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Identifying research trends in the emergency medical technician field using topic modeling (토픽모델링을 활용한 응급구조사 관련 연구동향)

  • Lee, Jung Eun;Kim, Moo-Hyun
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.19-35
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    • 2022
  • Purpose: This study aimed to identify research topics in the emergency medical technician (EMT) field and examine research trends. Methods: In this study, 261 research papers published between January 2000 and May 2022 were collected, and EMT research topics and trends were analyzed using topic modeling techniques. This study used a text mining technique and was conducted using data collection flow, keyword preprocessing, and analysis. Keyword preprocessing and data analysis were done with the RStudio Version 4.0.0 program. Results: Keywords were derived through topic modeling analysis, and eight topics were ultimately identified: patient treatment, various roles, the performance of duties, cardiopulmonary resuscitation, triage systems, job stress, disaster management, and education programs. Conclusion: Based on the research results, it is believed that a study on the development and application of education programs that can successfully increase the emergency care capabilities of EMTs is needed.

What is Emergency Medicine and Its Agenda for Future (응급의학은 어떤 의학분야이며 그 미래는?)

  • Do, Byung-Soo;Lee, Sam-Beom
    • Journal of Yeungnam Medical Science
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    • v.19 no.2
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    • pp.92-98
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    • 2002
  • Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

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A Technique to Recommend Appropriate Developers for Reported Bugs Based on Term Similarity and Bug Resolution History (개발자 별 버그 해결 유형을 고려한 자동적 개발자 추천 접근법)

  • Park, Seong Hun;Kim, Jung Il;Lee, Eun Joo
    • KIPS Transactions on Software and Data Engineering
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    • v.3 no.12
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    • pp.511-522
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    • 2014
  • During the development of the software, a variety of bugs are reported. Several bug tracking systems, such as, Bugzilla, MantisBT, Trac, JIRA, are used to deal with reported bug information in many open source development projects. Bug reports in bug tracking system would be triaged to manage bugs and determine developer who is responsible for resolving the bug report. As the size of the software is increasingly growing and bug reports tend to be duplicated, bug triage becomes more and more complex and difficult. In this paper, we present an approach to assign bug reports to appropriate developers, which is a main part of bug triage task. At first, words which have been included the resolved bug reports are classified according to each developer. Second, words in newly bug reports are selected. After first and second steps, vectors whose items are the selected words are generated. At the third step, TF-IDF(Term frequency - Inverse document frequency) of the each selected words are computed, which is the weight value of each vector item. Finally, the developers are recommended based on the similarity between the developer's word vector and the vector of new bug report. We conducted an experiment on Eclipse JDT and CDT project to show the applicability of the proposed approach. We also compared the proposed approach with an existing study which is based on machine learning. The experimental results show that the proposed approach is superior to existing method.

Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients (응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구)

  • Moon, Sun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.10
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    • pp.222-230
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    • 2018
  • This was a retrospective study that compared the characteristics of patients with decreased mental status (DMS) during their stays in an emergency department (ED) with that of patients with alert mental status (AMS). The participants in this study consisted of 90 patients with DMS who were staying in an ED along with 100 randomly selected patients with AMS. The DMS group contained more instances of cerebrovascular disease, liver disease, diabetes, and hypertension compared to the AMS group (p=0.001, p=0.003, p<0.001, and p=0.002, respectively). With regard to triage, the DMS group had higher severity than the AMS group (p<.001). The final diagnosis for the DMS group was as follows: 64.9% neurological and 63.3% related to the digestive system, which differed from that of the AMS group (p<.001). Fifty-six (62.2%) patients with DMS had their statuses discovered by nurses, while nine patients in the DMS group had received cardiopulmonary resuscitation. These results suggest that ED nurses frequently assess the consciousness of patients who they suspect may have neurologic or digestive diseases and are classified as high severity, even when the patients are alert.

Relationship of Mean Arterial Pressure with the Adverse Outcomes in Adult Blunt Trauma Patients: Cross-sectional Study (성인둔상환자에서 평균동맥압과 위해사건발생의 관련성:단면 조사 연구)

  • Cha, Seung Yong;Kim, Yong Hwan;Hong, Chong Kun;Lee, Jun Ho;Cho, Kwang Won;Hwang, Seong Youn;Lee, Kyoung Yul;Lee, Younghwan;Choi, Seong Hee
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.39-46
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    • 2013
  • Purpose: Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients. Methods: The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless. Results: There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg. Conclusion: Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.

