• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.141-152
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• 2002

The purpose of this study is to provide the basic materials for searching the way of improvement to heighten the emergency medical welfare level by one step further. To achieve this purpose, the subjects of this study were selected 452 college students in Gwangju, using a random sampling method. The statistical analysis methods utilized for analyzing the collected data are frequency analysis, $x^2$ test. The conclusions obtained from these analyses are as following ; 1. In question about necessary optimum number of persons for rescue first aid activity, health and non-health major college students responded by 39.2%, 45.3% respectively that rescue team 15 people, first aid team 3 people is most suitable. But there was no significant difference in major department(p<0.05). 2. In question about security of the public health doctor and the emergency medical technician, all health and non-health major college students are recognizing necessity urgently, but there was no significant difference in major department(p<0.05). 3. In question about 119 rescue first aid team member applying for an examination qualification grant to the department of EMT's graduate, all health and non-health major college students were highest by 52.9%, 52.4% respectively in "necessity" item. But there was no significant difference in major department(p<0.05). 4. Because rescue first aid equipment level appears higher than 41.7% in non-health major college student's case by 54.2% in health major college student's case, health major college students are recognizing that equipment level should be supplemented more but there was no significant difference in major department(p<0.05). 5. In question about equipment supplement, all health and non-health major college students appeared highest by 64.8%, 69.3% in accident type different special equipment. But there was no significant difference in major department(p<0.05). 6. In question about rescue ambulance car size, we could know being thinking that health and non-health major college student each 61.2%, 56.5% is small and narrow that large size of the rescue ambulance amount need. But there was no significant difference in major department(p<0.05). 7. In question about patient's state is worsened, because rescue first aid equipment is inferior, health major college student responded sometimes 55.1%, many 29.5%. very many by 11.5%, while non-health major college student responded 65.8%, 23.1%, 4.0% respectively. There was significant difference in major department(p<0.05). 8. In question about emergency patient must utilize for 119 rescue ambulance car, all health and non-health major college students appeared highest by 38.8%, 41.3% in "not so" item. In question about rescue first aid team's first-aid treatment ability improves more, all health and non-health major college students appeared highest by 58.1% and 58.7% respectively in "improve" item. In question about "119 rescue ambulance car must go more rapidly than now", all health and non-health major college students are recognizing that should be quicker by 58.1%, 60.9% respectively. When called to 119 all health and non-health major college students responded highest by 55.5%, 53.3% respectively that we must receive first-aid treatment direction from a doctor. In question about "119 rescue ambulance car must be made the pay system", all health and non-health major college students responded 74%, 80% respectively in "not so" item. There was significant difference in major department(p<0.05). In conclusions, In oder to provide superior rescue first aid service to people, a public health doctor should be placed in the situation room inside the fire station so that the doctor could instruct the proper emergency treatment suitable for each situation to the rescue first aid team. Also, national education about a first-aid treatment that do to all people is necessarily necessary in emergency delivery system and this should be spread extensively through school education and broadcasting medium and education should be gone side by side, and see that will can save emergency patients' life which is more when these education consists continuously fixed period for public institution of policeman, fire officer etc. specially. And for reinforcement of patient transfer system, public organization must procure special ambulance car so that emergency patient receive first aid treatment while transfer.

• The Korean Journal of Emergency Medical Services
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• v.11 no.3
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• pp.163-174
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• 2007

Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.26-35
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• 2019

Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.213-234
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• 2003

The purposes of this study which was done by questionnaire survey and case study of First Aid Certification Program in Seoul Health College were to analyze results and effects of the college financial support program from Ministry of Education & Human Resources Development. The significant 164 data were collected from 300 professors in 8 colleges having the Department of Emergency Care from Oct. 1, 2002 to Dec. 31, 2002 and analyzed using SPSS in terms of t-test, ANOVA, Pearson's correlation coefficient and so on. The conclusions and suggestions from this study were summarized as follows; (1) Degree of acknowledgement about aims, contents, results of the college financial support program was above the middle(participants 4.21, non-participants 3.63) and higher relation than the others in case of participants(r:0.32 p<0.001), planning team(r:0.22 p<0.05). (2) Degree of acknowledgement about improvement of curriculum & educational facilities through the program was above the middle and higher relation than the others in case of participants. (3) Degree of acknowledgement about positive influence on acquirement rate of certification(licence) & job through the program was above the middle and performance & adaptation at work place was higher relation than the others in case of participants. (4) Degree of acknowledgement about positive influence on improvement of learning of student's major through the program was above the middle and higher relation than the others in case of participants. (5) The respondents thought that the program had a negative influence on professor's educational activities & research such as study 40.4%, lecture 23.1%, student guidance 12.5%. (6) When the program was administered by planning team, there were difficulties such as execution of budget 42.1%, cooperation with companies 17.1%, cooperation among program teams 11.8%, when it was administered by non-planning team there were difficulties such as execution of budget 45.5%, cooperation among departments 22.7%, cooperation with companies 13.6%. (7) Because it was too short to execute the budget, the ministry have to select proposed programs before the next school year. (8) This program should be changed temporary, insufficient support into consecutive, sufficient support for more characterization & specialization of the college which has a long-term developmental plan & vision.

• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• Journal of The Korean Society of Clinical Toxicology
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• v.13 no.2
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• pp.55-61
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• 2015

Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.

• Journal of the Korean Society of Safety
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• v.38 no.6
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• pp.60-71
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• 2023

The purpose of this study is to propose a quantitative toxicity endpoint distance suitable for the initial response of firefighters by comparing and analyzing the commonly applied toxic level of concern (T-LOC), specifically emergency response planning guidelines (ERPG), acute exposure guideline levels (AEGL), and immediately dangerous to life or health (IDLH). This is to protect the fire brigade, which responds to toxic chemical accidents first during the golden time. Using areal locations of hazardous atmospheres, a damage prediction program, the amount of leakage for both acidic and basic substances, along with the endpoint distance, were analyzed for alternative accident and worst-case accident scenarios. The results showed that the toxicity endpoint distance, serving as a compromise between Level-3 and Level-2 of T-LOC, was longer than ERPG-3 and shorter than ERPG-2 with IDLH, while its values were analyzed in the order of ERPG-2, AEGL-2, IDLH, AEGL-3, and ERPG-3. It is suggested that the application of IDLH in an emergency (red card) and ERPG-2 endpoint distance in a non-emergency (non-red card) can be utilized for the initial response of the fire brigade.

• Journal of the Korean Applied Science and Technology
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• v.41 no.3
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• pp.673-684
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• 2024

This study aims to enhance the accuracy of severity classification by examining the usage patterns and characteristics of emergency department visits. It focuses on adult and elderly patients who visited a public hospital in Seoul. This descriptive study retrospectively reviewed the electronic medical records of patients who visited the emergency department of a public hospital between November and December 2023. The total number of participants was 1,033, with 46.4% (n=479) being elderly and 53.6% (n=554) being adults. The chief complaints of the participants were as follows: for the elderly, nervous system symptoms at 8.2% (n=85) and digestive symptoms at 7.5% (n=77) were the most common, while for adults, gastrointestinal symptoms at 11.0% (n=114) and trauma at 8.6% (n=89) were more prevalent. In the case of the elderly, patients classified as urgent accounted for the highest percentage at 23.9% (n=247), while for adults, non-emergency were more prevalent at 32.2% (n=333). The initial severity classification error rate for elderly patients in the urgent was 3.8%, indicating that the suitability of KTAS for elderly patients with high severity was low. To minimize severity classification errors and enhance KTAS accuracy, it's essential to address its current limitation of only classifying adults and children separately by developing a KTAS classification system that reflects the diverse characteristics of elderly patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.2
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• pp.127-129
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• 2013

The imidazopyridine, zolpidem, a non-benzodiazepine hypnotic drug, is widely-prescribed for insomnia. It is regarded as a good alternative to benzodiazepine because of the reduced possibility for abuse and development of dependence. However, more recently, due to the reduced possibility for abuse and development of dependence, it is regarded as a good alternative to benzodiazepine. adverse effects of zolpidem have been recognized. The objective of this report is to provide information on the potential for occurrence of benzodiazepine-like withdrawal seizure in patients who chronically take zolpidem continually. We present and discuss a case of seizure after sudden interruption of the protracted use of an abusively high dose of zolpidem. Zolpidem may not be the ideal drug for longterm pharmacotherapeutic management of insomnia. Clinicians should administer zolpidem at a low-dose for a short period of time for prevention of drug abuse and dependence and the potential for occurrence of benzodiazepine- like withdrawal seizure.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.143-147
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• 2018

Background: Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report: A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion: We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.