• Title/Summary/Keyword: Emergency Conditions

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Veiled Paraquat Poisoning - A Focus on Clinical Characteristics (베일에 가린 파라쿼트 중독 - 임상적 특징을 중심으로)

  • Song, Ye-Wan;Choi, Sang-Cheon;You, Young-Yeol;Shin, Yeoun-Ho;Park, Eun-Jung;Ahn, Jung-Hwan;Min, Young-Gi;Jung, Yoon-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.9 no.1
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    • pp.14-19
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    • 2011
  • Purpose: Most paraquat poisonings are easily diagnosed by history taking on physical examination, however, some are failed to be diagnosed initially if the poisoning was veiled. The purpose of this study was to explore the clinical characteristics of veiled paraquat poisoning. Methods: We retrospectively reviewed the medical records of patients whose discharge diagnosis was paraquat poisoning in one university teaching hospital between 1 Jan, 2001 and 31 Dec, 2010. Veiled paraquat poisoning was determined when there was a positive urine paraquat kit in patients who did not mention paraquat poisoning in an initial physical examination or had unknown cause of pulmonary fibrosis, acute renal failure, or multi-organ failure. Results: Of the 117 patients with paraquat poisoning during the study period, 6 patients (5.1%) had veiled paraquat poisoning. The clinical characteristics were 1) proteinuria - 6 (100%), 2) increased creatinine - 4 (66.7%), 3) green skin stains - 2 (33.3%), 4) mucosal ulcer - 3 (50%). Blood chemistry results were variable. Conclusion: We should suspect veiled paraquat poisoning for patients who have proteinuria, increased creatinine, green skin stain, mucosal ulcer and vomiting, or if they have rapidly progressing acute renal failure or multi-organ failure with unknown cause, even if patients didn't mention about paraquat poisoning upon the initial physical examination. In cases with the above clinical conditions, a thorough repeated physical examination including history taking and use of urine paraquat kits should be performed.

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Prediction of air inflow during central venous catheter insertion: experimental study (중심정맥관 삽입 시 발생하는 공기유입량의 예측: 실험연구)

  • Jung, Hyo Jae;Kim, Yang Weon;Park, Chang Min;Park, Chul Ho;Kang, Ji Hun;Yoon, Yoo Sang
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.641-648
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    • 2018
  • Objective: This study examined the incidence and amount of air inflow during central venous catheter (CVC) insertion. Methods: This study was an experimental study aimed at designing an apparatus to implement blood vessel and blood flow in the human body. A 1.5-m long core tube with a Teflon tube, suction rubber tube, and polyvinyl chloride tube were made. This core tube was assumed to be the blood vessel of the human body. Blood was replaced with a saline solution. The saline solution was placed higher than the core tube and flowed into the inside of the tube by gravity. The CVC was injected 15-cm deep into the core tube. The air was collected through a 3-way valve into the upper tube. The experiments were carried out by differentiating the pressure in the tube, CVC insertion step, and diameter of the end of the catheter. The experiment was repeated 10 times under the same conditions. Results: The amount of air decreased with increasing pressure applied to the tube. Air was not generated when the syringe needle was injected, and the amount of air increased with increasing size of the distal end catheter. Conclusion: To minimize the possibility of air embolism, it is necessary to close the distal end catheter at the earliest point as soon as possible.

Diagnostic performance of emergency medical technician for ST-segment elevation myocardial infarction

