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The Level of Awareness and Practice in Prehospital Emergency Patient Assessment and Emergency Care of Paramedic in Fire Station (1급 응급구조사의 병원 전 응급환자평가와 응급처치시행에 대한 인식과 실천정도)

  • Kang, Yong-Ju;Choi, En-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.2
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    • pp.67-84
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    • 2011
  • Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

Postoperative Changes of Pulmonary Function in Chest Surgery (개흉후 폐기능 변화에 대한 연구)

  • Jo, Gwang-Jo;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1169-1179
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    • 1992
  • To determine the period and degree of full recovery of postoperative pulmonary function, the author performed seiral pulmonry function test with spirometry at preoperative period and 1st, 2nd, 3rd, 4th, 6th and 8th postoperative week in 64 patients who underwent chest surgery form 1990. 1. to 1990. 8. at Dep. of Thoracic & Cardiovascular surgery, Pusan National University Hospitcal, Pusan, Korea 28 patients underwent lung resection[Group A], 14 patients mediastinal and other thoracic surgery[Group B], and 22 patients heart surgery with cardiopulmonary bypass[Group C]. Al of them recovered normally and discharged without any complications. Their serial changes of pulmonary function test were compaired and its results was as follows; l. Over all mean recovery time of restrictive ventilatory function tests[ie, VC, ERV, IC, FEF1, FVC, FEF200-1200, MVV] were 4th & 6th postoperative week, and that of obstructive ventilatory function tests[ie., EFE25-75%, Vmax50] were 2nd postoperative week. 2. In patient who underwent lung resection surgery[Group A], FEF1 recovered in 4th~6th postoperative week and its ratio to preoperative value was 70% in pneumonectomy, and 75% in lobectomy. FVC recovered in 4th~6th postoperative week and its ratio to preoperative value was 65% in pneumonectomy, and 80% in lobectomy. MVV was recovered in 4th~8th postoperative week and recovery ratio was 80%, FEF200-1200 was recovered at 4th~6th postoperative week and its recovery ratio was 70%, FEF25-75% and Vmax50 was recovered in 2nd~4th postoperative week and recovered nearly to preoperative level. 3. In patient who underwent mediastinal and other thoracic surgery[Group B], FEV1 and FVC and recovered in 4th~6th postoperative week and the recovery ratio of FVC in blebectomy was 90%. MVV reached preoperative level in 4th~8th postoperative week. FEF200-1200, FEF25-75% and Vmax50 were recovered in 2nd~4th postoperative week and the recovery of FEF25-75% and Vmax50 in blebectomy was prominant. 4. In patient who underwent heart surgery[Group C], FEV1 and FVC were recovered in 4th~6th postoperative week. The recover ratio of FEF25-75% and Vmax50 was delaied to 6th~8th postoperative week From the above results we concluded that the recovery time of posoperative restrictive ventilatory disorder was 4th postoperative week and pulmonary complication would possibly occure during that period. So more intensive observations will be needed.

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A Study on the Incidence of Diabetes and Its Risk Factors in the Impaired Glucose Tolerence (내당성장애군에서의 당뇨병 발생률과 그 위험요소에 관한 연구)

  • Park, Joo-Hee;Shin, Yeon-Gyo;An, Jae-Eok;Kim, Joo-Ja;Nam, Taik-Sung;Lee, Byung-Kook
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.3 s.47
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    • pp.425-436
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    • 1994
  • This is to study the incidence of Diabetes and its risk factors in the impaired glucose tolerence group. 1084 subjects who had been examined 3 times for regular check-up in one human dock center under the university hospital were studied between $1986{\sim}1993$. The results are as follows; Prevalence rate of diabetes was 3.56%, and that of impaired glucose tolerence was 30.90% as of initial examination. The rate of diabetes was increasing with the age where 1.2% at age group $30{\sim}39$, 3.21% at age group $40{\sim}49$, 5.84% at age group $50{\sim}59$, 14.28% at age group 60 and over. And also the rate of impaired glucose tolerance was increasing with the age where 21.29% at age group $30{\sim}39$, 31.42% at age group $40{\sim}49$, 38.91% at age group $50{\sim}59$, 33.33% at age group 60 and over Of the examinees who were initially examined, total incidence rate of diabetes who developed to obvious diabetes at the 3rd follow-up examination from the initially impaired glucose tolerence group was 4.63% and it was 11.3 times higher than from the normal group (0.41%). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (Relative Risk, 10.48). Test for trends for developing to diabetes by the increasing level of fasting blood sugar and 1hr blood sugar at the initial examination were statistically significant in either normal and impaired glucose tolerence group. To determine the risk factor for developing to diabetes, logistic regression test was applied. Only fasting blood sugar and 1hr blood sugar were predictors for developing diabetes from the impaired glucose tolerence group at initial examination.

