• Journal of The Korean Society of Clinical Toxicology
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• v.8 no.2
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• pp.106-112
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• 2010

Purpose: The purpose of this study is to investigate the factors that predict using mechanical ventilation for patients with organophosphate intoxication. Methods: We retrospectively reviewed the medical records of 111 patients with acute organophosphate intoxication and who were treated in our emergency center from January 2000 to December 2008. We compared the toxicologic characteristics, the laboratory findings and the APACHE II scores between the Mechanical Ventilation group (MV group) and the non-Mechanical Ventilation group (the non MV group). Results: Sixty three patients were in the MV group and 48 patients were in the non MV group. In the MV group, the patients had an older age (p<0.001), a larger amount of ingestion (p<0.001), a lower initial serum cholinesterase level (p=0.003), a higher APACHE II score (p<0.001) and they ingested a more toxic agent (p=0.001). There were no significant differences in gender, the type of visit and the arrival time between the MV group and the non MV group. Conclusion: We suggest that the patient's age, the amount of organophosphate ingestion, the toxicity of the agent, the initial serum cholinesterase level and the APACHE II score are important factors to determine if mechanical ventilation will be applied for patients with organophosphate intoxication.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.415-422
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• 2018

Objective: This study compared the prognosis of patients who visited the trauma center directly (direct visit group) with those transferred from the non-trauma center (transferred group). Methods: The patients, who were 18 or older with Injury Severity Score of 15 or more in the trauma center at Busan, were studied from October 2015 to October 2016. To compare the treatment time between the direct visit and transferred group, first treatment time, final treatment time, and time to visit the trauma center were examined. To compare the prognosis, this study compared the 48-hour, 7-day, and in-hospital mortality rate as well as the duration of intensive care unit (ICU) and total hospital stay. To analyze the factors affecting the outcome of transferred group, the physician's level and procedures that had been performed at the non-trauma center were examined. Results: The mortality was similar in the direct visit and transferred group (48-hour 7.6% vs. 4.6%, P=0.111; 7-day 11.1% vs. 7.2%, P=0.89; and in-hospital 14.6% vs. 11.3%, P=0.214). The length of ICU and total hospital stay were similar in the two groups. The mortality was higher in the patients in the transferred group when using intubation, transfusion, and pressure intensifier. The intubated patients showed higher mortality according to logistic regression. Conclusion: The mortality, length of ICU, and hospital stay were similar but the time to visit the trauma center and the final treatment time were longer in transferred group. Stabilizing the patient at the near non-trauma center may be more helpful for some patients.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.212-217
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• 2009

Purpose: To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma Methods: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008. Results: The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region. Conclusion: From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.

• The Korean Journal of Emergency Medical Services
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• v.12 no.1
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• pp.43-52
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• 2008

I studied and analyzed current status about the necessity of Medical Oxygen Respiration First Aid when we perform first aid at emergency locations. As immediate and efficient first aid methods it is necessary to be able to use medical oxygen respiration equipments. I presented the basic data to develop and standardize education system on medical oxygen respiration first aid. Among those who were working at emergency locations in Korea from September 15th, 2005 to September 30th, 2005, I performed a survey on a professional group of 75 people and a non-professional group of 132 people. The results of the survey are summarized as follows. 1) There was difference between the professional group and the non-professional group on recognition about whether general public can perform medical oxygen respiration first aid(p<0.05). 2) On the necessity of medical oxygen respiration first aid, 93.2% of the total answered it is necessary and 6.8% answered it is unnecessary, so both groups thought it is very necessary(p>0.05). 3) On the importance of medical oxygen respiration first aid, 95.2% of the total answered it is important and 4.8% answered it is unimportant, so both groups thought it is very important(p>0.05). 4) On correspondence on necessity and importance of medical oxygen respiration first aid, there was a difference in thoughts between the professional group and the non-professional group(p<0.05). 5) On the necessity of education on medical oxygen respiration first aid, 98.1% of the total answered it is necessary and 1.9% answered it is unnecessary, so both groups thought it is very necessary(p>0.05).

