The proposed application design for emergency medical system includes the functions that help securing the window of opportunity for the patients in an emergency situation and efficiently link rescue agency, emergency medical treatment center and patients together. First, the treatment time can be saved at the emergency room by understanding the patient's condition by entering his/her health information such as anamnesis, family history, social history and blood type together with an identification number. Also, if the siren function which signals whereabouts of patients to the rescue crew is used, it will be much easier to find the location of the patient in need. The design allows rescue crew to call the patient to check whether he/she is conscious or not. Just by receiving the call, he/she will be deemed conscious.
Purpose: This study was conducted to investigate the disaster response competencies of 119 emergency medical technicians (EMTs). Methods: The subjects of this study were 226 119 EMT's at the fire station located in G province. The questionnaire consisted of 5 sub-factors and 29 items for measuring disaster response competencies and the collected data were analyzed using SPSS program. Results: Disaster response competency comprising immediate response, patient triage, patient treatment, patient transport, and collaboration support were 3.48, 3.64, 3.52, 3.64, and 3.16, respectively. Advanced EMTs scored significantly higher in patient triage (p<.001), treatment (p<.001), and transport (p=.022) competency than basic EMTs. Conclusion: In order to improve disaster response competency, it is necessary not only to enhance individual ability but also to continue disaster management training with related organizations.
The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'($1.67{\pm}0.857$), 'fixation of dislocated TMJ'($1.70{\pm}0.853$) and 'post-avulsed tooth treatment'($1.78{\pm}0.774$) by 5-point Likert scale. Likewise, the scores were $2.02{\pm}0.806$ in the question 'treatment of maxillofacial trauma', $2.76{\pm}1.061$ in the question 'emergent care of avulsed tooth', $2.70{\pm}1.095$ in the question 'treatment time of avulsed tooth' and $2.79{\pm}1.056$ in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p<0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.
Objectives The purpose of this study was to revitalize pediatric emergency care in oriental medical hospital. Methods The study was composed of 281 pediatric patients who visited emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital, from March 2006 to February 2007. Results The age distribution showed that 1 to 3 year's patients(40.6%) are the most New pediatric patients(59.1%) were more than who received medical treatment in this place. The seasonal distribution of between month's section and the 24 solar terms's section made no differences and pediatric patients who visited in emergency room was most in spring, least in autumn. Moreover the changes of season's patients were more than others. Pediatric patients who visited during the weekends and holidays(50.9%) were more than during the weekdays(49.1%). Systemic division of the major problems were the digestive symptoms(44.5%) and nervous symptoms(30.6%), respiratory symptoms(12.5%), musculoskeletal symptoms(5.3%), dermatological symptoms(1.8%), cardiovascular symptoms(0.7%) and others(4.6%) followed. The time interval between arrival and onset : within 6 hours were the most(54.5%). Pediatric patients who had digestive, nervous, musculoskeletal diseases within 6 hours were the most, but in the case of patients who had respiratory diseases, most of them were visited within 48 hours. Acting and herb-med treatment(77.9%) were the most in medical treatments. Pediatric patients(69.0%) who didn't revisit in this hospital after treatment in emergency room were more than who revisited(29.9%). Conclusions Pediatric patients who visited in emergency room of oriental medical hospital were most not acute form of a serious diseases, patients most visited in disease prefer to oriental medicine; such as dyspepsia, convulsions, crying, ankle sprain. Further studies will be needed for the actual circumstance's reflecion from this hospital and other oriental hospitals nearby or other western emergency rooms for the accurate studies.
Purpose : The goal of the present study is to provide the basic information to medical control which is the most important improving factor of pre-hospital medical treatment. Method : A total of 749 records of direct medical control were collected from 119 EMTs in emergency medical information center of Daejeon, Chungcheongnam-do and Chungcheongbuk-do from March 1, 2010 to February 28, 2011. Results : The 119 EMTs should record the level of qualification of EMT and general patient history taking precisely when they receive direct medical controls. The doctors should take medical controls within the task range of qualification of EMTs. Conclusion : It is necessary to establish the guideline of medical direction and protocol of prehospital emergency care. The quality improvement of pre-hospital emergency services will be possible by the guideline and protocol.
Purpose: This study was conducted to shorten the time spent at each stage of treatment and to reduce the total amount of time patients spend in the emergency department (ED) by applying Six Sigma in the treatment of major trauma patients. Methods: This is a comparative study encompassing 60 patients presenting to the ED of Bundang CHA Hospital from January 2008 to December 2008 and from July 2009 to March 2010. The stages of treatment for major trauma patients were divided into six categories (T1: total emergency department staying time, T2: duration of visit-radiologic evaluation time, T3: duration of visit-consult to department of admission, T4: duration of consultation-issue of hospital admissions time, T5: duration of visit-issue of hospital admissions time, T6: duration of issue of hospital admission-emergency department discharge time) and the total time patients spent in the ED was compared and analyzed for periods; before and after the application of Six Sigma. Results: After the application of Six Sigma, the numerical values in four of the six categories were significantly reduced; T2, T3, T4, and T5. However, the average of the total time patients spent in the ED did not show any remarkable change because the T6 increased highly. The level of Six Sigma increased $0.17{\sigma}$. Conclusion: The application of Six Sigma for major trauma patients in the ED resulted in a significant improvement in the error rate for the total time patients spent in the ED. The Six Sigma activity has shown great potential. Therefore, the project is expected to bring better results in every stage of treatment if the levels of the hospital facilities are improved.
