• Title/Summary/Keyword: The Triage

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Multiple casualty disaster scene response management: a survey of 119 paramedics (119구급대원의 다수사상자 발생 재난 현장의 대응 역량에 관한 연구)

  • Lee, Hyo-Cheol;Kim, Jee Hee;Shin, Yo-Han;Kook, Jong-Won
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.73-85
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    • 2022
  • Purpose: The purpose of this study is to understand currently active Korean paramedics' disaster response abilities, including immediate response, severity classification, patient treatment, and patient transfer, in a disaster situation with multiple casualties. Methods: A structured questionnaire consisting of a total of 25 questions was used, including 5 questions on the subject's general characteristics and 20 questions on disaster-related emergency response abilities. Results: Among the disaster response abilities of the participants, the patient transport ability scores were high and the cooperative support ability scores were low. In terms of general characteristics, there was a significant difference in age, and it was high in the 40s, and there was a significant positive correlation between each competency. Conclusion: These results suggest that there is an urgent need to develop a systematic and specialized educational system with components inside and outside fire departments related to multiple casualty disasters to improve overall abilities.

Factors affecting the number of emergency room visits in a public hospital in Korea (일개 공공병원 응급실 방문건수 관련 요인)

  • Byung-Keun Yang;Jae-Hwan Oh;Kwang-Soo Lee
    • Korea Journal of Hospital Management
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    • v.28 no.3
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    • pp.39-46
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    • 2023
  • Purpose: Korean medical services are not balanced across regions and social classes. To prevent mortality gaps, Korea must distribute its medical resources more efficiently. Patient factors affecting emergency room visits serve as basic data for determining best practices for public healthcare distribution. Methods: The data included 18 473 visits by 14 949 de-identified patients who visited a public emergency room over one year. The dependent variable was the number of emergency room visits. A Poisson regression was conducted with the independent variables, comprising sociodemographic, socioeconomic, and spatial accessibility factors and patient characteristics. Results: Older men with higher Korean Triage and Acuity Scale scores visited more frequently. Greater patient-hospital distance decreased visits; however, the presence of a hospital within 1 km of a patient's residence did not affect the number of visits. The use of 119 services was negatively correlated with the number of visits. Visits increased with more medical benefits. Conclusions: Patient age, distance to hospital, use of 119 services, and medical benefits should be considered when planning or managing public hospitals in Korea.

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A Study on the Analysis and Improvement methods of Emergency Medical Service Systems for Large Scaled Fire (대형화재에 대비한 응급의료체계에 관한 분석과 개선방안)

  • Lee, Maria
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.1
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    • pp.41-52
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    • 2007
  • In Korea, Crowds, as well as more complex and larger structures, have been caused more victims in the event of fire. In that situation, EMSS should have done triage the patients according to their severity in the field, treat with standard guidelines as like advanced burn life support and transfer to appropriate facility. But in many cases, they didn't practice like that. The purpose of this study is to give basic data for proper emergency medical services by analysing EMSS of large scaled fire in Korea and suggesting some improvement methods. The improvment methods are like this ; First, developing of protocols about burn patient is needed for EMT and dispatcher. Second, Legal approval for advanced treatment is needed for EMT. Third, Fire-helicoptors are needed in Daejeon and Jeju. And Emergency Medical Helicoptors are needed in EMSS. Forth, more advanced emergency medical centers of burn must be established. Sixth, more pocket-mask and burn sheet are needed for 119 rescuer. Finally, building owners must change inflammable materials as non-inflammable materials and educate fire-prevention and first-aid to employees.

