• Title/Summary/Keyword: Simulated Emergency

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Factors Affecting the Delay of a Decision to Admit Severe Trauma Patients and the Effect of a Multidisciplinary Department System: a Preliminary Study (중증 외상 환자의 입원 결정 지연에 영향을 미치는 요인과 공동진료시스템)

  • Kang, Mun-Ju;Shin, Tae-Gun;Sim,, Min-Seob;Jo, Ik-Joon;Song, Hyoung-Gon
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.113-118
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    • 2010
  • Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

On Power System Frequency Control in Emergency Conditions

  • Bevrani, H.;Ledwich, G.;Ford, J. J.;Dong, Z.Y.
    • Journal of Electrical Engineering and Technology
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    • v.3 no.4
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    • pp.499-508
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    • 2008
  • Frequency regulation in off-normal conditions has been an important problem in electric power system design/operation and is becoming much more significant today due to the increasing size, changing structure and complexity of interconnected power systems. Increasing economic pressures for power system efficiency and reliability have led to a requirement for maintaining power system frequency closer to nominal value. This paper presents a decentralized frequency control framework using a modified low-order frequency response model containing a proportional-integral(PI) controller. The proposed framework is suitable for near-normal and emergency operating conditions. An $H_{\infty}$ control technique is applied to achieve optimal PI parameters, and an analytic approach is used to analyse the system frequency response for wide area operating conditions. Time-domain simulations with a multi-area power system example show that the simulated results agree with those predicted analytically.

A COMPUTER SIMULATION MODEL AS A MEANS OF EMERGENCY EVACUATION TRAINING FOR CONSTRUCTION PROJECTS

  • Chung-Suk Cho;Dong-Cheol Shin
    • International conference on construction engineering and project management
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    • 2009.05a
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    • pp.864-868
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    • 2009
  • Fire safety management on any construction site should start with recognizing fire risks in the workplace, understanding the extent of the risks, and proper assessment of the controls necessary to reduce the risks. However, the most important step to prevent fire-related accidents on jobsites is the constant review and monitoring of processes and controls by all individuals involved. This study was conducted to analyze the effectiveness of using computer simulation as an addition to maps or floor plans in safety training and management. Simulex was used on a real project to model various egress routes and to identify potential problem areas of the evacuation strategy. This study highlights the efficacy of simulated emergency evacuation as a training tool that visually shows constantly altering means of egress.

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Evaluation of a Self-efficacy-based Basic Life Support Program for High-risk Patients' Family Caregivers (자기효능 증진 기본생명소생술 프로그램의 효과 평가 -심정지 고위험 환자 가족을 대상으로 -)

  • Kang, Kyunghee;Lee, Insook
    • Journal of Korean Academy of Nursing
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    • v.35 no.6
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    • pp.1081-1090
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    • 2005
  • Purpose: The purpose of this study was to evaluate a Self-efficacy-based Basic Life Support (SEBLS) program for high-risk patients' family caregivers on cardiac arrest. The SEBLS program was constructed on the basis of Bandura's self-efficacy resources as well as the International Liaison Committee on Resuscitation's '2000 Guidelines for CPR and ECC'. Method: The effect of the SEBLS program on emergency response self-efficacy and emergency response behavior such as BLS(Basic Life Support) knowledge and BLS skill performance was measured by a simulated control group pretest-posttest design. Study subjects were38 high-risk patients' family caregivers(20 experimental subjects and 18 control subjects) whose family patients were admitted to a general hospital in Incheon, Korea. Result: 1. Emergency response self-efficacy was significantly higher in the experimental subjects who participated in the SEBLS program than in the control subjects. (t=8.3102, p=0.0001). 2. For emergency response behavior, BLS knowledge (t=5.6941, p=0.0001) and BLS skill performance (t=27.8281, p=0.0001) was significantly higher in experimental subjects than in control subjects. Conclusion: A SEBLS program can increase emergency response self-efficacy and emergency response behavior, and could be an effective intervention for high-risk patient's family caregivers. Long-term additional studies are needed to determine the lasting effects of the program.

Creating a digitized database of maxillofacial prostheses (obturators): A pilot study

  • Elbashti, Mahmoud;Hattori, Mariko;Sumita, Yuka;Aswehlee, Amel;Yoshi, Shigen;Taniguchi, Hisashi
    • The Journal of Advanced Prosthodontics
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    • v.8 no.3
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    • pp.219-223
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    • 2016
  • PURPOSE. This study aimed to create a digitized database of fabricated obturators to be kept for patients' potential emergency needs. MATERIALS AND METHODS. A chairside intraoral scanner was used to scan the surfaces of an acrylic resin obturator. The scanned data was recorded and saved as a single standard tessellation language file using a three-dimensional modeling software. A simulated obturator model was manufactured using fused deposition modeling technique in a three-dimensional printer. RESULTS. The entire obturator was successfully scanned regardless of its structural complexity, modeled as three-dimensional data, and stored in the digital system of our clinic at a relatively small size (19.6 MB). A simulated obturator model was then accurately manufactured from these data. CONCLUSION. This study provides a proof-of-concept for the use of digital technology to create a digitized database of obturators for edentulous maxillectomy patients.

