• Journal of the Korea Society of Computer and Information
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• v.24 no.3
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• pp.175-179
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• 2019

This study is a descriptive research of paramedic students who could be exposed to blood and body fluids during the clinical practicum to analyze the risk factors. From June 1 to June 30, 2018, 172 paramedic students who attended the University in Jeolla-do region were analyzed. The collected data were analyzed by using the SPSS WIN 21.0 program. The general characteristics of subjects, the exposure level of blood and body fluids, and etc were obtained for frequency and percentage analysis. The study found that 72.7 percent of students had experience to blood or body fluids exposure during the clinical practicum. Except for any needle injury, 70.4 percent of student were exposed to blood or body fluids. 28.8 percent of them which was the highest percentage of injection injury were exposed during the venous blood draw. 36.5 percent of exposure were related to wound dressings which was the highest percentage related to clinical procedures. 71.2 percent of students mentioned that they did not report this exposure because 68.5 percent students thought that it has no danger. According to the survey on hepatitis B, 50.6% of students had antibodies, but 31.8 percent of students did not confirm that the antibodies were formed. Even though paramedic students do practical training in a hazardous environment with repeated exposure to blood and body fluids due to the nature of job characteristics, the systemic infection control education program is insufficient. In order to prevent exposure and to protect paramedic students who do practical training with patients, it is necessary to make more systematic and active efforts in the continuous monitoring and the preventive education.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• The Korean Journal of Emergency Medical Services
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• v.20 no.2
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• pp.113-125
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• 2016

Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

• The Korean Journal of Emergency Medical Services
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• v.20 no.3
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• pp.7-19
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• 2016

Purpose: The purpose of the study was to investigate the correlation between injury and injury severity score (ISS) in geriatric traffic accident patients transported by 119 emergency medical technicians (EMTs). Methods: The subjects were 240 traffic accident patients over 65 years old transported by 119 rescue services emergency departments in Busan from January 1, 2014 to August 31, 2015. Results: ISS increased in motorcycle traffic accidents (p=.026), truck injuries (p=.005), and head and neck injury (p<.001). Vital signs were evaluated by 119 rescue EMT. ISS increased in cases of unresponsive unconsciousness (p<.001), hypotension (p=.001), and bradycardia (p<.001). The need for bleeding control and dressing by the EMTs increased ISS significantly (p=.022). Conclusion: In the initial evaluation of geriatric traffic patients, ISS can increase in motor cycle accidents and truck injuries. Due to high ISS, patients with head and neck injury, chest injury, hypotension, or tachycardia should be transferred to advanced level hospitals.

• Fire Science and Engineering
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• v.30 no.1
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• pp.130-137
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• 2016

The purpose of this study is to investigate the circumstances surrounding collisions involving ambulances with an aim to improving the safe operation of emergency services. Collisions are relatively common within paramedic emergency services. We analyzed the time, injury site, and any other specific factors of 908 collisions occurring within four cities. Within our study 29.6% of paramedics have been involved in accidents while responding to an emergency call, with the main cause of the accident being signal violation (35.7%), and is the other party's negligence (22.2%). 92.1% of these accidents occurred while the emergency lights were being operated. XX% of accidents took place in the afternoon, while xx% took place within the hours of xx:xx and xx:xx, during which time there is generally lower levels of traffic, which can cause severe brain and neck damage of 14.4% but the other part is 62.1%. (Ed note; this is not clear at all. 14.4% of collisions resulted in severe head and neck injuries, while 23.5% of collisions resulted in no injury. According to the respondents, defensive driving (xx%), observance of traffic laws (xx%), safe driving habits (xx%)to paramedics were the most critical factors in evading collision. Signal passes were identified as the most common cause of collision (70.1%). Although the majority of collisions occurred while the emergency lights were operational, the damage can cause severe damage at the time of accident occurred.

