• 시큐리티연구
• /
• 제42호
• /
• pp.229-249
• /
• 2015

탈냉전과 세계화의 추세로 테러리즘, 범죄, 환경재난, 인종갈등, 경제위기, 사이버테러, 질병, 에너지 등의 비안보적인 안보의 문제들이 인류와 국가를 위협하며 변화를 요구하고 있다. 또한 이 시대에 맞춰서 국가의 역할이 점차적으로 확대되면서 최대의 국가론이 부상하였다. 이처럼 현대사회는 복지국가의 실현이라는 목표 구현을 위하여 모든 국가가 '작은 정부론'에서 '큰 정부론'의 국가관으로 변화하게 된 것이다. 이와 같이 각종 범죄와 치안 유지 및 신종재난과 테러의 위협, 인간안보의 개념 등 외부의 침입뿐만 아니라 포괄적인 국민의 안전과 보호를 위해 안보의 개념을 종합적으로 넓게 해석해야 할 것 같다. 이러한 시대에 맞추어 국내적으로는 천안함, 연평도, 구제역, DDos 테러, 해적 피랍, 광우병, 조류독감 등과 남북관계의 인도적 지원과 남북 정상회담의 추진이 답보상태에 빠져 있다. 그에 따른 국가위기 대응체제와 종합적인 위기관리센터, 컨트롤 타워, 안보조직체계, 일반 국민들과의 협력기반, 법률적, 제도적 체제의 구축이 종합적으로 이루어져야 한다. 그에 따라 한국의 국가안보 및 테러, 위기관리 체계와 선진국인 미국 안보, 위기관리의 체제를 비교하여 앞으로 한국의 발전적인 국가안보 위기관리체제를 재정립하고 새로운 방향모색을 하고자 하는데 본 연구의 의의가 있다고 할 수 있다. 또한 각 정부부처의 다양한 법령과 행정조직이 제각각 분산되어 있어 통합적으로 효율적 기능을 발휘할 수 있는 상위법 제정, 가칭 테러방지법의 입법 제정이 필요하다고 사료된다.

• 한국안전학회지
• /
• 제27권3호
• /
• pp.77-82
• /
• 2012

The leakage of toxic chemicals impact seriously on human being and environment, therefore during their treatment process, a proper management system is necessary to control their toxic effect. This study was designed to suggest the management regulation that supports business managers and facilities management. There are no extra regulation to control emergency accidents and terrors in chemical facilities. Developed countries like USA operate the management standards to control the toxic chemical and facilities according to their toxicity and processes. In order to solve this problem, we have analysed the advanced nations standard methods of security in chemical plants to study the new security management regulation which helps to prevent the chemical accidents. Especially, in USA, CCPS (Center for Chemical Process Safety), SVA (Security Vulnerability Assessment) and RBPSs (Risk-Based Performance Standards) of DHS (Department of Homeland Security) were invest I gated. On the basis of the results, we have suggested the application methods of the security and safety regulation in Korea.

• 대한임상독성학회지
• /
• 제10권1호
• /
• pp.22-32
• /
• 2012

Purpose: The purpose of this study was to examine the occurrence of toxic exposure cases in Korean emergency centers using a toxic exposure surveillance system-based report form and to provide guidelines for the prevention and treatment of toxic exposures. Methods: We retrospectively reviewed the medical records of toxic exposure patients who had visited emergency centers from January 2009 to December 2009. Epidemiology data points for the toxic exposure cases included age, gender, type of exposure, number and kind of substances involved, reason and route of poison exposure, management of the patients in the emergency departments, and the clinical outcome. Results: A total of 3,501 patients from 12 emergency departments were enrolled in the study. 50.0% of the total exposure patients were male and 63.0% of the total cases were fatal. Acute intoxication occurred in 91.3% of the total patients and suicidal intent was the most common (43.3%) reason for exposure. The most common route of exposure was ingestion (75.9%). Of the total cases, pesticides were involved in 26.3%, sedatives/hypnotics/antipsychotics were involved in 22.0%, and bites and envenomations were involved in 15.7%. Conclusion: We provided a database of patients who were admitted to emergency departments after poisoning incidents. We recommend that toxicology professionals develop a classification scheme for toxicants which is adequate for Korean domestic circumstances and initiate a toxic surveillance system for all types of exposures. With support of a psychiatric surveillance system for suicidal patients and establishment of social mediation for pesticide poisoning, major reductions in poison exposures can be achieved.

