• 한국화재소방학회논문지
• /
• 제27권4호
• /
• pp.47-55
• /
• 2013

최근 소방안전 서비스는 위험의 사전방지와 일상생활에서 느끼는 생활안전 업무까지 확대되고 있다. 본 연구는 생활안전의 이론적 탐색과 119생활안전대의 실태분석을 바탕으로 소방공무원과 경기도민을 대상으로 설문조사의 결과를 토대로 소방조직의 효과적인 생활안전서비스 방안을 제시하는데 있다. 연구의 결과 지역사회의 사회적 자본 활용, 유관기관 협력관계 구축과 시민의 지지 확보, 다조직간의 협력, 긴급신고와 비긴급신고 구분, 생활안전 소방서비스의 사회안전망 역할 등을 제안하였다.

• Journal of Trauma and Injury
• /
• 제32권1호
• /
• pp.17-25
• /
• 2019

Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

• Journal of Multimedia Information System
• /
• 제6권1호
• /
• pp.23-30
• /
• 2019

A communications profile is a system that acquires information from communication links to an ambulance or other vehicle moving on a road and compiles a database based on this information. The equipment (six sets of HDTVs, fish-eye camera, satellite antenna with tracking system, and receiving power from the satellite beacon of the N-star) mounted on the roof of the vehicle, image data were obtained at Yokohama Japan. From these data, the polygon of the building was actually produced and has arranged on the map of the Geographical Survey Institute of a 50 m-mesh. The optical study (relationship between visibility rate and elevation angle) were performed on actual data taken by fish-eye lens, and simulated data by 3D-Map with polygons. There was no big difference. This 3D map system then predicts the communication links that will be available at a given location. For line-of-sight communication, optical analysis allows approximation if the frequency is sufficiently high. For non-line-of-sight communication, previously obtained electric power data can be used as reference information for approximation in certain cases when combined with predicted values calculated based on a 3D map. 3D maps are more effective than 2D maps for landing emergency medical helicopters on public roadways in the event of a disaster. Using advanced imaging technologies, we have produced a semi-automatic creation of a high-precision 3D map at Yokohama Yamashita Park and vicinity and assessed its effectiveness on telecommunications and ambulatory merits.

• Journal of Preventive Medicine and Public Health
• /
• 제54권1호
• /
• pp.1-7
• /
• 2021

The Korean government's strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.

• 한국응급구조학회지
• /
• 제27권3호
• /
• pp.33-46
• /
• 2023

Purpose: This study aims to evaluate the risk of work-related musculoskeletal disorders (WMSDs) in 119 EMT during patient-carrying tasks using a long backboard (LBB) and a variable stretcher. Methods: Manikins were used as patients, and 45 new 119 EMT from K Fire Academy were filmed performing patient-carrying tasks on stairs. The tasks were analyzed using Ovako working posture analysis system (OWAS) and Rapid entire body assessment (REBA). Results: In using LBB, the OWAS score was Mode 3(Mean 2.37, Maximum 3), requiring as soon as possible corrective action, the REBA score was Mode 11(Mean 9.16, Maximum 11), requiring immediate improvement. In using variable stretcher, the OWAS score was Mode 1(Mean 2.33, Maximum 3), non-necessity for corrective action, the REBA score was Mode 9(Mean 8.0, Maximum 11), requiring as soon as possible. Conclusion: In conclusion, improvement was needed in one task (carrying a patient using a LBB) in the OWAS and in two tasks (carrying a patient using a LBB, carrying a patient using a variable stretcher) in the REBA. Thereby, required attention and management of WMSDs during training. In addition, it is essential to carry out objective and quantitative assessments through ergonomic analysis by occupational health professionals when designing future training programs to prevent WMSDs.

• Journal of Trauma and Injury
• /
• 제21권1호
• /
• pp.28-35
• /
• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• 한국융합학회논문지
• /
• 제10권4호
• /
• pp.99-106
• /
• 2019

