• 제목/요약/키워드: emergency room

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원칩형 PLC를 이용한 IT 기반 방재용 자동화시스템 개발에 관한 연구 (A Study on Development of Disaster Prevention Automation System on IT using One-chip Type PLC)

  • 곽동걸
    • 전력전자학회논문지
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    • 제16권2호
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    • pp.97-104
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    • 2011
  • 본 논문은 건물 내에서 발생되는 각종 화재 및 재해를 자동으로 신속히 감지한 후 현지에 설치된 방재설비들을 자동으로 동작시켜 화재 및 재해를 초기진압하고, 이들 재해상황들을 유무선 통신망을 통하여 실시간으로 원격지 상황실의 중앙관리시스템에서 모니터링되는 고속 고정밀의 IT 기반의 방재용 자동화시스템을 개발한다. 본 논문에서 제안하는 방재용 자동화시스템은 소형.경량 및 고감도 고정밀의 원칩형 PLC (one-chip type PLC)가 적용되어, 각종 재해 센서로부터 감지된 신호를 분석하고 재해발생시 조기진압을 위한 현장의 방재용 구동장치들을 작동시킨다. 또한 검출된 데이터들은 RS232c 및 블루투스에 의한 유무선 통신망을 통해 원격지 상황실에 데이터 전송 및 긴급 경보신호를 송출시키고, 모니터링 프로그램을 구동시킨다. 제안한 IT 기반의 방재용 자동화시스템은 화재와 각종 재해에 대한 예방과 신속한 조치로 인명과 재산의 손실을 최소화 하고자 한다.

교통약자용 무료 셔틀버스 실내의 물리적 환경 특성 예비연구 - 노인의 특성을 중심으로 - (A Preliminary Study on the Physical Environment Characteristics of Free Shuttle Bus Interior for Vulnerable Pedestrian. - Focusing on the Characteristics of the Elderly -)

  • 정상원;남경숙
    • 한국실내디자인학회논문집
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    • 제27권1호
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    • pp.156-164
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    • 2018
  • This study analyzed the characteristics of Physical Environment of existing free shuttle bus Interior centered on elderly people who frequently use free shuttle buses. The purpose of this study is to provide basic data that can be used for improvement of existing free shuttle buses. In the case of the old type, in terms of accessible design, the middle entrance is not normally opened except the wheelchair occupant, so that the entrance of the front wheel is always used. Therefore, most elderly people go to the back seat and travel distance is twice longer. In addition, many stairs caused frequent inconveniences for boarding. In the case of the new type, it is planned to be a low-floor type, and various types of safety rods and handles, pictograms for enhancing the information convenience are well-equipped, and the measured value of the overall design characteristic is high. However, in the case of mental stability, it was confirmed that the seat of the bus is colored with a cold color system and is in a different relationship with the warm color which can feel mental stability. Overall, both old and new shuttle buses lack audiovisual feedback on bus routes and route guidance in terms of Supportive design. Also, since the cleaning tools and other miscellaneous items were left in the room, it became an obstacle to space utilization in terms of adaptable design. In terms of safety, both shuttle buses did not come into view with fire extinguishers shaded by miscellaneous items. Therefore, immediate action is unlikely in case of emergency. This problem should be resolved quickly.

외상성 횡경막 탈장: 5례 수술 보고 (Traumatic Diaphragmatic Hernia: A Report of 5 Cases)

  • 장순명
    • Journal of Chest Surgery
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    • 제7권2호
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    • pp.163-168
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    • 1974
  • Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

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간농양에 속발한 급성화농성 심 낭염 -1례 보고- (Acute Suppurative Pericarditis Caused by Liver Abscess -1 case report-)

  • 홍장수;노윤우
    • Journal of Chest Surgery
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    • 제29권7호
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    • pp.785-788
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    • 1996
  • 간농양에 이은 급성 화농성 심낭염은 드문 질환이다. 급성화농성 심낭염은 적절한 치료가 이루어지지 않을 경우 사망율이 매우 높은 위 험한 질환이다. 환자는 32세 남자 환자로 발열, 오한, 상복부동통 및 호흡곤란을 주소로 응급실로 내원 하였다. 단순 흉부사진상 심비대의 소견을 보이고 있었으며, 복부초음파상 간좌엽에 종괴가 있었다. 심초음파상 임박 심장압진의 소견을 보이고 있었다. 응급으로 횡격막천공을 통해 간농양을 배농시켰고 심낭절개술을 시 행하였다. 심낭은 비후되어 두꺼워져 있었고 600m1의 악취가 나는 농액과 괴사조직들이 배액되었다. 섬유소응괴(abrinclot)가심근과유착이 있었다 조직학적 검사상심낭은급성 염증소견과 미세한 괴사 소견을 보이고 있었고, 균배양검사상 혈액과 배농액 에서 모두 Escherichia coli가 나왔다. 환자는 항생제 치료 받고 4주만에 퇴원 했고 심초음파상 약간의 교착성 심낭염의 소견을 보였다.

