• Title/Summary/Keyword: first responders

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Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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A study of pre-hospital emergency medical system at correctional institutions (교정시설의 병원 전 응급의료체계에 대한 고찰)

  • Kim, Su-Il
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.121-131
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    • 2009
  • The purpose of EMS is to provide emergency patients with prompt and suitable emergency treatments therefore it saves their lives and makes them recover fast to return to normal. The purpose of correctional administration is to return inmates to society as sound citizens after their service by providing various correctional education, reformational programs, vocational training and etc. In this way, the aim of correctional administration and EMS is like mutual agreement by their returning to society safely. Therefore this study makes some propositions like the followings for the safety between many inmates who can have physical injury and exposure to diseases caused by particularity of subculture within correctional institutions and the staffs who work for them. It is said about efficient pre-hospital EMS through various causes of emergency situation in the correctional institution, system, manpower, facility, equipments and problems and so on. 1. Recruit the first-rate EMT(emergency medical technician) as central role of pre-hospital EMS according to each correctional institution and working terms. 2. Equip specialized transference system with symptom of patients and purpose of transference. 3. Emergency medical equipments and first-aid medicines should be equipped for field and ambulance. 4. Educate correctional officers as first responders and inmates within correctional institutions about systematic emergency treatment.

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Comprehensive Security and Crisis & Emergency Management for Protecting Critical Infrastructure

  • Lee, Jae-Enn
    • International Journal of Contents
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    • v.5 no.3
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    • pp.71-78
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    • 2009
  • Recently, interest has heightened over 'critical infrastructures' and their reliability in the face of potential terrorist attack. Assault on any of the critical infrastructures as transportation, power, water, telecommunications, and financial services, entails great consequences for their users as well as the other interdependent critical infrastructures. How to protect our vital critical infrastructures is the key question in this paper. The purpose of this article is to suggest the implications for crisis and emergency management to protect the critical infrastructures in our society. For achieving the purpose, we examined the concept of comprehensive security, national crisis, and critical infrastructure and, using the holistic approach, we examined the comprehensive emergency management for suggesting the implications for establishing the critical infrastructure protection system; building up the high reliability organization, organizing and partnering, assessing the risk, preparing first responders, working with private owners of critical infrastructures, working with communities, improving the administrative capacity.

Framework of a Training Simulator for the Accident Response of Large-scale Facilities (대형 기계 설비의 사고 대응을 위한 훈련 시뮬레이터 프레임워크)

  • Cha, Moohyun;Huh, Young-Cheol;Mun, Duhwan
    • Korean Journal of Computational Design and Engineering
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    • v.19 no.4
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    • pp.423-433
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    • 2014
  • For the proper decision making and responsibility enhancement for an unexpected accident in large-scale facilities, it is important to train operators or first responders to minimize potential human errors and consequences resulted from them. Simulation technologies, including human-computer interaction and virtual reality, enables personnel to participate in simulated hazardous situations with a safe, interactive, repetitive way to perform these training activities. For the development of accident response training simulator, it is necessary to define components comprising the simulator and to integrate them for the given training purpose. In this paper, we analyze requirements of the training simulator, derive key components, and design the training simulator. Based on the design, we developed a prototype training simulator and verified the simulator through experiments.

Design of First-Aid Service Support System based on Mobile Motion Recognition (모바일의 모션 인식 기반의 응급 처치 서비스 지원 시스템의 설계)

  • Park, Hung-bog;Seo, Jung-hee
    • 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.

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Ovarian Follicular Populations Prior to and during Superovulation in Cattle: Relationship with Superovulatory Response