• Journal of Preventive Medicine and Public Health
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• v.51 no.3
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• pp.163-168
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• 2018

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

• Fire Science and Engineering
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• v.28 no.3
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• pp.72-79
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• 2014

The purpose of this study is to draw the improvement plan through the analysis of problems of main stretchers that are being used by the 119 EMS. In order to find out the problems, we used the literature review and analysis, survey questionnaire and we also made full use of KJ method (Kawakita Jiro method, affinity diagram), graph method, and priority matrix method to produce the improvement indicators. The problems of main stretchers are summarized as follows. they are being recognized as part of the emergency vehicle, they have the imperfection of performance verification criteria, and they cause the injuries of paramedics and patients accidents in operation. The indicators such as the ease of operation, the high performance, the multi-function, the driving performance, the durability and the lightweight, was produced to improve the problems. The results of the interconnection analysis and the applying priority matrix method on the indicators are the ease of operation ${\rightarrow}$ the multi-function ${\rightarrow}$ the driving performance ${\rightarrow}$ the high performance ${\rightarrow}$ the durability and the lightweight in order of importance.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.289-296
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• 2015

This convergence study was conducted to compare difference of risk behaviors and injury incidence between younger(under 65 years) and elderly(over 65 years). For this analysis we used law data of nation-wide community health survey data during August to October 2010. Data of drink-driving, seat belt use, injury incidence rate, type of injury, cause of injury were used for comparison. Seat belt use(85.16% vs 78.81%) was high but drink-driving(12.99% vs 13.24%) was low in elderly. Injury incidence was high especially in falls(1.07% vs 2.22%). In conclusion, elderly do less risk behaviors, but experienced much more injuries especially falls.

• Journal of Trauma and Injury
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• v.35 no.3
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• pp.209-214
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• 2022

We describe a case of hyperbaric oxygen therapy (HBOt) as an adjunct to treatment of a crush injury to the hand. A 34-year-old male paramedic was involved in a motor vehicle accident and admitted for diagnosis and surgical treatment. He sustained a crush injury to his right hand and presented with significant muscle damage, including multiple fractures and dislocations, an avulsion injury of the flexor tendons, and amputation of the distal phalanx of the little finger. He underwent reconstructive surgery and received HBOt over the following days. In the following 2 months, he lost the distal and middle phalanges of the little finger and recovered hand function. Posttraumatic compartment syndrome responds well to HBOt, which reduces edema and contributes to angiogenesis, as well as promoting the cascade of healing events. High-energy trauma causes massive cell destruction, and the blood supply is usually not sufficient to meet the oxygen demands of viable tissues. Hyperbaric oxygenation by diffusion through interstitial and cellular fluids increases tissue oxygenation to levels sufficient for the host's responses to injury to work and helps control the delayed inflammatory reaction. HBOt used as an adjunct to surgical treatment resulted in early healing and rehabilitation, accelerating functional recovery. The results suggest that adjunctive HBOt can be beneficial for the treatment of crush injuries of the hand, resulting in better functional outcomes and helping to avoid unnecessary amputations.

• The Korean Journal of Emergency Medical Services
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• v.19 no.1
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• pp.19-33
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• 2015

Purpose: The purpose of this study was to improve the quality of prehospital care provided to infants and toddlers (preschoolers) based on questionnaire findings. Methods: A total of 1,634 running sheets from 119 centers of D city from patients older than 1 month and less than 7 years of age from January 1, 2013 to December 31, 2013 were reviewed for 119 emergency medical technicians (EMTs) activity analysis. And a self-reported questionnaire about knowledge and competency in prehospital care of preschoolers was completed by 159 EMTs at fire stations in D city. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: Of 1,634 patients, 58.6% were call to 119 due to disease, 33.8% due to injuries and 7.5% due to traffic accident. Knowledge and confidence in treating preschoolers was significantly higher among paramedic EMTs than basic EMTs. The 119 EMTs surveyed indicated that training for preschooler prehospital care was most needed. Conclusion: In order to provide high quality prehospital care for preschoolers transported to emergency rooms, it is necessary to equip ambulances with the proper equipment. In addition, EMTs should be provided educational opportunities and clinical training.