• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.7-16
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• 2023

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

• Korean Security Journal
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• no.43
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• pp.67-97
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• 2015

In Korea, a single emergency number, such as 911 of the USA and 999 of the UK, does not exist. This issue became highly controversial, when the Sewol Ferry Sinking disaster occurred last year. So, the Korean government has planned to adopt a single emergency number, integrating 112 of the Police, 119 of the Fire and Ambulance, 122 of the Korean Coast Guard, and many other emergency numbers. However, the integration plan recently proposed by the Ministry of Public Safety Security seems to be, what is called, a "partial integration model" which repeals the 122 number, but still maintains 112, 119, and 110 respectively. In this context, the study looks into USA's (diverse) 911 operating system, and subsequently tries to draw general features or characteristics. Further, the research attempts to derive policy implication from the general features. If the proposed partial integration model reflects the policy implications, the model can virtually operate like the 911 system -i.e. a single emergency number system - creating inter-operability between responding agencies such as police, fire, and ambulance, even though it is not a perfect integration model. The features drawn are (1) integration of emergency call-taking, (2) functional separation of call-taking and dispatching, (3) integration of physical facilities for call-taking and dispatching, and (4) professional call-takers and dispatchers. Moreover, the policy implications derived from the characteristics are (1) a user-friendly system - fast but accurate responses, (2) integrated responses to accidents, (3) professional call-taking and dispatching & objective and comprehensive risk assessment, and finally (4) active organizational learning in emergency call centers. Considering the policy implications, the following suggestions need to be applied to the current proposed plan: 1. Emergency services' systems should be tightly linked and connected in a systemic way so that they can communicate and exchange intelligence with one another. 2. Public safety answering points (call centers) of each emergency service should share their education and training modules, manuals, etc. Common training and manuals are also needed for inter-operability. 3. Personal management to enable-long term service in public safety answering points (call centers) should be established as one of the ways to promote professionalism.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.159-163
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• 2006

Purpose: The number of patients transported by the Helicopter Emergency Medical Service (HEMS) has increased recently. In our review of the Korean HEMS, there was no established helicopter utilization criteria or triage tool on the scene, so many patients with minor injuries were transported to tertiary care centers. The aim of this study is to evaluate the percentage of patients with minor injuries and to propose a more appropriate triage tool for predicting the need for transport to a tertiary care center. Methods: The subjects of this study were 59 trauma patients transported to Asan Medical Center (AMC) from the scene by Seoul HEMS from January 2004 to December 2005. The Triage score (TS), Injury Severity Score (ISS), and modified Canadian Triage and Acuity Scale (mCTAS) were calculated as severity scales. Patients with minor injuries were defined as those with TS=9, ISS${\leq}15$, and mCTAS${\geq}3$. We evaluated the association of TS, ISS, and mCTAS with the appropriateness of transport. Results: Many of the patients transported to tertiary medical centers were classified as having a minor injury: TS=9 group 35 cases (72.9%), ISS${\leq}15$ group 30 cases (62.5%) and mCTAS${\geq}3$ group 27 cases (56.2%). However, 56.2% (27/59) of the patients were appropriately transported according to need for admission or an operation. The more severely injured patients classified by TS, ISS, and mCTAS were more appropriately transported to a tertiary center (p<0.05). Conclusion: Many patients with minor injuries were transported to a tertiary center from the scene directly. The TS can be easily calculated by an emergency medical technician at the scene. Thus, we propose the TS as a useful triage tool for determining the necessity of transport to a tertiary center by helicopter.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.68-80
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• 2001

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

• Progress in Medical Physics
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• v.18 no.3
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• pp.144-148
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• 2007

Current digital radiography systems are rapidly glowing in clinical applications. The purpose of this study was to evaluate the characteristics of a mobile digital radiographic system. The performance of the mobile DR system was evaluated by measuring the modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE). Measurements were made on a LISTEM Mobix-1000 generator and a Teleoptic PRA Alpha-R4000 detector. Imaging characteristics were measured for these two systems using the IEC-61267 defined RQA5 (kVp: 74, additional filtration: 21 mmAl) radiographic condition. The MTF at 10% was measured as 2.4 cycles/mm and the DQE(0) values for radiation exposure 0.19, 0.5, and 1.3 mR were measured as 54%, 55%, and 76%, respectively. The NPS curves gradually decreased at high spatial frequencies. This high DQE at low frequencies, may be useful for low frequency information. The results suggested that mobile DR system could be integrated with emergency ambulance system in teleradiologic imaging applications.

• Fire Science and Engineering
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• v.29 no.3
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• pp.70-80
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• 2015

This research was conducted to improve the image of female emergency workers in a fire service organization by studying the perception trends of the increasing number of female paramedics. This human resource can be utilized more effectively by using the study results as baseline data. We conducted a survey from May 1 to June 30, 2013. The survey was analyzed using Q methodology and the program QUANL. For the Q sample, 31 emergency rescue paramedic students who had experienced ambulance field education were selected. As a result, four types of female paramedics were found; "superwoman," "hero" (who pushes against limits of stamina), "delicate guardian angel," and "skillful desk worker." The explanation powers were as follows: type I: 42.2%; type II: 4.8%; type III: 4%; and type IV: 3.6%. The sum of the figures explained 54.7% of the total variables. Generally, the students recognized female paramedics as professionals, but physical strength, baby care, and caring were considered as burdens. This requires changes in the organization's perception of female paramedics and an institutional strategy.