  • Manik, R.S.;Singla, S.K.;Palta, P.;Madan, M.L.
    • Asian-Australasian Journal of Animal Sciences
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    • v.11 no.5
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    • pp.486-490
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    • 1998
  • The present study examined the follicular populations prior to and during superovulation and investigated their relationship with superovulatory response in crossbred cattle. Eleven animals were administered i.m. 8 doses of Folltropin of 2.5 ml each (1.75 mg/ml) spread over 4 days beginning on Day 10 of oestrous cycle, and 30 and 20 mg Lutalyse was given alongwith the 5th and 6th injections of Folltropin, respectively, to induce luteolysis. The animals were artificially inseminated 48, 60 and 72 h after the first Lutalyse injection. The number of corpora lutea (CL) was recorded by palpation per rectum and embryos were recovered non-surgically on Day 6 (Day 0 day of superoestrus). The ovarian follicular population was examined by transrectal Ultrasonography 15 h prior to and 52 h after the first FSH injection, and then on the day of superoestrus and the day of flushing. The follicles were classfied on the basis of diameter as small (3-5 mm), medium (6-9 mm) and large (${\geq}10mm$). The total number of follicles increased significantly (p < 0.01) from $2.45{\pm}0.35$, 15 h prior to the first FSH injection to $8.09{\pm}1.12$, 52 h after the first FSH injection and then further to $13.27{\pm}1.89 $ on the day of superoestrus. A positive correlation was observed between the number of small follicles 15 h prior to the first FSH injection (r = 0.60, p < 0.05), the number of large follicles 52 h after the first FSH injection (r=0.59, p < 0.05) and the number of CL. The follicular population prior to and during superovulation was, however, not significantly different between high (> 6 CL) and low responders (${\leq}6CL$). The present study suggests that the follicular populations undergo dynamic changes during superovulation and that follicular populations prior to superovulation have a limited application as an indicator of the superovulatory response.

Management of Laryngeal Contact Granuloma (후두 접촉성 육아종의 치료)

  • Ko, Moon-Hee;Son, Young-Ik;Jang, Jeon-Yeob;So, Yoon-Kyoung;Chung, Man-Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.2
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    • pp.128-132
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    • 2008
  • Background: Laryngeal contact granuloma is an inflammatory hypertrophic granulation tissue arising at around the vocal process of arytenoid cartilage. Various approaches are currently used for the treatment, but a solid guideline has not been established. Objectives: We aimed to compare the each treatment modality in the hope of suggesting a guideline for the successful management of laryngeal contact granuloma. Method: Eighty-seven treatment cases of 56 patients were analyzed. Cases having recent intubation history were excluded from the study. All patients received vocal hygiene education. Proton pump inhibitors (PPI, N = 33) or H2 receptor antagonists ($H_{2}RA$, N =26) were used as a first-line treatment. Among the non-responders to $H_{2}RA$, 11 cases received PPI as a second-line therapy. Eight cases received botulinum toxin injection and 9 cases had laryngomicrosurgical removal. Results: As an initial therapy, response rate to PPI and $H_{2}RA$ was 60.6% and 38.5% respectively, which was not statistically different (p=0.091). Response rate of PPI as the second-line therapy was 36.3% (p=0.162 when compared to that of first-line PPI therapy). Response rate of Botulinum toxin injection was 75%. All cases of surgical removal recurred in a relatively short period (mean 1.9months). Conclusion: In patients having laryngeal contact granuloma, combined therapy with vocal hygiene education and PPI medication would provide more than 60% of therapeutic response. Botulinum toxin injection is highly effective even in non-responders to antireflux therapy. The only indications of surgery are to resolve diagnostic doubt or to treat acute airway compromise.

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Outcomes of Non-Metastatic Gestational Trophoblastic Neoplasia: Twelve Year Experience from a Northern Thailand Tertiary Care Center

  • Suprasert, Prapaporn;Manopunya, Manatsawee
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5913-5916
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    • 2015
  • Gestational trophoblastic neoplasia (GTN) is the malignant form of gestational trophoblastic disease. In non-metastatic GTN, the outcomes of treatment are impressive with methotrexate (MTX) or actinomycin D. We retrospectively reviewed the outcomes of non-metastatic GTN treated at our center from January, 1999 to December, 2013. One hundred and nine patients were recruited to the study. The median age was 33.1 years and over 90% were referral cases. Abnormal vaginal symptoms developed in 37.6% while 56.4% were asymptomatic. The most common antecedent pregnancy was a complete mole (92.7%) with the median interval time from antecedent pregnancy to GTN development being 2.0 months. The median pretreatment B-hCG was 5,624 mIu/ml. The most common first line treatment was methotrexate (MTX) and folinic acid (91.7%) followed by weekly MTX (4.6%), etoposide+ MTX+actinomycin D (EMA) (2.8%), and actinomycin D (0.9%), with the median number of cycles at 5.0. The positive response to first line chemotherapy was 73.8%. The patients were given subsequent chemotherapeutic regimens after resistance to the first line therapy and showed a final remission rate of 89.9%.The significant factor that was frequently found in patients who were non-responders to the first line treatment was a hysterectomy procedure. Two patients developed lung metastasis and brain metastasis at one and four years after the first treatment, respectively. In conclusion, the outcomes of non-metastatic GTN were excellent. However, the patients need long term follow up due to the possibility of developing multiple organ metastases.