Purpose: This study was designed to determine the factors hindering psychiatric intervention for suicide attempters in the emergency room (ER). Methods: Participants were 299 patients aged 18 years or older admitted to the ER for suicidal drug overdose between July 2012 and June 2014. Patients were divided into two groups according to whether they had received psychiatric treatment in the ER. Medical histories and follow-up treatments were determined by examining patients' medical records and through phone surveys, and were then compared using ${\chi}^2$-test and Fisher's exact test. In addition, the rate of satisfaction of the treatment group and the reasons for their dissatisfaction were also determined. Results: The treatment and non-treatment groups comprised 135 (45%) and 164 patients (55%), respectively. Factors influencing participation in psychiatric intervention were previous history of suicide attempts (p=0.004), history of psychiatric disorder (p<0.001), time of day (p=0.039), and day of the week (p=0.040) of arrival in the ER. Whether or not the patient received follow-up psychiatric treatment was not significantly relevant (p=0.300). Of the 82 patients who participated in the treatment satisfaction survey, 50.2% reported being unsatisfied, mainly because of unfriendly medical personnel (36.6%), discomfort regarding other people's perceptions (24.4%), and cursory care (14.6%). Conclusion: To raise the participation rate of psychiatric consult, cooperation with psychiatry at night and on weekends is required, and incorporation of patients without previous history of suicidal attempt or other psychiatric disorder is important. Resolution of complaints toward psychiatric consult in suicide attempt survivors is also required.
This study was performed to identify the level of stress recognized by the parents as a support system for their infant patients who were hospitalized in an emergency department, thus to provide the resulting data as the basic material of care intervention for the families of infant patients. This study subjected the parents with infant patients who were hospitalized in emergency department of C University Hospital in Daejeon, and the data was collected from questionnaires for them, dating from Mar. 20, to Jun. 24, 2001 This study used the tool(30 questions) which was originally developed by Ji, Dong-ok (1992) for measuring the stress of families of infant patients in emergency room, and then was modified and complemented by this researcher suitably for infant patients. Collected data was statistically analyzed with frequency, percentage, mean, standard deviation, t-test, ANOVA, by using SPSS WIN10.0 program, and the results were as follows: 1. The stress of parents with infant patients hospitalized in emergency department averaged 3.31 on the basis of 5-point measure, which means that they felt stress beyond means. 2. The factor with high average out of stress factors the parents of infant patients recognized included the followings: 'about the pain of infant patients due to examination(3.91±1.00)'; 'about rare opportunity to be in contact with physician(3.78±1.09)'; 'delay in emergent treatment required for infant patients(3.75±1.31)'; 'delay in the general treatment of infant patients(3.72±1.32)'. Factors of the stress level includes the followings: 'care and medical treatment'(3.46±.72); 'body and diseases'(3.41±.97)'; 'lack of information and supportable resources (3.25±.77)'; and so on. 3. For the stress level according to general characteristics, there were statistically significant differences in the result of the condition of infant patients, medical treatment(P<.01), religion, the procedure of treatment(P<.05). With little preceding studies for infant patients hospitalized in emergency department, this study looked through the level of stress recognized by the parents of infant patients. Based on the comprehension on the parents with infant patients and the knowledge on stress factors recognized by the parents, it is expected that we can seek the methods of care intervention such as explanation of care and treatment procedures, unit policies, continuous interest and emotional supports as well as the provision of information to understand the responses of parents and reduce accompanied stresses.
As the medical environment and dental services change, the importance of educating dentists in responses to systemic emergencies is increasing. The current student-oriented education paradigm is moving towards training students in the abilities required to address the daily crises they will face, while also providing them with the ability to deliver knowledge. Before addressing a patient's situation, emergency physicians begin by diagnosing symptoms. As they must decide on the tests and treatments that are immediately required and must solve problems through interdisciplinary treatment, emergency physicians require additional skills and communication abilities besides clinical knowledge. Since dentistry colleges provide education that emphasizes the skills dentists require to treat oral diseases, they do not have sufficient time to teach emergency care. Additionally, because their professors lack expertise in pedagogy, dental students also have insufficient motivation to study the pathophysiology of systemic diseases. This review proposes a direction of teaching that can help dental students recognize problems and situations in emergency cases and that can help them develop their capability to immediately make a decision and resolve the problem. To do this, the author surveyed the educational philosophy and knowledge provided in the instructional design of clinical professors who give lectures on emergency care, and also examined the teaching methods of the learner-oriented education paradigm.
Ethylene glycol poisoning can cause profound morbidity and is almost universally fatal if untreated. Central nervous system depression, pulmonary edema, and acute oligulic renal failure with crystalluria are among the most commonly encountered complication of ingestion. Ingestion of ethylene glycol may be an important contributor in patients with metabolic acidosis and subsequent renal failure. The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement of ethylene glycol. As a result, diagnosis and treatment sometimes can be delayed. We describe 52-year-old man who visited to emergency department with mental change of unknown origin. The patient has high anion gap metabolic acidosis and renal failure due to ingestion of antifreeze that contained ethylene glycol. We used hemodialysis for elimination technique. The patient was discharged with minimal complication.
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