• Title/Summary/Keyword: Emergency medical

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메스암페타민 검사 양성 환자에 대한 임상적 고찰: 단일기관 연구 (A Clinical Review of Patients Who Visited Emergency Medical Center with Positive Methamphetamine Tests: A Single Institute Study)

  • 옥영빈;김진용;이경룡;홍대영;백광제;박상오;김종원;김신영
    • 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.

119 구급대원의 임파워먼트와 직무만족과의 관계 (The Relationship Between the Empowerment and the Job Satisfaction of 119 Emergency Medical Technician)

  • 한송이
    • 한국응급구조학회지
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    • 제14권1호
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    • pp.47-63
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    • 2010
  • Objective : The objective of this study was to survey the job-related empowerment and job satisfaction of 119 emergency medical technicians provide emergency patients with first aid, to examine the correlation between their empowerment and job satisfaction, and to provide basic materials for developing programs to enhance 119 emergency medical technicians' empowerment and job satisfaction. Methods : The survey was conducted with 249 119 emergency medical technicians working at fire stations in an area of Gyeonggi-do during the period from June 26 to August 21, 2009. Using SPSS 14.0 program, we obtained frequencies percentages, means, and standard deviations, and performed independent two sample t-test, one way ANOVA, and Pearson correlation analysis, and Cronbach's ${\alpha}$. Results : 1) The mean score of the subjects' empowerment was 3.32, and that of their job satisfaction was 2.94. 2) As to difference according to general characteristics, no statistically significant difference was observed in empowerment but job satisfaction was statistically significantly different according to gender(t = 2.296, p = .023). 3) As to difference according to job related characteristics, empowerment was significantly different according to license type(F = 3.767, p = .011), and job satisfaction was statistically significantly different according to position(t = 3.222, p = .042), fire fighting experience(t = 2.689, p = .035), and first aid experience(t = 3.991, p = .007). 4) Empowerment was in a positive correlation with job satisfaction(r = .502, p = .000) in general, and by the sub areas of job satisfaction, the correlation with empowerment was high in order of job itself(r = .695, p = .000), interaction area(r = .493, p = .000), organizational demand area(r = .328, p = .000), working condition area(r = .153, p = .015), and wage area(r = .137, p = .031). By the sub areas of empowerment, the correlation with job satisfaction was high in order of significance(r = .424, p = .000), influence(r = .397, p = .000), competence(r = .372, p = .000), and self determination(r = .259, p = .000). Conclusion : The 119 emergency medical technicians' empowerment was in a high correlation with their job satisfaction, and had a strong effect on it. This suggests that 119 emergency medical technicians' job performance can be enhanced by improving their empowerment. These results are expected to be useful in making human resource management plans to enhance 119 emergency medical technicians' job satisfaction by empowering them.

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응급의료서비스 중 발생되는 소송사례와 대책 연구 (A Study on Lawsuit Cases and Measures of Emergency Medical Service)

  • 권혜란
    • 한국응급구조학회지
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    • 제13권3호
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    • pp.77-90
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    • 2009
  • Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

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모바일 기기를 이용한 통합 응급의료센터 관리 시스템 설계 (Design integrated emergency center management system with mobile device)

  • 백성현;장종욱
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2012년도 추계학술대회
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    • pp.414-417
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    • 2012
  • 최근 전문의 응급의료센터 당직을 규정하는 것을 골자로 응급의료법이 개정되면서 응급의료센터 시스템에 많은 변화가 생길 것 이다. 응급환자가 응급의료센터를 찾을 경우 응급실 근무의사 ${\rightarrow}$ 해당과 인턴 ${\rightarrow}$ 1 2년차 전공의(레지던트) ${\rightarrow}$ 3 4년차 레지던트를 거쳐야 전문의 진료를 받을 수 있던 것을 응급실 근무의사 ${\rightarrow}$ 해당과 당직전문의 진료 또는 호출로 그 절차가 간소화됐다. 문제는 이런 시스템을 하려면 모든 진료과목에 대해 당직전문의를 배치해야 한다. 하지만 모든 병원이 모든 진료 과목에 대해 전문의를 배치하는 것은 어렵다. 본 논문에서는 모바일 기기를 이용하여 사용자 근처의 응급의료센터가 있는 병원과 해당 병원이 어떤 전문의가 있는지와 병원의 정보와 응급실의 사용현황을 개정되는 응급의료법을 위해 통합 응급실 관리 시스템을 설계한다.

