• 한국응급구조학회지
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• 제2권1호
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• pp.58-72
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• 1998

This study is implemented in the Department of Emergency Medical Technology of the Cheju Halla College in to evaluate behavioral changes in the recognition of the importance of the first aid, coping ability in the field, and competence of the first aid skills after taking the in-service program. The in-service program was hold from December 14 to December 22, 1998 under the title of "1998 First Aid and Emergency Rescue Training" for 176 drivers. The Questionnaire was distributed to 176 drivers, among them, 88 drivers took in-service program and 88 ones did not. After the data analysis, following conclusions we re made. 1. There are no significant statistical differences among demographic factors such as the level of education, age, career, and marital state of the subjects in the recognition of the importance of the first aid and competence of the first aid skills. 2. The drivers, who were the in-service program, significantly higher score in educated in represented all the area of recognition of the importance of first aid than non-educated drivers. 3. The drivers, who were educated in the in-service program, showed also significantly high score in competence of the first aid skills. According to the conclusions, there were significant change made In the recognition of the importance of the first aid and competence of the first aid skills after the in-service program. Therefore, nationwide emergency training program should be considered to improve emergency care ability of the nation. To make the program more effective for drivers, the in-service program should be required to newly licensed drivers during orientations or licence issuing.

• 지역사회간호학회지
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• 제30권4호
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• pp.581-587
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• 2019

Purpose: Abdominal pain is the most common symptom of patients visiting the emergency department (ED). Abdominal pain is caused by a variety of causes, so it is difficult for a triage nurse to determine the urgency of a patient, but it is still a must. The purpose of this study was to identify the related factors to the urgent diseases of patients with abdominal pain visiting ED. Methods: This study was a retrospective descriptive study. The study setting was an ED in a tertiary hospital in Korea. Data were collected from September 1, 2017 to October 15, 2017. During the study period, of a total of 6,181 patients visiting the ED, 731 complained of abdominal pain. Patients with obvious cause of pain and patients who could not express detailed symptoms were excluded. The 573 patients were included in the final analysis. We collected demographics, clinical characteristics, and final diagnosis. We divided final diagnoses into urgent diseases which were more likely to be life-threatening without treatment and non-urgent diseases. We identified the related factors to the urgent diseases of patients with abdominal pain using the logistic regression. Results: 173 (30.2%) patients had urgent diseases. Age (OR=1.02, 95% CI=1.00~1.03), referral from other clinics (OR=2.92, 95% CI=1.86~4.60), ambulance utilization (OR=2.00, 95% CI=1.27~3.15), diarrhea (OR=0.44, 95% CI=0.25~0.76), and tachycardia (OR=2.27, 95% CI=1.44~3.58) were related to urgent diseases. Conclusion: Triage nurse should take into account the patient's age, mode of visiting, and route of visiting ED; and check the symptom of tachycardia or diarrhea.

• 한국통신학회논문지
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• 제34권10A호
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• pp.796-806
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• 2009

본 논문에서는 모바일 자동재난경보방송을 위하여 T-DMB 기반의 재난 정보 운영 방법과 이를 위한 T-DMB AEAS 수신 모델에 대하여 제안한다. 제안한 수신 모델에서는 T-DMB 방송 신호에 포함된 지리 정보와 DMB 신호를 전송하는 기지국의 위치 정보를 비교함으로써 현재 사용자 수신 지역을 재난지역, 인접지역 및 미경보지역으로 구문한 다음 각 지역에 따라 재난경보를 전송한다. 이 때 재난지역의 지리정보는 T-DMB 방송 신호 내에 FIG 5/2 EWS의 AEAS 메시지 내에서 얻어지며, DMB 기지국 위치 정보는 FIG 0/22의 TII 신호 내에 주 식별자와 보조 식별자의 위도 및 경도 정보와 TII 배분표를 이용하여 예측된다. 본 실험에서는 제안한 수신 모델을 화면부, 저장부, 방송 수신 모듈에 해당되는 DMB 모듈 및 제어부로 나누어 구현한 다음, T-DMB 신호발생기를 이용한 테스트 재난경보방송을 수행하였다.

• 대한임상독성학회지
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• 제18권2호
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• pp.94-101
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• 2020

Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.

• Journal of Digestive Cancer Research
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• 제9권2호
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• pp.43-49
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• 2021

Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권12호
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• pp.5835-5854
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• 2017

The implementation of IEEE 802.15.6 in Wireless Body Area Network (WBAN) is contention based. Meanwhile, IEEE 802.15.4 MAC provides limited 16 channels in the Superframe structure, making it unfit for N heterogeneous nature of patient's data. Also, the Beacon-enabled Carrier-Sense Multiple Access/Collision-Avoidance (CSMA/CA) scheduling access scheme in WBAN, allocates Contention-free Period (CAP) channels to emergency and non-emergency Biomedical Sensors (BMSs) using contention mechanism, increasing repetition in rounds. This reduces performance of the MAC protocol causing higher data collisions and delay, low data reliability, BMSs packet retransmissions and increased energy consumption. Moreover, it has no traffic differentiation method. This paper proposes a Low-delay Traffic-Aware Medium Access Control (LTA-MAC) protocol to provide sufficient channels with a higher bandwidth, and allocates them individually to non-emergency and emergency data. Also, a Contention Differentiated Adaptive Slot Allocation CSMA-CA (CDASA-CSMA/CA) for scheduling access scheme is proposed to reduce repetition in rounds, and assists in channels allocation to BMSs. Furthermore, an On-demand (OD) slot in the LTA-MAC to resolve the patient's data drops in the CSMA/CA scheme due to exceeding of threshold values in contentions is introduced. Simulation results demonstrate advantages of the proposed schemes over the IEEE 802.15.4 MAC and CSMA/CA scheme in terms of success rate, packet delivery delay, and energy consumption.

