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Relevance of emergency level assessment by the Korean Triage and Acuity Scale for adult patients in a local emergency medical center

  • Lee, Gun Woo;Lee, Suk Hee;Lee, Kyung-Woo;Jang, Tae Chang;Kim, Gyun Moo;Seo, Young Woo;Ko, Seung Hyun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.595-602
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    • 2018
  • Objective: The Korean Triage and Acuity Scale (KTAS), which was implemented in 2016, needs to be assessed for its validity and reliability. Here we evaluate the relevance of emergency level assessment by analyzing the validity of KTAS as a Korean standardized triage system. Methods: We retrospectively analyzed the medical records of adults who presented to a local emergency room (ER) during an 18-month period. We compared medical resources used, life-saving interventions performed, length of stay (LOS) in ER, admission rate, and mortality at each KTAS level. Results: Among a total of 40,339 patients, most patients were at KTAS 4 (n=19,532, 48.4%) and the longest median LOS in ER was 450 minutes at KTAS 2. As the KTAS level increased, the percentage of medical resources used and lifesaving interventions performed increased significantly. The odds of total admission and intensive care unit admission were significantly higher at KTAS 1 through 4 compared to those at KTAS 5. The odds related to admission and mortality were also significantly higher at KTAS 3 than at KTAS 4. Conclusion: We concluded that the KTAS, as a Korean standardized triage system of emergency level assessment, is relevant. Further, KTAS 1-3 and KTAS 4-5 are appropriate criteria to distinguish emergency and non-emergency patients.

Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma (외상성 급성 경막하 혈종 환자의 생존 관련 요인)

  • Ha, Hey-Jin;Woo, Sang-Jun;Lee, Seung-Woo
    • Journal of the Korea Convergence Society
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    • v.12 no.4
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    • pp.285-291
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    • 2021
  • This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

Case Study on the Building Organization of Medibio Research Laboratory Facilities in Research-driven Hospital (연구중심병원 의생명연구원의 실험실 구성 사례 조사)

  • Kim, Young-Aee
    • Journal of the Architectural Institute of Korea Planning & Design
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    • v.34 no.11
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    • pp.95-104
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    • 2018
  • Healthcare technology has been growing and fostering cooperation between industry, university and hospitals as growth engines in korea. So, the medibio research institutes in hospital have been constructed to promote research and industrialization centering on healthcare technology. The purpose of this study is to investigate the cases of research institutes in hospitals, and search the characteristics of building organization of medibio research laboratory facilities. Case study is investigated by floor plan, homepage and site visits about five research institutes selected in research-driven hospitals. The facility title and size of research laboratory is originated from site area and research building location. The building function include not only the research lab and business office reflecting on the development platform, and but assembly and meeting room in the ground level. Laboratory floor plans have three types, rectangular, rectangular+linear and linear type, one is traditional and efficient, the others are people and friendly. And building core types are correlated with lab space unit modules, single and double side core are shown in rectangular type. All the laboratories are open lab, composed with laboratory bench and research note writing desk facing the lab service and enclosed lab-support area. And they have communication space looking as warm and cozy common area for the innovation, convergence and collaboration. As the high risk of contamination and high standard for safety and security, equipment and facilities are well managed with biological environment including BSC, fume hood, PCR classification, eye washing and emergency shower.

A Risk Assessment of Asbestos Fiber Leaks to Environment during Asbestos Removal Activity in Buildings (건물 내 석면제거 작업과 공기 중 석면의 외부누출 위험성 평가)

  • Paik, Namwon;Lee, Soungcheoul;Byeon, Jaecheol;Lee, Donghee
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.30 no.4
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    • pp.405-411
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    • 2020
  • Objectives: The objectives of this study were to investigate whether airborne fibers were released to the outside air from the asbestos removal area in buildings, and to confirm the existence of asbestos fibers in samples using transmission electron microscopy(TEM). Methods: A total of 1,295 samples was collected from inside and outside 155 asbestos removal areas. To investigate the release of asbestos fibers from the removal area, samples were collected at three locations, such as an entrance to change room, an exit of negative pressure unit(NPU) and perimeter areas. Samples were also collected in the removal area prior to and after removal activity. All samples were analyzed by phase contrast microscopy(PCM) and one-tenth of the samples was analyzed using TEM to discriminate asbestos fibers. Results: During the asbestos removal activity, 27(4.1%) of 662 samples collected outside the removal area showed airborne fiber concentrations equal to or in excess of 0.01 f/cc, the permissible emission standard of the Korean Ministry of Environment. Further, 111 samples were analyzed using TEM. The distribution of asbestos fiber concentrations was log-normal. It was found that 51 of 111 samples(46%) contained asbestos fibers. Conclusions: There is a potential risk of asbestos exposure among neighbors and the public outside the asbestos removal areas. It is recommended that the asbestos removal work be conducted strictly following the specifications required by government and/or professional organizations.

