• Title/Summary/Keyword: Emergency Treatment Facility

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Comparison of Mortality Rate according to Hospital Level among Patients with Poisoning Based on Korean Health Insurance and Assessment Service (의료 기관 구분에 따른 중독 환자의 사망률 - 건강보험심사평가원 자료 기반)

  • Kim, Soyoung;Choi, Sangchun;Kim, Hyuk-Hoon;Yang, Hee Won;Yoon, Sangkyu
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.21-27
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    • 2019
  • Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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A Comparative Study on the Evacuation Preparedness and Guidelines for Peoples with Disability (장애인 행태를 고려한 피난 매뉴얼 비교연구)

  • Lee, Jeong-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.470-478
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    • 2016
  • This study focused on the emergency evacuation guidelines considering the behaviors of people with disabilities in Korea. For these purposes, this study reviewed the movement behaviors of people with disability and the treatment characteristics of emergency and hazards in United States. The results are as follows. First, it is necessary to suggest establishment requirements and building design guidelines considering the behaviors of inhabitants and the occupant load in social welfare facility for people with disabilities. Second, it is important to establish disaster preparedness and evacuation planning in emergency and hazards reflecting the movement behaviors of people with disabilities in national organizations and institutions on disability. Third, periodical emergency and fire drills are necessary for people with disabilities and should be managed considering the impaired prototypes, evacuation aids and service animals.

The Developmental Program of Emergency Medical System in Correctional Facilities (교정시설 내 응급의료체계 발전방안)

  • Kim, Su-Il
    • Journal of forensic and investigative science
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    • v.3 no.1
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    • pp.60-73
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    • 2008
  • The purpose of Emergency Medical System(EMS) is what a patient returns to society with recovering mental tone in the shortest time as giving prompt and proper medical treatment to patient in emergency situation, and the Correctional Administration(CA) is purposed for the convict to return and settle down to society after release from prison in success as executing schooling, enlightenment activity, vocational training to convict who was quarantined from the society for the term of imprisonment. The EMS and CA will coincide each other which is reverting people to society in safety. This study aims to suggest the developmental program of EMS in correctional facilities through the cause of emergency situation, system, human resources, establishment, medical equipments, state of budget and the point issue for safety of victim who has many chances that is exposed to physical damage and disease because of particularity of lower culture in correctional facilities and the staff who works there. First, in the view of the correctional facility security system, a proper number of the emergency rescuers should be employed. Second, the effective transportation system along with some emergency medical equipment needs to be established. Third, the correctional officers and the prisoners should be learned the first-aid training which is realistic, practical and systematic. Fourth, the cooperative system should be established such as 1339 emergency medical information center in society. Fifth, the Ministry of Health and Welfare must increase EMS budget for correctional facilities.

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A Study on the Spatial Configuration for Regional Trauma Center in Korea by Using Space Syntax (공간구문론을 이용한 국내권역외상센터 공간구성에 관한 연구)

  • Park, Su-Roh;Park, Jae-Seung
    • Korean Institute of Interior Design Journal
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    • v.26 no.6
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    • pp.172-179
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    • 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.

Acute cardiovascular complications in patients with diabetes and hypertension: management consideration for minor oral surgery

  • Jadhav, Ajinath Nanasaheb;Tarte, Pooja Raosaheb
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.4
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    • pp.207-214
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    • 2019
  • Objectives: Medically compromised patients often fear required dental surgical procedures that can increase the risk of medical emergency when combined with reduced tolerance for stress. A stress reduction protocol (SRP) helps doctors minimize treatment-related stress and improves patient management with minimum complications. Diabetes and co-morbid hypertension carry 4-fold risk of aggravation of cardiovascular emergencies and 7.2-fold risk of mortality. Diabetic neuropathy can result in difficult diagnosis of myocardial infarction and reduces chances of surviving a myocardial infarction compared with a non-diabetic person. The aim of the study was to assess the feasibility of a protocol for management of patients having both diabetes and hypertension who required minor oral surgery to minimize the rate of cardiovascular emergencies. Materials and Methods: A prospective study was conducted in 140 patients having both diabetes and hypertension who required minor oral surgical procedures. A systematic approachable protocol was designed for management of such patients. Results: Among 140 patients, 6 patients (4.3%) had cardiovascular complications, while 3 patients (1 with syncope and 2 with hypertension) did not require any intervention other than observation. Two patients were managed with aspirin and nitroglycerin, and 1 patient had possible myocardial infarction (overall incidence 0.7%) with chest pain, S-T segment elevation on electrocardiogram, and troponin level of 0.60 ng/mL. Conclusion: The proposed protocol helps to improve management of patients having both diabetes and hypertension. We recommend that patients with uncontrolled diabetes and uncontrolled hypertension and/or patients having history of cardiovascular complication should be treated in a medical facility with a readily available cardiology unit. This facilitates prompt response to emergency and instant implementation of treatment, helping to reduce morbidity and mortality.

A Study on the Architectural Planning of Spatial Configuration and Area Composition for Regional Trauma Center in Korea (국내 권역외상센터의 공간구성 및 면적구성에 대한 건축계획적 연구)

  • Park, Suroh;Park, Jaeseung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.3
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    • pp.81-90
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    • 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.

A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea (일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究))

  • Kim, Yong-Ik;Yun, Dork-Ro;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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A Study on GunjungUihak(軍中醫學) ("군중의약(軍中醫藥)" 번역(飜譯) 연구(硏究))

  • Park, Sang-Young;Han, Chang-Huyn;Ahn, Sang-Young;Kwon, Oh-Min;Ahn, Sang-Woo
    • Journal of Korean Medical classics
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    • v.23 no.1
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    • pp.31-46
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    • 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.

Cost-Benefit Analysis of Electrical Safety Speed-call Service Using Electrical Fire Statistics Analysis and Outcome Analysis Logic Model (전기화재 통계 및 성과 분석 모델을 이용한 전기안전 긴급출동 고충처리 서비스의 비용 편익 분석)

  • Jeon, Jeong Chay;Yoo, Jae-Geun
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.65 no.11
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    • pp.1943-1947
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    • 2016
  • Korea Electrical Safety Cooperation(KESCO) have provided the electrical safety speed-call service from 2007 year. Purpose of the service is to reduce discomfort of electricity use and to prevent electrical accident like as electrical fire and shock accident by providing emergency treatment service on fault of the residential electrical facilities notified in the specific house like as a lower-income group and a social welfare facility. But efficiency and economic evaluation of the electrical safety speed-call service is impossible because analysis on the quantitative effect of the service is difficult. This paper presents cost-benefit analysis method and result of the electrical safety speed-call service. The presented cost-benefit analysis method has a two-step process: the first step is to measure quantitative electrical fire prevention effect of the service by using electrical accident statistics and developing outcome analysis logic model of the service effect, and the second step is to analysis cost-benefit(B/C)of the service by calculating quantitative benefit analysis on the measured quantitative electrical fire prevention effect. The results showed that cost-benefit(B/C)of the electrical safety speed-call service is over 4 after 2010 year.