• 임상간호연구
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• 제14권1호
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• pp.99-111
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• 2008

Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.

• 동서간호학연구지
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• 제20권2호
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• pp.93-102
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• 2014

Purpose: This study aimed to investigate the characteristics of patients attempting suicide and to analyze treatment determination factors for patients with mental illness who go to an emergency center for treatment. Methods: Data collected from 117 suicide attempters who visited Busan Regional Emergency Medical Center were analyzed using frequency, percentage, ${\chi}^2$-test with SPSS/WIN 15.0. Results: Only 31 cases consulted with the psychiatric department; the other attempters' refused to consult (26.5%). Among the 31 attempters who consulted, 23 cases (74.2%) were suffering from depression. The most common reason (38.6%) suicidal attempters gave to refuse psychiatric treatment was "I'm not mad. I don't need the psychiatric treatment". Treatment determination factors for mental illness were religion (p<.001), past history (p=.017), financial satisfaction (p=.048), previous history of suicidal attempts (p=.006), sleep disturbance (p<.001), expression of suicide (p=.010), and type of leaving the emergency room (p=.020, p<.001). Conclusion: Results suggest that people frequently misunderstand psychiatric treatment which leads to their refusal to accept psychiatric treatment. Therefore hospitals need to develop standard guidelines and procedures for suicidal attempters with the collaboration of emergency and psychiatry departments. In addition, medical teams need to provide attempters appropriate information and encourage them to actively seek psychiatric treatment.

• 대한임상독성학회지
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• 제11권1호
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• pp.9-18
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• 2013

Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

• 한국응급구조학회지
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• 제23권2호
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• pp.43-59
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• 2019

Purpose: The purpose of this study was to assess 119 emergency medical technicians' perception of child abuse, attitudes towards mandatory reporting, and perceptions of mandatory reporting system, and to promote early reporting. Methods: The questionnaire was filled out by one hundred ninety 119 EMTs with paramedic or nurse licenses. The questionnaire consisted of 53 items with responses based on a five-point scale. Data were collected from July 10 to July 31, 2018, and were analyzed using IBM SPSS version 24.0 software. Results: The average score for 119 EMT's perception of child abuse was 3.76. The average score for positive attitude towards mandatory reporting was 3.63, and the average score for negative attitude towards mandatory reporting was 2.63. The average score for perceptions of the mandatory reporting system was 3.50. There was a significant positive correlation between perception of child abuse and positive attitude towards mandatory reporting (r=.244, p=.001), between perception of child abuse and perceptions of the mandatory reporting system (r=.209, p=.004), and between positive attitude towards mandatory reporting and perceptions of mandatory reporting system (r=.336, p=.000). Conclusion: Systemic educational programs for 119 EMTs on perception of child abuse and reporting are needed. It is very important to establish institutional strategies such as the use of checklist for suspicion of child abuse, procedural simplicity after reporting, and protection of reporter information.

• 대한임상독성학회지
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• 제15권2호
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• pp.116-121
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• 2017

Purpose: The aim of this study was to compare the toxicologic profiles and outcome of poisoned patients by comparing the data obtained through telephone counselling, each provided by emergency medical information center (1339) and emergency dispatch center (119). Methods: We analyzed the telephone-based poison exposure data before and after Seoul 1339 merged to 119. We compared the Seoul 1339 call response data in 2008 with Seoul and Busan 119 call response data between 2014 and 2016. We analyzed the changes in the trend and quality of data obtained, as well as the quality of service provided by each center before and after this reallocation, by comparing the data each obtained through telephone counselling. Results: The data was collected for a total of 2260 toxin exposure related calls made to Seoul 1339 in 2009, and 1657 calls to 119 in Seoul and Busan between 2014 and 2016. Significant difference was observed for age, sex, and reason for exposure to toxic substance between the two groups. Conclusion: After the integration of 1339 with 119, 119 focused on role of field dispatch and hospital transfer, lacking the consulting on drug poisoning. Moreover, data on exposure to toxic substances at the pre-hospital stage indicate that drug information and counseling are missing or unknown. In addition, first aid or follow-up instructions are not provided. Thus, systematic approach and management are required.

• 한국병원경영학회지
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• 제13권4호
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• pp.27-45
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• 2008

This research focused on a total of 378 patients with external injuries under the age of 14 who visited the emergency center at a university hospital in Korea, during the months of January, April, August and November between January and December of 2007. In addition, the survey was conducted only on even number days and ranged across the whole year to reflect the impact of seasonal characteristics on the collected data. The research focused on determining the characteristics and inflicting cause of these patients with external injuries, analyzed the total time spent in the emergency room and obtained the following results. 1. When classifying the patients into different genders, the proportion of males (67.5%) was higher than that of females (32.5%). According to the different age groups, the highest ratio, at 61.1 %, was patients under the age of six. 2. Looking at the total number of minutes spent in the emergency room, the longest amount of time occurred during April with 162.7 minutes, followed by 121.9 minutes in January and 92.4 minutes in November. August had the shortest period of time spent in the emergency room, a significant statistical difference from the other periods of the year (p<0.001). 3. Regarding the amount of time required for each examination, patients required to provide a urine test spent an average of 204.7 minutes while those who did not spent 113.5 minutes on average. This is a 5% statistical difference among the two groups (p>0.05). 4. Looking at the five most commonly diagnosed problems in the emergency room, the total number of people with these top five commonly diagnosed illnesses comprised 55.6%, or 210 patients out of 378. 5. Utilizing the Decision Tree Model to estimate the total number of minutes required per visit, the first classifications were made using a chemical examination factor. People subject to chemical classification spent an average of 177.7 minutes, which was longer than the overall average of 115.2 minutes, and those exempt from chemical examination spent an average of 103.8 minutes, which was shorter than the average Conclusion; Effort to curtail the total time spent in emergency rooms is vital in guaranteeing efficient management of hospitals and providing medical services. The delay experienced by many comprehensive professional medical centers must be resolved through the establishment of effective delivery of medical services, increased supply of patient rooms and other policy oriented implementations. However, for now, this problem must be resolved by increasing the level of patient satisfaction and guaranteeing effective operation of patient rooms, which will significantly contribute to the general management and success of hospitals and institutions.

