• 한국응급구조학회지
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• 제19권2호
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• pp.83-97
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• 2015

Purpose: Although appointed as a national competency standards (NCS) based reserves department, the department of emergency medical technology, an NCS-based emergency department, is mainly focused on subject deduction for a NCS-based curriculum. Methods: Job models were formed and verified by combining the competency unit of NCS and the duty of Developing a curriculum (DACUM) based on the development procedure indicated in the guidelines for a NCS-based curriculum. The mapping method of the subject was performed by deducting necessary competency units (duty) and competency unit elements (task) by connecting with the composition items of NCS and DACUM. Results: Job models combined with job analysis for the NCS and DACUM were reduced to 13 competency units (duty) and 79 competency unit elements (task). A modified method such as the 1:N method was mainly applied as a subject-matching method with consideration of the competency level and size of the competency unit. Conclusion: It would be a desirable direction to develop a NCS-based curriculum in the center of the practice subject in consideration of the size of the competency unit and competency level of the competency unit element. The existing curriculum should be promoted as a field-oriented curriculum at the complementary level.

• Journal of Trauma and Injury
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• 제34권2호
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• pp.87-97
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• 2021

Purpose: This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening. Methods: This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test. Results: Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031). Conclusions: After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

• 보건행정학회지
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• 제32권2호
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• pp.164-172
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• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

• 인터넷정보학회논문지
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• 제23권3호
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• pp.87-95
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• 2022

최근 스마트기술의 발달로 의료정보플랫폼에서 환자의 생체데이터가 실시간으로 측정 및 데이터베이스에 축적되며, 환자의 응급상황을 판단할 수 있다. 또한, 의료진은 이동단말기를 이용하여 간단한 인증 이후 환자정보에 쉽게 접근이 가능하다. 그러나 이동단말기를 이용한 의료정보 접근에 있어 환자상황과 이동단말기를 고려한 인증에 대한 연구가 필요하다. 본 논문에서는 응급상황에서 의료진의 이동단말기를 이용한 의료정보 접근허가를 위해 빅데이터 처리 및 에지컴퓨팅 기반의 자동인증지원 의료정보플랫폼에 대해 연구하였다. 기 연구된 자동인증 시스템은 응급상황에서 사용자인증과 이동단말기인증을 동시에 수행하며, 상위 의료정보 접근권한을 인증된 의료진과 이동단말기에 부여하는 인증 시스템이다. 환자의 고혈압, 당뇨와 같은 환자상태를 고려한 응급상황을 판단하기 위해 빅데이터 처리 및 분석기법을 제안한 플랫폼에 적용하였다. 또한 환자의 빠른 응급상황 판단을 위해 에지컴퓨팅을 의료정보 서버 앞단에 두어 의료정보 서버 대신 에지컴퓨팅에서 응급상황을 판단하도록 하였다. 의료정보 서버는 입력된 환자정보와 축적된 생체데이터를 이용하여 응급상황 판단수치를 도출하고, 에지컴퓨팅에 전달하여 환자 맞춤형 응급상황을 판단하도록 하였다. 결론적으로, 제안한 의료정보플랫폼은 빅데이터 처리와 에지컴퓨팅을 통해 환자상태를 고려하고 응급상황을 빠르게 판단하였으며, 자동인증을 통해 응급상황에서의 신속한 인증과, 환자상황과 의료진의 역할에 따른 접근권한 부여를 통해 환자정보를 보호하였다.

• 한국응급구조학회지
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• 제11권2호
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• pp.87-101
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• 2007

Health and disease related characteristics of 226 selected by systematic sampling from 452 personal emergency response system(PERS) beneficiaries and actual conditions of using PERS by them are as follows. Over 86% of PERS beneficiaries have not good health conditions and 70.7% of them have chronic diseases. On social supports family was highest as 52.2% and cases having social workers' assistance were 15.2%, but 53 as 23.7% had not visit or call from anyone and showed very low social supports. 86.2% was given PERS within 3years and 79.1% had it by the recommendation from related agencies and 4.0% was by their demand. On wearing it, 78.3% didn't bring it with them and 92% of them answered they were not sick and then it was found that they didn't use it because they had not special emergency. On satisfaction with paging system's operation, 81.3% answered they were satisfied with it, 48.8% used it for 'acute and emergency diseases' and 29.3% called ambulance for 'appointed medical treatment'. Time required for ambulance to arrive at the field was within 10 min. in 87.8% and after 10 min. in 12.2% and emergency service for beneficiaries by fire service was very good. On satisfaction with use of PERS, 85.4% were satisfied with it, 81.9% who requested repair or replacement of radio paging got it back after one or two days of their request and they answered they were satisfied with A/S. 45.5% answered they powered off it because 'they didn't use it' and 12.1% had 'economical reason of phone charge'.

