korean journal of applied entomology
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    • v.43 no.2
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    • pp.163-168
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    • 2004
  • Reproductive behavior of the red-striped golden stink-bug, Poecilocoris lewisi Distant, was investigated in a room at 25${\pm}$1$^{\circ}C$, 60${\pm}$5% R.H. and the 16L:8D photo regimen. Mating of adults started on the 9th day after emergence, peaked 84.5% on the 21st day. Mating behavior of this insect was observed as follows : approach, antennal contact, mount, abdominal approach and copulation (end-to-end position). Males were quite active and produced by rubbing their body with the cages while searching for the females. However, the females responded passively during mating. Studios were further carried to see the response of virgin pairs under controlled conditions. It was observed that 69% of pairs succeeded in mating within one hour after the lights were switched on. Females remained unreceptive for 7 days of first mating, however, males were very much positive subject to the availability of virgin females. Although the remating frequency of female was positively correlated with fertility, but a male showed lower fertility as its frequency increased.

Simplistic QA for an Enhanced Dynamic Wedge using the Reversed Wedge Pair Method (역방향 조사방식을 통한 동적쐐기의 품질관리)

  • Lee Jeong Woo;Hong Semie;Suh Tae Suk
    • Progress in Medical Physics
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    • v.15 no.3
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    • pp.161-166
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    • 2004
  • A simplistic quality assurance (QA) method was designed for a Linac built-in enhanced dynamic wedge (EDW), which can be utilized to make wedged beam distributions. For the purpose of implementing the EDW symmetry QA, a film dosimetry system, low speedy dosimetry film, film densitometer and 3D RTP system were used, and the films irradiated by means of a 60$^{\circ}$ Reversed wedge pair (REWP) method. The profiles were then analyzed in terms of their symmetries, including partial treatment, which is the case of stopping it abruptly during EDW irradiation, and the measured and calculated values compared using the Cad Plan Golden Segmented Treatment Table (Golden STT). The result of this experiment was in good agreement, within 1 %, of the 'reversed wedge pair counterbalance effect'. For the QA of the effective wedge factor (EWF), the authors measured EWFs in relation to the 10$^{\circ}$, 15$^{\circ}$, 20$^{\circ}$, 25$^{\circ}$, 30$^{\circ}$, 45$^{\circ}$ and 60$^{\circ}$ EDW, which were compared with the calculated values using the correction factor derived from the Golden STT and the log files produced automatically during the process of EDW irradiation. By means of this method it was capable of check up the safety of effective wedge factor without any other dosimetry system. The EDW QA was able to be completed within 1 hour from irradiation to analysis as a consequence of the simplified QA procedure, with maximized effectiveness. Unlike the metal wedge system, the EDW system was heavily dependent on the dose rates and jaw movements; therefore, its features could potentially cause inaccuracy. The frequent simplistic QA for the EDW is essential, and could secure against the flaw of dynamic treatment that uses the EDW.

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Analysis of Semantic Relations Between Multimodal Medical Images Based on Coronary Anatomy for Acute Myocardial Infarction

  • Park, Yeseul;Lee, Meeyeon;Kim, Myung-Hee;Lee, Jung-Won
    • Journal of Information Processing Systems
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    • v.12 no.1
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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.

Improvement Strategies of Arriving Time to the Scene by Enhancing EMTs' Recognition of Triage (구급출동지령서 개선을 통한 구급대원 현장 도착시간 단축방안)

  • Oh, Won Sin;Joung, Suck Hwan;Yoon, Myong Oh
    • Journal of the Korea Safety Management & Science
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    • v.17 no.1
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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.

A Study on the Improvement of e-Call Services Using V2N(Vehicle to Nomadic Device) Technology (V2N(Vehicle to Nomadic Device) 기술을 이용한 e-Call 서비스 개선에 관한 연구)

  • Choi, Su-min;Shin, Yong-tae
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.10a
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    • pp.321-324
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    • 2018
  • Recently, the evolution of V2X (Vehicle to Everything) technology is accelerating. In particular, it can be seen that C-V2X (Cellular V2X) technology and services combined with mobile telecommunication network are developing rapidly. However, in Korea, e-Call and emergency communication services are inferior to the developed communication technologies and the proportion of vehicles arriving at Golden Hour is considerably low. Therefore, this paper designed the communication architecture with C-V2X and Android operating systems, and presented ways to improve existing e-Call services using V2N (Vehicle to Nomadic Device) communication based on it.

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Feasibility Study for College of Medicine Establishment in Western Region of Chungcheongnam-do (충청남도 서부권 의과대학 설립에 대한 타당성 연구)

  • Kim, Jeong-Koo;Lee, Young-Shin;Kim, Woong-Yi;Yi, Jin-Bok
    • Journal of radiological science and technology
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    • v.43 no.4
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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.