• KSII Transactions on Internet and Information Systems (TIIS)
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• v.8 no.2
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• pp.406-423
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• 2014

The recent advances in wireless communication systems and semiconductor technologies are paving the way for new applications over wireless sensor networks. Health-monitoring application (HMA) is one such emerging technology that is focused on sensing and reporting human vital signs through the communication network comprising sensor devices in the vicinity of the human body. The sensed vital signs can be divided into two categories based on the importance and the frequency of occurrence: occasional emergency signs and regular normal signs. The occasional emergency signs are critical, so they have to be delivered by the specified deadlines, whereas the regular normal signs are non-critical and are only required to be delivered with best effort. Handling the occasional emergency sign is one of the most important attributes in HMA because a human life may depend on correct handling of the situation. That is why the underlying network protocol suite for HMA should ensure that the emergency signs will be reported in a timely manner. However, HMA based on IEEE 802.15.4 might not be able to do so owing to the lack of an appropriate emergency-handling mechanism. Hence, in this paper, we propose a new emergency-handling mechanism to reduce the emergency reporting delay in IEEE 802.15.4 through the modified superframe structure. A fraction of an inactive period is modified into three new periods called the emergency reporting period, emergency beacon period, and emergency transmission period, which are used opportunistically only for immediate emergency reporting and reliable data transmission. Extensive simulation is performed to evaluate the performance of the proposed scheme. The results reveal that the proposed scheme achieves improved latency and higher emergency packets delivery ratio compared with the conventional IEEE 802.15.4 MAC.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.223-229
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• 2012

Purpose: The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries. Methods: Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor ($$ISS{\leq_-}15$$)-injury and major ($$ISS{\geq_-}16$$)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups. Results: In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups($-6.86{\pm}2.40mmol/L$ vs. $-1.37{\pm}0.73mmol/L$, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups($-2.50{\pm}1.28mmol/L$ vs. $-1.51{\pm}0.74mmol/L$, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832). Conclusion: We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.

• Journal of Korean Clinical Nursing Research
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• v.14 no.3
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• pp.61-72
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• 2008

Purpose: The purpose was to identify quality of chest pain according to causal diseases and pain expression of patients with coronary artery diseases. Method: Participants were 1,964 patients with pain who visited the emergency department of A hospital from January to December 2006. Data were collected from nurses' and doctors' records as to causal disease, and quality and expression of chest pain. Results: Causal diseases were coronary artery diseases, non-specific chest pain, respiratory diseases, non-coronary artery heart diseases and digestive diseases in that order of frequency. Every disease except respiratory disease caused mostly dull and tract pain, but 63.7% of patients with coronary artery diseases complained of typical angina pain and 24.9% complained of atypical angina pain. Patients with coronary artery diseases mostly used word 'heaviness' in describing their dull pain, and 'squeezing' for tract pain. Both male and female patients who were diagnosed with coronary artery disease complained mostly frequently of dull pain and tract pain. Conclusion: The most common causal disease for patients with chest pain was coronary artery disease. Patients with other diseases also frequently complained of dull and tract pain, the same as patients with coronary artery diseases. A considerable number of patients complained various types of atypical angina pain in coronary artery diseases.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.108-113
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• 1999

Background: There is some concern that the administration of epidural analgesia for pain relief during labor increases the likelihood of cesarean delivery. But, several investigators showed a decrease in the rate of emergency cesarean delivery after epidural analgesia. The purpose of this study was to compare the emergency cesarean rate between the two groups with and without epidural analgesia. Methods: We reviewed retrospectively the medical records for 7846 parturients admitted our hospital between January 1, 1995 and December 31, 1996 and whose attending physician anticipated a normal labor and vaginal delivery. The number of parturients with epidural analgesia using 0.25% bupivacaine with fentanyl were 2839 and parturients without epidural analgesia were 5017. Results: An administration of epidural analgesia was not associated with the incidence of cesarean rate. 149 (5.25%) of 2839 parturients in epidural group and 371 (7.31%) of 5017 parturients in non-epidural group underwent emergency cesarean section. Conclusions: Our retrospective study has shown that an administration of epidural analgesia neither decrease nor increase in the rate of emergency cesarean delivery when compared with a non-epidural analgesia.

