• The Journal of the Korea institute of electronic communication sciences
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• v.19 no.4
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• pp.753-762
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• 2024

Tunnels have limited evacuation areas, and It is difficult for cars coming from behind to recognize the accident situation in front. Since an accident is very likely to lead to a serious secondary accident, a IoT-based smart tunnel accident warning system was studied to prepare for traffic accidents that occur in tunnels. If the measured values from the flame detection sensor, gas detection sensor, and shock detection sensor in the tunnel exceed the standard, it is judged to be an emergency situation and an alert system is designed to operate. The accident information message was designed to be displayed on the LCD and transmitted to drivers inside and outside the tunnel through a Wi-Fi communication network. A performance test system was established and performance evaluation was performed for several accident scenarios. As a result of the test, it was confirmed that the accident alert system can accurately detect accidents based on given reference values, perform alert procedures, and transmit alert messages to smart phones through Wi-Fi wireless communication. And through this, its effectiveness could be confirmed.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.2
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• pp.69-78
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• 2017

Purpose: This study reports the clinical features of infant, child, school aged and adolescent patients treated for acute poisoning in nationwide emergency departments (EDs). Methods: We retrospectively analyzed clinical data pertaining to patients under 19 years of age who were treated for acute poisoning in nationwide EDs from 2013 to 2015. The data were collected by the National Emergency Department Information System (NEDIS). All patients were divided into three groups: 'Infant and child group' (0 to 5 years), 'school age group' (6 to 12 years) and 'adolescent group' (13 to 18 years). General characteristics, Korea Standard Classification of Disease $7^{th}$ (KCD-7) codes and results of care were collected. Results: There were 14,500 pediatric poisoning cases during the study period. The distribution of patient age was bimodal with two peaks among infant, child and adolescent group. The proportion of alert mentality at the ED visit of the infant and child group was 99.3%, while that of the adolescent group was 86.4%. The proportion of intentional intoxication was higher in the adolescent group (40.7%) than other age groups. Among children less than 13 years of age, various poisonous substances and therapeutic drugs were common. Conclusion: There were some clinical differences in acute poisoning patients between age groups. It is necessary to establish a preventive plan considering characteristics by age. Since the KCD-7 code has limitations in analyzing the characteristics of poisoning patients, it is necessary to consider the registration system of poisoning patients.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.411-422
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• 2000

The purpose of this study is to identify the difference of emergency care conditions where the nurse is posted in the 119 relief squard or not. The data composed a total of 777 cases of emergency activity of one police stand in Seoul during March, June. September and December in 1998. The results of this study were as follows: 1. The age of the subjects was 20-60 age 54.3%, over 60 age 35.4% with an average age of 50.2. Among them men were 55.0%, the unemployed were 60.8%. The place of the occurrence of an accident was the house, 49.7% and the cause as illness was 59.6%. 2. The main symtom was pain the 36.2% the main consciousness state was alert 76.9%: The state of the patients as chronic was 59.6%. 3. The consulting hospital of the 119 relief squad as a third medical center was 79.9%. The distance to the medical center as less than 5 km was 77.2%, and an average transfer distance was 5.38 km. The cases of doctor guided emergency care was 0.9%, the cases that had posted nurses in 119 relief squads was 48.6%. 4. The case of the best emergency care operation was difficulty in breathing, 62.1% and the second was unconsciousness, 46.1 %. The more serious the consciousness state, the higher the rate of emergency care operation. There wasn't any difference in emergency care operation concerning transfer distance. 5. The cases that had the posted nurses was 19.1%, the cases of no nurse was 11.7% among the cases of emergency care operation during transfering; the cases that had posted nurses had the higher emergency care operation. (p<0.05). Airway maintenance was 14.8% in cases that had the posted nurses, while in the cases of no nurse, 10.9%; and oxygen inspiration was 16.0% in cases that had the posted nurses while in the cases of no nurse 7.6% (p<0.01); spinal fixation was 6.6% in cases that had the posted nurses while in the cases of no nurse 4.6%(p<0.05). With these results, we can conclude that the cases that had the posted nurse showed higher emergency care operation.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.58-65
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• 2022

