• 대한응급의학회지
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• 제29권6호
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• pp.595-602
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• 2018

Objective: The Korean Triage and Acuity Scale (KTAS), which was implemented in 2016, needs to be assessed for its validity and reliability. Here we evaluate the relevance of emergency level assessment by analyzing the validity of KTAS as a Korean standardized triage system. Methods: We retrospectively analyzed the medical records of adults who presented to a local emergency room (ER) during an 18-month period. We compared medical resources used, life-saving interventions performed, length of stay (LOS) in ER, admission rate, and mortality at each KTAS level. Results: Among a total of 40,339 patients, most patients were at KTAS 4 (n=19,532, 48.4%) and the longest median LOS in ER was 450 minutes at KTAS 2. As the KTAS level increased, the percentage of medical resources used and lifesaving interventions performed increased significantly. The odds of total admission and intensive care unit admission were significantly higher at KTAS 1 through 4 compared to those at KTAS 5. The odds related to admission and mortality were also significantly higher at KTAS 3 than at KTAS 4. Conclusion: We concluded that the KTAS, as a Korean standardized triage system of emergency level assessment, is relevant. Further, KTAS 1-3 and KTAS 4-5 are appropriate criteria to distinguish emergency and non-emergency patients.

• 한국응급구조학회지
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• 제14권3호
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• pp.13-28
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• 2010

Purpose: In this study, we investigated the better application of the law which is about the AED installation and more effective ways of emergency medical care system, to understand the law and to research the current condition of public facilities which belong to local governments, and to seize the aspect of safety guards who currently work in order to provide the installation of AED in the public facilities and to provide more efficient emergency medical service with the effectuation of the immunity law of the good intention of first-aid treatment. Methods: In Gwang-ju, 234 public facilities have been identified by 31 December, 2008. With the exception of the duplication, we researched 158 facilities and received the answers from 95 of them. Results: In the research, 53% of them have had internal emergency first-aid education, and 55% of them didn't have this education and a CPR education manual, and 30% of the facilities even didn't know how to connect with the manager of the company for the first-aid department. On the other hand, most of them were highly interested in CPR and AED education on the ratio of 91% and 93%. 88% of them have been trained about first-aid, 51% of them haven't been retrained, 17% have never been trained. so, the reality of emergency system at public facilities is serious. 78% of them knew they are working at public facilities, though 49% of them didn't know about AED installation. 57% of them didn't know the fact there is the immunity law related with good intentions for first-aid treatment. 63% of the facilities have security guards, and 30% of them didn't answer the questions. Also, many of them agreed to the opinion that all employees should have first-aid training. At representative survey report of participator of public-facility, emergency treatment is 61%, 16% of patients calling. Accordingly they importantly think better doing an on-site first-aid than evacuating the patient. And the rates show that 57% of them answerers tend to call Fire-Office(119) for evacuating the patients, and 28% of them EMIC(1339) for the first-aid. Conclusions: In this study, we are suggest to improve the details of the efficient operations and management after the grasp of the uninstallation, indifference, and unreliable conditions of AED. 1) Need a publicity of AED install cognition which is an emergency medical instrument at public facilities. 2) Arrangement of safety agents at facilities and concerns about them for good management from the parties concerned. 3) Need a designation of legal details according to the decision of the AED installation and the standard of the AED installation. 4) Training about first-aid of safety guards and the persons concerned in the facilities should be practiced participation with the positive and through this, first-aid treatment could be done by anyone who knows the immunity law related to medical emergency. 5) The brochures for the potential users and the results form practicing the instructions need to be improved in many ways through recording the emergency cases that have happened.

• 보건행정학회지
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• 제34권1호
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• pp.17-25
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• 2024

연구배경: 본 연구의 목적은 17개 광역시·도 내 응급의료병상 적정 분배수준과 분배수준에 따른 경제적 편익을 추정하기 위함이다. 방법: 각 지역별 응급의료병상의 적정 분배수준을 추정하기 위하여 통계청에서 발표한 '2014-2021년 사망원인통계자료', '지역·인구·성별·연령에 관한 지역통계' 그리고 '장래인구추계'를 활용하였으며, 추가적으로 건강보험심사평가원에서 발표한 '시군구별 응급실 병상 수' 자료도 활용하였다. 또한 응급의료시설 증가로 인해 감소된 예방 가능한 응급사망자들의 경제적 편익을 추정하기 위해 한국개발연구원과 한국교통연구원의 지침을 참고하여 응급사망에 따른 임금 손실비용을 계산하고 적용하였다. 결과: 응급의료병상의 적정 분배량은 경기, 서울, 경남, 경북, 부산 순으로 높았고 대전, 제주, 세종은 상대적으로 낮은 수준을 보였다. 또한 응급의료시설 증가로 인한 경제적 편익은 경기, 서울, 경북, 경남, 부산에서 가장 높은 것으로 분석되었다. 한편, 17개 광역시·도별 인구표준화를 통해 계산한 경제적 편익은 경북, 충남, 전남, 경남 그리고 부산 순으로 높은 것으로 분석되었다. 결론: 본 연구결과는 향후 지역별 적정 응급의료시설 분배를 위한 기초자료로 활용될 수 있으며, 지역 간 응급의료시설 공급의 불균형을 해소하기 위한 정책에 기여할 수 있다. 또한 지역 특성을 감안하여 응급의료시설의 분배수준을 조정하는 것은 궁극적으로 국가 재정의 효율성을 증가시키고 경제적 편익을 얻을 수 있을 것으로 판단한다.