• 한국응급구조학회지
• /
• 제13권2호
• /
• pp.17-59
• /
• 2009

Purpose : This study is to provide the basic data for developing the curriculum standardization of emergency medical technology by analyzing the three-year and four-year period curriculum and high-advanced major course to bring up highly qualified paramedics. Method : This study was analyzed, divided in 3 sections, majors, teaching profession subjects and liberal arts of 18 three-year curriculum universities and 7 four-year curriculum universities. Majors were analyzed, departmentalized in the national examination for license, the clinical and on-the-job training(OJT) and other major-related subjects. It is descriptive study, analyzed by dividing high-advanced major course into majors and liberal arts. Result : 1) The average number of subjects established in three-year-course college were 58.1. The completion credit was 130.1 in average. Also, the average number of established subjects at four-year-course were 61.1. The average completion credit was 141. 2) Three-year-course college professors give lecture in theory for 95.4 hours on average, which account for 59.9% of overall lecture, and 63.8 hours for practical training that takes 40.1% of the hours lectures are given. Meanwhile, four-year-course give lecture in theory for 111 hours on average, taking a part of 59.5%, and 76.5 hours for practical training, 40.5%. 3) In regard to liberal arts, at three-year-course college, the average credit was 16 but the proportion that liberal arts charge among the completion credit was 11.6. Meanwhile, at four-year-course universities, the average credit was 28.4 and the percentage that the liberal arts took part in the completion credit was 20.1. 4) Looking over national examination subjects among majors at three-year-course college, basic medicine's average credit was 17.2, introduction to advanced emergency care's average credit was 15.5, Special advanced emergency care's average credit was 28, emergency patient management's average credit was 9.2 and emergency medicine statute's average credit was 3.6. Meanwhile, in case of four-year-course universities, basic medicine's average credit was 14.3, introduction to advanced emergency care's average credit was 12.7, special advanced emergency care's average credit was 31, emergency patient management's average credit was 8.3 and emergency medicine statute's average credit was 2.9. 5) Among national examination subjects, in case of three-year-course, the range of basic medicine credits was 6 to 23, the average credit showed 17.2. The range of introduction to advanced emergency care credits was 9 to 21, the average credit showed 15.5. The range of special advanced emergency care credits was 19 to 36, the average credit showed 28. The range of emergency patient management credits was 5 to 12, the average credit was 9.2. The range of legal medicine credits was 3 to 6, the average was 3.6 credit. In case of four-year-course the range of basic medicine was 12 to 17, the average of the credit was 14.3. The range of introduction to advanced emergency care was 9 to 19, and the average of the credit was 12.7. The range of special advanced emergency care was 18 to 41, and the average of the credit was 31. The range of emergency patient management was 7 to 12, and the average of the credit was 8.3. The range of legal medicine was 3 to 4, and the average of the credit was 2.9. So except special advanced emergency care, all the other subjects had higher score in three-year-course than four-year-course. 6) About the other major-related subjects, the completion credit was 23 on average at three-year-course and 13.5 at four-year-course. 7) The clinical and on-the-job training(OJT), In the case of three-year-course, the average completion credit was 13.5 and 13.5 at four-year-course. 8) The teaching profession subject, In the case of three-year-course, the average credit was 3 and the percentage that the teaching profession subject took part in the completion credit was 2.3% on average. Four-year-course established the subject only at one university. 9) In high-advanced major process, the entire established subjects on average were 12.8 and the average completion credit was 36.3. In liberal arts, the average established subjects were 6.5 and the completion credit was 19.5. The number of majors were 9.5 on average and the credit was 26.5 Conclusion : According to the aforemention results, the curriculum for emergency medical technology needs to be developed and standardized.

• Journal of Trauma and Injury
• /
• 제25권3호
• /
• pp.72-78
• /
• 2012

Purpose: Clinical observation and research findings show that acute traumatic coagulopathy (ATC) is a major factor that must be addressed in the early care of severe trauma patients. ATC is associated with increased transfusion requirements and poor clinical outcomes. This study aimed to correlate the early predictable factors of ATC with the outcomes in severe trauma patients. Methods: Retrospective data from the trauma registry on severe trauma patients (Injury Severity Score (ISS) ${\geq}16$) were used to identify variables independently associated with coagulopathy. Univariate associations were calculated, and a multivariable logistic regression analysis was used to determine variables independently associated with ATC. Results: Patients were mostly male, aged $51.9{\pm}17.8$ years, with an injury severity score of $24.1{\pm}12.4$. ATC, as diagnosed in the emergency department (ED), occurred in 17% of the severe trauma patients. Using a multivariable logistic regression analysis, early predictable variables independently associated with ATC were base deficit (odds ratio (OR): 13.03; 95% confidence interval (CI): 3.47-48.93), acute liver injury (OR: 4.24; 95% CI: 1.06-17.00), and transfer from another hospital (OR: 21.00; 95% CI: 3.23-136.60). Conclusion: ATC is associated with mortality in severe trauma patients, and some variables associated with trauma and shock are an independent predictors of ATC. These variables contribute to the early recognition and management of coagulopathy, which may improve the outcome from trauma resuscitation.

