• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.126-131
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• 2019

Purpose: Herbicide-related mortality has decreased since the complete ban of paraquat product sales in 2012, but there still have been other herbicides intoxications with relatively severe complications. Glyphosate and glufosinate herbicides are used widely, and considerable research has been conducted. Chlorophenoxy herbicide is another major herbicide that has shown poor outcomes and mortality without proper management, but research in this area is lacking. Therefore, this study compared the clinical features of chlorophenoxy herbicide with those of other herbicides. Methods: The medical records of patients exposed to herbicides at a tertiary academic university hospital in Korea from May 2014 to April 2019 were reviewed retrospectively. The demographic and clinical data of 135 patients were then analyzed to identify the recent herbicides intoxication trends after the paraquat sales ban, focusing mainly on chlorophenoxy herbicide poisoning. Results: Of the 135 patients, 13 patients (9.6%) had chlorophenoxy herbicide poisoning. No significant differences in all the variables were observed between the chlorophenoxy herbicide poisoning group and non-chlorophenoxy herbicides poisoning groups. Toxic symptoms after poisoning varied from nothing noticeable to confusion; none of the patients had severe complications after their treatments. Conclusion: Acute chlorophenoxy poisoning is relatively less severe, with lower mortality rates than glyphosate and glufosinate poisoning.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.81-92
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• 2021

Purpose: The aim of the study is to measure the quality of cardiopulmonary resuscitation (CPR) and the fatigue of rescuers wearing PPE (Level D) during a CPR session and to ultimately provide suggestions of safety standards for rescuers. Methods: 36 subjects were enrolled in the study. The subjects were divided randomly into three groups of two-members, three-members, and four-members. Each group performed CPR for 30 minutes. Blood lactate concentration, heart rate, rating of perceived exertion, chest compression depth and rate were measured before experiment and after each cycle. Results: There was a difference in the blood lactate concentration during CPR cycle by member of shifts (p=.014). The blood lactate concentration increased during CPR (p=.000). Subjective fatigue was a significant difference of chest compression in cycles 3, 4, and 5 for the member of shifts during CPR (p=.049, p=.009, p=.015). Depth and rate of chest compression were not different for the member of shifts during CPR. Conclusion: It is necessary to establish standards for the member of shifts during CPR, to reduce the fatigue of rescuers.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.130-137
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• 2022

Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.213-234
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• 2003

The purposes of this study which was done by questionnaire survey and case study of First Aid Certification Program in Seoul Health College were to analyze results and effects of the college financial support program from Ministry of Education & Human Resources Development. The significant 164 data were collected from 300 professors in 8 colleges having the Department of Emergency Care from Oct. 1, 2002 to Dec. 31, 2002 and analyzed using SPSS in terms of t-test, ANOVA, Pearson's correlation coefficient and so on. The conclusions and suggestions from this study were summarized as follows; (1) Degree of acknowledgement about aims, contents, results of the college financial support program was above the middle(participants 4.21, non-participants 3.63) and higher relation than the others in case of participants(r:0.32 p<0.001), planning team(r:0.22 p<0.05). (2) Degree of acknowledgement about improvement of curriculum & educational facilities through the program was above the middle and higher relation than the others in case of participants. (3) Degree of acknowledgement about positive influence on acquirement rate of certification(licence) & job through the program was above the middle and performance & adaptation at work place was higher relation than the others in case of participants. (4) Degree of acknowledgement about positive influence on improvement of learning of student's major through the program was above the middle and higher relation than the others in case of participants. (5) The respondents thought that the program had a negative influence on professor's educational activities & research such as study 40.4%, lecture 23.1%, student guidance 12.5%. (6) When the program was administered by planning team, there were difficulties such as execution of budget 42.1%, cooperation with companies 17.1%, cooperation among program teams 11.8%, when it was administered by non-planning team there were difficulties such as execution of budget 45.5%, cooperation among departments 22.7%, cooperation with companies 13.6%. (7) Because it was too short to execute the budget, the ministry have to select proposed programs before the next school year. (8) This program should be changed temporary, insufficient support into consecutive, sufficient support for more characterization & specialization of the college which has a long-term developmental plan & vision.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.58-67
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• 1995

Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.9
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• pp.4485-4491
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• 2013

This study was to investigate emergency medical service demands, fire service force of local governments, and relationship between these two factors for developing effective prehospital emergency medical services. For this, this study was measured the ratio of the number of patients transported and residents, ambulances and residents, patients transported and ambulance workers of 16 local governments. And then examined hypotheses. Data were collected from 2000 year to 2010 year. This study results indicated that average number of patients transported are significant differences not only between metropolitan district and general district, but also between capital area and non-capital area. And this study indicated that the fire service force are significant differences not only between metropolitan district and general district, but also between capital area and non-capital area. Also, the numbers of patients transported per ambulance, and the numbers of patients transported per ambulance worker were significant by regional groups. The number of patients transported per ambulance was a significant difference between the first half and the second half, but there was not a significant different the number of patients transported between the first half and the second half.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.29-40
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• 2010