• 한국임상보건과학회지
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• 제1권1호
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• pp.35-45
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• 2013

Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• 대한한방내과학회지
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• 제39권3호
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• pp.350-362
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• 2018

Objectives: By analyzing the characteristics and the distribution of diseases of patients who visited the emergency room of a Korean medical hospital, we sought to determine the methods of activating the Korean emergency medical system and to use this analysis as a basis for future research. Methods: We conducted a retrospective review of 959 patients who visited the emergency department of the Dong-Eui University Korean Medical Hospital from January 2016 to December 2016. The review was conducted using electronic medical records created during the emergency department visit. Results & Conclusions: In distribution of sex, the rate of males was 47.9%, and that of females was 52.1%. In distribution of age, the greatest number of patients were in their 50s (27.5%), followed by those in their 60s (19.9%) and 40s (14.8%). In distribution of residence, most patients were from Busan (84.9%). In distribution of week, more patients visited the emergency room on Sundays and holidays (44.3%). September was the busiest month (12.5%). Visits usually occurred during daytime and nighttime, and there were few visits at dawn. In the analysis of the time interval between onset of symptoms and the emergency room visit, most patients visited within 24 hours (46.5%). In the distribution of diseases, facial palsy was the most common (34.6%). In the systematic distribution of diseases, circulatory diseases were the most common (56.7%), followed by diseases of the musculoskeletal system (28.6%). The rate of first emergency room visit was 52.9%, and the rate of revisit was 47.1%. The rate of hospitalization after emergency room treatment was 27.5%, and the rate of discharge was 72.4%. The rate of revisit was 63.4%. In the distribution of treatment before arrival at the emergency room, direct was the most common (51.0%), and the outpatient department of western medicine was next. In the distribution of treatment in the emergency room, acupuncture was the highest (91.4%), followed by herb-med (43.0%).

• 대한임상독성학회지
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• 제16권2호
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• pp.131-140
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• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.

• 한국정보전자통신기술학회논문지
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• 제3권4호
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• pp.28-34
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• 2010

본 논문은 인체의 생체 신호를 이용하여 응급상황을 예측할 수 있는 의료정보 시스템을 제안한다. 기존의 응급상황 관리를 위한 연구들은 대부분 바디 센서 네트워크를 중심으로 연구되고 있다. 이들 연구의 문제점은 응급상황이 발생한 후에 단순히 응급상황만을 전달하기 때문에 실제 상황이 발생하여 응급조치까지는 시간이 걸리는 응급조치 지연문제를 가지고 있다. 이러한 문제는 환자들에게 심하면 치료 불능상태에서 사망에까지 이르게 할 수 있다. 이러한 문제를 해결 하기위해서는 응급상황이 발생하기 전까지의 사전 응급징후를 파악하여서 신속히 응급조치를 할 수 있도록 응급상황에 대한 예측이 필요하다. 이를 위해서 본 논문은 센서 네트워크 기술, 인터넷 정보검색 기술, 데이터 마이닝 기술 및 의료정보와 개인정보 보호를 위한 보안 기술을 융합하여 응급상황을 예측할 수 있는 의료정보 시스템을 제안하고자 한다.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.149-157
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• 2015

Purpose: Traumatic brain injury (TBI) is the most common cause of pediatric trauma patients came to the emergency department. Without guidelines, many of these children underwent repeat brain computed tomography (CT). The purpose of this study was to evaluate the value of repeat brain CT in children with TBI. Methods: We conducted a retrospective study of TBI in children younger than 19 years of age who visited the emergency department (ED) from January 2011 to December 2012. According to the Glasgow Coma Scale (GCS) and Pediatric Glasgow Coma Scale score of the patients, study population divided in three groups. Clinical data collected included age, mechanism of injury, type of TBI, and outcome. Results: A Total 83 children with TBI received repeat brain CT. There were no need for neurosurgical intervention in mild TBI (GCS score 13-15) group who underwent routine repeat CT. 4 patients of mild TBI group, received repeat brain CT due to neurological deterioration, and one patient underwent neurosurgical intervention. Routine repeat CT identified 12 patients with radiographic progression. One patient underwent neurosurgical intervention based on the second brain CT finding, who belonged to the moderate TBI (GCS score 9-12) group. Conclusion: Our study showed that children with mild TBI can be observed without repeat brain CT when there is no evidence of neurologic deterioration. Further study is needed for establish indication for repetition of CT scan in order to avoid unnecessary radiation exposure of children.

• 한국응급구조학회지
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• 제7권1호
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• pp.147-178
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• 2003

In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations : Building up security system along with operational expansion, building up a system for emergency medical treatment, buliding up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119, we can review the following considerations : Improving the education for fire fighting trainging corps under Jeju Provicial Fire and disaster management department, providing rescue members with more opportunity for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. Provide little more superior quality high fire fighting service to jeju islander, and need long-term and elaborate research to correspond in rising fire fighting man-power demand newly and investment. Construction of well-matched disaster administration system is assignment that must hurry in international free city. That jejudo receives time factor about that is received for another thing area's number of persons or equipment when regional special quality large scale or disaster happens is that of course the support receives limitation immediately. Jeju fire fighting services is one story reform, specialization taking into account particular situation of jeju area to grow as sightseeing and center of culture intending international free city, should be upgraded. So, it may do big contribution naturally in jeju international free city phase that coincide jeju islander's social welfare promotion and safety desire.