• The Korean Journal of Emergency Medical Services
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• v.28 no.2
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• pp.77-98
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• 2024

Purpose: This study aimed to derive detailed insights into emergency medical technicians' (EMTs) perceptions regarding continuing education. Methods: We conducted a descriptive survey. The interview participants were 20 EMTs, divided into four groups: six Fire Department EMTs, five Hospital EMTs, five Clinical EMTs (excluding the ER and Fire Department), and four Non-Clinical EMTs. Data were collected through focus group interviews (FGIs) and semistructured questionnaires. The interview periods were March 25, 2022, and March 27, 2022. Results: Continuing education was primarily field-oriented, leading to lower satisfaction among non-field EMTs. To enhance satisfaction, training should be tailored to the specific roles and experiences of the EMTs. Additionally, quality management of lectures, instructor selection, and video quality require reconsideration. Key factors that enhance satisfaction include a wider variety of courses, up-to-date information, and relevant course content, regardless of job role or experience. Conclusion: Incorporating feedback into EMTs' perceptions of continuing education can lead to the development of more effective curricula and improved quality management. This approach is expected to enhance both educational satisfaction and job performance.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.157-167
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• 2021

Purpose: The study was a qualitative study to examine the synchronous and asynchronous distanced learning experience of online paramedic students during the COVID-19 pandemic. Methods: The subjects included 10 students enrolled in the department of emergency medical service at J City C University. Written consent was provided by the subjects prior to the study, and focus group interviews were then conducted with sufficient explanation. The interviews were recorded and were directly transcribed immediately after the interview. Research results were then derived through content analysis. Results: A total of 4 domains and 9 categories were derived from the experiences of paramedic students on distanced learning. The 4 domains included "distanced lectures type," "student's adaptation and non-adaptation," "change of evaluation," and "learning anxiety." Conclusion: Contents of each domain derived from this study are expected to be used as basic data for the design of the distanced learning in the future.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.107-112
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• 2006

Purpose: In many Korean hospitals, serum acetaminophen concentrations in cases of overdose cannot be measured initially because of inadequate laboratory facilities. Under these circumstances, physicians base the administration of the antidote, N-acetylcysteine, on ingestion amounts as determined by initial history taking. We therefore examined the correlated between ingested amounts and serum acetaminophen concentrations. Methods: Medical records were reviewed retrospectively for patients who presented to the ED with acetaminophen overdose between January 2002 and March 2006. Fifty-nine patients were recruited and sixteen patients were excluded. The forty-three remaining patients were placed into either the high-risk or low-risk group based on their ingested amount (140 mg/kg), and were separately categorized into the toxic or non-toxic group based on their serum acetaminophen concentrations, according to the Rurnack-Matthew nomogram. Results: Ten patients (83.3%) among twelve in the high-risk group were found to have non-toxic serum concentrations, and just one patient (3.2%) among thirty-one in the low-risk group fell into the toxic group based on their serum concentrations. The sensitivity and specificity of risk stratification of the ingested amount as a predictor of intoxication requiring antidote therapy were 66.7% and 75.0%, respectively. Conclusion: This study suggests that the therapeutic decision for acetaminophen overdose should not be based solely on ingested amount only, but requires assessment of acetaminophen concentration.

• The Korean Journal of Physiology and Pharmacology
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• v.26 no.3
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• pp.195-205
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• 2022