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Determination of Unit Hydrograph for the Hydrological Modelling of Long-term Run-off in the Major River Systems in Korea (장기유출의 수문적 모형개발을 위한 주요 수계별 단위도 유도)

  • 엄병현;박근수
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.26 no.4
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    • pp.52-65
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    • 1984
  • In general precise estimation of hourly of daily distribution of the long-term run-off should be very important in a design of source of irrigation. However, there have not been a satisfying method for forecasting of stationar'y long-term run-off in Korea. Solving this problem, this study introduces unit-hydrograph method frequently used in short-term run-off analysis into the long-term run-off analysis, of which model basin was selected to be Sumgin-river catchment area. In the estimation of effective rainfall, conventional method neglects the Soil moisture condition of catchment area, but in this study, the initial discharge (qb) occurred just before rising phase of the hydrograph was selected as the index of a basin soil moisture condition and then introduced as 3rd variable in the analysis of the reationship between cumulative rainfall and cumulative loss of rainfall, which built a new type of separation method of effective rainfall. In next step, in order to normalize significant potential error included in hydrological data, especially in vast catchment area, Snyder's correlation method was applied. A key to solution in this study is multiple correlation method or multiple regressional analysis, which is primarily based on the method of least squres and which is solved by the form of systems of linear equations. And for verification of the change of characteristics of unit hydrograph according to the variation of a various kind of hydrological charateristics (for example, precipitation, tree cover, soil condition, etc),seasonal unit hydrograph models of dry season(autumn, winter), semi-dry season (spring), rainy season (summer) were made respectively. The results obtained in this study were summarized as follows; 1.During the test period of 1966-1971, effective rainfall was estimated for the total 114 run-off hydrograph. From this estimation results, relative error of estimation to the ovservation value was 6%, -which is mush smaller than 12% of the error of conventional method. 2.During the test period, daily distribution of long-term run-off discharge was estimated by the unit hydrograph model. From this estimation results, relative error of estimation by the application of standard unit hydrograph model was 12%. When estimating by each seasonal unit bydrograph model, the relative error was 14% during dry season 10% during semi-dry season and 7% during rainy season, which is much smaller than 37% of conventional method. Summing up the analysis results obtained above, it is convinced that qb-index method of this study for the estimation of effective rainfall be preciser than any other method developed before. Because even recently no method has been developed for the estimation of daily distribution of long-term run-off dicharge, therefore estimation value by unit hydrograph model was only compared with that due to kaziyama method which estimates monthly run-off discharge. However this method due to this study turns out to have high accuracy. If specially mentioned from the results of this study, there is no need to use each seasonal unit hydrograph model separately except the case of semi-dry season. The author hopes to analyze the latter case in future sudies.

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The Effect of the Unsaturated Oil on the Normal Liver and Lipid Metabolism of Rats Fed Several Plant Oils (불포화도가 다른 식물성 유지를 섭취시킨 흰쥐에서 정상적 간 및 지질대사변화의 고찰)