• 대한임상독성학회지
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• 제17권1호
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• pp.14-20
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• 2019

Purpose: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. Methods: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. Results: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. Conclusion: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

• 한국응급구조학회지
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• 제26권1호
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• pp.71-85
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• 2022

Purpose: This study aimed to investigate the current status of non-face-to-face education at universities for paramedicine and measure students' education satisfaction after the coronavirus infectious disease 2019 (COVID-19) outbreak. Methods: A cross-sectional survey was conducted for paramedic students at the Chungcheong and Honam areas using Google Forms. Convenience sampling was used. A structured questionnaire was created and modified according to Park and Choi's test tool developed to review online lectures and practical courses. Results: A total of 202 students responded to the survey. The satisfaction level of online lectures was 3.06±1.12 (n=202) out of 5. Students experiencing online lectures responded that it was difficult to focus on the class, and the overall quality and lecture delivery should be improved. They also experienced technical difficulties. The satisfaction level of practical course lectures was 3.24±1.04 (n=133) out of 5. It was higher than those of other types of classes because it was conducted by the more familiar face-to-face lecture. Conclusion: This study has shown that the universities and instructors have examined a variety of methods in paramedic education after the COVID-19 pandemic. However, further research and consideration are required to improve paramedic education during the COVID-19 pandemic.

• 대한임상독성학회지
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• 제18권2호
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• pp.57-65
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• 2020

Purpose: Since 2012, acetaminophen can be accessed easily not only at pharmacies but also at convenience stores. The relationship between the easy access of acetaminophen and the risk of poisoning has been controversial. Several studies also reported different results regarding the risk of acetaminophen poisoning after access to acetaminophen was relaxed. This study examined the long-term effects on the risk of acetaminophen poisoning after easy access to acetaminophen was implemented. Methods: This was a retrospective analysis of an emergency department (ED)-based in-depth Injury Surveillance Cohort by the Korea Center for Disease Control and prevention from 2011 to 2018. Poisoning cases were selected from the Cohort, and the incidence of acetaminophen poisoning and the characteristics of the cases of acetaminophen poisoning were analyzed. The purchase path and the amount of ingestion in acetaminophen poisoning were sub-analyzed from data of six EDs. Results: Of 57,326 poisoning cases, 4.0% (2,272 cases) were acetaminophen poisoning. Of 2,272 cases of acetaminophen poisoning, 42.8% (974 cases) required in-patient care after ED management. Two hundred and sixty-four of these 964 cases required intensive care. The rates of cases that required in-patient treatment and the rates of cases that required intensive care increased from 29.4% in 2011 to 48.1% in 2018, and from 3.1% in 2011 to 15.2% in 2018, respectively (p<0.001, p<0.001). In the poisoning group with in-depth toxic surveillance (n=15,908), the incidence and proportion of acetaminophen (AAP) poisoning increased from 55 cases per year to 187 cases per year and 4.9% to 6.1%, respectively (p=0.009, p<0.001, respectively). The most common age group of acetaminophen poisoning was teenagers, which is different from the most common age group of other pharmaceutical agents: the middle age group of 40-49 years (p<0.001). Of 15,908 in-depth toxic surveillance patients, 693 patients had AAP poisoning, of whom 377 cases (54.2%) purchased acetaminophen from a non-pharmacy. The proportions of the purchase path from non-pharmacy were 41.4% at 2011-12 and 56.4% (2013-18) (p=0.004). The amount of acetaminophen ingestion was 13.5±14.3 g at 2011-12 and 13.9±15.1 g at 2013-18 (p=0.794). Conclusion: Although the incidence of acetaminophen poisoning did not increase remarkably in the short term after the implementation of the new regulation, the incidence of acetaminophen poisoning has increased slightly during the study period of 2017-18. In addition, the proportion of the purchase path from non-pharmacies has increased since the emergence of new regulations for the easy access of acetaminophen in 2012. The incidence of acetaminophen poisoning might have been affected after the increasing accessibility of acetaminophen in convenience stores. Continuous control of acetaminophen poisoning is required. Furthermore, the prevention of acetaminophen poisoning should be focused on teenagers with specialized school education programs.

• 한국응급구조학회지
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• 제17권3호
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• pp.139-147
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• 2013

Purpose: The purpose of the study is to confirm the effect of ACLS program using simulations and understanding self-efficacy, practice satisfaction, learning attitude, and interest in ACLS after theory classes and simulation-based practice. Methods: A non-equivalent simulation-based practice post test design was used. The participants were 28 paramedic students. The students participated in simulation-based practice for 3 weeks and conventional instruction class for 12 weeks. Results: The students showed higher level of self-efficacy(p=.043), practice satisfaction(p<.001) and learning attitude(p=.003) compared to the conventional lecture students. Conclusion: Level of self-efficacy after simulation-based practice for ACLS was higher than that of self-efficacy after conventional instruction classes. Level of practice satisfaction was also higher. Academic achievement after simulation-based practice was higher than that in conventional instruction classes.