• 제목/요약/키워드: Local emergency department

검색결과 202건 처리시간 0.027초

도심지 토사재해 예방을 위한 기존 매뉴얼 분석과 개선 방안 (Analysis and Improvement for Manual to Protect Mountain Disaster in Urban Area)

  • 송병웅;백우현;윤정환;심우배
    • 한국지반환경공학회 논문집
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    • 제16권7호
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    • pp.43-53
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    • 2015
  • 우리나라는 국토의 70% 이상이 산지로 되어 있어 지속적인 도시화에 따른 산지 개발이 필수불가결한 요소이므로 위험요인에 대한 대응기술 개발이 필수적이며 토사재해 예방을 위한 기준과 매뉴얼 정립이 필요하다. 토사재해와 관련된 국가법령에서는 재난유형에 따라 위기관리 매뉴얼을 작성 운용하게 되어 있지만, 도심지 토사재해에 대한 위기관리 표준매뉴얼, 위기대응 실무매뉴얼 및 현장조치 행동매뉴얼이 아직까지 없는 실정이다. 본 연구에서는 기존의 풍수해 표준 및 실무매뉴얼 분석을 통하여 우리나라법으로 정해져 있는 사항이지만 아직까지 도심지 토사재해 분야에서 명확하게 정립되지 못한 부분에 대한 개선 방안을 제시하고자 한다. 주요 개선 방안은 다음과 같은 7가지로 나타낼 수 있다. 1) 도심지 토사재해에 적용 가능한 매뉴얼 제작이 필요하다. 2) 평상시 주관기관과 유관기관과의 수직적 수평적 상시교류 및 협력이 강화 구축되어 있어야 한다. 3) 개선되는 도심지 토사재해 매뉴얼은 각각의 공무원들이 실제 행동할 수 있는 행동절차(SOP) 매뉴얼이 필요하다. 4) 국민안전처에서 선정한 13가지의 항목을 중심으로 도심지 토사재해에 대한 필요한 항목을 우선적으로 선정해야 한다. 5) 이해할 수 있도록 도식화할 필요가 있다. 6) 주요 항목들을 체크리스트로 만들어서 위급상황 시 실무에 적용되도록 해야 한다. 7) 분기별로 1회 이상의 교육훈련이 필요하다.

Phlegmonous Gastritis with Early Gastric Cancer

  • Kim, Kyung Hee;Kim, Chan Gyoo;Kim, Young-Woo;Moon, Hae;Choi, Jee Eun;Cho, Soo-Jeong;Lee, Jong Yeul;Choi, Il Ju
    • Journal of Gastric Cancer
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    • 제16권3호
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    • pp.195-199
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    • 2016
  • Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the stomach wall, with a high mortality rate. Antibiotics with or without surgical treatment are required for treatment. We present a case in which phlegmonous gastritis occurred during the diagnostic evaluation of early gastric cancer. The patient showed improvement after antibiotic treatment, but attempted endoscopic submucosal dissection failed because of submucosal pus. We immediately applied argon plasma coagulation since surgical resection was also considered a high-risk procedure because of the submucosal pus and multiple comorbidities. However, there was local recurrence two years later, and the patient underwent subtotal gastrectomy with lymph node dissection. Considering the risk of incomplete treatment immediately after recovery from phlegmonous gastritis and that recurrent disease can be more difficult to manage, delaying treatment and evaluation until after complete recovery of PG might be a better option in this particular clinical situation.

Structural Factors of the Middle East Respiratory Syndrome Coronavirus Outbreak as a Public Health Crisis in Korea and Future Response Strategies

  • Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • 제48권6호
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    • pp.265-270
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    • 2015
  • The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system's weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of "control tower" in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.