본 연구는 시뮬레이션을 기반으로 한 전문심장소생술 교육이 병원 전 단계에 구급대원이 환자에게 시행하는 전문심장소생술 직무수행에 미치는 영향을 분석하고 효과적인 전문심장소생술을 시행하기 위한 기초자료를 제공하는데 그 목적이 있다. 비동등성 대조군 전후 설계를 기초하였으며 연구대상은 K소방학교의 신규 임용된 구급대원 16명이 참여하였다. 평가 도구로 사용된 시뮬레이션 교육 프로그램과 평가지는 ACLS 시뮬레이션 전문가 6인(응급의학 전문의 2명, 전공교수 2명, 전문강사 2명)에게 사전 검토 및 의견을 받아 본 연구에 적합한 도구로 개발하였다. 교육은 이론 30분, 실습 150분으로 구성하여 4인 1조 1개팀으로 구성하였다. 강사가 5분간 시연을 한 후 개인별 실습 후 디브리핑(debriefing)을 통한 교정을 거친 후 개별, 팀별 교육을 실시하였다. 평가척도는 5점 리커트(Likert) 척도로 수행능력 평가 점수를 부여하였다. 자료분석은 Windows용 SPSS 22.0 프로그램을 사용하였으며, 대상자의 일반적 특성은 빈도분석을 하였으며, 실험군과 대조군의 동질성 검증은 t검정을 하였고 두 그룹의 집단의 차이 분석은 대응표본 t 검정(paired t-test)으로 분석하였다. 동질성 검사에 실험군과 대조군의 동질성을 확인 할 수 있었다. 전문심장소생술(ACLS) 수행기술 6가지에 대한 평가에서 시뮬레이션 교육을 받은 실험군이 교육을 받지않은 전통적 교육 방식의 대조군보다 모든 면에서 수행능력이 우수하였음을 증명하였다. 수행기술은 1. 심전도 2. 전문기기 3. 수액처치 4. 리더십과 팀워크 5. 의료지도 6. 이송중 평가 이상 6가지 이다. 일반적인 강의와 실습을 한 구급대원보다 시뮬레이션 교육을 받은 구급대원이 직무수행 능력이 향상된 것이 검증되었다 따라서 종합술기 과정에 있는 학생이나 임상에 종사하는 응급구조사에게 시뮬레이션 훈련과 교육이 확대 적용된다면 더 능숙하게 직무를 수행해 나갈 수 있을 것이며, 심정지 환자에게 제공되는 구급서비스가 향상될 것으로 기대한다.

• 대한임상전기생리학회지
• /
• 제10권2호
• /
• pp.43-49
• /
• 2012

Purpose : This study is to supply basal data need to development of First-Aid education program for female college students of non-health department that we surveyed safety awareness practice, First-Aid knowledge, educational requirement and necessity of the female college students of health and non-health department. Methods : This date was collected from September 1th in 2012 until October 5th by 5 person selected of which explain to purpose and method of the writing. We distributed the subject questionnaire of total 410 and analyzed questionnaire 385 only. Results : The results of this study are follows. First, the health group was higher than non-health group in conductive score of safety awareness and score of First-Aid knowledge in female students and there was statistically significant difference. Second, There was significant difference in Economical state, Educational state of the Safety awareness Practice score and First-Aid knowledge score about the general characteristic of the female college students of health department. Third, there wasn't significant difference in most of all item of the Safety awareness Practice score and First-Aid knowledge score about the general characteristic of the female college students of non-health department. Conclusion : Finally, We found that the female college students of health department lower than the female college students of non-health department in First-Aid knowledge level and surveyed that they felt the needs of First-Aid education. Therefore, there are able to need the opening of a course in order to raise the quality of safety awareness and First-Aid knowledge or to needs construction of educational system in continuously.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권6호
• /
• pp.3725-3728
• /
• 2013

Background: The mammalian target of rapamycin (mTOR) /RPS6KB1 activation has recently been implicated in tumour development, but its role in lung cancer remains unclear. The aim of this study was to explore the role of mTOR/RPS6KB1 signaling pathway in non-small-cell lung cancer (NSCLC). Methods: Immunohistochemistry was performed to assess the expression of phosphorylated mammalian target of rapamycin (p-mTOR) and its downstream ribosomal phosphorylated RPS6KB1 (p-RPS6KB1) in NSCLC patients. We also analyzed p-mTOR/p-RPS6KB1 protein expression in 45 fresh NSCLC tissues using Western blotting. Results: The expression level of p-mTOR and p-RPS6KB1 was significantly higher in NSCLC tumor specimens than that in adjacent noncancerous normal lung tissues (P<0.01). p-mTOR expression correlated with p-RPS6KB1. Furthermore, high expression level of p-mTOR or p-RPS6KB1 in NSCLC was associated with a shorter overall survival (both P<0.01). Multivariate analysis indicated high level of p-mTOR expression was an independent prognostic factor (HR=2.642, 95%CI 1.157-4.904, p=0.002). Conclusions: p-mTOR and p-RPS6KB1 could be useful prognostic markers for NSCLC.

• Journal of Korean Neurosurgical Society
• /
• 제48권4호
• /
• pp.354-356
• /
• 2010

Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of $2{\times}2\;mm$ with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, $9{\times}13\;mm$ sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.