  • 서화중;김선희;정두례
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.20 no.5
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    • pp.426-432
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    • 1991
  • To investigate the effect of the unsaturated plant oil on the normal liver and lipid metabalism rats were fed the daily dose of 1.57ml/kg body weight of perilla oil (Iodine value 190~207), corn oil (Iodine value 115~130) and olive oil (Iodine value 80~85) respectively for 28 days. The results were as follows. For the 14 days the test groups showed normal weight gain with 7.86~20.89% increase rate. In the period of the 3rd and the 4th week the increase rate of the perilla oil group was decreased significantly under 17.53~13.8% of control level, but the remainders(corn oil, olive oil) keep normal. The feeding of corn and olive oil for 28 days did show any harmful effect on normal GOT, GPT activity, ALK-P, serum cholesterol and serum triglyceride value of rat. The perilla oil feeding for 21~28 days slightly increased the GOT, GPT activity as 174.87, 93.46u but decreased the cholesterol and triglycerids value as 54.6~0.36mg/dl compared to control. In the pathological finding of test group liver some rats in 28 days feeding group showed reactive vesicula nuclei in corn oil group and mild fatty metamorphosis in olive oil group. But most subjects did not show any characterized sign of acute or subacute liver damage.

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A Clinical Study of Tsutsugamushi Fever in Children during 1997~2000 in the Western Kyungnam Province (최근 4년간 서부 경남지역의 소아에서 발생한 쯔쯔가무시열의 임상적 고찰)

  • Ju, Hye Young;Lee, Jun Su;Kim, Jeong Hee;Yoo, Hwang Jae;Kim, Chun Soo
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.213-221
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    • 2001
  • Propose : Tsutsugamushi fever is a acute febrile disease, which is caused by O. tsutsugamushi. Recently, this disease is increasingly reported in children. This study was undertaken to investigate clinical features of tsutsugamushi fever in children. Methods : This study involved 17 children with tsutsugamushi fever who were admitted to Masan Samsung hospital between September 1997 and December 2000. We investigated the age, sex ratio, clinical manifestations, laboratory findings, response of therapy and prognosis. Results : The age of patients was $6.9{\pm}3.6$ years, ranging from 6 months to 12 years and male predilection(58.8%) was noted and all cases of patients occured in October or November. The most common symptoms were fever in all cases and headache in 8(47.1%). The most common signs were skin rash in all cases, eschar in 14(82.4%) and lymphadenopathy 8(47.1%). Locations of the eschars were back and inguinal area in each 3 cases, neck and chest in each 2, popliteal area in 2, scalp and thigh in each 1. Laboratory findings included anemia in 1 case, leukopenia and thrombocytopenia in each 5, hematuria and proteinuria in each 1, ESR elevation in 2 and positive CRP in 12, AST elevation in 9 and ALT elevation in 7. Serologic diagnosis was made by passive hemagglutination assay(PHA) in 8 cases(47%) on admission, 4 cases in initial negative group were performed follow-up test at 2nd or 3rd weeks of illness and then all cases of 4 were converted to positive reaction. Clinical improvement was noticed in all cases after treatment to chloramhenicol or doxycycline. Mean duration for defervescence after treatment was $1.4{\pm}0.8$ days. Complications were interstitial pneumonia in 1 case and aseptic meningitis in 3, but all cases of patients were recovered without sequelae or recurrence. Conclusions : Tsutsugamushi fever in children was similiar to adult in the clinical features except male predilection. Early diagnosis and empirical treatment based on clinical manifestations such as fever, skin rash, eschar, lymphadenopathy is important and serologic diagnosis need to perform follow-up test at 2nd or 3rd weeks of illness.

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Effects of Glue Sniffing on Weight Increase or Central Nervous System of Young Rat (반복된 본드 흡입이 백서의 정상발육에 의한 체중증가와 중추신경계에 미치는 영향)

  • Kim, Heon;Kim, Sun-Min;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.222-230
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    • 1993
  • Industrial glues, known as 'Bonds' in Korea, contain many kinds of organic solvents, and glue sniffing of youths became one of the social problems in Korea. Mixed exposures to solvents by glue sniffing may induce chronic toxicities different from those by exposures to solvents of single component. To test effects of the glue sniffing on weight gain or central nervous system, two groups of 20 male Sprague-Dawley rats were exposed to air(control group) or vapors of the glues to narcotic status(exposed group), and weight check, tail flick test, hot plate test, rotarod treadmill test were done on the 14th,24th, 36th, 45th, 53rd, 86th, 102nd, 117th, 134th and 151st days after the first exposure. On the 188th day, their brains were excised and examined by a pathologist. Weight gain, controlled against time change, showed significant difference between the groups, but response times in tail flick test, hot plate tests, and rotarod treadmill test didn't. In pathological examination with blind method, no macroscopic or microscopic differences were found between the two groups. These results suggests that organic lesion in central nervous system may not ensue glue sniffing, but, before firm conclusion, more studies in various exposure conditions should be followed.

