• 한국화재소방학회:학술대회논문집
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• 한국화재소방학회 2003년도 춘계학술논문발표회논문집
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• pp.248-254
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• 2003

저자들은 2003년 2월 18일 대구지하철 중앙로역에서 발생한 화재 시의 환자 이송현황의 분석을 통하여 다음과 같은 결론을 얻었다. 환자들이 이송된 의료기관은 주로 의료 기관의 규모가 크고, 이송 거리가 짧은 기관 중심으로 이송이 이루어졌다. 경증의 환자가 가깝고 규모가 큰 응급의료기관으로 이송됨에 따라, 중증의 환자가 멀거나 규모가 적은 응급의료기관으로 이송되어야 하는 상황도 있었으며, 병원도착전에 사망한 환자들은 거리에 상관없이 이송되었다. 따라서 적절한 중증도분류에 따른 적절한 의료기관으로의 이송이 향후 시행되어야 하며, 이를 위해서 초기 피난 및 대응과 이송방법과의 연계, 재해시 이송의 지역적 지침 확보 및 재해 정보와 응급의료기관 정보와의 연계 등이 향후 수정, 연구되어야 한다.

• 임상간호연구
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• 제20권1호
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• pp.75-89
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• 2014

Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.225-230
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• 2018

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

• 한국응급구조학회지
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• 제26권2호
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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.

• 동의생리병리학회지
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• 제28권2호
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• pp.243-250
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• 2014

This study examined the knowledge and understanding of integrative medicine in Korea, specifically conflicts between western and oriental medicine within Parallel (Dual) health care systems. Qualitative methodology using grounded theory guided semi-structured, in-depth interviews with Western Medical Doctors (W.M.D., n = 6), Oriental Medical Doctors (O.M.D., n = 5) and Traditional Chinese Medicine Practitioners (T.C.M.P., n = 4). Thematic analysis was used to determine broad themes from the interviews. 15 professionals (W.M.D. (40%), O.M.D. (33%), T.C.M.P. (27%), 10 males (67%) and 5 females (33%), mean age 45) were interviewed, recorded, and transcribed. Thematic analysis revealed three key themes: systematic conflicts, integration and future directions. Subthemes of systematic conflicts included: credibility of Oriental Medicine, commercial imperatives, maintaining social standing of O.M.D., professional qualifications and lack structures supporting collaborative practice. Integration subthemes included lack of academic linkage and clarity for appropriate triage, opposing medical paradigms and limited social imperative. Future directions should include: social justification, guarantee of oriental medicine legitimacy, role of government and understanding of scientific evidence. To successfully integrate dual medical systems there is a need to address differences in social-environmental factors and perceptions of scientific understanding, as well as developing strong academic links in clinical practice.

• 정보보호학회논문지
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• 제23권1호
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• pp.57-67
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• 2013

침해사고는 시스템 해킹, 바이러스 및 웜, 홈페이지 변조, 자료 유출 등 그 유형이 다양하고, 단순한 바이러스나 웜 등의 유포가 아닌 개인정보 및 기업기밀 정보를 취득하거나 금전적 이득을 취하기 위한 목적으로, 공격자가 사용하는공격 기법이 고의적인 데이터의 삭제나 변경 등 고도의 은닉 기법을 활용하여 흔적을 남기지 않기 때문에, 정확한 자료를 수집하기가 쉽지 않다. 침해사고 초기 대응시 초동 대응자는 신속한 조사를 수행해야할 필요가 있는 침해위협 또는 범죄와 관련 현장 정보를 취급한다, 이때 체계적인 증거 수집을 위하여 침해사고의 식별에 적합한 디지털 포렌식 프로세스 방법론의 적용이 요구된다. 본 논문에서는 초동 대응자가 효과적인 초기 대응을 위하여, 윈도우 시스템 환경에서의 디지털 포렌식 측면에서 CFFTPM 포렌식 프로세스 모델을 적용하여 사용자 사용 정보, 타임라인 정보, 인터넷 정보 등 증거 수집 기본정보를 분석하고 이에 따라 클라이언트/서버 모델로 증거수집 응용시스템을 설계하고 이를 구현하였다.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.42-47
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• 2014

Objective : Helicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea. Methods : This retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT. Results : Ninety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001). Conclusion : In this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.

• 한국산학기술학회논문지
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• 제14권9호
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• pp.4326-4334
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• 2013

본 연구는 보훈병원에 입원한 노인환자들의 약물정보인식, 약물사용 실태 및 약물오용상태를 파악하기 위해 시도된 서술적 조사연구이다. 연구기간은 2011년 5월부터 6월까지이며 연구대상자는 전국 5개 지역 보훈병원에서 약물을 사용하고 있는 만 65세 이상된 국가유공자 220명이다. 자료분석은 SPSS Win 18.0 프로그램을 이용하였고 영역별 분석은 평균과 표준편차, t-test와 ANOVA, 다중회귀분석으로 통계적 진술하였다. 연구결과로는 대상자의 일반적 특성인 연령, 결혼유형, 교육정도, 환자분류, 건강상태가 통계적으로 유의한 수준을 나타내었다. 약물정보인식 영역에 영향력 있는 변수는 '연령'으로 나타났으며 약물오용과 약물사용 실태 요인은 '건강상태'에 영향력을 보였다. 따라서 향후에는 보훈병원 입원 노인환자와 일반 노인환자를 대상으로 한 비교 연구가 필요하며, 또한 국가적 차원에서 전액 보상되는 치료비와 진료비는 보훈병원 입원 노인환자들의 약물의존도를 부추기는 경향으로 일부 작용하므로 보훈병원 입원 노인환자들에게 보훈의료제도의 합리적 지원방안에 관한 연구와 보훈의료 서비스의 질적인 향상을 위한 연구가 이루어져야 한다.

• 보건행정학회지
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• 제32권2호
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• 한국재난정보학회 논문집
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• 제18권4호
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• pp.839-846
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• 2022

연구목적:감염병 유행시 감염병 의심 환자의 구급활동을 위해 출동한 소방대원의 안전을 확보하고, 현장에서 수집된 정보를 바탕으로 지역별 감염병 의심환자 발생 현황을 파악하여 현장 통제 및 지원이 가능한 소방 감염병 관리 시스템을 개발하고자 한다. 연구방법: 감염병 의심 환자를 분류할 수 있는 스마트폰 앱을 개발하여 감염병 의심 여부를 확인하고, 감염병 의심 환자로부터 감염을 방지하기 위해 환자 식별용 NFC 태그를 1회용 형태로 개발한다. 현장에서 입력되는 감염병 의심 응급환자 관련 데이터를 수집하고 분석할 수 있는 관리 시스템을 개발하여 해당 업무 관련자에게 제공하여 감염병 의심 응급환자의 이송을 개선하는지 평가한다. 연구결과: 실험결과 스마트폰 앱에 구현된 알고리듬을 통해 감염병 의심 여부를 판단할 수 있었으며, 적정 이송병원으로 이송함으로써 재이송 비율히 현저히 감소되었다. 결론:본 연구를 통해 응급의료 서비스에 ICT 기술을 적용하여 응급의료 서비스를 개선할 수 있는 가능성을 확인하였으며, 특히 감염병 의심환자에 대한 적정병원 이송으로 이송시간 단축 및 응급환자의 소생률 향상과 함께 구급대원의 안전을 적극적으로 확보할 수 있을 것으로 기대된다.