KSII Transactions on Internet and Information Systems (TIIS)
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v.17
no.4
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pp.1049-1065
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2023
Recently, with the development of IoT, AI, and mobile terminals, medical information platforms are expanding. The medical information platform can determine a patient's emergency situation, and medical staff can easily access patient information through a mobile terminal. However, in the existing platform, emergency situation decision is delayed, and faster and stronger authentication is required in emergency situations. Therefore, we propose an edge computing-based medical information platform for automatic authentication using patient situations. We design an edge computing-based medical information platform architecture capable of rapid transmission of biometric data of IoT and quick emergency situation decision, and implement the platform data flow in emergency situations. Relying on this platform, we propose the automatic authentication using patient situations. The automatic authentication protects patient information through patient-centered authentication by using the patient's situation as an authentication factor, and enables quick authentication by automatically proceeding with mobile terminal authentication after user authentication in emergencies without user intervention. We compared the proposed platform with existing platforms to show that it can make quick and stable emergency decisions. In addition, comparing the automatic authentication with existing authentication showed that it is fast and protects medical information centered on patient situations in emergency situations.
This study is for an effective response as the pre-stage for railway agencies to prepare the rail road kind based emergency response standard operation procedures when the emergency event occurs. Accordingly, I would like to increase the utility in helping the railroad employees to make their decisions. And that is possible through suggesting them to make computerized Emergency situation based activity and Emergency response that is individual based. And of course all of this procedure would be based on the emergency event categorized response scenario.
Purpose: This study explores school nurses' emergency care experiences and their needs for systemic institutional support. Methods: Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data. Results: The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training. Conclusion: The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.
Kim, Hyun-Tae;Han, Jeong-Hun;Jang, Bong-Seob;Kim, Hwang-Bae
Journal of Korean Society for Geospatial Information Science
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v.16
no.3
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pp.87-94
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2008
In this study, deals with selection of monitoring objects to handle emergency cases of multi-modal transfer stations and information required for emergency surveillance, recognition, verification, propagation, processing and situation closing. Furthermore, this article suggests integrated management scheme for the above information and methods which offer appropriate information required for situation handling decisions at each stage of situation changes. The transfer station which consists of facilities, passengers, and transportations has limitations in required monitoring information. So, for the situation recognition and handling strategy, case-based reasoning of the expert system was used to apply experience, knowledge, and past cases of situation handling experts. The article also suggests methods to control facilities which are operated at transfer stations and these methods can minimize spatial confusions and damages at the emergency situation. The real time situation information will be shared by proper facility controls to support services from external institutions.
This article examines the requirements of Article 37 of the ICDR International Arbitration Rules and issues that could arise if a party petitions a U.S. Federal Court to enforce an emergency arbitrator's Article 37 decision to grant pre-arbitration provisional relief. On May 1, 2006, ICDR introduced a new procedure for the granting of emergency arbitral relief under its ICDR Rules. The procedure enables a party to apply for emergency interim relief before the appointment of an arbitrator or tribunal to adjudicate the merits of the dispute. Instead, the application for emergency relief is considered by an emergency arbitrator appointed by the ICDR. In short, the ICDR has quickly appointed emergency arbitrator and resolved a challenge to an appointment within 36 hours. In addition, the emergency decisions have been issued within just a couple of weeks. In particular, we looked at what would happen after Article 37 emergency relief is granted. Based on my examination of U.S. cases on the enforceability of interim awards and orders, We conclude that U.S. courts would enforce Article 37 interim measures, whether they are characterized by the emergency arbitrator as an interim order or award. Where the situation warrants, arbitration executives should embrace and use emergency relief procedure of ICDR Rules.
Bimodal tram is a transit with no-step floor for wheel-chaired persons, with docking to the station precisely and moving on schedule like train. Because of the automatic traveling of bimodal tram to search and follow the magnet embedded in roadway, bimodal tram should be careful about rainfall, snow and wind like a car driving on roadway in respect to natural disasters. Though response procedures in emergency are different according to the passengers' boarding, emergency mobilization is needed if any emergency situation happens. Emergency mobilization is the act of preparing for major catastrophic events, which may affect public transportation systems or their service areas, by assembling and organizing resources, including people, equipment, facilities, communications systems, expert technical support, and public information systems and protocols. Mobilization is the process that ensures that the right people will deploy appropriate resources at the correct time. Effective mobilization requires a partnership of local and state agencies. Public transportation operators and systems play vital roles in response to and recovery from emergencies and other unexpected catastrophic events. These systems, and their capabilities to mobilize resources, are profoundly affected by the decisions and directives of others during these activities. In this study, we focused on the emergency management for bimodal tram and reviewed the considerations about infrastructures under natural disasters, especially heavy rainfall.
By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.
A physician has to do his best for the better treatment of his patiensts. But, if a physician cannot remedy his patients because of the lack of hospital facilities, the lack of medical knowledge and etc., the physician must transfer his patients to another suitable hospital immediately. This is called the duty of interhospital transfer of patients. The necessity of interhospital transfer of patients is primarily ocurred in emergency medical care situations. The Supreme Court Decision 2010DO7070 delivered on April 29, 2010 is one of the important decisions related to the duty of interhospital transfer of patients. The Supreme Court ruled that there were the physician's medical malpractice and the causation between the physician's medical malpractice and the death of patient, as the physician has left the patient without due observations for 1 hour and 30 minutes after the caesarean operation inspite of mass bleeding during the operation, and has transferred the patient to another suitable hospital later. And the Supreme Court ruled that the transferring physician has to explain the situation of the patient in detail to the physician being transferred. I agree with the Supreme Court Decision. As decided by the Supreme Court, physicians will treat their patients more carefully and in case of necessity for transfer, physicians will transfer their patients with more caustion. However, the study for this issue should be continued hereafter because concrete standards are not given to lawers and physicians just by the Supreme Court Decisions itself.
The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.
In the current medical information system, a system environment is constructed in which Biometric data generated by using IoT or medical equipment connected to a patient can be stored in a medical information server and monitored at the same time. Also, the patient's biometric data, medical information, and personal information after simple authentication using only the ID / PW via the mobile terminal of the medical staff are easily accessible. However, the method of accessing these medical information needs to be improved in the dimension of protecting patient's personal information, and provides a quick authentication system for first aid. In this paper, we implemented an automatic authentication system based on the patient's situation and evaluated its performance. Patient's situation was graded into normal and emergency situation, and the situation of the patient was determined in real time using incoming patient biometric data from the ward. If the patient's situation is an emergency, an emergency message including an emergency code is send to the mobile terminal of the medical staff, and they attempted automatic authentication to access the upper medical information of the patient. Automatic authentication is a combination of user authentication(ID/PW, emergency code) and mobile terminal authentication(medical staff's role, working hours, work location). After user authentication, mobile terminal authentication is proceeded automatically without additional intervention by medical staff. After completing all authentications, medical staffs get authorization according to the role of medical staffs and patient's situations, and can access to the patient's graded medical information and personal information through the mobile terminal. We protected the patient's medical information through limited medical information access by the medical staff according to the patient's situation, and provided an automatic authentication without additional intervention in an emergency situation. We performed performance evaluation to verify the performance of the implemented automatic authentication system.
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