메틸렌 블루 (Methylene Blue)

  • 유지영
    • 대한임상독성학회지
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    • 제8권1호
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    • pp.1-6
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    • 2010
  • Methylene blue is a very effective reducer of drug-induced methemoglobinemia. It has dose-dependent oxidation or reduction properties. In most cases, a dose of 1 to 2 mg/kg IV given over 5 minutes and immediately followed by a 15- to 30-mL fluid flush to minimize the local pain is both effective and relatively safe. The onset of action is quite rapid, and the effects are usually seen within 30 minutes. The dose may be repeated after 30 to 60 minutes and then every 2 to 4 hours as needed. The total dose should not exceed 7 mg/kg as a single dose or 15 mg/kg within 24 hours. Repeated treatment may be needed for treating compounds that have prolonged elimination or those compounds that undergo enterohepatic recirculation (e.g., dapsone). Methylene blue can cause dose-related toxicity. At high doses, methylene blue can also induce an acute hemolytic anemia and rebound methemoglobinemia. The reasons for treatment failure with methylene blue include ineffective GI decontamination, the existence of other forms of hemoglobin (e.g., sulfhemoglobin), a low or high dose of methylene blue and the toxicokinetics of some agents, such as aniline, benzocaine or dapsone.

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지하시설물 DB의 유지관리를 위한 LBS 시스템 개발 (Developed Location Based Service System for Management of Underground Facilities' DB)

  • 이현직;황창섭;박기석;유지호
    • 한국측량학회:학술대회논문집
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    • 한국측량학회 2004년도 추계학술발표회 논문집
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    • pp.325-333
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    • 2004
  • Since 1995, One of the NGIS(National Geographic Information System) projects, the underground utilities project has been finished in 2003. The 19 cities in korea for this project will use underground utilities management system using underground utilities database focusing on water and sewage system. However, special expert, technical and experience problem in computer environment has not been had in working department for water and sewage management and maintenance for each local government. The management and maintenance of underground utilities database by manual method is getting lowered a data quality of underground utilities database because of the data omitting, error in writing and securing of the lasted database. Therefore, in this study, Application test for field workers using a mobile tool and environment analysis of wireless communication in Korea and application test of GPS receiver for mobile tools had been processed and made a mobile working environment. The efficient management and maintenance method for underground utilities database has been developed an off- line method for modification and update of database about general work which has a high working frequency because of the limitation of wireless communication environment Also, the emergency working has been applied for on-line method.

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Data complement algorithm of a complex sewerage pipe system for urban inundation modeling

  • Lee, Seungsoo;An, Hyunuk;Kim, Yeonsu;Hur, Young-Teck;Lee, Daeeop
    • 농업과학연구
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    • 제47권3호
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    • pp.509-517
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    • 2020
  • Geographic information system (GIS) sewer network data are a fundamental input material for urban inundation modeling, which is important to reduce the increasing damages from urban inundation due to climate change. However, the essential attributes of the data built by a local government are often missing because the purpose of building the data is the maintenance of the sewer system. Inconsistent simplification and supplementation of the sewer network data made by individual researchers may increase the uncertainty of flood simulations and influence the inundation analysis results. Therefore, it is necessary to develop a basic algorithm to convert the GIS-based sewage network data into input data that can be used for inundation simulations in consistent way. In this study, the format of GIS-based sewer network data for a watershed near the Sadang Station in Seoul and the Oncheon River Basin in Busan was investigated, and a missing data supplementing algorithm was developed. The missing data such as diameter, location, elevation of pipes and manholes were assumed following a consistent rule, which was developed referring to government documents, previous studies, and average data. The developed algorithm will contribute to minimizing the uncertainty of sewer network data in an urban inundation analysis by excluding the subjective judgment of individual researchers.