Factors associated hospital admission in patients with low acuity visiting emergency department (응급실 방문환자 중 낮은 우선순위를 가진 환자의 입원에 영향을 주는 요소)

  • Oh, Min Taek;Lee, Seong Hwa;Park, Seong Wook;Park, Soon Chang;Kim, Hyung Bin;Jo, Young Mo;Bae, Byung Gwan;Wang, Il Jae
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.408-414
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    • 2018
  • Objective: Patients with low acuity who need hospitalization may be at risk if they do not receive proper treatment in overcrowded emergency rooms. This study was conducted to investigate factors affecting the hospitalization of patients with low acuity of Korean Triage and Acuity Scale (KTAS). Methods: This study was a retrospective chart review analysis of patients aged 15 years or older who had triaged as KTAS 4 and 5 grades when visiting a local emergency medical center from January 1, 2016 to December 31, 2017. Multivariate logistic analysis was performed to analyze the effects of age, sex, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission. Results: A total of 10,540 patients were enrolled and the odds ratio (OR) increased with age from those aged over 34 years (P<0.001). Patients that triaged as KTAS grade 5 (adjusted OR, 1.57; 95% confidence interval [CI], 1.36-1.82), had a condition caused by disease (adjusted OR, 2.31; 95% CI, 2.00-2.68), and visited by using an ambulance (public: adjusted OR, 1.05; 95% CI, 0.91-1.22; private: adjusted OR, 4.60; 95% CI, 3.85-5.49) were more likely to be hospitalized. Individuals in the "general" major category were more likely to be hospitalized than those falling into other major categories (P<0.001). Conclusion: The factors influencing the hospitalization of patients with low acuity were age, reasons for visiting, visiting route, ambulance utilization, KTAS grade and major category on patient admission.

A Chronological Study on the Transformation and the Spatial Characteristics of Emergency department in the United States (미국의료시설 응급부의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.17-27
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    • 2018
  • Purpose: This study aims to examine spatial characteristics of emergency department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight emergency departments, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing case studies. Results: The spatial configuration of emergency department has been changed from five or more emergency department specialties to four or less specialties such as psychiatric, pediatrics, emergency, and trauma. In the case of care initiation area, the concentrated arrangement mode was switched from the distributed arrangement mode. The spatial maps indicate that it can be seen that the tree structure changes to an annular structure emphasizing the connection between the spaces in the emergency department. This shows that the space efficiency, safe, visual control and flexibility in the planning of the emergency department are important factors affecting the spatial structure of the emergency department. Implications: In the future, it is expected that Korean emergency department will be more focused on efficiency, safe, visual control, and flexibility in the planning as in the case studies of the United States.

Comparison of the Characteristics according to Injury Severity Score between Elderly and Non-elderly with Trauma (노인과 비노인 외상환자의 손상중증도에 따른 특성 비교)

  • Kim, Hyunju;Kim, Younkyoung
    • Journal of Korean Public Health Nursing
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    • v.32 no.2
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    • pp.304-318
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    • 2018
  • Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

Radiological Accident and Acute Radiation Syndrome (방사선 사고와 급성 방사선 증후군)

  • Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.2
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    • pp.39-48
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    • 2011
  • In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

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Trauma Surgery and War: A Historical Perspective

  • Hwang, Kun
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.219-224
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    • 2021
  • The aim of this review is to introduce the progress in trauma surgery made during war. In the 16th century, Paré reintroduced ligature of arteries, which had been introduced by Celsus and Galen, instead of cauterization during amputation. Larrey, a surgeon in Napoleon's military, adapted the "flying artillery" to serve as "flying ambulances" for rapid transport of the wounded. He established rules for the triage of war casualties, treating wounded soldiers according to the seriousness of their injuries and the urgency of medical care. To treat fractures and tuberculosis, Thomas created the "Thomas splint", which was used to stabilize fractured femurs and prevent infection; in World War I (WWI), use of this splint reduced the mortality of compound femur fractures from 87% to less than 8%. During WWI, Cushing systematized the treatment of head injuries, reducing mortality among head injury patients. Gillies repaired facial injuries, and his experiences became the basis of craniofacial and aesthetic surgery. In WWII, McIndoe discovered that immersion in saline promoted burn healing and improved survival rates, and thus began saline baths and early grafting instead of using tannic acid. A high mortality rate in patients with acute renal failure was noted in WWII and the Korean War. In the Korean War, Teschan used the Kolff-Brigham dialyzer. The first use of medevac with helicopters was the evacuation of three British pilot combat casualties by the US Army in Burma during WWII. As a lotus blooms in the mud, military surgeons have contributed to trauma surgery during wartime.