Purpose: We investigated the motivation of selecting major, the satisfaction of major and the view on occupation of emergency medical technology (EMT) students. The results of study will be used to increase the satisfaction of major of university students. Also, it can be used to support decision of major for high school students. Method: We conducted 1,586 surveys from 665 students at six four-year colleges and 921 students at seven three-year colleges. Our research period was from Aug. 27th to Oct. 31st in 2010. The surveys were analyzed by SPSS 18.0 using description statistics, t-test, ANOVA, Scheffe and Pearson correlation coefficient. Result: In our study, the motivation of selecting major is 35.8% of students selected 'good employment prospects', satisfaction of major's $M{\pm}SD$ is $3.15{\pm}.486$, adaptation of major's $M{\pm}SD$ is $3.11{\pm}.472$. The satisfaction of major show difference (t = 4.548 p = .000) by sex, also the adaptation of major show difference (t = 2.279, p = .023) by sex. The satisfaction of major show first grade students higher (F = 3.605, p = .013) than fourth grade students at four-year colleges. If satisfaction of major is high, accumulation evaluation score is high (F = 3.276, p = .011), too. Clinical practice experienced students was higher (t = -2.878, p = .004) than non experienced it satisfaction. In view of occupation, ideal job's factors and actual job's factors a lot of students selected 'aptitude'. Also, there is a statistically significant correlation (r = .618, p = .000) between the satisfaction of major and the adaptation of major. High satisfaction indicates high adaptation of major. Conclusion: In our study satisfaction of major and adaptation of major was very high score. EMT students concern about employment prospects at most. It is inferred that they select job which match with one's aptitude. We can suppose that students select major as a tool for employment by seeing result that a lot of students consider employment prospects at most when they select major. A method to improve the satisfaction and adaptation of major should be developed by realizing problems which occur the dissatisfaction of major. Also, there as on why students conflict between ideal and actual job should be revealed. There as on seems students want stable occupation in unstable job market situation. Therefore, the expansion of job matching aptitude and being stable should be processed. Finally, university should actively support the method that help to finding jobs for student by identifying job preparation of students.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.42-48
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• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.1-7
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• 2021

Purpose: The purpose of this study was to conduct a systematic review to investigate the socio-economic benefits of the poison control center (PCC) and to assess whether telephone counseling at the poison control center affects the frequency of emergency room visits, hospitalization, and length of stay of patients with acute poisoning. Methods: The authors conducted a medical literature search of the PubMed, EMBASE, and Cochrane Library databases. Two reviewers evaluated the abstracts for eligibility, extracted the data, and assessed the study quality using a standardized tool. Key results such as the cost-benefit ratio, hospital stay days, unnecessary emergency room visits or hospitalizations, and reduced hospital charges were extracted from the studies. When meta-analysis was possible, it was performed using RevMan software (RevMan version 5.4). Results: Among 299 non-duplicated studies, 19 were relevant to the study questions. The cost-benefit ratios of PCC showed a wide range from 0.76 to 36 (average 6.8) according to the level of the medical expense of each country and whether the study included intentional poisoning. PCC reduced unnecessary visits to healthcare facilities. PCC consultation shortened the length of hospital stay by 1.82 (95% CI, 1.07-2.57) days. Conclusion: The systematic review and meta-analysis support the hypothesis that the PCC operation is cost-beneficial. However, when implementing the PCC concept in Korea in the future, it is necessary to prepare an institutional framework to ensure a costeffective model.

• Korean Journal of Radiology
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• v.23 no.9
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• pp.878-888
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• 2022

Objective: To investigate the clinical impact of a quality improvement program including dedicated emergency radiology personnel (QIP-DERP) on the management of emergency surgical patients in the emergency department (ED). Materials and Methods: This retrospective study identified all adult patients (n = 3667) who underwent preoperative body CT, for which written radiology reports were generated, and who subsequently underwent non-elective surgery between 2007 and 2018 in the ED of a single urban academic tertiary medical institution. The study cohort was divided into periods before and after the initiation of QIP-DERP. We matched the control group patients (i.e., before QIP-DERP) to the QIP-DERP group patients using propensity score (PS), with a 1:2 matching ratio for the main analysis and a 1:1 ratio for sub-analyses separately for daytime (8:00 AM to 5:00 PM on weekdays) and after-hours. The primary outcome was timing of emergency surgery (TES), which was defined as the time from ED arrival to surgical intervention. The secondary outcomes included ED length of stay (LOS) and intensive care unit (ICU) admission rate. Results: According to the PS-matched analysis, compared with the control group, QIP-DERP significantly decreased the median TES from 16.7 hours (interquartile range, 9.4-27.5 hours) to 11.6 hours (6.6-21.9 hours) (p < 0.001) and the ICU admission rate from 33.3% (205/616) to 23.9% (295/1232) (p < 0.001). During after-hours, the QIP-DERP significantly reduced median TES from 19.9 hours (12.5-30.1 hours) to 9.6 hours (5.7-19.1 hours) (p < 0.001), median ED LOS from 9.1 hours (5.6-16.5 hours) to 6.7 hours (4.9-11.3 hours) (p < 0.001), and ICU admission rate from 35.5% (108/304) to 22.0% (67/304) (p < 0.001). Conclusion: QIP-DERP implementation improved the quality of emergency surgical management in the ED by reducing TES, ED LOS, and ICU admission rate, particularly during after-hours.