  • Soo Hoon Lee;Daesung Lim;Seo Young Ko
    • Journal of Medicine and Life Science
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    • v.21 no.2
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    • pp.31-39
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    • 2024
  • This study was conducted to determine whether level-1 emergency medical technicians (EMTs) can adequately recognize ST-segment elevation myocardial infarction (STEMI) in the emergency department (ED) and whether their ability to do so differs from that of emergency medicine physicians (EMP). From December 2022 to November 2023, patients aged 20 years or older visiting the ED with chief complaints suggesting acute coronary syndrome (ACS) were enrolled. As soon as the patient arrived at the ED, a level-1 EMT conducted a 12-lead electrocardiogram (ECG) to assess STEMI; an EMP subsequently assessed whether to activate the percutaneous coronary intervention team. Demographic characteristics, test results, and final diagnoses were collected from the medical records. Among the 723 patients with case report forms, 720 were included in the analysis. These were categorized as follows: 117 (16.3%) with STEMI, 159 (22.1%) with non-ST-segment elevation ACS, and 444 (61.7%) with other conditions. STEMI was correctly recognized in 100 patients (91.7%) by level-1 EMTs and in 104 patients (95.4%) by EMPs (kappa=0.646). EMTs with less than 1 year of ED work experience correctly recognized 60 out of 67 STEMI patients (89.6%), which was comparable with the EMPs who recognized 65 out of 67 STEMI patients (97.0%, kappa=0.614). EMTs with more than 1 year of ED work correctly recognized 40 out of 42 STEMI patients (95.2%), and therefore performed better than EMPs, who recognized 39 out of 42 STEMI patients (92.9%, kappa=0.727). The level-1 EMTs adequately recognized STEMI using a 12-lead ECG and were in substantial agreement with the evaluations of the EMPs.

Analysis of Abnormal Event Detection Research using Intelligent IoT Devices for Human Health Cares

  • Lee, Do-hyeon;Kim, Da-hyeon;Ahn, Jun-ho
    • Journal of Internet Computing and Services
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    • v.23 no.2
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    • pp.37-44
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    • 2022
  • With the outbreak of COVID-19, non-face-to-face activities such as remote learning and telecommuting have increased rapidly. As a result, the number of people staying at home and the number of hours spent inside the house have also increased since the pandemic. Our team had previously worked on methods for detecting abnormal conditions in a person's health in various circumstances within the house by converging single sensor-based algorithms. In our previous research, we installed IoT sensors indoors to detect people emergency situations requiring aids, the scope of detection was limited to indoor space due to the limitation in sensors. In this study, we have come up with a system that integrates our previous study with a new method for detecting abnormal conditions in outdoor environments using outdoor security cameras and wearable devices. The proposed system enables users to be notified of emergency situations in both indoor and outdoor areas and respond to them as quickly as possible.

Planning and decommissioning of a disused Theratron- 780 teletherapy machine and the dose assessment methodology for normal and radiological emergency conditions

  • Mohamed M.Elsayed Breky ;Muhammad S. Mansy;A.A. El-Sadek ;Yousif M. Mousa ;Yasser T. Mohamed
    • Nuclear Engineering and Technology
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    • v.55 no.1
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    • pp.238-247
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    • 2023
  • The present work represents a technical guideline for decommissioning a disused teletherapy machine model Theratron-780 and contains category one 60Co radioactive source. The first section predicts the dose rate from the source in case of normal and radiological emergency situations via FLUKA-MC simulation code. Moreover, the dose assessment for the occupational during the whole process is calculated and compared to the measured values. A suggested cordoned area for safety and security in a radiological emergency is simulated. The second section lists the whole process's technical procedures, including (preview, dismantle, securing, transport and storage) of the disused teletherapy machine. Results show that the maximum obtained accumulated dose for occupational were found to be 24.5 ± 4.9 μSv in the dismantle and securing process in addition to 3.5 ± 1.8 μSv during loading on the transport vehicle and unloading at the storage facility. It was found that the measured accumulated dose for workers is in good agreement with the estimated one by uncertainty not exceeding 5% in normal operating conditions.

Concept Design of Fire Safety Module for SV20 Service in the Korean e-Navigation System

  • Kim, Byeol;Moon, Serng-Bae;Hwang, Kwang-Il
    • Journal of Navigation and Port Research
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    • v.42 no.5
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    • pp.323-330
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    • 2018
  • The Korean e-Navigation system is a Korean approach to correspond with implementation of IMO e-Navigation. It provides five services, among them SV20 service, a ship remote monitoring system that collects and processes sensor information related to fire, navigation, and seakeeping performance safety. The system also detects abnormal conditions such as fires, capsizing, sinking, navigation equipment failure during navigation, and calculates the safety index and determines the emergency level. According to emergency level, it provides appropriate emergency response guidance for the onboard operator. The fire safety module is composed of three sub-modules; each module is the safety index sub-module, the emergency level determination sub-module and emergency response guidance sub-module. In this study, operational concept of the fire safety module in SV20 service is explained, and fire safety assessment factors are estimated, to calculate the fire safety index. Fire assessment factors included 'Fire detector position factor,' 'Smoke diffusion rate factor,' and 'Fire-fighting facilities factor.'