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.5
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• pp.391-398
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• 2018

Objective: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. Methods: The records of patients transferred from the '119' emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. Results: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semi-urgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32-0.39) than according to prehospital staging (95% CI, 0.50-0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16-0.22) than according to prehospital staging (95% CI, 0.37-0.48). Conclusion: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.20-32
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• 1999

The purpose of this retrospective research of 603 patients who were transferred to the emergency medical center of university hospital from 1 Jan, 1998 to 31 Jan, 1998 was making of basic data for emergency medical transfer system improvement countermeasure and the point at issue of overlapping reexamination ststus of patients transfered to emergency medical center of university hospital from 1,2 level hospital. The data analysis was done by SPSS, t-test, ANOVA, Pearson correlation. The results were as follows: 1. Male to female ratio was 1.7:1 and peak age group was patients over forties and under nine years of age(70.5%) 2. Traumatic patients were 17.8%, motor vehicle accident patients were 16.7% and Non-traumatic patients were 65.3%. Transferring hospital was divided into 2groups: primary hospital, secondary hospital. The majority was secondary hospital(73.3%). The result of symptom severity classification of patients transferred to 3rd emergency medical center was urgent patients 32.5%, emergency patients 33.58%, non-emergency patients 34.0% 3. Most highest score items amoung overlapping reexamination of patients transfered to emergency medical center of university hospital from 1,2 level hospital were CBC test, simple X-ray (0.93점), CBC test(0.97점), urin test(0.88점), chemistry test(0.94점), simple X-ray(0.98점), CT(0.42점), EKG(0.89점) amoung overlapping reexamination of motor vehicle accident patients were more higher reexamination score than traumatic patients and non-traumatic patients 4. CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.001), CT(P<0.01), EKG(P<0.001) amoung overlapping reexamination of patients in 2 level hospital were more higher reexamination score than 1 level hospital patients 5. About symptom severity classification of patients transferred to 3rd emergency medical center, CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.01), CT(P<0.001), EKG(P<0.001) amoung overlapping reexamination items in urgent patients were more higher reexamination score than other patients 6. Influencing variation for overlapping reexamination in hospital was CBC test(P<0.001), CT (P<0.001), MRI (P<0.05).

• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.53-63
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• 2012

Purpose: This study examines and compares the differences between self-esteem and health promotion behavior of health department and non-health department college students. Method: The research instruments were as follows : The first one is RSES developed by Rosenberg and translated into Korean by Jeon. The second one is HPLP developed by Walker et al, and including six subareas by Lee and modified to be suitable to Korean culture by Suh. Data were statistically analyzed with SPSS PC/12.0. Results : 1. Comparison of self-esteem had no significant difference(p=.190) and health promotion behaviors had significant differences(p=.000) between the two groups. 2. According to general characteristics and health-related characteristics, the differences of self-esteem in health department showed significant differences in grade(p=.020), sex(p=.000), age(p=.000), parents' economic conditions(p=.048), and smoking(p=.030) while non-health departments revealed significant differences in grade(p=.003), sex(p=.000), age(p=.000) and smoking(p=.001). 3. According to general characteristics and health-related characteristics, the differences of health promotion behaviors in health department showed significant differences in grade(p=.008), sex(p=.021), age(p=.000) and parents' economic conditions(p=.017) while non-health department revealed significant differences in sex(p=.000) and age(p=.000). 4. There were positive correlations between self-esteem, health promotion behaviors and subareas in health department (r=.422) and non-health department (r=.383). Conclusion: There were significant positive correlations between self-esteem and health promotion behaviors in health and non-health department college students. Therefore, health related programs should be developed to enhance self-esteem and health management by college students can influence themselves on self-esteem and health promotion behaviors.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.63-70
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• 2021

Purpose: The study aimed to collect data from patients who were rejected by emergency requests for transfer to a tertiary hospital through 119 EMT and to analyze the data in the hospital to improve the plan. Methods: We analyzed 4,702 cases of emergency requests made by patients who were rejected by 119 emergency assistance out of the 22,568 patients who visited the emergency medical center in the C area of G metropolitan city from January 2018 through December 2020. The collected data were analyzed using IBM SPSS Statistics Version XX (IBM Corp., Armonk, N.Y., USA). Results: The major medical department with the largest number of such cases was the department of emergency medicine, with 2,519 cases (53.6%). Simple bruises were the most common diagnosis, with 2,819 cases (61.2%). KTAS classification was the highest with 3,562 patients (75.8%) in grade 4. As for the results, 4,084 patients (86.9%) were discharged from the hospital. Conclusion: Most of the patients who were rejected by emergency requests were non-emergency patients and were discharged from the hospital. emergency requests must be rejected at public relations and sites. In addition, the law should be amended to specifically present the reasons for refusal of emergency requests.

• Journal of radiological science and technology
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• v.45 no.3
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• pp.205-211
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• 2022

This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.