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Systemic Inflammation Response Syndrome Score Predicts the Mortality in Multiple Trauma Patients

  • Baek, Jong Hyun;Kim, Myeong Su;Lee, Jung Cheul;Lee, Jang Hoon
    • Journal of Chest Surgery
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    • 제47권6호
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    • pp.523-528
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    • 2014
  • Background: Numerous statistical models have been developed to accurately predict outcomes in multiple trauma patients. However, such trauma scoring systems reflect the patient's physiological condition, which can only be determined to a limited extent, and are difficult to use when performing a rapid initial assessment. We studied the predictive ability of the systemic inflammatory response syndrome (SIRS) score compared to other scoring systems. Methods: We retrospectively reviewed 229 patients with multiple trauma combined with chest injury from January 2006 to June 2011. A SIRS score was calculated for patients based on their presentation to the emergency room. The patients were divided into two groups: those with an SIRS score of two points or above and those with an SIRS score of one or zero. Then, the outcomes between the two groups were compared. Furthermore, the ability of the SIRS score and other injury severity scoring systems to predict mortality was compared. Results: Hospital death occurred in 12 patients (5.2%). There were no significant differences in the general characteristics of patients, but the trauma severity scores were significantly different between the two groups. The SIRS scores, number of complications, and mortality rate were significantly higher in those with a SIRS score of two or above (p<0.001). In the multivariant analysis, the SIRS score was the only independent factor related to mortality. Conclusion: The SIRS score is easily calculated on admission and may accurately predict mortality in patients with multiple traumas.

판지를 이용한 입원실 위생 수납가구 개발에 관한 연구 - 상두대 개발을 중심으로 - (A Study on the Development of Sanitary Cabinet Made of Cardboard in the Ward - Focus on developing the bedside Table -)

  • 이낙현;김미숙
    • 한국가구학회지
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    • 제27권4호
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    • pp.383-391
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    • 2016
  • Recently, the hospital infection has emerged as a major concern in the media. In everyday life, but not good if the infection refers to infection with the population living in the hospital. The case with which the equipment is used in a hospital if the person mediating and mediated, patients sometimes with the pathogen causing the disease to their patients. disease in our country for some time, and Mers is finished, large hospitals are taking place is a change in hygiene and operating systems. The Mers is spreading visits and influenced the patient or patient care. And the hygiene to limit the visiting hours for hospital infection prevention and stabilization of the patient. The infection, especially infection among patients and patients but a number of factors, from the emergency room or intensive care unit of frequent hospital contacts between patients with infection and of course, furniture for storing multiple people to use in the ward also become a source of infection. Hospital, another patient is a Cabinet that used to accept the next patient will cause a secondary infection and the role of infectious agents. Therefore, the general public will have a nervousness in the hospital, also medical care needed to avoid the problem occurred. This study examines such issues for the Cabinet of the hospital with a secondary infection is concerned, eco-friendly and hygienic storage furniture and one-off development that will help to improve the hospital environment for research purposes.

관상동맥 스텐트를 삽입한 급성 심근경색 환자의 진료비 및 재원일수 관련 요인에 대한 다수준분석: 2010년과 2015년 국민건강보험공단 맞춤형 데이터베이스 자료를 바탕으로 (Multilevel Analysis of Factors Related to Cost and Length of Stay in Acute Myocardial Infarction Patients with Coronary Stenting: Based on Korean National Health Insurance Service's Customized Database in 2010 and 2015)

