• Journal of Preventive Medicine and Public Health
• /
• v.47 no.6
• /
• pp.309-316
• /
• 2014

Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

• Proceedings of the Korean Society for Noise and Vibration Engineering Conference
• /
• 2004.05a
• /
• pp.535-541
• /
• 2004

For housing estate of a new administrative capital city, Noise reduction method is a important design factor. As measuring a noise level of traffic noise according to separation from road, it can be created a quite housing estate. Analyzing of merits and demerits in sound barrier walls and tunnels can be proposed environment friendly soundproofing facilities. Number of measurement was performed to know what kind of layout of housing estate is good for noise reduction. Through this measurement, ㄷ shaped layout or parallel layout has the advantage of sound insulation rather than right angled layout. In this case (ㄷ shaped layout or parallel layout) buildings neighboring to the road should be designed to insulate sound. Evergreen trees should be planted between housing estate and road more than 30m (at least 7～8m) in order to reduce noise and have masking effects. If broad-leaved trees are planted more than 30m, approximately 10dB noise is reduced and 2～4dB if 7～8m. Roads in the estate should be designed considering pedestrians first, and special roads for moving and ambulance should be designed as skew road, if possible. The result shows that 15$^{\circ}$-sloped‘S’road reduces 1～2dB noise and 30$^{\circ}$-sloped road reduces 4～7dB. If noise barrier is inevitably installed, it should be designed to go well wit neighboring environment so as to install Environment Friendly Noise Barrier using materials and trees including wood and soil. Through this study the results are used to guideline for construction of environment friendly housing estate

• Journal of Chest Surgery
• /
• v.50 no.1
• /
• pp.8-13
• /
• 2017

Background: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. Methods: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes. Results: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, $65.9{\pm}88.1km$) and the average transport time was $56.1{\pm}57.3minutes$ (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived. Conclusion: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.

• Health Policy and Management
• /
• v.16 no.4
• /
• pp.128-146
• /
• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• Fire Science and Engineering
• /
• v.34 no.4
• /
• pp.125-134
• /
• 2020

This paper aimed to statistically analyze the impact of fire needs not considered in previous reports based on preventive and preparedness strategies of fire administration and fire budget.. The panel data came from 16 metropolitan councils from 2008 to 2018 and was statistically analyzed based on the preventive measures of the fire administration (agreement for building permission, specific target for fire-fighting, public use facilities, and special fire inspection [SFI]), preparedness of the fire administration (fire safety education [FSE]), response of the fire administration (mobilization for fire suppression [MFS] and mobilization for ambulance service [MAS]), and fire budget. In the results, SFI, FSE, and MFS had a significant negative influence on the fire budget. Meanwhile, MAS had a significant positive effect on the fire budget (p < 0.01). These results reflect public policy in Korea; there has been a paradigm shift in fire administration: from disaster acceptance (focusing on recovery) to disaster response (focusing on field response) to disaster preparedness (focusing on preparedness).

• Fashion & Textile Research Journal
• /
• v.22 no.4
• /
• pp.534-539
• /
• 2020

Experimental research is needed to provide information on the removal of bloodstains since washing clothes contaminated with blood is necessary for medical related fields (such as ambulance workers and doctors) as well as for women of childbearing age. This study investigated efficient washing conditions for the removal of bloodstains with a focus on washing temperature, fiber type and blood ageing time. Polyester/cotton fabric showed the highest detergency from among three fabrics that were influenced by the composition of the fiber and the structure of the yarn and fabric. When examining the effect of detergent, it was concluded that the alkalinity over pH 10 was essential to remove bloodstains and that auxiliary agents such as soil antiredeposition agents and bleach had a significant effect on the removal of bloodstains. Washing temperature showed the highest detergency at 20℃ due to the activity of the enzyme without the denaturalization of blood. Blood-ageing influenced detergency by inducing changes in the adsorption area and chemical bond. A combination of methods such as quick removal after contamination, use of alkaline detergents including soil antiredeposition agents and bleach, and low-temperature washing could help remove bloodstains.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.13 no.5
• /
• pp.987-994
• /
• 2018

In this paper, an automatic transmission system of traffic information is presented. Here, a traffic event is defined as an obstacle to an emergency vehicle such as an ambulance or a fire truck. When a traffic event is detected from a video recorded by a black box installed in a vehicle, the implemented system automatically transmits a proof image and corresponding information to the control center through an e-mail. For this purpose, we realize an algorithm of identifying the numbers and a character from the license plate, and an algorithm for determining the occurrence of a traffic event. To report the event, a function for automatic transmission of the text and image files through e-mail and file transfer protocol (FTP) is also appended. Therefore, if the traffic event is extended and applied to the presented system, it will be possible to establish a convenient reporting system for the violation of various traffic regulations. In addition, it will contribute to significantly reduce the number of traffic violations against the regulations.

• The Korean Journal of Emergency Medical Services
• /
• v.21 no.1
• /
• pp.87-98
• /
• 2017

Purpose: This study investigated the use of infection management and the frequency of emergency equipment sterilization by emergency rescue crews to provide basic guidelines and suggestions for infection control. Methods: A self-reported questionnaire was completed by 160 emergency medical technician rescue crews in J area from May 7 to May 22 in 2015. The questionnaire consisted of 95 items, including the general characteristics of the subjects (8 items), the use of emergency equipment (33 items), the frequency of facility sterilization (33 items), infection control (12 items), vaccination (4 items), and the use of personal protective equipment (5 items). Results: In all, 97.3% of respondents were aware of the "Guidelines of Infection management for Rescue Operators' and 90.9% received training on infection control. A total of 72.7% and 47.3% of rescue centers were equipped with disinfection facilities and laundry rooms, respectively. The average frequency of sterilization was $3.17{\pm}0.75$, which significantly differed for teams with more clinical experience (p=.050) and teams with three members (p=.030). The average score for individual protective equipment supplies was $1.95{\pm}0.66$. Conclusion: For proper infection management of emergency equipment, our results suggest that the number of crew members should be increased for each ambulance, protective equipment and rescue products should be supplied, and the number of facilities for sterilization and laundry at rescue centers should be doubled.

• The Korean Society of Law and Medicine
• /
• v.13 no.1
• /
• pp.249-293
• /
• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• The Korean Journal of Emergency Medical Services
• /
• v.1 no.1
• /
• pp.42-53
• /
• 1997

To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.