Clinical Efficacy of Belotecan (CKD-602), Newly Developed Camptothecin Analog, in the 2nd Line Treatment of Relapsed Small Cell Lung Cancer (재발된 소세포폐암환자에서 이차 약제로 사용되는 Belotecan (CKD-602)의 임상적 효용성)

  • Ban, Hee-Jung;Oh, In-Jae;Kim, Kyu-Sik;Ju, Jin-Yung;Kwon, Yong-Soo;Kim, Yu-Il;Lim, Sung-Chul;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.93-97
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    • 2009
  • Background: Belotecan (Camtobell, CKD-602, Chongkundang Pharm., Korea), a camptothecin derivative, has anticancer effects by inhibiting topoisomerase I such as topotecan. This study observed the response, survival and toxicity of belotecan monotherapy after the failure of etoposide and platinum (EP). Methods: Forty nine small cell lung cancer (SCLC) patients (M/F=41/8; age, 64.5${\pm}$7.6 (mean${\pm}$SD) years), who failed in their first line chemotherapy were enrolled in this study. Twenty one SCLC patients showed relapsed lung cancer more than 90 days after their priorEP chemotherapy (sensitive relapse group, SR) and 28 patients relapsed within 90 days (refractory relapse group, RR). Results: The response rate was 25%. Eleven patients showed partial responses and 5 patients could not be checked. The response rate of the SR and RR patients was similar. The relative dose intensity was lower in the responders (78${\pm}$15%) than non-responders (83${\pm}$13%, p=0.03). The median survival time (MST) was 10.3 months (290 days). The MST of the non-responders and responders was 186 days (95% CI; 67-305) and 401 days (95% CI; 234-568, p=0.07), respectively. The median progression free survival (MPFS) was similar in the SR (79 days) and RR (67 days) patients. Grade 3-4 neutropenia, anemia, and thrombocytopenia were observed in 59.6%, 12.8% and 23.4% of patients, respectively. Conclusion: The efficacy and survival were demonstrated in the second-line setting. However, a randomized comparative trial with topotecan will be needed.

The characteristic laboratory findings of non-responsiveness to intravenous immunoglobulin in children with Kawasaki disease (가와사끼병 재 치료군의 특징적인 검사 지표)

  • Cho, Han Gil;Cho, Young Kuk;Ma, Jae Sook
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.228-234
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    • 2010
  • Purpose : Although intravenous immunoglobulin (IVIG) treatment is an effective first-line treatment for Kawasaki disease, 10-20% of the patients develop persistent fever or coronary artery complications. Medical records of Kawasaki disease patients were reviewed to assess the characteristic laboratory findings of IVIG nonresponsiveness. Methods : We reviewed the clinical records of 118 children with Kawasaki disease who were treated at the Chonnam National University Hospital from March 2003 to February 2008. The laboratory findings of the IVIG-responder group (n=110) and the IVIG-nonresponder group (n=8) were compared at admission day and at 48 hours and 14 days after IVIG administration. Results : At admission, the level of creatine kinase (CK) was lower (P =0.03) and that of total protein was higher (P <0.01) in the nonresponders than in the responders. At 48 hours after IVIG administration, the white blood cell (WBC) count (P =0.04) and neutrophil% (P <0.01) was higher in the nonresponders than in the responders. The neutrophil% (P <0.01) and CK (P =0.01) level at admission was lower than that at 48 hours after IVIG administration in the responders; this decrease was not as apparent in the nonresponders. Conclusion : IVIG nonresponders have lower CK and higher total protein levels at admission and higher WBC count and neutrophil% at 48 hours after IVIG administration. The decrease in the neutrophil% and CK level between at admission and at 48 hours after IVIG administration is remarkably higher in responders than in nonresponders.