Purpose: Alcohol is one of the most commonly co-ingested agents in deliberate self-poisoning (DSP) cases presenting at the emergency department (ED). The increased impulsivity, aggressiveness, and disinhibition caused by alcohol ingestion may have different clinical features and outcomes in cases of DSP. This study investigates whether alcohol co-ingestion affects the clinical features and outcomes of DSP patients in the ED. Methods: This was a single-center retrospective study. We investigated DSP cases who visited our ED from January 2010 to December 2016. Patients were classified into two groups: with (ALC+) or without (ALC-) alcohol co-ingestion. The clinical features of DSP were compared by considering the co-ingestion of alcohol, and the factors related to discharge against medical advice (AMA) of DSP were analyzed. Results: A total of 689 patients were included in the study, with 272 (39.5%) in the ALC+ group. Majority of the ALC+ group patients were middle-aged males (45-54 years old) and arrived at the ED at night. The rate of discharge AMA from ED was significantly higher in the ALC+ group (130; 47.8%) compared to the ALC- group (p=0.001). No significant differences were obtained in the poisoning severity scores between the two groups (p=0.223). Multivariate analysis revealed that alcohol co-ingestion (odds ratio [OR]=1.42; 95% confidence interval [CI], 1.01-1.98), alert mental status (OR=1.65; 95% CI, 1.17-2.32), past psychiatric history (OR=0.04; 95% CI, 0.01-0.28), age >65 years (OR=0.42; 95% CI, 0.23-0.78), and time from event to ED arrival >6 hrs (OR=0.57; 95% CI, 0.37-0.88) were independent predictive factors of discharge AMA (p=0.043, p=0.004, p=0.001, p=0.006, and p=0.010, respectively). Conclusion: Our results determined a high association between alcohol co-ingestion and the outcome of discharge AMA in DSP patients. Emergency physicians should, therefore, be aware that DSP patients who have co-ingested alcohol may be uncooperative and at high risk of discharge AMA.

• Journal of The Korean Society of Clinical Toxicology
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• v.10 no.1
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• pp.33-36
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• 2012

Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.91-98
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• 2008

Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.24 no.3
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• pp.49-53
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• 2024

Maritime safety is a critical factor in protecting lives from accidents at sea and fostering a safer marine environment. In this study, we developed a TPMS device aimed at enhancing maritime safety, providing technological solutions for detecting accidents at sea and enabling swift responses. The device utilizes a Tube Pressure Monitoring System (TPMS) to detect tube expansion and is designed to collect real-time data and communicate with surrounding devices for rapid responses. Experimental results confirm the effective detection of pressure by TPMS (Tube Pressure Monitoring System) and stable data transmission and reception with the main IoT device. Additionally, a mobile app capable of receiving emergency alert messages and accessing information for rapid responses in emergency situations was developed. The developed device and mobile app encompass technology applicable not only in the maritime safety field but also in various other application areas, with potential for expanded application in real-world scenarios in the future. These results are expected to contribute to enhancing safety in the marine environment.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.21 no.5
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• pp.1-9
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• 2021

In Korea, various information related to COVID-19 has been provided to the public through an EAM (Emergency Alert Message) service using CBS (Cell Broadcast Service) technology to respond to COVID-19. In particular, local governments have been actively using the EAM service as a major means of responding to COVID-19. However, since excessive use of EAM service has caused the inconvenience of the people rather than the positive effects, the authority to be able to send EAMs has be limited. In this paper, with the purpose of providing primary data for establishing a plan to properly operate EAMs, we compare and analyze the number of EAMs issued and the incidence rate of COVID-19 cases during the period from 2020 to the present. In addition, the monthly EAM usage and incidence rate of COVID-19 cases are compared in detail and correlation analysis is performed for local governments that have issued many EAMs. We expect that the analysis results of this paper will be used as primary data in establishing strategies for EAM service to counteract the prolonged COVID-19.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2018.10a
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• pp.286-287
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• 2018

As the number of single-person households is increasing in Korea, the demand for emergency support networks for the elderly and women is also growing. To meet the need, systemic solutions, such as a wide distribution of cell phones with embedded motion sensors that can alert the first responders or police in case of health or safety crisis, are regarded as critical issues. This paper introduces a design which registers the user's motions to process emergency reports via a mobile app running in the background. The method offers an affordable solution to reporting emergencies taking place both indoors and outdoors as it does not require an addition of hardware but only simple hand gestures.