Preparation and Characterization of Ordered Perovskite (CaLa) (MgMo) $_6$

  • Choy, Jin-Ho;Hong, Seung-Tae;Suh, Hyeong-Mi
    • Bulletin of the Korean Chemical Society
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    • v.9 no.6
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    • pp.345-349
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    • 1988
  • The polycrystalline powder of (CaLa) (MgMo)$O_6$ has been prepared at $1350^{\circ}C$ in $H_2/H_2O$ and $N_2$ flowing atmosphere. The powder X-ray diffraction pattern indicates that (CaLa) (MgMo)$O_6$ has a monoclinic perovskite structure with the lattice constants $a_0=b_0=7.901(1){\AA}$, $c =7.875(1){\AA}\;and\;{\gamma}=89^{\circ}$16'(1'), which can be reduced to orthorhombic unit cell, a = 5.551(1) ${\AA}$, b = 5.622(1) ${\AA}$ and c = 7.875(1) ${\AA}$. The infrared spectrum shows two strong absorption bands with their maxima at 590($ν_3$) and 380($ν_4$) cm, which are attributed to $2T_{1u}$ modes indicating the existence of highly charged molybdenum octahedron $MoO_6$ in the crystal lattice. According to the magnetic susceptibility measurement, the compound follows the Curie-Weiss law below room temperature with the effective magnetic moment 1.83(1)$_{{\mu}B}$, which is well consistent with that of spin only value (1.73 $_{\mu}_B$) for $Mo^{5+}$ with $4d^1$-electronic configuration within the limit of experimental error. From the thermogravimetric analysis, it has been confirmed that (CaLa) (MgMo)$O_6$ decomposes gradually into $CaMoO_4,\;MoO_3,\;MgO,\;La_2O_3$ and unidentified phases due to the oxidation of $Mo^{5+}$ to $Mo^{6+}$.

Comparison between Korean Triage and Acuity Scale and Injury Severity Scoring System in Emergency Trauma Patients (외상환자의 한국형 중증도 분류와 손상중증도 점수체계의 비교)

  • Choi, YoonHee;Kim, BoHwa;Shin, JiEun;Jang, MyungJin;Lee, EunJa
    • Journal of East-West Nursing Research
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    • v.28 no.1
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    • pp.10-20
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    • 2022
  • Purpose: We compared the Korean Triage and Acuity Scale (KTAS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) determined the validity of KTAS for classifying trauma patients. Methods: A retrospective chart review of 10,865 trauma patients (aged ≥15 years) who visited a single regional trauma and emergency medical center from January 1, 2016, to December 31, 2020, was conducted. Data were collected from the Korean Trauma Data Bank. Based on KTAS classification, the rates of intensive care unit admission, surgery and intervention, transfusion, emergency room (ER) and hospital mortality, and ER stay time were investigated. Data were analyzed using Chi-square test, Pearson's correlation coefficient, receiver operating characteristic curve, and area under the ROC curve. Results: In the KTAS, severe trauma patients (ISS ≥16) were classified as Level 1 (79.6%), 2 (44.8%), 3 (15.5%), 4 (4.0%) and 5 (7.6%). The following were the predictive powers of KTAS, ISS, and RTS for different parameters: surgery and intervention rate, KTAS (.71), ISS (.70), and RTS (.63); transfusion rate within 4h, KTAS (.82), ISS (.82), and RTS (.74); ER stay time within 90 min, KTAS (.72), ISS (.62), and RTS (.56); and ER mortality, KTAS (.84), ISS (.72), and RTS (.88). These findings were statistically significant (p<.001). The sensitivity and specificity of KTAS for trauma patients were .88 (.87~.90), and .38 (.37~.39), respectively. Conclusion: KTAS is a useful classification system that can predict the clinical outcomes of patients with trauma, and effectively triage acutely ill trauma patients, thus provide appropriate treatment.

Effect of dietary pumpkin (Cucurbita moschata) seed meal on layer performance and egg quality characteristics

