• 한국응급구조학회지
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• 제7권1호
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• pp.179-198
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• 2003

If see disaster administration system of our country, start in terms of is coping by countermeasure after four immediately after disaster occurrence many problems blessing with a sons by tribe and so on of link nature between formation, disaster administration complete charge utensil's absence, disaster charge manpower and budget be indicated and join. If examine improvement way accordingly, is as following ; Necessity of synthetic disaster administration system, Fire fighting formation's independence guarantee, Integration of fire fighting connection similarity business, Disaster administration's permanent establishment complete charge utensil's necessity, Disaster administration midautumn complete charge utensil at a metropolitan autonomous fire fighting system reorganization, Role division of labor between center and local government, Disaster administration professional human strength positivity, Disaster administration information system construction practical use, Equipment and improvement of budget state, Education public information for safety culture consciousness fixing, Internationalization of fire fighting business, globalization propulsion, Structure, member of rescue confrontation system and efficiency. Fire fighting environment is changing greatly, and fire fighting must become center to correspond to do confrontation that do one thing troble when produce disaster.

• 한국암반공학회:학술대회논문집
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• 한국암반공학회 2008년도 국제학술회의
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• pp.33-41
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• 2008

The longest tunnel has been halted at Daekwanryung by the failure of the host country of the Winter Olympiad in 2014, but modern High-Power TBM will come to Korea to excavate these long tunnels to establish the better horizontal connection between the western and eastern countries to improve the strong powerful logistic strategy of Korean peninsula. Train operation provides a key function of air movements in a long underground tunnel, and heat generation from transit vehicles may account of the most heat release to the ventilation and emergency systems. This paper indicates the optimal fire suppress services and safety provision for the long railway tunnel which is designed twin tunnel with length 22km in Gangwon province of Korea. The design of the fire-fighting systems and emergency were prepared by the operation of the famous long-railway tunnels as well as the severe lessons from the real fires in domestic and overseas experiences. Designers should concentrate the optimal solution for passenger's safety at the emergency state when tunnel fires, train crush accidents, derailment, and etc. The optimal fire-extinguishing facilities for long railway tunnels are presented for better safety of the comfortable operation in this hard rock tunnel of eastern mountains side of Korea. Since year 1900, hard rock tunnel construction has been launched for railway tunnels in Korea, tunnels have been built for various purposes not only for infrastructure tunnels including roadway, railway, subway, and but also for water and power supply, for deposit food, waste, and oils etc. Most favorable railway tunnel system was discussed in details; twin tunnels, distance of cross passage, ventilation systems, for the comfortable train operations in the future.

• 한국응급구조학회지
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• 제25권3호
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• pp.127-143
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• 2021

Purpose: The purpose of the study is to investigate the actual state of activity on domestic and foreign civil anti-disaster organizations, related suggestions, and development plans. Methods: This study used the documentary survey research method and the technical approach method. Civil anti-disaster organizations' information was derived from detailed scholarly monographs, specialty publications, and previous studies of master doctorate dissertation. Results: Volunteer Fire Department and voluntary crime prevention groups show problems related to budgetary deficits and volunteer deficiency. In order to resolve these issues, laws must be enacted to guarantee interest and support. In addition, the Citizen Corps Active in Disaster (CAIND) organization requires a dedicated salary system to address the investment of its workforce and the cost of heavy equipment. Moreover, deficiencies were revealed regarding the lack of systems in support of occupational education and training. In conclusion, several weak points require close attention. Conclusion: The results of this comparative analysis study about the domestic and foreign civil anti-disaster organizations provide insight into identity materialization and concept establishment.

• 대한치과의사협회지
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• 제50권12호
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• pp.755-762
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• 2012

Objective : The aim of this study was to investigate risk factor, precaution and treatment of aspirated foreign body during dental procedure. Material and Methods : Twenty cases of accidental aspiration of the foreign body, which removed by bronchoscopy at the Asan Medical Center between 2008 and 2012, were analyzed retrospectively. Results : Ten cases of accidental aspiration were occurred during dental procedure. Symtoms include cough(65%), dyspnea(50%), sputum(25%) and wheezing(25%). The most common location of foreign body was right bronchial tree(50%), left bronchial tree(45%) and carina(5%). Patients risk factors were chronic obstructive pulmonary disease, lung cancer, pulmonary tuberculosis, esophageal cancer and vegetative state. Conclusion : Accidental aspiration or swallowing of dental instrument or material is not uncommon accidents in dental practice. Most foreign bodies enter into gastrointestinal tract spontaneously. But aspiration into broncho-trachea can be more serious events and must be treated as an emergency situation. Prompt emergency treatment and removal of the foreign body is necessary to avoid complication. Dentists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental procedures.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권4호
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• pp.235-239
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• 2015

