• 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 Korea Convergence Society
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• v.10 no.5
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• pp.85-94
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• 2019

This study was aimed to identify a study on the effect of chest compressions combined with abdominal drawing-in technique on prevention of back pain and chest compression quality. We tested motion analysis, electromyography, and chest compression quality of 15 paramedics. Data were normalized to SPSS 21.0 (Kolmogorov-Smirnov and Shapiro-Wilk test). The paired t-test was used for the pre- and post-test chest compressions, the one-way ANOVA was used for the analysis of the measurement point-in-time differences, and LSD was used for the post-test. The results of the study showed significant difference in muscle activity and chest compression success rate when the chest pressure was applied with abdomen drawing-in. Therefore, it is necessary to study cardiopulmonary resuscitation education which can increase the chest compression success rate while preventing the back pain of the paramedics in the future.

• Tuberculosis and Respiratory Diseases
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• v.68 no.3
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• pp.162-167
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• 2010

Background: To date, there are few data on the risk factors for severe cases and deaths associated with the 2009 pandemic H1N1 influenza A. Here, we describe the clinical and epidemiologic characteristics of patients hospitalized for pneumonia and identify those factors associated with the development of major complications (MC). Methods: We reviewed the medical records of 41 cases of pneumonia admitted to a university-affiliated tertiary hospital between Aug 26 and Dec 10, 2009, and who had confirmed H1N1 influenza A based on real-time reverse transcriptase-polymerase-chain-reaction assay. There were 7,962 patients that fit these criteria. We compared the clinical features and demographic characteristics of patients who developed MC to with those who did not develop MC. Results: During the study period, 10 patients developed MC (required admission to the intensive care unit, n=10; required ventilator therapy, n=6; death, n=4). Patients with MC were significantly older than those without MC and more frequently had underlying medical conditions (90.0% vs 41.9%, p-value <0.01). In the patients with developed MC, the median $PaO_2/FiO_2$ ratio of 230.0 (145.0~347.3) at admission and pneumonia severity index (PSI) score of 141.5 (88.3~158.5) were higher than patients without MC. However, no differences were observed in laboratory findings or in viral shedding between the 2 groups. Conclusion: In hospitalized pneumonia patients of 2009 H1N1 influenza, old age, a history of malignancy, initial hypoxemia, $PaO_2/FiO_2$ ratio, and PSI score appear to be risk factor significantly related to developing MC. These findings might be the basis to influence strategies for admitting patients to an intensive or intermediate care unit and for pre-emptive antiviral therapy.

• Health Policy and Management
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• v.33 no.4
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• pp.440-449
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• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.147-168
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• 2005

It examined the doubt point which AED motive relates until now, the AED should have bought a life how, present address of our country site pre-hospital care, comparison it tried to observe the advanced nation instance back. Gist of this research the AED important cold region once compared to informed to how many cardiac arrest patient, against him the what kind of preparation wanted informing the necessary cold region. It soaks simultaneously but the AED motive is widely supplied distant in future and it is generality and it is feeble but it wanted doing one morning. The habit difference of an American who does of course meat diet mainly and a Korean is many and it compares in the United States and the cardiac arrest patient comparison occurs holds a point few. To become Western anger but and be caused by with thin dietary life, stanching bleeding cung, with the fact that the heart attack is increasing rapidly with the hyperextension. It is a talk which anyone it knows all. The major league most Choi huy Sub in condition will catch the ball which floats and the multi co-player and to collide when falling down, the medical device which is committed with emergency aid is AED motive. From the United States subway station and the shopping which are a public place on the baseball field outside the jar which it will drive, the museum and the school, easily there is it will be able to discover the AED from the court of justice back. The Pittsburg university the students per the individual $30 the core phyey were receiving the smallness lifestyle alcoholic beverage and a AED motive actual training with mercy of degree. From the United States distant in future the AED motive is sold even from the retail store and. From our country like this plan government offices temporary disposal education from from 119 fire fighters emergency structure company in fire fighting government employee and nursing must magnify a former enterprise rainy spell in summer multi temporary disposal education with the head which it will burn with the head. This plan in early rising will be able to become fixed in Korea it forecasts with the fact that. The research which it sees it leads and like the United States to some day become fixed even from our country to believe and suspicion it is not and in the people in approach ease one AED supply plan fire fighting government employees stand in the first and feed with the fact that must be positive at this enterprise they become.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.120-131
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• 2024

Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

• The Journal of Korean Academic Society of Nursing Education
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• v.11 no.2
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• pp.278-286
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• 2005

Purpose: The purpose of this study was to find out the effectiveness of the CPR training for non-healthcare providers by checking the performing ability of the subjects before and after the teaching class. Method: This study was a single primary experimental study designed with pre and post test. Study subjects were 37 office staffs who participated in all test from March, 10th, 2005 to April, 18th, 2005. The tools of this study were CPR performing evaluation sheet and CPR teaching computer program. Data analyzed by descriptive statistics, t-test, repeated ANOVA and Bonferroni with SPSS 12.0 program. Result: The CPR practice performing ability statistically significant increased by the step of test. The CPR practice performing ability of learning experience group had significantly high score than non experience group. The self-confidence about CPR practice when faced emergency situation was increased after practice training. Conclusion: One to one CPR practice teaching method using simulation by CPR teaching specialists was turned out to be very effective in improving the ability of CPR practice of non-healthcare providers in a tertiary hospital than self-study.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1427-1431
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• 2016

Background: Potential disadvantages of blood transfusion during curative gastrectomy for gastric cancer have been reported, and the role of peri-operative transfusions remains to be ascertained. Thus, the aim of our study was to survey its impact in patients with gastric cancer undergoinging gastrectomy. Materials and Methods: Clinical data of patients receiving curative gastrectomy at Far Eastern Memorial Hospital were obtained. Findings for pre-operative anemia states, pre-, peri- and post-operative transfusion of red blood cell (RBC) products as well as post-operative complication events were collected for univariate analysis. Results: A total of 116 patients with gastric cancer received gastrectomy at Far Eastern Memorial Hospital from 2011 to 2014. Both pre-operative and intra- and post-operative transfusion of RBC products were markedly associated with post-operative infectious events (OR: 3.70, 95% CI: 1.43-9.58, P=0.002; OR: 8.20, 95% CI: 3.11-22.62, P<0.001, respectively). In addition, peri- and post-operative RBC transfusion was significantly associated with prolonged hospital stay from admission to discharge (OR: 8.66, 95% CI: 1.73-83.00, P=0.002) and post-operative acute renal failure (OR: 19.69, 95% CI: 2.66-854.56, P<0.001). Also, the overall survival was seemingly decreased by peri-operative RBC transfusion in our gastric cancer cases (P=0.078). Conclusions: Our survey indicated that peri-operative RBC transfusion could increase the risk of infectious events and acute renal failure post curative gastrectomy as well as worsen the overall survival in gastric cancer cases. Hence, unnecessary blood transfusion before, during and after curative gastrectomy should be avoided in patients with gastric cancer.

• Journal of the Korea Convergence Society
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• v.13 no.3
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• pp.265-274
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• 2022

This study was conducted on 3,418 cases of cardiopulmonary arrest patients' detailed status table (2020, raw data) collected in 2020. Also, it is a retrospective narrative research that investigates and examines related laws and guidelines. The main findings are as follows. First, the implementation rate of 'bystander CPR' was 30.66% (1047 cases) and it was a remarkable result. It can be inferred the quality of the relevant laws and guidelines. Second, 'Public access defibrillation (shock)' accounted for only 0.10%(5 cases). it is considered that the relevant laws and guidelines are weighted towards 'stock and obligation.' Strategic differentiation of response by region is needed. Third, out-of-hospital cardiac arrest occurred at house was 71.97%(2,640 cases). To operate the 'special ambulance team' efficiently, it is necessary to analyze regional data more closely and develop an efficient strategy in the future.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.23-30
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• 2020

Purpose: Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations. Methods: This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups. Results: We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%. Conclusions: Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.