  • 최보영;이해종
    • 보건행정학회지
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    • 제30권3호
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    • pp.418-429
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    • 2020
  • Background: This study aims to analyze the cost and the length of stay (LOS) of acute myocardial infarction (AMI) patients with coronary artery stenting according to the characteristics of individuals and institutions. Methods: The data was collected from Korean National Health Insurance Service's customized database in 2010 and 2015. Chi-square test, t-test, analysis of variance, and multilevel analysis were performed. Results: The intraclass correlation coefficients for cost were 7.02% in 2010, 5.61% in 2015 and for LOS were 3.17%, 1.40%, respectively. The average costs were 9,067,000 won in 2010 and 9,889,000 won in 2015 (p<0.0001). However, the cost in 2015 was lower than the cost applying increased fee. The costs increased in aged 50-59 years, 60-69 years, and aged ≥70 years versus in aged under 49 years. The cost was higher in Charlson comorbidity index (CCI) 3 to 4 and ≥5 than in CCI 0. The costs were lower in male, medical aid recipients, metropolises, and local hospitals in other regions in 2010. LOS decreased from 8.1 days in 2010 to 7.4 days in 2015. It decreased in male, high income group, and the group of admission via emergency room. However, it increased in higher ages and medical aid recipients, and it also increased when CCI rose. The Internal Herfindahl Index was related to LOS in 2010. Conclusion: The variation of hospital level was small compared to the patient level. Therefore, it is important to implement applicable policies at the patient level in order to reduce cost and LOS of AMI patients.

시뮬레이션과 1일 급수량 분석을 이용한 갈수기 감압에 의한 제한급수 방법 (Pressure restricted water supply method during drought using a computer simulation and daily water supply analysis)

  • 남영욱;김경수;현인환;김두일
    • 상하수도학회지
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    • 제34권5호
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    • pp.335-344
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    • 2020
  • Due to global climate change, mega-droughts have occurred frequently. Since long-term droughts make it difficult to secure the water resources, water supply needs to be restricted in a reasonable manner. In the event of limited water supply, the waterworks need to develop a restricted water supply strategy. This study showed that analyzing daily water supply could be used to respond to the first stage of a drought. According to an analysis of Korea's major water authorities, there was about 7~21% of room for daily minimum water supply in case of a drought. Restricting the water supply by lowering pressure is a good strategy for local water authorities with high water leakage rate since leakage is inversely dependent with pressure. For this method, it is necessary to quantify water deficiency and pressure at each node using a simulation. Since DDA-based software is not possible to predict changes in demand at nodes with pressure reduction, WaterGEMS, a PDA software, was used to quantitatively predict water shortages and pressures at each node. Locations where water is deficient need to install booster pumps or to be dispatched with water tank truck and bottled water. Without these support, lowering pressure could not be an option for water works. This paper suggests a method for waterworks to plan a drought by lowering pressure to restrict water supply using daily water supply analysis and PDA based simulation.

외상에 의한 심장 손상의 수술적 치료 (Surgical Management of Traumatic Cardiac Injury)

  • 강준규;윤유상;김형태;박인덕;소동문;이철주
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.335-341
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    • 2004
  • 외상에 의한 심장 손상은 드물게 발생하지만 진단 및 치료가 지연되었을 경우 치사율이 매우 높다. 이에 본원에서는 외상성 심장 손상 환자를 대상으로 후향적 연구를 진행하였다. 대상 및 방법: 1995년 3월부터 2002년 7월까지 본원 응급실을 통하여 내원한 외상성 심장 손상 환자 대상으로 하였다. 총 17명의 환자 중 흉기 등에 의한 자상이 5예, 둔상 중에서 교통사고로 인한 손상이 7예, 작업장 등에서 추락한 경우가 4예, 원인을 알 수 없는 경우가 있었다. 모든 예에 있어서 응급 수술을 진행하였고, 6예의 경우 심폐기를 이용한 수술을 진행하였다. 결과: 수술 후 4예의 사망이 있었다. 수술 후 모든 환자는 중환자실로 이송하였고 평균 중환자실 재원기간은 3.86$\pm$3.35일, 평균 총재원기간은 18.27$\pm$14.99일이었다. 응급실에 도착하여 수술의 진행까지 생명 징후가 비교적 안정적이었던 경우 사망한 예는 없었다. 결론: 수술 전의 환자의 상태는 환자의 예후에 직접적인 영향을 주는 중요한 인자이기 때문에 흉부외상 환자에게 있어서 심장손상 여부의 판단은 매우 중요하다.

S병원 성과평가지표 개발에 관한 연구 (Development of Performance Measurement Indicators in S Hospital)

  • 이희원;유승흠;이해종;박창일
    • 한국병원경영학회지
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    • 제5권1호
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    • pp.1-23
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    • 2000
  • This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

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