The Combitube is an emergency airway-maintaining device, which can supply oxygen to dyspneic patients in emergency situations following two-jaw surgery. These patients experience difficulty in opening the mouth or have a partially obstructed airway caused by edema or hematoma in the oral cavity. As such, they cannot maintain the normal airway. The use of a Combitube may be favorable compared to the laryngeal mask airway because it is a thin and relatively resilient tube. A healthy 24-year-old man was dyspneic after extubation. Oxygen saturation fell below 90% despite untying the bimaxillary fixation and ambubagging. The opening of the mouth was narrow; thus, emergency airway maintenance was gained by insertion of a Combitube. The following day, a facial computer tomography revealed that the airway space narrowing was severe compared to its pre-operational state. After the swelling subsided, the patient was successfully extubated without complications.

• Journal of Korean Biological Nursing Science
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• 제8권2호
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• pp.73-92
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• 2006

Purpose: This study was to understand actual state of supportive behavior of parents and nurses during invasive procedure for children who visit emergency medical center. Method: The object group was children's parents who have from 0 to 7 aged children takes invasive procedure except neonates and nurses who take part in the invasive procedure. Among them, 80 children's parents and 31 nurses were selected. For data analysis, SPSS for Window 8.0 was used and especially content analysis was performed for concrete supportive behavior of parents and nurses by survey. Results: Supportive behavior of parents and nurses during children's invasive procedure gave negative influences to the children, because most parents supplied poor supportive behavior without preparation, nurses performed work-oriented and treatment-oriented nursing due to speciality and busy business in emergency medical center. Conclusion: To lead positive and affirmative supportive behavior of parents and nurses during children's invasive procedure, for parents, positive supportive behavior ability must be strengthen through the overall education about children's invasive procedure when they visit emergency medical center or go to hospital: for nurses, hospital must provide successive instruction and policy to make nurses perform not work-oriented but patient-oriented nursing and positive supportive behavior.

• 대한임상독성학회지
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• 제16권2호
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• pp.86-92
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• 2018

Purpose: Cardiovascular or respiratory complications of acute intoxication are the most common causes of mortality. Advanced cardiac life support (ACLS) or specific antidotes help manage these cardiac or respiratory complications in acute intoxication. On the other hand, some cases do not respond to ACLS or antidotes and they require some special treatment, such as extracorporeal life support (ECLS). ECLS will provide the chance of recovery from acute intoxication. This study examined the optimal timing of ECLS in acute intoxication cases. Methods: This paper is a brief report of a case series about ECLS in acute poisoning. The cases of ECLS were reviewed and the effects of ECLS on the blood pressure and serum lactate level of the patients were analyzed. Results: A total of four cases were reviewed; three of them were antihypertensive agent-induced shock, and one was respiratory failure after the inhalation of acid. The time range of ECLS application was 4.8-23.5 hours after toxic exposure. The causes of ECLS implementation were one for recurrent cardiac arrest, two for shock that did not respond to ACLS, and one for respiratory failure that did not respond to mechanical ventilator support. Three patients showed an improvement in blood pressure and serum lactate level and were discharged alive. In case 1, ECLS was stared at 23.5 hours post toxic exposure; the patient died due to refractory shock and multiple organ failure. Conclusion: The specific management of ECLS should be considered when a patient with acute intoxication does not recovery from shock or respiratory failure despite ACLS, antidote therapies, or mechanical ventilator support. ECLS improved the hemodynamic and ventilator condition in complicated poisoned patients. The early application of ECLS may improve the tissue perfusion state and outcomes of these patients before the toxic damage becomes irreversible.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.71-76
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• 2009

