• 한국통신학회:학술대회논문집
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• 한국통신학회 2004년도 하계종합학술발표회논문초록집
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• pp.171-171
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• 2004

• 한국응급구조학회지
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• 제24권1호
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• pp.25-36
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• 2020

Purpose: We analyzed the characteristics and differences in patients' medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

• 대한임상독성학회지
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• 제2권2호
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• pp.90-95
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• 2004

Purpose: The purpose of this study is to compare the toxicologic characteristics of two groups of patients with acute intoxication for two different time periods and to make recommendations based on the results of this study. Methods: We reviewed retrospectively the medical records of patients with acute intoxication in our emergency center from June 1997 to May 1998 (group A) and from June 2000 to May 2003 (group B), and we evaluated differences in the epidemiologic and the toxicologic characteristics between the two groups. Results: The ratios of the number of patients with acute intoxication to the total numbers of patients who visited our emergency department were $0.49\%$ and $0.52\%$ for groups A and B, respectively. In both groups many poisoned patients visited our emergency center from 4:00 pm to midnight. The interval between the time of intoxication and arrival at the hospital was significantly shorter in group B. The number of patients transferred to our emergency center was larger in group B. Attempted suicide was the major cause of acute intoxication in both groups. Major toxic substances in both groups were centrally active drugs and insecticides. The number of comatose and mechanically ventilated patients was larger in group B. However, there was no statistically significant difference in the mortality rates. Conclusion: Emergency physicians who manage intoxicated patients should recognize regional characteristics and differences in the toxicologic characteristics of poisoning. In addition, the establishment of a poisoning control center in the regional emergency center is necessary to integrate data control and to enhance specialized management of intoxicated patients.

• Spatial Information Research
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• 제12권2호
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• pp.193-209
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• 2004

본 연구는 응급환자의 의료기관 이용 현황자료를 토대로 GIS를 이용하여 응급의료 진료권을 분석하는데 목적을 두었다. 진료권을 분석하기 위해 6개 응급의료센터를 사례로 선정하여 2003년 9-11월까지 내원한 환자의 주소 자료를 수집하였다. 해당 응급의료기관을 중심으로 하여 거리에 따른 내원환자의 분포 비율을 산출하여 진료권을 분석한 결과 해당 응급의료센터와 인접한 지역에 거주하고 있는 환자의 비율이 가장 높게 나타났다. 그러나 6개 응급의료센터의 1차 진료권의 범위는 상당한 차이를 나타내었는데, 이는 병상 규모 뿐만 아니라 인지도와 환자들의 선호도 등에 따라 응급의료센터의 진료권역이 달라짐을 말해준다. 본 연구에서는 서울시 응급의료 서비스의 공급 표면도를 구축하는 방법을 모색하였다. 32개 응급의료센터로 부터 거리에 따른 내원환자의 분포 비율을 가중치로 부여하여 거리조락에 따른 공급력 수준을 나타내는 개개의 커버리지를 구축한 후, 이를 지도 대수 연산을 통해 합성하였다. 이렇게 구축된 응급의료 서비스의 공급 표면도를 통해 응급의료 서비스 공급 수준은 공간상에서 상당한 차이가 나타나는 것으로 파악되었다.

• 대한임상독성학회지
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• 제12권2호
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• pp.54-62
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• 2014

Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

• 한국응급구조학회지
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• 제25권3호
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• pp.71-80
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• 2021

Purpose: The purpose of this study is to investigate the characteristics and appropriateness of the Korean-type severity classification by ambulance based on the medical records of 43,561 emergency patients who were brought to the emergency medical center via ambulance between January 1, 2015 and December 31, 2017. Methods: This study analyzed the classification characteristics of the Korean severity classification tool by applying them to emergency patients who visited the emergency medical center. Results: As a result of the study first, among the categories of home hospitals according to the results of visits, "other," "low consciousness," and "dyspnea" in the order of 129 ambulances were statistically significantly higher. In the order of "low consciousness" and "trauma," the "trauma" category was 5.3% higher than that of 129 ambulances. Conclusion: Among the classification items, "others," "low consciousness," and "dyspnea" were significantly higher in the group of patients who boarded 129 ambulances, and "others," "low consciousness," and "traumatic" were significantly higher in the 119 ambulances.

• 대한임상독성학회지
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• 제5권1호
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• pp.61-66
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• 2007

Trichloroethylene (TCE) is an unsaturated chlorinated hydrocarbon in the form of a colorless, volatile liquid, which is used as an industrial organic solvent for spot removal and for metal degreasing. In general, the primary complications of TCE poisoning result from involvement of the central nervous and respiratory systems, including aspiration pneumonia. A case is reported of a 54-year-old man who presented in a comatose state after accidental ingestion of 100 ml of TCE, and who recovered after conservative treatment and mechanical ventilation. We discuss this case and present a literature review.

• 대한응급의학회지
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• 제29권6호
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• pp.578-584
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• 2018

Objective: This study examined the initial partial pressure of carbon dioxide ($PCO_2$) as a possible indicator of prehospital ventilation and its association with prehospital i-gel in out-of-hospital cardiac arrest (OHCA) patients. Methods: The demographics and arrest parameters, including i-gel insertion and initial arterial blood gas analysis, of OHCA patients who visited the emergency department were analyzed retrospectively. Linear regression analysis was performed to examine the association between i-gel insertion and the initial $PCO_2$. Results: A total of 106 patients were investigated. Fifty-six patients had prehospital i-gel insertion and 50 patients did not have a prehospital advanced airway. The initial $PCO_2$ was higher in the i-gel group than the no advanced airway group (105.2 mmHg [77.5-134.9] vs. 87.5 mmHg [56.8-115.3], P=0.03). Prehospital i-gel insertion was associated with a higher initial $PCO_2$ level (${\beta}$ coefficient, 20.3; 95% confidence interval, 2.6-37.9; P=0.03). Conclusion: Prehospital insertion of i-gel was associated with higher initial $PCO_2$ values in OHCA patients compared to no advanced airway.

• 보건행정학회지
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• 제2권2호
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• pp.152-178
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• 1992

This study focuses on making recommendations for the improvement of poor emergency medical services or EMS in Korea. Problems of the current EMS system is widely reviewed. As an alternative of the current system, a franchises system is introduced to EMS. A feasibility study of the new system is carried out as follows. 1) The current EMS system shows such problem as; - Inadequacy of emergency medical fee schedule, - Shortage of emergency medical resources, - Concentration of emergency medical facilities in metropolitan area, - Unestablishment of training program for emergency personnel, - Inappropriateness of patients' behvaviro pattern in emergency care system. 2) Recommendations for the improvement of EMS are as follows: - Well organized communication and transportation system needs to be established by utilizing all the availabl EMS is to be devised for the provision of appropriate emergency care. - A franchises system can be widly adopted so that private organizations are willing to establish a free standing emergency center. - Emergency care fee schedule of the franchises system needs to be appropriate for the system to provide high standard medical services.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.119-126
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• 2005

Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.