• Korean Circulation Journal
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• v.53 no.9
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• 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."

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.804-812
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• 2016

Purpose: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). Methods: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. Results: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. Conclusion: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center directly should be implemented for patients and/or caregivers.

• Journal of the Korea Society of Computer and Information
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• v.18 no.10
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• pp.141-148
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• 2013

This paper proposes an EMS algorithm designed to determine the optimal locations for Emergency Medical Service centers that both satisfy the maximum ambulance response time T in case of emergency and cover the largest possible number of residents given a limited number of emergency medical services p in a city divided into different zones. This methodology generally applies integer programming whereby cases are categorized into 1 if the distance between two zones is within the response time and 0 if not and subsequently employs linear programming to obtain the optimal solution. In this paper, where p=1, the algorithm determines a node with maximum coverage. In cases where $p{\geq}2$, the algorithm selects top 5 nodes with maximum coverage. Based on inclusion-exclusion method, this selection entails repeatedly selecting a node with the maximum coverage when nodes with lower numbers are deleted. Among these 5 selected nodes, the algorithm selects a single node set with the greatest coverage and thereby as the optimal EMS location. The proposed algorithm has proven to accurately and expeditiously obtain the optimal solutions for 12-node network, 21-node network, and Swain's 55-node network.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.7-19
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• 1999

Background : We are in the edge of some human made disasters such as hazardous materials and air pollution, for example, the world news reported that the city of Bhopal, India had serious victims related with a leaking out of the chemical materials, Methyl Isocyanate and many people in India were killed by. These situations many people who live in this world are world are worrying about are not others, but just ours and people consider about that kind of the disasters are the possible situation to happen to all the people. Therefore, we performed this basic study to recognize the risk of Methyl Isocyanate leak accident and to prepare local disaster plan with EMS system. Method : Trace 8.0, a simulation software made by the U.S. company Safer System was used as a tool to estimate the diffusion distance, area and its victims at the concentrations of 0.02ppm, 0.2ppm 5ppm respectively for an assumed B-city of 2 hundred thousands population count in which was presumed 500kg Methyl Isocyanate gas to leak out. Results : 1. During 1 hour, maximum diffusion distances of 0.02ppm 0.2ppm and 5ppm were 5.41km, 1.61km and 0.29km respectively on the plume impact. 2. Maximum population counts influenced by Methyl Isocyanate gas at the concentrations of 0.02ppm 0.2ppm and 5ppm were 40838, 4346 and 222 on the plume impact, while those were 138238, 17261 and 1588 on the vulnerability impact, respectively. 3. Therefore, 17261 persons must put on respiratory device and 138283 persons must be evacuated to safety place within 1 hour. Conclusions : Only small amount leak of Methyl Isocyanate may cause tremendous chemical disaster in urban area, so its disaster plan must be prepared with an accident simulation program and Material Safety Data Sheets(MSDS). Especially, nearby emergency center of an industrial complex must have a strong position about preparation of chemical disaster plan and perform a disaster dill of hazardous material accident annually.

• Fire Science and Engineering
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• v.27 no.6
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• pp.122-128
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• 2013

This study analyzed the emergency activity daily reports and emergency instruction sheets of the research subjects and proceeded with the shockable cardiac arrest cases transported to 119 emergency units for two years before the hospital from January 1, 2010 through December 31, 2011. The most frequently predicted instruction by the dispatchers at the 119 Emergency Situation Control Center was 74 cases of fainting (33.3%). Among varied types of predicted instructions, 112 cases (50.5%) like fainting, chest pain, general prostration and others were not able to be predicted while predictable instructions involved with cardiac arrest such as consciousness disorders, difficult breathing, cardiac attacks and convulsion were 110 cases (49.5%). In such cases, success rates of cardiopulmonary resuscitation (CPR) trials by eyewitnesses at predictable instructions involved with cardiac arrests were significantly higher. As mentioned, situation agents must categorize types of cardiac arrests accurately by posing questions over assessments regarding patients' consciousness and respiration in detail. The patients categorized by such methods must guide eyewitnesses to be able to do CPR. Moreover, not only emergency medical technicians who receive predictable instructions involved with cardiac arrests given by dispatchers (49.5%) but also filed emergency medical technicians who are not able to reach a precise conclusion to non-cardiac arrests on unpredictable instructions on cardiac arrests (50.5%) must prepare for situations related to cardiac arrests before being dispatched to the field.

• Fire Science and Engineering
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• v.32 no.5
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• pp.95-104
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• 2018

The 119 emergency medical services(EMS) personnel studied in this research are constantly exposed to traumatic events, which can lead to a variety of psychosocial problems and poor quality of life. In this study, we examined the effects of the Mind Subtraction Meditation Program on post-traumatic growth and resilience of 119 EMS personnel. In this study, we measured the conditions of 26 EMS personnel of A firefighting headquarters based on post-traumatic growth and resilience before and after implementing the short-term intensive for 2 nights and 3 days in $201^*$. The results showed that there was a significant increase in post-traumatic growth from $2.85({\pm}.67)$ to $3.60({\pm}.72)$ and resilience from $2.45({\pm}.39)$ to $2.83({\pm}.48)$ of the subjects between before and after the Mind Subtraction Meditation. In conclusion, the Mind Subtraction Meditation Program was effective in improving the posttraumatic growth and resilience of 119 EMS personnel. Therefore, Mind Subtraction Meditation Program could be proposed as a mental health promotion program for EMS personnel.

• The Journal of Korean Academic Society of Nursing Education
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• v.15 no.2
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• pp.274-284
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• 2009

Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company's vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was $372.65{\pm}719.17$ minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.