Purpose: The goal of this study was to compare the outcome of the after trauma team (AfterTT) group to the before trauma team (BeforeTT) group. Methods: All trauma patients who visited to emergency room (ER) between July 1, 2006 and February 29,2008 based on trauma registry, with systolic blood pressure (SBP) < 90 mmHg or GCS < 9 were included in this study. We compared the amount of packed RBC transfusion, the ER stay time, the ER visit to CT evaluation time, the ER visit to operation time, the length of ICU stay, the length of hospital admission and the survival discharge rate between the AfterTT group and the BeforeTT group. Patients with brain injuries had little chance of survival. Burn patients, who visited the ER 24 hours after injury and patients who were dead on arrival (DOA) were excluded from this study. Results: Total of 93 patients were included in this study: 42 in the AfterTT group and 51 in the BeforeTT group. The AfterTT group and the Before TT group showed no differences in Revised Trauma Score (RTS) and mean age. The amount of packed RBC transfusion was lower in the AfterTT group, but no statistically significant difference was noted (AfterTT 11${\pm}$11units, BeforeTT 16${\pm}$15units, p=0.136). The ER visit to operation time was shorter in the AfterTT group, but there were no statistically significant difference between the groups (AfterTT 251${\pm}$223 minutes, BeforeTT 486${\pm}$460 minutes, p=0.082). The length of ICU stay was shorter in the AfterTT group, but the difference was not statistically significant (AfterTT 11${\pm}$12 days, Before TT 15${\pm}$30 days, p=0.438). The length of Hospital admission was shorter in the AfterTT group (AfterTT 43${\pm}$37 days, BeforeTT 68${\pm}$70 days, p=0.032), but this difference was not statistically significant. Conclusion: Simple Trauma team activation criteria decreased the amount of packed RBC transfusion and the hospital admission duration. Hemodynamic instability (SBP < 90 mmHg) and decreased mental state (GCS<9) are good indices for activating the trauma team.

• 한국응급구조학회지
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• 제13권2호
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• pp.5-15
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• 2009

Purpose : This study was to examine the secondary traumatic stress(STS) and related factors of emergency medical technicians. Methods : This study was conducted among 190 emergency medical technicians, over the age of 25, with the 1st or 2nd grade qualification, who serve at fire stations in U and P city of Korea. The collected data for this study was analyzed using SPSS 12.0. Result : The average character type of A-type personality technicians was 43.25 points and the average of B-type personality technicians was 37.82 points. It suggested that the former was higher than the latter. State anxiety did not show statistically significant difference between A-Type group and B-Type group with the score of 48.51 for A-Type and 47.91 for B-Type. Physical symptoms showed statistically significant difference between the two groups with the higher score of 28.45 for A-type group than that of 28.13 for B-Type group. The level of STS related to the volunteers' job characteristics was found to be low when the volunteers were satisfied with their job and didn't want to transfer to another division. Those on duty who had slept more than seven hours that day had the highest points. The number of points was highest when the frequency for the onset of trauma was between 20~30 times. Furthermore it was found that for most technicians, 71.05%, the period of symptoms lasted for a few weeks at most, and this was where the STS was the lowest, whereas on the other hand the highest STS occurred when the symptoms lasted for a period of up to six months. The findings showed significant correlations with a relation of r=.24 between STS and level of anxiety and r=.45 between STS and physical symptoms. However, no significant correlation was found between the level of anxiety and physical symptoms. Conclusion : The more emergency medical technicians are exposed to accidents, the more serious the STS are. Those with an A-type personality are especially prone to have higher STS. The higher the STS level is, the higher the level of physical states and anxiety is.

• 한국건설관리학회논문집
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• 제20권3호
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• pp.46-53
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• 2019

최근 화재나 지진 등의 대규모 재난에 대한 위험이 증가함에 따라 효율적인 재난의료대응을 위한 자원관리체계가 요구된다. 이를 위해 행정안전부에서 재난관리자원 공동활용시스템 구축을 완료하였으나, 응급의료시설관련 자원은 에어텐트와 음압텐트가 장비로 분류되어 관리되는 등 투입시점, 존치기간, 운송 및 설치 방법과 같은 시설특성을 반영한 관리체계는 구축되어 있지 않고 있는 실정이다. 따라서 본 연구에서는 현재 재난관리 공동활용시스템에서 자재와 장비로 구분하여 관리하고 있는 재난관리자원의 효율적 관리를 위해 응급의료 시설자원을 고려한 응급의료 시설자원 관리 개선방안을 제시하고자 한다. 재난현장 응급의료 시설자원은 장비로 분류되는 의료자원과의 복합적인 연계를 통해 관리되어야 하므로, 현재 자재와 장비로 분류되어 관리되고 있는 재난관리자원 공동활용시스템에서의 반영이 요구되며, 재난관리자원 투입에 따른 금액을 고려한 시설구축방안에 대한 연구가 추진되어야 할 것으로 판단된다.