  • Vlaicu, Petru Alexandru;Panaite, Tatiana Dumitra
    • Animal Bioscience
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    • v.35 no.2
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    • pp.236-246
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    • 2022
  • Objective: The objective of this study was to investigate the effect of dietary pumpkin (Cucurbita moschata) seed meal (PSM) on laying hens' performance, quality, fatty acids, cholesterol, antioxidant compounds and shelf life of eggs. Methods: Eighty Tetra SL laying hens, 50-week-old, were randomly divided into two equal groups, having 10 replicates with 4 birds in each. The control (CON) treatment was fed with basal diet, while experimental treatment was fed a diet with 9% PSM, for a 6 week period. Results: Dietary PSM significantly decreased average daily feed intake (p<0.05), with no significant effect on other performance parameters. The PSM, enriched the eggs with polyunsaturated fatty acids, especially α linolenic acid (0.33 vs 0.21 g/100 g) and linoleic acid (20.65 vs 18.37 g/100 g), whereas it reduced the amount of arachidonic acid with 3.91% and n-6/n-3 ratio in PSM eggs compared with CON. The inclusion of 9% PSM significantly (p<0.05) diminished the cholesterol concentration in yolk with 11.31% and in egg with 10.38%, in respect to the CON samples. The significantly (p<0.05) higher concentration of polyphenols and antioxidant compounds, determined in PSM eggs, proved to be effective on shelf life of eggs preserved at refrigerator (5℃) and room temperature (21℃) for 28 days, by delaying the lipid oxidation and protein denaturation. This effect was reflected in significantly (p<0.05) higher Haugh unit in eggs stored 28 days at 21℃ and lower albumen pH values for the overall storage time, both at 5℃ and 21℃, proving the antioxidant effect of pumpkin. Conclusion: Dietary PSM supplementation was significantly effective on average daily feed intake and egg quality by increasing some fatty acids while lowering the cholesterol concentration. Also, PSM proved to be effective improving shelf life of eggs for 28 days storage time.

Characterizing Residual Stress of Post-Heat Treated Ti/Al Cladding Materials Using Nanoindentation Test Method (나노압입시험법을 이용한 후열처리된 Ti/Al 클래딩재의 잔류 응력 평가)

  • Sang-Kyu Yoo;Ji-Won Kim;Myung-Hoon Oh;In-Chul Choi
    • Journal of the Korean Society for Heat Treatment
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    • v.36 no.2
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    • pp.61-68
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    • 2023
  • Ti and Ti alloys are used in the automobile and aerospace industries due to their high specific strength and excellent corrosion resistance. However their application is limited due to poor formability at room temperature and high unit cost. In order to overcome these issues, dissimilarly jointed materials, such as cladding materials, are widely investigated to utilize them in each industrial field because of an enhanced plasticity and relatively low cost. Among various dissimilar bonding processes, the rolled cladding process is widely used in Ti alloys, but has a disadvantage of low bonding strength. Although this problem can be solved through post-heat treatment, the mechanical properties at the bonded interface are deteriorated due to residual stress generated during post-heat treatment. Therefore, in this study, the microstructure change and residual stress trends at the interfaces of Ti/Al cladding materials were studied with increasing post-heat treatment temperature. As a result, compared to the as-rolled specimens, no difference in microstructure was observed in the specimens after postheat treatment at 300, 400, and 500℃. However, a new intermetallic compound layer was formed between Ti and Al when post-heat treatment was performed at a temperature of 600℃ or higher. Then, it was also confirmed that compressive residual stress with a large deviation was formed in Ti due to the difference in thermal expansion coefficient and modulus of elasticity between Ti Grade II and Al 1050.

Comparative Research on the Carbon Dioxide Liquefaction Using Several Refrigerants (몇 가지 냉매를 사용한 이산화탄소 액화에 대한 비교 연구)

  • ILSU PARK;PHILSUNG HWANG;KICHEOL JUNG;JUNESHU ANH;JUNGHO CHO
    • Transactions of the Korean hydrogen and new energy society
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    • v.34 no.2
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    • pp.226-233
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    • 2023
  • In this study, we compared the performance of several refrigeration cycles using different refrigerants and utilizing the cold heat of liquefied natural gas (LNG) for the liquefaction of carbon dioxide. The final conditions for the liquefied CO2 were set to -20℃ and 20 bar. The refrigerants used included R404a, ammonia, propane, and propylene using a vapor recompression refrigeration cycle. For the refrigeration cycle, the CO2 at room temperature and pressure was compressed in a two-stage compression process with an intermediate cooling stage using a refrigeration unit. To compare with the liquefaction process using refrigeration, we compressed the CO2 to 8 bar in a single compression stage and cooled it to around -50℃ using the cold heat of the LNG before liquefying it. Results showed that using ammonia as the refrigerant required the least amount of compressor power for the liquefaction process, and the heat transfer area of the evaporator was the smallest when using propylene as the refrigerant. Using the cold heat of LNG instead of refrigeration using R404a resulted in approximately 69% less energy consumption.

COVID-19 Vaccination and Clinical Outcomes at a Secondary Referral Hospital During the Delta Variant-dominant Period in West Sumatra, Indonesia

  • Didan Ariadapa Rahadi;Elfira Yusri;Syandrez Prima Putra;Rima Semiarty;Dian Pertiwi;Cimi Ilmiawati
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.3
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    • pp.221-230
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    • 2023
  • Objectives: The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model. Methods: This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables. Results: A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes. Conclusions: Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.