• Title, Summary, Keyword: Emergency department

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Factors associated with satisfaction with pediatric emergency department services in Korea: analysis of Korea Health Panel Data 2010 to 2012

  • Lee, Kyeong Jae;Kim, Min Joung;Park, Joon Min;Kim, Kyung Hwan;Park, Junseok;Shin, Dong Wun;Kim, Hoon;Jeon, Woochan;Kim, Hyunjong
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.3
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    • pp.156-164
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    • 2018
  • Objective We aimed to investigate the factors related to satisfaction with the pediatric emergency department service in Korea. Methods This study examined data from the Korea Health Panel Data from 2010 to 2012. Pediatric patients who visited the emergency department at least once between 2010 and 2012 in Korea were included. Data were collected on patient satisfaction with the emergency department service, and factors related to the patient characteristics, emergency department service process, and medical institution. We compared the dissatisfied and satisfied groups, and calculated the odds ratios for satisfaction according to each variable. Results A total of 1,505 emergency department visits from 947 pediatric patients during the 3-year period were analyzed. We estimated that about 79.5% of patients in the population were satisfied. The odds of expressing satisfaction were higher among males than in females, and among patients who were hospitalized after emergency department treatment compared to those who were transferred to another hospital. Conversely, the odds of expressing satisfaction were lower among patients who had a chronic disease, a financial source other than National Health Insurance, experienced hospitalization within 1 year. Conclusion Our study results might be helpful for establishing a satisfactory pediatric emergency medical service system. In the future, further prospective studies evaluating the causal relationships between the relevant factors and patient satisfaction are warranted.

Effects of Paraquat Ban on Herbicide Poisoning-Related Mortality

  • Ko, Dong Ryul;Chung, Sung Phil;You, Je Sung;Cho, Soohyung;Park, Yongjin;Chun, Byeongjo;Moon, Jeongmi;Kim, Hyun;Kim, Yong Hwan;Kim, Hyun Jin;Lee, Kyung-Woo;Choi, SangChun;Park, Junseok;Park, Jung Soo;Kim, Seung Whan;Seo, Jeong Yeol;Park, Ha Young;Kim, Su Jin;Kang, Hyunggoo;Hong, Dae Young;Hong, Jung Hwa
    • Yonsei Medical Journal
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    • v.58 no.4
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    • pp.859-866
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    • 2017
  • Purpose: In Korea, registration of paraquat-containing herbicides was canceled in November 2011, and sales thereof were completely banned in November 2012. We evaluated the effect of the paraquat ban on the epidemiology and mortality of herbicide-induced poisoning. Materials and Methods: This retrospective study analyzed patients treated for herbicide poisoning at 17 emergency departments in South Korea between January 2010 and December 2014. The overall and paraquat mortality rates were compared pre- and post-ban. Factors associated with herbicide mortality were evaluated using logistic analysis. To determine if there were any changes in the mortality rates before and after the paraquat sales ban and the time point of any such significant changes in mortality, R software, version 3.0.3 (package, bcp) was used to perform a Bayesian change point analysis. Results: We enrolled 2257 patients treated for herbicide poisoning (paraquat=46.8%). The overall and paraquat poisoning mortality rates were 40.6% and 73.0%, respectively. The decreased paraquat poisoning mortality rate (before, 75% vs. after, 67%, p=0.014) might be associated with increased intentionality. The multivariable logistic analysis revealed the paraquat ban as an independent predictor that decreased herbicide poisoning mortality (p=0.035). There were two major change points in herbicide mortality rates, approximately 3 months after the initial paraquat ban and 1 year after complete sales ban. Conclusion: This study suggests that the paraquat ban decreased intentional herbicide ingestion and contributed to lowering herbicide poisoning-associated mortality. The change point analysis suggests a certain timeframe was required for the manifestation of regulatory measures outcomes.

A Case of Tricuspid Regurgitation after Blunt Chest Trauma (스키 손상에 의한 외상성 삼첨판 역류 1례)

  • Choi, Gi Hun;Seo, Jeong Yeol;Ahn, Moo Eob;Ahn, Hee Cheol;Kim, Sung Eun;Cheun, Seung Hwan;Lee, Seung Yong;Choi, Kwang Min;Kim, Hyung Soo;Chung, Jae Bong;Cho, Jun Hwi;Mun, Joong-Bum;Park, Chan Woo
    • Journal of Trauma and Injury
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    • v.19 no.2
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    • pp.188-191
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    • 2006
  • Tricuspid regurgitation after blunt chest trauma is rarely seen in the emergency department. A 19-year-old patient visited our emergency department with chest discomfort after collision with his brother while skiing. Recently, Skiing as a winter sports has become popular with the Korean people, so there is an increasing tendency for patients with diverse traumas associated with ski accidents to visit the emergency department. From simple abrasions or contusions to deadly injuries with unstable vital signs, we are seeing many kind of injuries in the emergency department. We present the case report of a patient with tricuspid regurgitation after a blunt chest trauma during the skiing.

Improvement in emergency medical technician-basic training program : a review of the status of training institutions and designation criteria (2급 응급구조사 양성과정 개선방안 연구 : 양성기관 현황 및 지정기준 검토)

  • Lee, Nam-Jong;Shin, Dong-Min;Kim, Byung-Woo;Park, Si-Eun;Yoo, Eun-Ji;Yoon, Byoung-Gil;Yun, Seong-Woo;Yun, Hyeong-Wan;Lee, Kyoung-Youl;Choi, Jae-Woong;Hwang, Sung-Hoon
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.2
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    • pp.139-151
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    • 2019
  • Purpose: To discuss the records and legal standards of emergency medical technician training institutions in Korea and abroad, to identify the problems, and to provide the basic resources for improving the EMT-basic training institutions. Methods: We received advice through an advisory meeting of experts (professors of department of emergency medical technicians) and interested parties (Korean Association of Emergency Medical Technicians, officials of emergency medical technician training institutions) and referred to various reports published by governments, official institutions, and other trustworthy organizations. Also, we communicated with the related experts abroad (3 countries) on the phone or by email for surveys. Results: Compared to the abroad, it is necessary to categorize the standards and procedures of designating the emergency medical technician training institutions in Korea and improve the management of training institutions to train competent emergency medical technicians. Conclusion: It is necessary to designate and manage continuously the emergency medical technician-basic training programs for the systematic primary healthcare service.