Urosepsis and postrenal acute renal failure in a neonate following circumcision with Plastibell device

  • Kalyanaraman, Meena;McQueen, Derrick;Sykes, Joseph;Phatak, Tej;Malik, Farhaan;Raghava, Preethi S.
    • Clinical and Experimental Pediatrics
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    • 제58권4호
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    • pp.154-157
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    • 2015
  • Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

An unusual abscess formation in the masticator space after acupressure massage: a case report

  • Ko, In-Chan;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Bae, Jung-Ho;Lee, Kwon-Woo;Chin, Young-Jai
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제41권1호
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    • pp.52-56
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    • 2015
  • Clinical features of masticator-space abscess (MSA) are very similar to those of parotitis or temporomandibular disorder (TMD), making early differential diagnosis difficult. Local causes of MSA include nerve block anesthesia, infection after tooth extraction, and trauma to the temporomandibular joint (TMJ); the systemic cause is immunodeficiency. Odontogenic causes account for most etiologies, but there are also unusual causes of MSA. A 66-year-old male patient visited the emergency room (ER) presenting with left-side TMJ pain three days after receiving an acupressure massage. He was tentatively diagnosed with conventional post-trauma TMD and discharged with medication. However, the patient returned to the ER with increased pain. At this time, his TMD diagnosis was confirmed. He made a third visit to the ER during which facial computed tomographic (CT) images were taken. CT readings identified an abscess or hematoma in the left masticator space. After hospitalizing the patient, needle aspiration confirmed pus in the infratemporal and temporal fossa. Antibiotics were administered, and the abscess was drained through an incision made by the attending physician. The patient's symptoms decreased, and he was discharged.

Implementation and Results of a Survey on Safe Community Programs in Gangbuk-gu, Korea: Focusing on Participants at a Local Public Health Center

  • Kim, Hyun-Joong;Hwang, Se-Min;Lee, In-Young;Cho, Joon-Pil;Kwon, Myoung-Ok;Jung, Jae-Hun;Byun, Ju-Young
    • Journal of Preventive Medicine and Public Health
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    • 제47권1호
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    • pp.47-56
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    • 2014
  • Objectives: The purpose of this study was to investigate the current status of and problems with the Safe Community Programs in Gangbuk-gu, one of the 25 districts of the capital city of Korea. Methods: The study subjects were 396 individuals who were involved in Safe Community Programs between 2009 and 2011. We examined the effectiveness and willingness of respondents to participate as a safety leader of the Safe Community Program with a questionnaire. We examined the injury death rates of Gangbuk-gu by using of the death certificate data of Korea's National Statistical Office. Descriptive statistics and chi-squared tests were used. Results: The effectiveness of programs did not differ but active participation differed significantly among subjects (p<0.05). The injury death rate of Gangbuk-gu as a whole increased during the implementation period. However, senior safety, in particular, may be a helpful program for reducing injuries in Gangbuk-gu. Conclusions: This study suggests that the lack of active participation may be a major problem of Safe Community Programs in Gangbuk-gu. Therefore, Safe Community Programs should be expanded to the entire district of Gangbuk-gu and more active participation programs should be developed.

급성 경막하 혈종에서 응급 두개골 천공의 위치 (Emergency Trephination Site of Acute Subdural Hematoma)

  • 문수현;김근회;권택현;박윤관;정흥섭;서중근
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.659-663
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    • 2000
  • The motality rate of acute subdural hematoma(ASDH) associated with closed head injury is high in spite of recent advances in neurosurgery. Many variables in regard to outcome of ASDH have been assessed. But among them, intracranial pressure(ICP) control and the time interval between injury and operative evacuation are the only things that can be affected by doctor. We introduced a simple method to the management of ASDH for reducing the time interval between injury and operation. When the immediate decompressive operation of ASDH was impossible by any causes, we made a burr hole at the center of hematoma, usually on 2-3cm above temporal squama and 1-2cm behind coronal suture under local anesthesia before main operation. Partial hematoma evacuation was achieved through the burr hole and it was effective in preventing further worsening of patients neurological status before main operation. Prompt hematoma evacuation through the burr hole seemed to be effective in delaying secondary ischemic brain damage and made easy to closing the dura opening and replacement of the bone flap at the end of main decompressive operation. This easy method may reduce the time interval between injury and operation. We represent surgical technique with two cases of ASDH managed with this simple method.

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