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A Study on the Knowledge and Attitude about Tuberculosis on Elementary School student in Seoul (서울 시내 일부 국민학교 6학년 학생들의 결핵에 대한 지식 및 실태에 관한 연구)

  • Kim, Eun-Hee
    • Research in Community and Public Health Nursing
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    • v.5 no.2
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    • pp.181-202
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    • 1994
  • This study was conducted in order to grasp the condition of the student's knowledge and attitude about tuberculosis. And to offer the basic materials for the prevent tuberculosis in elementary school. The objects were comprised 395 of volunteered 6th grade students who study in two elementary schools. The material of this study was the questionaire(chronbach $\alpha=.9016$) suited to the purposed of this research which has been made through studying references. All the questionaire were collected immediately without explanation. The data was collected from 13rd to 25th of May on 1994. Analysis of the data was done utilizing SPSS for percentage, mean, ANOVA and pearson-Correlation Coefficient. The Result are as follows; 1. General features of the objects of study. Sex distribution was similar. Salary of 1000-1500 thousand won were highest (40.2%), nuclear family was highest (87.1%), fathers of graduated high school were the highest(44.0%), mothers of graduated high school were the highest(56.8%). And there was nobody about tuberculosis patient in one's close relatives were highest(95.4%). 2. The conditions of attitude about tuberculosis. Having experience of tuberculin test were highest(59.0%). Less than 9mm indulation among the tuberculin tested group were 85.1%, more than indulation were 14.9%. Have a B. C. G. injection among the less than 9mm indulation were 83.2%. Leave alone among the more than 10mm indulation were 56.0%. Think it too much trouble to do not tuberculine test were 63.0%. Do not take a chest X-ray in the past were 60.3%. And take a chest X-ray in the past were 39.7%. Health educated group was 74.3%. If tuberculosis sign was developed, notified to parent was 73.8%. 3. The condition of knowledge about tuberculosis. When 5 points was given to 'very affiming' and 1 point was given to 'very deny', the total average was 3.54. And symptom of tuberculosis secion was 3.67, vaccination of tuberculosis section was 3.66, tuberculine test section was 3.56, epidemiology of tuberculosis section was 3.54, infection of tuberculosis section was 3.38. And every section showed affirmative correlation(P<.001). 4. Correlation between the general features and attitude variables. High incomed group may have more attitude on tuberculin test than low incomed group($x^2=16.$ 190, P<.01). High educated group may have more attitude on tuberculin test than low educated group(Father : $x^2=28.530$, P<.001, Mother: $x^2=26.060$, P<.001). High educated group may have more attitude on health education than low educated group(Father: $x^2=20.$ 767, P<.000, Mother: $x^2=10.639$, P<.05). Nuclear family may have more attitude on notify to parent than others($x^2=51.45$, P<.000). Tuberculosis patient in one's close associates have more attitude on notify to parent than others($x^2=51.$ 45, P<.000). 5. Difference between the general features and knowledge of tuberculosis. High incomed group were highest score in knowledge (F=3.99, P<.01). High educated group were highest score in knowledge(Father : F=8.81, P<.000, Mother: F=9.09, P<.000). 6. Difference between the attitude and knowledge of tuberculosis. Tuberculin tested group were highest score in knowledge(t=9.88, P<.000). Taken chest X-ray group were highest score in knowledge (t=2.07, P<.05). Received health education group were highest score in knowledge(t=6.83, P<.000). Notified symptoms to teachers and parent group were highest score in knowledge(F=3.89, P<.01).