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Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial

  • Sotoodehnia, Mehran;Farmahini-Farahani, Mozhgan;Safaie, Arash;Rasooli, Fatemeh;Baratloo, Alireza
    • The Korean Journal of Pain
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    • 제32권2호
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    • pp.97-104
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    • 2019
  • Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

119 구급대원의 곤충교상환자에 대한 응급처치 현황 및 개선방안 (Prehospital care and improvement of 119 emergency medical technician for the insect bite patients)

  • 김지혜;이경열
    • 한국응급구조학회지
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    • 제17권1호
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    • pp.63-78
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    • 2013
  • Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.

응급실 간호사의 건강신념이 낙상예방활동에 미치는 영향 (Effects of Health Belief on Fall Prevention Activities of Emergency Room Nurses)

  • 박민경;김현영
    • 간호행정학회지
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    • 제20권2호
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    • pp.176-186
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    • 2014
  • Purpose: The purpose of this study was to analyze factors affecting fall prevention activities of emergency room (ER) nurses based on their health belief factors (perceived susceptibility, perceived benefits, perceived severity, perceived barriers, and cues to action). Methods: The study design was a descriptive survey using questionnaires which were given to 127 emergency room nurses from two regional emergency medical centers, four local emergency medical centers, and two local emergency medical facilities. Data were analyzed using descriptive analysis, t-test, one-way ANOVA with LSD test, Pearson correlation, and multiple regressions. Results: ER nurses' fall prevention activities had a mean of $3.78{\pm}0.50$. Eight individual characteristics and health belief factors accounted for 30.8% of the fall prevention activities. Fall prevention activities were found to be positively affected by emergency medical facilities, perceived benefits, and cues to action and negatively affected by factors, such as ER career and perceived severity. Conclusion: The results indicate that it is necessary to formulate a plan for enhancing perceived benefits and cues to action to improve fall prevention activities. In addition, fall prevention activities should be encouraged for ER nurses who have worked in local medical institutions for less than 1 year or more than 5 years.

NFC를 이용한 모바일 응급 의료 시스템 구현에 관한 연구 (A Study on Implementation of Mobile Emergency Medical System Using NFC)

  • 박주희
    • 한국항행학회논문지
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    • 제18권6호
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    • pp.633-639
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    • 2014
  • 최근 IT와 BT를 융합한 스마트 헬스케어를 통해 다양한 의료 서비스를 제공하는 연구가 활발하게 진행되고 있다. 짧은 시간에 최상의 응급 의료 서비스를 제공하기 위해서는 응급 상황 발생시 신속한 응급 조치가 필수적이다. 본 논문에서는 NFC 태그를 휴대하거나 NFC 기능을 적용한 스마트폰을 휴대한 사람이 의식을 잃는 사고를 당했을 때 효율적으로 응급 조치를 취할 수 있는 응급 의료 서비스 플랫폼을 제안한다. NFC를 이용하면 일상생활 중에서 낙상과 같은 사고로 의식이 없는 응급 환자에게 신체 접촉 없이 도움을 주는 것이 가능하다. 본 논문에서는 모바일 응급 의료시스템을 구현하여 환자가 스마트폰을 활용하여 응급 상황 발생시 주위 사람들에게 도움을 청하고 응급 조치 정보를 전달할 수 있음을 보였다.