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The trinity of ribosome-associated quality control and stress signaling for proteostasis and neuronal physiology

  • Park, Jumin;Park, Jongmin;Lee, Jongbin;Lim, Chunghun
    • BMB Reports
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    • v.54 no.9
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    • pp.439-450
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    • 2021
  • Translating ribosomes accompany co-translational regulation of nascent polypeptide chains, including subcellular targeting, protein folding, and covalent modifications. Ribosome-associated quality control (RQC) is a co-translational surveillance mechanism triggered by ribosomal collisions, an indication of atypical translation. The ribosome-associated E3 ligase ZNF598 ubiquitinates small subunit proteins at the stalled ribosomes. A series of RQC factors are then recruited to dissociate and triage aberrant translation intermediates. Regulatory ribosomal stalling may occur on endogenous transcripts for quality gene expression, whereas ribosomal collisions are more globally induced by ribotoxic stressors such as translation inhibitors, ribotoxins, and UV radiation. The latter are sensed by ribosome-associated kinases GCN2 and ZAKα, activating integrated stress response (ISR) and ribotoxic stress response (RSR), respectively. Hierarchical crosstalks among RQC, ISR, and RSR pathways are readily detectable since the collided ribosome is their common substrate for activation. Given the strong implications of RQC factors in neuronal physiology and neurological disorders, the interplay between RQC and ribosome-associated stress signaling may sustain proteostasis, adaptively determine cell fate, and contribute to neural pathogenesis. The elucidation of underlying molecular principles in relevant human diseases should thus provide unexplored therapeutic opportunities.

Analysis of Patient Transport in Taegu Subway Fire Disaster (대구지하철화재 시의 피해자 이송의 분석)

  • 왕순주;정제명
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2003.04a
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    • pp.248-254
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    • 2003
  • According to the analysis of the patient transport in the fire disaster occuring at Taegu Subway Jungangro Station February 18th, 2003, authors concluded as follows. Patients were transported mainly to medical institutes which were larger and that had shorter distance. Because of non-emergenct patient's transport to larger and nearer institutes, some critical patients should be transported to more distant institutes. Dead patients before arrival were transported relatively evenly. An adequate transport according to adequate triage should be performed in the future. Early mitigation and response, correlation with the method of transport, regional guide line of disaster transport and correlation between disaster information and emergency medical information should be corrected and need research in the future.

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Comparison of p16INK4a Immunocytochemistry with the HPV Polymerase Chain Reaction in Predicting High Grade Cervical Squamous Intraepithelial Lesions

  • Indarti, Junita;Fernando, Darrell
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.4989-4992
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    • 2013
  • Aim: To compare p16INK4a immunocytochemistry with the HPV polymerase chain reaction in predicting high grade cervical squamous intraepithelial lesions. Materials and Methods: This diagnostic case-control study was conducted from January 2010 until December 2010. We obtained 30 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 11 samples for CIN 1, 9 samples for CIN 2, and 10 samples for CIN 3. HPV PCR, p16INK4a immunocytochemistry, and histopathological examination were performed on all samples. Statistical analysis was conducted using SPSS 20.0. Results: In predicting CIN 2-3, we found p16INK4a to have similar specificity and positive predictive value as HPV PCR (95%, 97.2% vs 96.7%), but better sensitivity (87.5% vs 72.5%) and negative predictive value (82.1% vs 67.6%). The most prevalent types of high-risk HPV in our study were HPV 33, 35, 58, 52, and 16. Conclusions: p16INK4a has better diagnostic values than HPV PCR and may be incorporated in the triage of ASCUS and LSIL to replace HPV PCR. Genotype distribution of HPV differs in each region, providing a challenge to develop HPV vaccines based on the epidemiology of HPV in that particular region.

