• Title/Summary/Keyword: System Pre-hospital

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A Study on the Evaluation of the Emergency Medical System in Seoul (서울시 응급의료체제에 대한 평가 연구)

  • Lee, Teuk Koo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.6 no.10
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    • pp.77-94
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    • 2000
  • The purpose of this thesis is to lay groundwork for the development of emergency care system in metropolitan area. It compares the performance and outcome of the current system with foreign counterparts and investigates the changing aspects of future medical environment. Emergency medical system can be divided into two parts of both pre-hospital care, which refers to the emergency measures taken before arriving at a hospital, and hospital care that is given within a hospital. Pre-hospital care includes on-the-spot expedients, information system and delivery system, whereas hospital care is related to the classification and specialization of medical care facilities. This research focuses on the evaluation of the performance of a rescue party, which is part of pre-historical care system. As a result, it provides valuable material for the development of the emergency medical system in Seoul.

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Improvement of the pre-hospital emergency medical service system in China (중국의 병원 전 응급의료체계 개선방안)

  • Wang, Chengying;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.2
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    • pp.53-66
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    • 2012
  • Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the "120" reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

EMS fund, is it functioning or fumbling? (응급의료기금, 무엇이 문제인가?)

  • Baek, Hong-Seok;Lee, Jun-Ho;Kim, Igic-Sung;Park, Hyun-Suk;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.1 no.1
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    • pp.35-45
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    • 2013
  • Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

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Pre-diagnosis Management in WSN based Portable Healthcare Monitoring System (무선센서네트워크 기반 휴대용 헬스케어 모니터링 시스템을 위한 휴대폰 자체 간이진단 관리)

  • Hii, Pei-Cheng;Lee, Seung-Chul;Chung, Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.10a
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    • pp.538-541
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    • 2009
  • Increasing of number of people who suffered from long term chronic diseases which required frequent daily health monitoring and body check up in conjunction with the trendy uses of mobile phones and Personal Digital Assistants (PDAs) in various ubiquitous computing had make portable healthcare system a well known application today. A mobile phone based portable healthcare monitoring system with multiple vital signals monitoring ability at real time in WSN and CDMA network is developed. This system carries out real time monitoring and local data analysis process in the mobile phone. Any detection of abnormal health condition and diagnosis at earlier stage will reduce the risk of patient's life. As an extension to the existing model, a pre-diagnosis management system (PDMS) is designed to minimize the time consuming in pre-diagnosis process in the hospital or healthcare center. An alert is sent to the web server at the healthcare center when the patient detects his health is at critical state where the immediate diagnosis is needed. Preparation of diagnosis equipments and arrangement of doctor and nurses at the hospital side can be done earlier before the arrival of patient at the hospital with the help of PDMS. An efficient pre-diagnosis management increases the chances of diseases recovery rate as well.

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The Effect of Backrest Elevation Education on ICU Nurse's Knowledge, Perception and Performance (침상각도 상승 교육에 대한 중환자실 간호사의 지식, 인식 및 수행 정도)

  • Lee, Hyun Sim;Park, Young Woo;Kim, Jung Yeon;Lee, Eun Sook;Park, Ai Soon;Han, A Reum;Kim, Eun A;Lee, Ho Sun;Koh, Shin Ok
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.117-128
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    • 2008
  • Purpose: This study was conducted to examine the differences of knowledge, perception, and performance between the points of time before and after ICU nurses had the backrest elevation education. Method: The study subjects were 58 nurses at a medical and surgical ICU of one general Y hospital located in Seoul. They received the education, including backrest elevation guideline and related education materials. Data were collected from May 11 throughout August 12, 2007 with a structured questionnaire. Results: 1) There were significant differences in the mean scores of knowledge(2.21 at pre-education, 5.24 at post-education), perception(36.96 at pre-education, 53.36 at post-education), and performance(32.08 at pre-education, 43.51 at post-education), 2) There was a significant correlation between nurse's perception and performance (p=.000). 3) The nurse's perception regarding the importance of the back rest elevation education was significantly effective on their performance (p=.000). Conclusion: The backrest elevation education would contribute to improve ICU nurse's knowledge, perception and performance. The more the nurses would consider the importance of this education, the better they would perform the nursing intervention of backrest elevation.

