• Journal of Preventive Medicine and Public Health
• /
• v.45 no.3
• /
• pp.174-180
• /
• 2012

Objectives: An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), and vancomycin-resistant $Enterococci$ (VRE) in patients transported by ambulance. Methods: This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection. Results: The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively. Conclusions: A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.22 no.2
• /
• pp.132-141
• /
• 2019

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnetattached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).

• Journal of Korean Medical classics
• /
• v.23 no.1
• /
• pp.31-46
• /
• 2010

This research is aimed at contriving to expand to its base on the research work Military medicine in East Asia by introducing GunjungUihak(means Military medicine) and adding translations and commentaries to it and propagating to academic circles. GunjungUihak is the only technical book on GunjungUihak which was written for the purpose of treating soldiers in time of war. One of the characteristics shown in its prescription is convenience in medical treatment; the writer of GunjungUihak Wangmyeonghak(王鳴學) edited pills and a powdered medicine to be prescribed in large proportions so that they could be used urgently in the situation of battles at a viewpoint of a general while collecting knowledge of medicine. In addition, this book is compiled with a very short edition with one volume and 18 units. Including only a little amount in the book means that it was compiled by extracting only the contents needed in preparation for the wartime emergency, and such a measure was taken for military surgeons to carry it with facility during the time of war. In addition, much weight of this book was given to the diseases caused by environment with which soldiers came in contact in time of combat, not the wounds by the weapons of war as specified from the beginning of the book, which suggests that the environmental factor of the friendly forces was much more threatening than the arms of enemy troops in the situation of a combat. Like this, GunjungUihak is a material of great value in that it is showing a model of the aspects of Military medicine in East Asia at that time even in its fragmentary writings and it has been preserved by Korea.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.25 no.4
• /
• pp.47-60
• /
• 2019

Purpose: Regional public hospitals have implemented functional reinforcement projects, and the facilities to accommodate them have increased in size. Nevertheless users in hospital are concerned about space shortage and area imbalances. Therefore I will trace the factors and trends that influence the size, and derive the relationship between these and the uses' critical opinion. Methods: Among the indicators for determining the size of medical facilities, the number of beds and total floor area are the essential indicators that directly affect the composition of space and allocation of area inside the medical facility. The purpose of this study is to investigate the change and the factors of change on the these two indicators in regional public hospitals and analyze the trend of changes. Results: In accordance with support undertaking, regional public hospitals have been increased the number of chronic-based beds and expanded additional facilities such as O.P.D specialized centers, emergency centers and funeral homes for reflecting the needs of the regions and times. However, as a result of analyzing the area, regional public hospitals are growing in size mainly on the ward and O.P.D is only expanded the scope of functional reinforcement division but total area level of O.P.D is lower than the recent level. In addition, the levels of D&T, Supply, mechanical/electrical equipment area related to medical support and control environment quality are very low. This is because the functional reinforcement projects have been done without concerning diagnose the whole facility. Implications: If functional reinforcement projects are conducted, to cope with problems of space shortage and imbalance of area, it is judged that an architectural planning that comprehensively analyzes existing facilities and related departments should be included.

• Fire Science and Engineering
• /
• v.24 no.3
• /
• pp.9-19
• /
• 2010

Recently, Korea is constantly increasing its elderly care hospitals, and requires establishment of general evacuation plan considering old people's behavioral characteristics and physical states in emergency situations such as fire, and etc. In addition, because most of the facility users are patients under serious dementia and stroke, they feel difficulty evacuating by themselves, with differing evacuation time according to each walking status (bed, wheel chair, and various supplementary instruments), which is why it makes it difficult to have them all evacuate. This paper, in order to suggest data reference for designing on the basis of functionality, used various collected data utilizing Simulex to measure evacuation time through the model of elderly care hospital, a medical facility. During the study, several problems were found.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.1
• /
• pp.234-243
• /
• 2016

The aim of this study was to identify the self-confidence in performance and education demand of first aid in kindergarten and daycare center teachers. The data from a questionnaire were collected from teachers in kindergarten and daycare centers from March 5 to 31, 2015. The responses from 149 teachers were analyzed using SPSS 21.0. The results showed that self-confidence in the performance of first aid was mostly low (mean score 2.70), but was significantly high in cases of having a willingness to perform first aid (p=.002). The education demand for first aid was mostly high (mean score 4.04), and significantly high in the case of having experience of emergency situations (4.21, p=.006), and being educated in first aid while working in a childcare facility (4.14, p=.001). Therefore, it is important to educate teachers in first aid regularly after developing an optimized program considering the frequency of emergency situations, and level of self-confidence in the performance and education demand of first aid.

• Korean Institute of Interior Design Journal
• /
• v.26 no.6
• /
• pp.172-179
• /
• 2017

The regional trauma center should be a trauma treatment center equipped with facilities, equipments, and manpower capable of providing optimal treatment from emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. This study analyzes the connectivity, control, integration, and mean depth of current trauma centers using the convex map of space syntax, And to provide basic data for building for more efficient regional trauma center. The major areas that must be included in the regional trauma center are trauma resuscitation room, trauma operating room, trauma intensive care unit, and trauma general ward. It is necessary to carry out the architectural planning to increase the interconnection of the four areas. Also, the elevator plan for trauma patients should be emphasized. In addition, a regional trauma center should be separated from the existing facility for independent operation. According to the case analysis of the space configuration of the regional trauma center, the location of the operating room is most important considering the connection with each department of the hospital and the treatment flow of the severe trauma patients.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.23 no.3
• /
• pp.81-90
• /
• 2017

Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.

• Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
• /
• v.37 no.4
• /
• pp.253-265
• /
• 2019

In this study were analyzed the errors on the registration of details information, location of E-GEN (Emergency medical-GEN) AED (Automated External Defibrillator) installation site and the adequacy of spatial arrangement, which suggests an improvement methods of constructing an app or web based on time and space data for efficient operation of considering accessibility and usability. As a result of this study, first, it was not equal to each other for locations of each installation point of AED, that confirmed some area were dense or requiring additional installation. Second, it confirmed the inaccuracies in inputting and registering information about the installed location, such as the actual installation location information and the attribute information of the AED. Third, the main access node and the main address node were connected to a straight line that was found not be connected to the back door, the straight line, the stairs. Also, the opening times of AED installation sites varied according to the week and the season, the entrance was managed by the apartment management office in a separate place, it needs to be established on this information. In conclusion, it proposed a method to improve spatial equity and accessibility, a method to provide accurate distance and time according to actual movement routes in case of emergency, and a possibility of using each facility considering day and time.

• Journal of Korean Academy of Nursing
• /
• v.49 no.6
• /
• pp.724-735
• /
• 2019

Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.