• 한국컴퓨터정보학회논문지
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• 제25권11호
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• pp.239-244
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• 2020

본 연구는 광주지역 권역응급의료센터에 내원한 환자의 의료정보를 기초로 외상의 중등도별 특성 분석을 통한 손상발생의 위험요소를 파악하여 손상예방대책을 위한 보건예방정책 제언 및 기초 자료를 마련하는데 목적이 있다. 2019년 9월 1일부터12월 31일까지 4개월간 응급의료센터에 내원한 2585명의 환자를 대상으로 손상외인 관련성을 연구의 통계학적 분석을 위하여 SPSS-Window(ver. 20.1)프로그램을 이용하였다. 연구 분석결과는 다음과 같다. 응급의료센터에 내원한 손상 환자 중 전체 2585명 환자에서 성별은 남성(61.3%)이 여성(38.7%)보다 더 많았으며, 20대에서 50대까지의 연령층에서 발생률이 높았으며 중증도를 감안하면 50대(16.8%)의 연령층이 가장 많았다(P<.001). 둘째, 중등도에 따른 손상외인의 발생장소로는 도로 및 교통지역(35.1%)이 가장 높았다(P<.001). 셋째, 중등도에 따른 손상발생의 시간은 12-18시(35.8%)로 높았다(P<.001). 넷째, 중등도에 따른 손상부위는 두부 및 안면부(55.4%)에서 가장 높았다(P<.001). 다섯째, 중등도에 따른 손상 유형은 열린상처(31.2%)에서 높았다(P<.001). 향후 손상에 대한 지속적인 관심과 연구로 외상환자 등 중증도별 특성에 따라 구체적인 보건예방정책 수립이 요구된다.

• 한국보건간호학회지
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• 제9권1호
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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.

• 대한임상독성학회지
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• 제5권2호
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• pp.106-111
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• 2007

Purpose: Inadequate hospital stocking and unavailability of essential antidotes is a worldwide problem. The purpose of this study was to determine the adequacy of antidote stocks in Korean hospitals based on a modified version of US antidote stocking guidelines. Methods: Both written and telephone surveys to collect information on hospital demographics and antidote stocking were given to the emergency departments or hospital pharmacies of 117 hospitals with emergency medical centers. The twenty antidotes included in the survey were taken from year 2000 US antidote stocking guidelines, except for activated charcoal and black widow spider antivenin. Antidote stocks were compared by hospital size, geographic location, and type of emergency medical center. Results: Complete responses were received from all hospitals. A mean of $12.4{\pm}2.9$ antidotes were adequately stocked per hospital. All hospitals stocked atropine, $CaCl_2$ naloxone, and sodium bicarbonate. However, digoxin Fab fragment (16%), cyanide kits (15%), EDTA (10%), BAL (9%), and fomepizole (1%) were not uniformly stocked. Large and teaching hospitals were significantly more likely to stock greater numbers of antidotes. Conclusions: Korean hospitals as a group do not have adequate antidote stocks. Korean stocking guidelines and an antidote management system are recommended in order to correct these deficiencies.

• 전기전자학회논문지
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• 제10권1호
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• pp.55-61
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• 2006

현대 사회는 의료 기술의 발달로 인한 인간 수명의 연장과 핵가족화로 인하여 혼자 지내는 노인이 많아지면서 응급상황 발생시 신속한 의료서비스를 받지 못하는 경우가 많아지고 있다. 또한 대표적인 성인병인 심혈관질환과 뇌졸중 그리고 노인의 건강에 치명적인 낙상의 발생율도 높아지고 있는 추세이다. 본 논문에서는 심전도, 체온, 사용자의 움직임 등의 생체신호를 획득하고 획득된 생체신호를 분석하여 심혈관질환, 뇌졸중, 낙상 등의 응급상황 발생시 응급의료센터와 보호자에게 구조메시지를 전송할 수 있는 시스템을 제안하였다. 시스템은 크게 생체신호 획득부와 모바일부 두 부분으로 나눌 수 있다. 생체신호 획득부는 사용자에 따라 생체신호의 추가, 제거가 어렵다는 단점을 보완하기 위해 심전도, 체온, 가속도 센서 모듈로 모듈화 하여 구성하였다. 모바일부는 생체신호 획득부로부터 전송된 생체신호의 처리 및 응급상황시 메시지 전송, 생체신호의 디스플레이 역할을 수행하며, 생체신호 획득부에서 획득된 생체신호는 블루투스 모뎀을 통하여 모바일부로 전송된다. 또한 모바일부에서 처리된 신호는 802.11b 무선랜을 통하여 PC로 전송된다.