• Korean Security Journal
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• no.50
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• pp.11-32
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• 2017

The Civil Contingencies Act 2004 in the United Kingdom provides a comprehensive definition of "Emergency", calling upon the Uk's emergency management to deal with any disaster risk regardless of cause or source. Old contingency plans for civil defense and peacetime emergencies have been integrated into current integrated emergency management. In the UK, emergencies are managed by emergency services and other responders at the local level without direct involvement of central government. On top of this, a classified assessment of the risks of civil emergencies is also conducted on a regular basis, not only at the local level but also at the national level. This research looks into the Uk's emergency management system, including recent changes, and its risk assessment systems. Finally, the research draws policy implications for the development of Korea's disaster management mechanism as follows: 1) Korea should adopt an integrated emergency management system and combine civil defense with peacetime emergency planning, 2) it should create inter-operability between emergency responding organizations such as police, fire and ambulance, and finally 3) it must develop risk evaluating tools, such as a Community Risk Register and National Risk Register, both at the local and the national level. Last but not least, the UK emergency management system cannot be directly lifted from the UK and applied to risks and hazards faced by South Korea. Therefore, cross-cultural synthesis of many national approaches to emergency management is further required particularly for customizing policy to the particular needs of Korea.

• Journal of The Korean Society of Clinical Toxicology
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• v.1 no.1
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• pp.59-64
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• 2003

Objective: This study was conducted for the nationwide statistical survey of poison exposure to provide the rationale for establishing and developing the poison control center (PCC) in Korea. Design: Study group for Korea PCC in National Medical Center reviewed the medical literature on poison exposure of Korea from death reports of National Statistical Office (NSO), the toxic exposure statistics from the report of National Health Insurance Corporation (NHIC), and poison related data from 119 ambulance services (FD) for the purpose of obtaining the poison and its related data. We also conducted questionnaire from the expert who work in emergency medicine department at the designated 320 emergency medical centers in Korea for the preparedness and acknowledgement about necessity of PCC and their need for that. Results: We reviewed the reliable data from the death report of NSO, poison exposure data from NHIC, and running report from FD. Poisoning death occured at home ($36.7\%$) and hospital ($46.3\%$). Poisoning are more common in rural area than the city area. Patients were seen more frequently in the local clinics than in any hospital. The drugs ($45.7\%$) and pesticide ($18.1\%$) are common poison. Common place to poison exposure were residential area ($39.9\%$), industry ($9\%$). mass residential area ($7\%$). and farm ($6\%$). The education level were primary school ($33.2\%$), high school ($23.7\%$), and middle schol ($21.3\%$) in order. We have to provide the poison guideline for lay public to understand easily, and for medical experts. The medical facilities need to be invested and have more interest for toxicology. All medical staff who work in the designated emergency medical center want PCC to establish. They want to have poison information from hospital ($91.3\%$), regional poison information center ($45.0\%$), regional poison control center ($52.5\%$), nationwide poison information center ($48.8\%$), nationwide poison control center ($46.25\%$), as a role of poison control center. They also want that pcc have poison epidemiologic study and statstics, training program for the experts, registration of rare case of posion on website, reflection of policies to activities for antidote production etc., speedy consultation system for poison analysis, public education, establishment of both regional and national pee, etc. Conclusion: Poison center must be established to provide poison information for all the public and medical experitise, focusing rural area and private clinic, to detoxify, to reduce the cost, time, morbity, and mortality through the whole country.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.1004-1008
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• 1998

We report a case of heart-lung transplantation in a 32 year-old female with Eisenmenger syndrome secondary to patent ductus arteriosus. She has been suffered from congestive heart failure since June 1996 and repeatedly treated at Intensive Care Unit with intravenous inotropic support since July 1997. Preoperative echocardiography showed a patent ductus arteriosus with right to left shunt, severe regurgitation of tricuspid valve and estimated right ventricular systolic pressure of 100mmHg. The brain-dead donor was an 18 year-old male with head trauma from traffic accident 3 days ago. Heart-lung block procurement was performed at another general hospital and was transported to the Seoul National University Hospital by ambulance. Total ischemic time of the transplanted heart and lung were 249 minutes and 270 minutes, respectively. The immunosuppressive therapy was commenced preoperatively with cyclosporine and azathioprine. Corticosteroid was not used until postoperative 3 weeks in order to avoid infection and delayed healing at the tracheal anastomotic site. The patient was discharged at 31st postoperative day, and has been regularly followed up at outpatient clinic without specific complication. The follow-up bronchoscopy, performed 2 weeks and 4 months after surgery, revealed no evidence of cellular rejection.

• Journal of the Society of Disaster Information
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• v.12 no.4
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• pp.389-402
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• 2016

This research is about Department of Emergency medical services students' cognition type of female 119 paramedics. The purpose of this research is to understand department of emergency medical servises students' cognition of female 119 paramedics and identify characteristics classified by types. To this end, applying Q-method, this research objectively analyzes 72 department of emergency medical services students' reaction who complete the field training about ambulance about female 119 paramedics. The result of the department of emergency medical services students recognized type of female 119 paramedics could be typed into four types. The type I is recognized as "Stamina limit type", the type II as "expert type", the type III as "guardian angel type", and the type IV as "feminine experience type". The type I has 28.3%, the type II has 12.7%, the type III has 6%, and the type IV has 3.8% explanation power, and these explain 51% of total variable. Generally department of emergency medical services students' cognition of female 119 paramedic is that they are expert in first aid but students' cognition is negative because of female 119 paramedic's limit of stamina, exposure to danger, and giving birth and infant care thus we should arrange solution of these cognition.