• 한국응급구조학회지
• /
• 제22권3호
• /
• pp.101-115
• /
• 2018

Purpose: This study aimed to provide fundamental data for the development of a human management strategy depending on the followership type in 119 EMTs. Methods: The subjects were thirty eight 119 EMTs working out of hospital in Y, D, S, G city. Data were collected from June 25 to August 10, 2017. The Q sample was selected as 40 statements in total and analyzed using the PC QUANL program. Results: As a result of the study, three followership types explained 67.59% of all the variables. Three different types were identified from the examination. The types were labeled as 'Responsible helper type', 'Quick response type', and 'Enterprising self-development type'. Conclusion: For each type, a leader and follower should develop a team management strategy for 119 EMTs to provide high-quality emergency medical services.

• 한국건설관리학회논문집
• /
• 제18권6호
• /
• pp.38-46
• /
• 2017

최근 전 세계적으로 다양한 유형의 재난이 발생하고 있으며, 재난으로 인한 피해를 최소화하기 위한 재난관리 체계구축의 중요성이 대두되고 있다. 국내에서도 마우나리조트, 세월호 사건 이후 국민안전처 신설, 국가안전관리기본계획 발표 등 재난안전과 관련하여 많은 정책적 개선을 추진하였으며, 재난거점병원을 확충하는 등 시설 확보에도 많은 노력을 기울였다. 그러나 미국, 유럽, 일본 등 선진국과 비교하여 인구 당 응급의료시설이 부족한 실정이며, 재난 시 다양한 기관의 미흡한 협조체계로 효율적 재난관리가 이행되지 못하고 있는 실정이다. 따라서 본 연구에서는 재난상황에 요구되는 응급의료시설의 효율적 구축과 체계적 운영방안을 제시하고자 하며, 이를 위해 선진국 대비 국내 응급의료시설의 현황을 파악하고, 재난현장 응급의료시설 유형 및 상황별 구축 방안을 제시하고자 한다.

• Journal of Chest Surgery
• /
• 제49권2호
• /
• pp.130-133
• /
• 2016

The rupture of an internal mammary artery (IMA) aneurysm in a patient with type 1 neurofibromatosis (NF-1) is a rare but life-threatening complication requiring emergency management. A 50-year-old man with NF-1 was transferred to the emergency department of Kyungpook National University Hospital, where an IMA aneurysmal rupture and hemothorax were diagnosed and drained. The IMA aneurysmal rupture and hemothorax were successfully repaired by staged management combining endovascular treatment and subsequent video-assisted thoracoscopic surgery (VATS). The patient required cardiopulmonary cerebral resuscitation, the staged management of coil embolization, and a subsequent VATS procedure. This staged approach may be an effective therapeutic strategy in cases of IMA aneurysmal rupture.

• 중환자간호학회지
• /
• 제10권3호
• /
• pp.41-52
• /
• 2017

Purpose : This concept analysis identified attributes and defined triage competency among emergency nurses. Method : Walker and Avant's approach was used to guide the concept analysis. A literature review was completed including 26 studies, 5 reports of related associations, and 5 books. Results : The concept of triage competency in emergency nurses was identified as five attributes: clinical judgment, expert assessment, management of medical resources, timely decision, and communication. Antecedents of the concept were triage education and emergency room experience. The consequences of the concept were efficiency of care, patient rating, and safety. Triage competency in emergency nurses was defined as the comprehensive ability to prioritize patients' urgency and allocate limited medical resources. Conclusion : This study is meaningful since it clarified triage competency among emergency nurses. The attributes and empirical indicators of this study will likely lay the foundation for development of triage competency metrics.

• Clinical and Experimental Emergency Medicine
• /
• 제5권4호
• /
• pp.272-277
• /
• 2018

Objective While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance. Methods The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively. Results During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39). Conclusion Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.