Survey of the Need for the Development of a Simulated Training Program that Reproduces Automobile Accidents (자동차 사고를 재현한 시뮬레이션 교육 프로그램 개발을 위한 요구도 조사)

  • Kang, Min-Ju
    • Fire Science and Engineering
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    • v.33 no.1
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    • pp.179-187
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    • 2019
  • This study performed a survey on the need for an automobile accident-simulation training program for 60 emergency workers and nine emergency medical professors. The results showed that the need for cervical spine immobilization use was highest (76.8%) in first-aid requiring simulation training, and the need for head injury was highest (75.4%) in the scenario requiring simulation training. Based on the 43-month working experience of emergency workers, the uses of pneumatic anti-shock garment, KED, and the need for rapid extrication were significantly different between the two groups (p=0.01, p=0.05). In addition, the scenario showed statistically significant differences in the need for face, abdomen, and other injuries in both group (p=0.05, p=0.04, p=0.03). The needs of emergency workers and emergency medical professors for an automobile accident simulation-training program were high, and the development of a simulation program is needed.

Analysis of the Emergency Water Supply Capacity in Agricultural Reservoirs Using K-HAS and Ratio Correction Factors (K-HAS와 비율보정 계수를 이용한 농업용 저수지의 비상연계 용수공급 가능량 분석)

  • Kim, Hayoung;Lee, Sang-Hyun;Na, Ra;Joo, Donghyuk;Yoo, Seung-Hwan
    • Journal of The Korean Society of Agricultural Engineers
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    • v.65 no.2
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    • pp.59-71
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    • 2023
  • As the frequency of drought increases due to climate change, water scarcity in agriculture would be a main issue. However, it seems difficult to solve the water scarcity by securing alternative water sources. The aim of this study is to analyze optimal water supply capacity of agricultural reservoir for emergency operation connecting reservoirs and dams. First, we simulated the water storage of agricultural reservoir playing the role emergency water supplier to other water facility such as dams and other reservoirs. In particular, the results of simulation of water storage through K-HAS model was calibrated using the optimization process based on ratio correction factors of outflow and inflow. Finally, the optimal amount of water supply securing water supply reliability in emergency interconnection operation was analyzed. The results of this study showed that Janchi reservoir could supply 12.8 thousand m3/day maintaining 90 % water supply reliability. The result of this study could suggest the standard for connecting water facilities as emergency water supply.

Flexible Intelligent Exit Sign Management of Cloud-Connected Buildings

  • Lee, Minwoo;Mariappan, Vinayagam;Lee, Junghoon;Cho, Juphil;Cha, Jaesang
    • International Journal of Advanced Culture Technology
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    • v.5 no.1
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    • pp.58-63
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    • 2017
  • Emergencies and disasters can happen any time without any warning, and things can change and escalate very quickly, and often it is swift and decisive actions that make all the difference. It is a responsibility of the building facility management to ensure that a proven evacuation plan in place to cover various worst scenario to handled automatically inside the facility. To mapping out optimal safe escape routes is a straightforward undertaking, but does not necessarily guarantee residents the highest level of protection. The emergency evacuation navigation approach is a state-of-the-art that designed to evacuate human livings during an emergencies based on real-time decisions using live sensory data with pre-defined optimum path finding algorithm. The poor decision on causalities and guidance may apparently end the evacuation process and cannot then be remedied. This paper propose a cloud connected emergency evacuation system model to react dynamically to changes in the environment in emergency for safest emergency evacuation using IoT based emergency exit sign system. In the previous researches shows that the performance of optimal routing algorithms for evacuation purposes are more sensitive to the initial distribution of evacuees, the occupancy levels, and the type and level of emergency situations. The heuristic-based evacuees routing algorithms have a problem with the choice of certain parameters which causes evacuation process in real-time. Therefore, this paper proposes an evacuee routing algorithm that optimizes evacuation by making using high computational power of cloud servers. The proposed algorithm is evaluated via a cloud-based simulator with different "simulated casualties" are then re-routed using a Dijkstra's algorithm to obtain new safe emergency evacuation paths against guiding evacuees with a predetermined routing algorithm for them to emergency exits. The performance of proposed approach can be iterated as long as corrective action is still possible and give safe evacuation paths and dynamically configure the emergency exit signs to react for real-time instantaneous safe evacuation guidance.

Implementing Best Practice in Critically Ill Organophosphate Poisoned Patient Through Simulation-Based Learning Program (중환임상중독환자의 상황 인지와 대처 방법에 대한 시뮬레이션 교육의 효과 연구)

  • Lee, Ji Hwan;Chung, Sung Phil;Chung, Hyun Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.15 no.1
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    • pp.31-39
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    • 2017
  • Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.

Development of Portable Wireless Emergency Units and Integrated System (휴대용 무선 응급 단말기 및 통합 시스템 개발)

  • Song, M.H.;Myoung, H.S.;Lee, K.J.
    • Proceedings of the KIEE Conference
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    • 2006.07d
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    • pp.2161-2162
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    • 2006
  • In this study, we developed five mobile units and an integrated system which can manage vital signs from each unit using Bluetooth wireless communication. The five kinds of mobile unit were so designed that each has different function to be applied according to the condition of patient properly. The mobile units can measure ECG signal of single or 12 channel, blood pressure, pulse and SpO2 signal from a patient. Also, to reduce the uncomfortable measurement, several types of units such as belt type, wrist type and necklace type were designed. Our proposed system can integrate and monitor several biological signals from different patient by using Bluetooth wireless communication simultaneously. The developed system was evaluated in the simulated emergent situation and showed the system can monitor 5 patients in maximum according to the data quality. It showed the possibilities that the developed system can be used effectively for emergency situation or in- or out-hospital transport of patient. In future, with the combination of mobile communication technique, a patient who is in emergency situation can be provided with proper first-aid and a doctor can pile information of patient and give better diagnosis and treatments.

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