The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments

  • Jung, Hyemin;Do, Young Kyung;Kim, Yoon;Ro, Junsoo
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.309-316
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    • 2014
  • Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

Does the direction of J-tip of the guide-wire influence the misplacement of subclavian catheterization?

  • Kang, Changshin;Cho, Sunguk;Ahn, Hongjoon;Min, Jinhong;Jeong, Wonjoon;Ryu, Seung;Oh, Segwang;Kim, Seunghwan;You, Yeonho;Park, Jungsoo;Lee, Jinwoong;Yoo, Insool;Cho, Yongchul
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.636-640
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    • 2018
  • Objective: Central venous catheter (CVC) misplacement can result in incorrect readings of the central venous pressure, vascular erosion, and intravascular thrombosis. Several studies have examined the correlation between the guidewire J-tip direction and misplacement rate. This study examined whether the guidewire J-tip direction (cephalad vs. caudad) affects the misplacement rate in right subclavian venous catheterization. Methods: This prospective randomized controlled study was conducted between February 2016 and February 2017. The subjects were divided into two groups (cephalad group vs. caudad group) and the misplacement rate was compared according to guidewire J-tip direction in each group. Results: Of 100 patients, the cephalad and caudad groups contained 50 patients each. The age, sex, and operator experience were similar in the two groups. In the cephalad group, misplacement of CVC insertion into the ipsilateral internal jugular vein occurred in two cases. In the caudad group, misplacement of CVC insertion into the contralateral subclavian vein occurred in one case, with loop formation in the brachiocephalic trunk in one case. Guidewire J-tip direction showed no significant correlation with CVC misplacement. Conclusion: The guidewire J-tip direction does not influence the rate of misplacement.

A Chronological Study on the Transformation and the Spatial Characteristics of Emergency department in the United States (미국의료시설 응급부의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.17-27
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    • 2018
  • Purpose: This study aims to examine spatial characteristics of emergency department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight emergency departments, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing case studies. Results: The spatial configuration of emergency department has been changed from five or more emergency department specialties to four or less specialties such as psychiatric, pediatrics, emergency, and trauma. In the case of care initiation area, the concentrated arrangement mode was switched from the distributed arrangement mode. The spatial maps indicate that it can be seen that the tree structure changes to an annular structure emphasizing the connection between the spaces in the emergency department. This shows that the space efficiency, safe, visual control and flexibility in the planning of the emergency department are important factors affecting the spatial structure of the emergency department. Implications: In the future, it is expected that Korean emergency department will be more focused on efficiency, safe, visual control, and flexibility in the planning as in the case studies of the United States.

2008 Database of Korean Toxic Exposures: A Preliminary Study (2008년 국내 중독환자 실태조사; 예비연구)

  • So, Byung-Hak;Lee, Mi-Jin;Kim, Hyun;Moon, Jeong-Mi;Park, Kyung-Hye;Sung, Ae-Jin;Yeom, Seok-Ran;Oh, Seong-Beom;You, Ji-Young;Lee, Kyung-Woo;Lee, Kyung-Won
    • Journal of The Korean Society of Clinical Toxicology
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    • v.8 no.2
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    • pp.51-60
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    • 2010
  • Purpose: The aim of this study was to investigate toxic exposures in emergency centers with using a toxic exposure surveillance system-based report form as a preliminary study. Methods: We retrospectively reviewed the medical records of toxic exposure patients who visited emergency centers from January to December 2008. Results: 3,157 patients from 11 emergency centers were enrolled. Males were involved in 47.9% of the total cases of exposure and in 60.1% of the cases of fatal exposure. Suicidal intent was the most common (61.0%) reason and most (87.4%) fatal exposures were suicidal. Pesticides were involved in 30.7% of the cases and sedative/hypnotics/antipsychotics were involved in 20.5%. The substances most frequently involved in fatalities were pesticides, and a 48.4% fatality rate was recorded for paraquat exposure. Conclusion: The toxic exposure data showed the preliminary poisoning events in emergency centers. It is recommended that toxicology professionals should develop a toxic surveillance system and serial reporting should be performed.

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Analysis of major indicators of departments of emergency medical technology in college through the university information disclosure system (대학정보공시를 통한 3년제 응급구조과의 주요 지표 분석)

  • Lee, Jung Eun;Koh, Bong-Yeun;Hong, Sung-Gi
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.29-40
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    • 2020
  • Purpose: This study looked into the reality of the emergency medical technology department by analyzing the major indicators of university information disclosure systems and finding the competitiveness of the department of emergency medical technology by reviewing various evaluation indices. Methods: This study is a survey of 24 colleges with emergency medical technology and emergency medical technology departments across the country. Quantitative index data from 2017 to 2019 were collected and analyzed through the university information disclosure center web site. Results: Departments of emergency medical technology are generally higher than the target colleges in quantitative indicators, but the indices are somewhat insufficient in terms of "rate of faculty in full service" and "research performance of per one faculty in full service." Conclusion: Based on the results of this study, we recommend increasing the low indicators to enhance the competitiveness of the departments of emergency medical technology.