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The Development and Effect of a Group Counseling Program for Unemployed Matriarchs (실직 여성가장을 위한 집단 상담 프로그램 개발 -생의 의미에 미치는 효과검증-)

  • Lee, Jeong-Ji;Shin, Kyung-Il;Choi, Soon-Ock;, Sook-Nam;Lee, Boo-Hyeon
    • Journal of Korean Academy of Nursing
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    • v.30 no.4
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    • pp.982-994
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    • 2000
  • This study was designed to develop a program for unemployed matriarchs and show if the program affected their view on the meaning in life. The subjects were women registered in an occupational training program for unemployed matriarchs, which is being practiced in the 'Working Women Center' located in Busan. The researchers selected 44 persons from the group who agreed to our program. This study was done from the 10th of March, 1999 to the 9th of October. The researchers used the measurement tools, The Purpose in Life, Self-esteem, Hope and Meaning in Life which was composed of 63 items developed by them. Their Cronbach's alpha were .88, .79, .76 and .95. The researchers analyzed the data with frequency, percentage, Mean, S.D, Wilcoxon signed ranks test which were deduced from SPSS 10.0 WIN program. The results of this study were as follows: 1) The program is composed of 'becoming intimate', 'open-minded', 'exploration on self', 'relax of repressed emotion', 'self- acceptance', 'establishing the life-goal', 'enrichment of human relationship' and closing. It took 20 hours for this program to come into practice. 2) According to the analysis of the general traits of all subjects, average age was 39.36. High school graduates were 86%, college graduates were 14% and divorce were 57%, bereavement were 18%, and the rest were 25%. 3) The result of 1st progam showed self-esteem during the program was high. 4) The result of 2nd progam showed self-esteem during the program was high. 5) The result of 3rd progam showed the sum scores of meaning in life, creative meaning, and attitudinal meaning during the program was high. 6) The result of 4th progam showed the sum scores of meaning in life and creative meaning during the program was high. On the viewpoint of above results, we convinced that 'a program for unemployed matriarch is effective to establish a stronger meaning in life. Therefore, it is demanded that support for unemployed matriarchs should not only be economic help such as technical training and help of living expenses, but also psychological, professional and systematic support.

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A Review on Stress and Coping Level at Dysmenorrhea Perceived by Middle School Girls in Seoul (월경곤란시 여자중학생이 지각하는 스트레스 및 그 대응에 관한 소고)

  • Jung Moon-Hee
    • Journal of Korean Public Health Nursing
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    • v.5 no.2
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    • pp.45-51
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    • 1991
  • The purpose of this study is to investigate the stress and coping level as a result of dysmenorrhea which was experienced by girls. For the collection of data, the girls from the 1st to the 3rd grade in middle school in Seoul were selected through a random sampling technique. The survey was conducted from the 1st. to the 14th of June, 1991 by the use of questionnaires made after a pilot study. The final subjects for analysis were restricted to only those who had experienced me~arche, the number of which totaled 1,131. The stress, coping level, and other variables, were tested and analysed by descriptive statistics (eg, frequency, percentage, mean and standard deviation), t-test, ANOVA and Pearson's correlation coefficients. The obtained results are summarized as follows. 1. The chronological start for menarche was at a mean age of 13.1 The respondents who had experienced menarche numbered $70.9\%$ of the 1st grades and $96.2\%$ of the 2nd grades in middle school, otherwise the starting age for menarche was in the 4th grade in primary school. 2. Their menstrual cycle and period were longer than adult's one. The number of students studied who had experienced dysmenorrhea during their menstrual cycle were 860, and 650 of those revealed that their mothers or sisters had experienced similar problems. 3. The subjects who were late or head left early rather than being absent from school every menstruation cycle were more stressful. The results are thought to show that the girl's perception of dysmenorrhea seems to be more sensitive than adult's one. 4, A significant negative correlation was found between the perception of menstrual flow and strees level. It means that an increase in the stress of dysmenorrhea was associated with decreased menstrual bleeding. The degree of hypochondrical concern assessed by the girls was significantly correlated to stress and coping level. When the girls perceived high stress as a result of dysmenorrhea, they worried about their physical health more. The above results lead us to the suggestion that the starting point of early education with a school program is appropriate for the 4th grade in primary school. Especially if the girls in middle school should be required to give the information about correct knowledge and sufficient self -care management of menstruation monthly, if this could be implemented the loss in school days among the students due to dysmenorrhea would be minimized with more ease.

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