The Work and Job Satisfaction of Paramedics in the Emergency Room of University Hospitals (대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도)

  • Lee, Ok-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.47-63
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    • 2011
  • Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

Knowledge and Current Status about AED in the Public Facilities - Focused on the Gwangju City - (다중이용시설에서의 AED에 관한 지식 및 운영실태에 관한 연구 - 광주광역시 중심으로 -)

  • Park, Si-Goo;Park, Chang-Hyun;Chae, Min-Jung
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.3
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    • pp.13-28
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    • 2010
  • Purpose: In this study, we investigated the better application of the law which is about the AED installation and more effective ways of emergency medical care system, to understand the law and to research the current condition of public facilities which belong to local governments, and to seize the aspect of safety guards who currently work in order to provide the installation of AED in the public facilities and to provide more efficient emergency medical service with the effectuation of the immunity law of the good intention of first-aid treatment. Methods: In Gwang-ju, 234 public facilities have been identified by 31 December, 2008. With the exception of the duplication, we researched 158 facilities and received the answers from 95 of them. Results: In the research, 53% of them have had internal emergency first-aid education, and 55% of them didn't have this education and a CPR education manual, and 30% of the facilities even didn't know how to connect with the manager of the company for the first-aid department. On the other hand, most of them were highly interested in CPR and AED education on the ratio of 91% and 93%. 88% of them have been trained about first-aid, 51% of them haven't been retrained, 17% have never been trained. so, the reality of emergency system at public facilities is serious. 78% of them knew they are working at public facilities, though 49% of them didn't know about AED installation. 57% of them didn't know the fact there is the immunity law related with good intentions for first-aid treatment. 63% of the facilities have security guards, and 30% of them didn't answer the questions. Also, many of them agreed to the opinion that all employees should have first-aid training. At representative survey report of participator of public-facility, emergency treatment is 61%, 16% of patients calling. Accordingly they importantly think better doing an on-site first-aid than evacuating the patient. And the rates show that 57% of them answerers tend to call Fire-Office(119) for evacuating the patients, and 28% of them EMIC(1339) for the first-aid. Conclusions: In this study, we are suggest to improve the details of the efficient operations and management after the grasp of the uninstallation, indifference, and unreliable conditions of AED. 1) Need a publicity of AED install cognition which is an emergency medical instrument at public facilities. 2) Arrangement of safety agents at facilities and concerns about them for good management from the parties concerned. 3) Need a designation of legal details according to the decision of the AED installation and the standard of the AED installation. 4) Training about first-aid of safety guards and the persons concerned in the facilities should be practiced participation with the positive and through this, first-aid treatment could be done by anyone who knows the immunity law related to medical emergency. 5) The brochures for the potential users and the results form practicing the instructions need to be improved in many ways through recording the emergency cases that have happened.

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A Review on the Improvement of the Meaning and Composition Requirements of Interference with Fire Protection Activities - Focusing on Interference with 119 EMS Activities - (소방활동방해죄의 의미와 구성요건 개선에 관한 검토 -119구급활동 방해를 중심으로-)

  • Young Pyo Hong
    • The Korean Society of Law and Medicine
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    • v.24 no.3
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    • pp.105-124
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    • 2023
  • Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

Short-Time Emergency Rating Considering Facility-Conditions of Transmission Lines in KEPCO (송전선로의 설비특성을 고려한 단시간정격 검토)

  • Sohn, H.K.;Lee, H.K.;Park, I.P.;Han, H.J.;Kim, B.G.;Ahn, S.H.;Lee, D.I.;Jang, T.I.;Choi, I.H.;Choi, J.S.;Kim, S.K.
    • Proceedings of the KIEE Conference
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    • 2008.07a
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    • pp.448-449
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    • 2008
  • This paper presented survey and analysis on short-term Emergency rating by considering facility-conditions of transmission lines in KEPCO, such as the age of ACSR conductors, a place of sleeve connecting, and road clearance, etc.

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