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A study of pre-hospital emergency medical system at correctional institutions (교정시설의 병원 전 응급의료체계에 대한 고찰)

  • Kim, Su-Il
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.121-131
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    • 2009
  • The purpose of EMS is to provide emergency patients with prompt and suitable emergency treatments therefore it saves their lives and makes them recover fast to return to normal. The purpose of correctional administration is to return inmates to society as sound citizens after their service by providing various correctional education, reformational programs, vocational training and etc. In this way, the aim of correctional administration and EMS is like mutual agreement by their returning to society safely. Therefore this study makes some propositions like the followings for the safety between many inmates who can have physical injury and exposure to diseases caused by particularity of subculture within correctional institutions and the staffs who work for them. It is said about efficient pre-hospital EMS through various causes of emergency situation in the correctional institution, system, manpower, facility, equipments and problems and so on. 1. Recruit the first-rate EMT(emergency medical technician) as central role of pre-hospital EMS according to each correctional institution and working terms. 2. Equip specialized transference system with symptom of patients and purpose of transference. 3. Emergency medical equipments and first-aid medicines should be equipped for field and ambulance. 4. Educate correctional officers as first responders and inmates within correctional institutions about systematic emergency treatment.

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Applying HACCP for Microbiological Quality Control in Hospital Foodservice Operations (병원 급식시설의 미생물적 품질관리를 위한 위험요인 분석에 관한 연구)

  • Kwak, Dong-Kyung;Joo, Se-Young;Lee, Song-Mee
    • Korean journal of food and cookery science
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    • v.8 no.2
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    • pp.123-135
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    • 1992
  • Time and temperature conditions, and microbiological qualities of six categories of menu items were assessed according to the process of food product Row in a 500 bed general hospital. The Harzard Analysis Critical Control Point (HACCP) system was applied to determine harzards, to assess their severity and risks, and to identity CCPs and memos for monitoring mem. The Critical Control Points identified for each category of menu items were: Meat Soup (Kyung Sang Do Gogi Guk): Pre-preparation, holding after pre-preration, and holding after cooking; Pot Stewed Stuffed Cabbage (Soe Yangbaechu Mali Chim): pre-preparation, holding after Pre-preparation, stuffing, cooking and holding after cooking; Boned Pork Sour Salad (Doeji Suyuk Muchim): Pre-preparation, holding after pre-preparation, and post-preparation after cooking; Sauteed Pork Ball (Jeyuk Wanja Jon): pre-preparation, holding after pre-preparation, shaping, and holding after cooking; Stir-fried Fragrant Mushroom (Pyogo Bosot Bokkum): basic ingredients, Pre-preparation, holding after pre-preparation, and holding after cooking; and Fried Corn with Vegetables (Oksusu Yachae Tuigim): pre-preparation, holding after pre-preparation, mixing, and holding after cooking.

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Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries

  • Paul Jie Wen Tern;Amar Vaswani;Khung Keong Yeo
    • Korean Circulation Journal
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    • v.53 no.9
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    • pp.594-605
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    • 2023
  • Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

Early Traumatic Deaths (외상 후 초기사망에 대한 고찰)

  • Paik, Seung-Won;Han, Chul;Hong, Yun-Sik;Choi, Sung-Hyuk;Lee, Sung-Woo;Moon, Sung-Woo;Yoon, Young-Hoon;Yu, Woo-Sung;Kim, Duk-Hwan
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.75-82
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    • 2010
  • Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital

  • Kim, Kyoung Hwan;Han, Sung Ho;Chon, Soon-Ho;Kim, Joongsuck;Kwon, Oh Sang;Lee, Min Koo;Lee, Hohyoung
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.1-7
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    • 2019
  • Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.