Effectiveness of the Infectious Disease (COVID-19) Simulation Module Program on Nursing Students: Disaster Nursing Scenarios

  • Hwang, Won Ju;Lee, Jungyeon
    • Journal of Korean Academy of Nursing
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    • v.51 no.6
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    • pp.648-660
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    • 2021
  • Purpose: This study aimed to develop an emerging infectious disease (COVID-19) simulation module for nursing students and verify its effectiveness. Methods: A one-group pretest-posttest quasi-experimental study was conducted with 78 under-graduate nursing students. A simulation module was developed based on the Jeffries simulation model. It consisted of pre-simulation lectures on disaster nursing including infectious disease pandemics, practice, and debriefings with serial tests. The scenarios contained pre-hospital settings, home visits, arrival to the emergency department, and follow-up home visits for rehabilitation. Results: Disaster preparedness showed a statistically significant improvement, as did competencies in disaster nursing. Confidence in disaster nursing increased, as did willingness to participate in disaster response. However, critical thinking did not show significant differences between time points, and neither did triage scores. Conclusion: The developed simulation program targeting an infectious disease disaster positively impacts disaster preparedness, disaster nursing competency, and confidence in disaster nursing, among nursing students. Further studies are required to develop a high-fidelity module for nursing students and medical personnel. Based on the current pandemic, we suggest developing more scenarios with virtual reality simulations, as disaster simulation nursing education is required now more than ever.

Practical and Legal Challenges of Cloud Investigations (클라우드 환경에서 수사 실무와 법적 과제)

  • James, Joshua I.;Jang, Yunsik
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.14 no.6
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    • pp.33-39
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    • 2014
  • An area presenting new opportunities for both legitimate business, as well as criminal organizations, is Cloud computing. This work gives a strong background in current digital forensic science, as well as a basic understanding of the goal of Law Enforcement when conducting digital forensic investigations. These concepts are then applied to digital forensic investigation of cloud environments in both theory and practice, and supplemented with current literature on the subject. Finally, legal challenges with digital forensic investigations in cloud environments are discussed.

Infection Control through Emergency Room Layout (응급의료센터 감염예방을 위한 동선분리를 고려한 평면계획 연구)

  • Kim, Joong-gi;Seo, Hyun-Bo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.1
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    • pp.7-15
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    • 2020
  • Purpose: Emergency room(ER) is the first place to enter a hospital where patients who might have been infected with contagious disease. Therefore, ER should be designed with infection control in mind. Researchers examined hospital ER layouts to identify layout design that support infection control. Methods: This study analyzed the hospital ER layout of Korean and other hospitals abroad. Researchers focused on route of incoming patients who potentially have infectious disease. Crossing of this route with other routes such as for imaging and testing should be avoided for infection control. Results: There were certain hospital ERs with better control of infection related incidents. ER floor plan layout is analyzed about allocation of key functions with movement routes for each role such as patients and medical staff in mind. To identify layout strategies for ER functions researchers simplified the routes in ER into diagrams. Layout options show that bypassing infection suspected routes over other routes is possible. Implications: Hospitals can control infection easier when they adopt strategic ER layout identified in this study.

Biomarkers and Associated Immune Mechanisms for Early Detection and Therapeutic Management of Sepsis

  • Alissa Trzeciak;Anthony P. Pietropaoli;Minsoo Kim
    • IMMUNE NETWORK
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    • v.20 no.3
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    • pp.23.1-23.20
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    • 2020
  • Sepsis is conceptually defined as life-threatening organ dysfunction that is caused by a dysregulated host response to infection. Although there has been significant advancement in recent decades in defining and understanding sepsis pathology, clinical management of sepsis is challenging due to difficulties in diagnosis, a lack of reliable prognostic biomarkers, and treatment options that are largely limited to antibiotic therapy and fundamental supportive measures. The lack of reliable diagnostic and prognostic tests makes it difficult to triage patients who are in need of more urgent care. Furthermore, while the acute inpatient treatment of sepsis warrants ongoing attention and investigation, efforts must also be directed toward longer term survival and outcomes. Sepsis survivors experience incomplete recovery, with long-term health impairments that may require both cognitive and physical treatment and rehabilitation. This review summarizes recent advances in sepsis prognosis research and discusses progress made in elucidating the underlying causes of prolonged health deficits experienced by patients surviving the early phases of sepsis.