• 한국융합학회논문지
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• 제10권5호
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• pp.111-117
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• 2019

본 연구는 차량 사고에서 병원 전 응급의료 대응시간을 단축시키기 위한 방안을 모색한 융합연구이다. 연구방법은 한국형 교통사고 심층조사 분석 체계(Korea In-Depth Accident Study)에서 2011년 1월 1일부터 2016년 7월 30일까지 3개의 응급의료센터에 119구급대로 내원한 차량 탑승자 353명을 대상으로 날씨, 도로유형, 사고유형, 구조대 출동 여부를 활용하여 병원 전 응급의료 대응시간에 대해 요인 분석하였다. 연구결과에서 고속도로는 병원 전 응급의료 대응시간을 가장 많이 소요하였고 전체시간에 영향을 주는 요인으로 확인되었다(${\beta}=.543$, p<.001). 따라서 고속도로에서 소요되는 시간을 단축시키기 위해 고속도로 119구급대의 운영과 비상회차로의 적극적인 사용, 개별 장치를 부착한 자동 긴급구조신호 서비스의 제공을 제시하였다.

• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.31-38
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• 2022

Background: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21-September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21-September 8, 2019) and control period 2 was set as July 1-19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results: During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

• 한국응급구조학회지
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• 제16권2호
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• pp.91-102
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• 2012

Purpose : This study was designed to identify factors influencing burnout of nurses in emergency medical center. Methods : Data were collected by questionnaires from 178 emergency room nurses randomly selected from 6 general hospitals in two metropolitan cities. Measures were burnout, QEC, depression, decision latitude and job demand. Data were analysed using frequencies, means, standard deviation, t-test or one way ANOVA, Pearson's correlation coefficients and multiple regression with SPSS/win 18.0 version. Results : The mean score for burnout in emergency room nurses was 2.59 out of possible 4. There were significant differences in burnout according to exercise, leisure, position, job demand and depression. Burnout correlated negatively with exercise and leisure, and positively with job demand and depression. Factors influencing burnout in emergency room nurses were identified as exercise(${\beta}$=-.399, p<.001), leisure(${\beta}$=-.354, p<.001), job demand(${\beta}$=.301, p=.006) and depression(${\beta}$=.189, p=.021). These factors explained 49.8% of burnout reported by emergency room nurses. Conclusion : The result indicate which factors are major factors influencing burnout in emergency room nurses in general hospitals. Therefore, these factors may serve as predictors of burnout in emergency room nurses.

• 간호행정학회지
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• 제15권1호
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• pp.64-71
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• 2009

Purpose: This study shows the prehospital emergency nursing practices, and analyzes them associated with their individual characteristics and job conditions. Method: Based on a survey of the National Emergency Medical Center in Korea(2008), principal components were extracted from 7 prehospital emergency nursing practices by factor analysis, and some regression analyses of principal components(CPR-AED and V/S-I.V.) were executed on individual characteristics and job conditions. Results: The PENs gave themselves higher order ratings for vital sign check, airway management for loss of consciousness patients, CPR for suspicious cardiac arrest, keeping vein open for shock patients, AED for abnormal pulse rate, AED for suspicious cardiac arrest, and AED for loss of consciousness. Age and duty periods were statistically significant influential factors on the CPR-AED component. Conclusion: The results indicate that the PENs were competent in overall prehospital emergency activities and procedures even some weak self-evaluations, and that the standard curriculum and practice standard for prehospital nursing should be developed in order to increase nursing leadership in prehospital emergency settings.

• 대한임상독성학회지
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• 제16권1호
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• pp.25-32
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• 2018

Purpose: Methamphetamine is an ongoing illegal drug problem worldwide, and its use in South Korea has spread over the last few years. In this study, a clinical review of patients who visited emergency medical centers with positive methamphetamine tests was conducted. Methods: Patients underwent methamphetamine screening based on physician suspicion over a period of 13 years. Their patient characteristics, clinical features, and drug administration properties were described. Results: A total of 297 patients were included, with 19 positive methamphetamine results. Patient age ranged from 21 to 84, with a mean of 37.52. Additionally, 13 were male and 6 were female. The mean BP, PR, RR were 131/82 mmHg, 94/min, 20/min. Saturation levels were all over 95%. Five patients had a psychiatric history. Patient showed varied symptoms ranging from mental changes to chest discomfort. In addition, seven showed abnormal electrocardiography findings and one showed elevated cardiac enzyme levels. Other laboratory results revealed no significantly abnormal results. Six patients also suffered from related trauma. The majority of patients consumed the methamphetamine orally, with unknown motivation at unknown locations. Most were transported by 119 and six patients co-ingested other drugs. Conclusion: Patients who showed positive results to a methamphetamine screening test in Korea visited the emergency medical center mostly by 119 and were unaware of or reluctant to reveal the fact that they had ingested methamphetamine. Emergency physicians should be more aware of the possibility that a patient may have consumed methamphetamine.