Determining blood loss [100% - RBV (%)] is challenging in the management of haemorrhagic shock. We derived an equation estimating RBV (%) via serial haematocrits (Hct₁, Hct₂) by fixing infused crystalloid fluid volume (N) as [0.015 × body weight (g)]. Then, we validated it in vivo. Mathematically, the following estimation equation was derived: RBV (%) = 24k / [(Hct₁ / Hct₂) -1]. For validation, non-ongoing haemorrhagic shock was induced in Sprague-Dawley rats by withdrawing 20.0%-60.0% of their total blood volume (TBV) in 5.0% intervals (n = 9). Hct₁ was checked after 10 min and normal saline N cc was infused over 10 min. Hct₂ was checked five minutes later. We applied a linear equation to explain RBV (%) with 1 / [(Hct₁ / Hct₂) -1]. Seven rats losing 30.0%-60.0% of their TBV suffered shock persistently. For them, RBV (%) was updated as 5.67 / [(Hct₁ / Hct₂) -1] + 32.8 (95% confidence interval [CI] of the slope: 3.14-8.21, p = 0.002, R² = 0.87). On a Bland-Altman plot, the difference between the estimated and actual RBV was 0.00 ± 4.03%; the 95% CIs of the limits of agreements were included within the pre-determined criterion of validation (< 20%). For rats suffering from persistent, non-ongoing haemorrhagic shock, we derived and validated a simple equation estimating RBV (%). This enables the calculation of blood loss via information on serial haematocrits under a fixed N. Clinical validation is required before utilisation for emergency care of haemorrhagic shock.

• The Korean Journal of Emergency Medical Services
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• v.11 no.1
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• pp.53-64
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• 2007

Purpose: Ths study aims to examine characteristics of patients using emergency room after execution of five-day workweek system by government and provide basic materials for operation of efficient emergency room. Methods: Data were collected tbrough medical records of patients visiting emergency room from July of 2004 to October of 2006 and they were analyzed with SPSSlPC 10.0. Conclusion : 1. The number of patients visiting emergency room was average 16.7 persons a day in 2004, 17.5 in 2005 and 18.6 in 2006 and it was found that it was increasing every year since the execution of five-day workweek system 2. Gender distribution of subjects using emergency room was higher in male than in female every year. 3. Means of transport to emergency room were mostly private car and others(public transport or on foot), but use of ambulance was increasing. 4. Residential areas of subjects were mostly 'Myeon area' in 2004~2005, but it was changed to residents at 'Eup area' in 2006. 5. Distribution of patients by medical departments was highest in internal medicine and surgery in 2004~2006 and rate of visiting pediatrics was increasing every year. 6. Time to stay at emergency room was most at 'below 30 min'. in 2004~2006, but cases of stay for 'more than 2 hours' were increasing every year. 7. On presence or absence of trauma in patients visiting emergency room, rate of visit to emergency room with 'no trauma' was higher and this result was increasing every year. 8. As a result of classifying severity of patients visiting emergency room, use rate of emergency room by 'non-emergency' patients was over 90% in 2004~2006 and such a phenomenon was deepened in 2006 compared to that in 2004. 9. Measures after emergency care of patients were most in case of 'discharge' in 2004~2006, but cases of admission to hospital after emergency care were increased every year. 10. According to use of emergency room by a day of the week, use on Sunday was most frequent in 2004~2006, but use on Friday the day before holiday was increasing. 11. According to distribution by age, use by those between '40~49' was most in 2004~2005, but use by those 'below 10' was most in 2006. 12. According to time to visit emergency room, using emergency room at "15:31~23:30 was most in 2004~2006, cases of visiting emergency room at day working hour were decreased every year and those at evening and night working hours were increased. Conclusion: In sum, it was found that characteristics of patients visiting emergency room and their actual status were changed after the execution of five-day workweek system and efforts to rearrange emergency medical system are required.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.21-33
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• 2014

Purpose: A descriptive study design was used to investigate infection management awareness and infection management performance for clothing management in 119 emergency medical technicians (EMTs). Method: 188 paramedics and basic EMTs completed questionnaires between March 1 and April 30, 2013 in Jeollabuk-do. Results: Participants' average score for infection control awareness was 2.69 and that for performance was 1.58, with the differences being statistically significant (t = 931.455, p = .003). Participants' general characteristics resulted in differences in infection management performance. Women (1.63) have scored higher than men (1.28), and the difference was statistically significant (t = 11.174, p = .001). Participants who had clinical experience (1.63) had higher scores than participants who did have clinical experience before (1.53) and, again, the difference was significant (t = 7.167, p = .009). Conclusion: Education program for infection management is need to be developed for more effective infection management.