• Journal of Society of Preventive Korean Medicine
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• v.27 no.3
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• pp.13-24
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• 2023

Objective : This study was aimed to reassess the scope of practice for medical personnel based on laws. Method : The law specifying the scope of practice for medical personnel has been selected searching Korean Law Information Center(https://www.law.gov.kr). The result was categorized as 'examination, diagnosis, treatment, procedure, prescription, and others'. Results : The laws related to medical procedures were divided into three categories: diagnosis, treatments, and public health and others. In the field of diagnosis, traditional Korean medicine practitioners are generally allowed to play a role. However, some laws specify that only medical doctors can be the primary authorities for diagnosing infectious diseases. In the area of treatments, particularly in emergency medical situations, only medical doctors or nurses are typically mentioned. There are debates in the field of public health and other areas concerning issues such as vaccination, disability diagnosis, and the qualifications for health center directors. A reevaluation is also needed for the Occupational Safety and Health Act, where only medical doctors are set as the personnel standard for workers' health examinations. Conclusion : To safeguard and promote the health of the citizens, there is a need for a clear definition of the licensure and scope of practice for healthcare professionals. Consistent interpretation of conflicting provisions among various laws and clear criteria for the term 'physician' in legal contexts are essential.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.26 no.11
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• pp.1571-1576
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• 2022

This study aims to analyze the interest of modern people in non-face-to-face medical counseling in the medical industrys. Big data was collected on two social platforms, 지식인, a platform that allows experts to receive medical counseling, and YouTube. In addition to the top five keywords of telephone counseling, "internal medicine", "general medicine", "department of neurology", "department of mental health", and "pediatrics", a data set was built from each platform with a total of eight search terms: "specialist", "medical counseling", and "health information". Afterwards, pre-processing processes such as morpheme classification, disease extraction, and normalization were performed based on the crawled data. Data was visualized with word clouds, broken line graphs, quarterly graphs, and bar graphs by disease frequency based on word frequency. An emotional classification model was constructed only for YouTube data, and the performance of GRU and BERT-based models was compared.

• The Korean Journal of Emergency Medical Services
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• v.13 no.2
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• pp.87-98
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• 2009

Purpose : This study set out to compare the educational effects of a video self-instruction program for child CPR education on childcare teachers by applying the 2006 KACPR Guideline. By adopting the nonequivalent control group posttest quasi-experimental design, the study examined the educational effects on a group that did not receive instructions from the instructor, another group that received his instructions, and the other group that received an extra three-minute practice training session in addition to instructions. Methods : Data were gathered from August 6 to 18, 2008. As for research tools, the Knowledge Instrument of CPR by Connolly (2006) was used along with the National Practice Test Protocol for C1ass 1 Emergency Medical Technicians (2007) and Common Protocol for CPR (2006) to examine the performance of child CPR. By shooting the guide screen of $Resusci^{(R)}$ Junior CPR Manikin of Leardal with a video camera and using the Skill Guide Checklist of the Common Protocol for CPR (2006), the subjects' technical accuracy of chi1d CPR was evaluated. There were three subject groups: 29 childcare teachers randomly assigned to received the video self-instruction program training for chi1d CPR and no instructions from the instructor made up the control group; 22 childcare teachers randomly assigned to received the program training and instructions from the instructor made up experiment group I; 23 childcare teachers randomly assigned to received an extra three-minute practice training session in addition to the program training and the instructions made up experiment group II. The gathered data were analyzed with SPSS/PC+ (Version 14.0) in frequency, percentage, $X^2$-test, ANOVA, Scheffe test. Results : 1) There were no statistically significant differences (F=1.030, p=.362) among the groups in terms of knowledge scores after the child CPR education. 2) There were statistically significant differences (F=13.625, p=.000) among the groups in terms of performance abilities after the child CPR education. 3) There were no statistically significant differences (F=1.610, p=.207) among the groups in terms of technical accuracy of mouth-to-mouth resuscitation after the child CPR education 4) There were no statistically significant differences (F=1.484, p=.234) among the groups in terms of technical accuracy of chest compression after the child CPR education. Conclusion : The results indicate that childcare teachers can improve their performance abilities in child CPR when the instructors are active with their instructions and extra practice hours are secured through a VSI program. It's also needed to provide education with increasing concentration ratio about the items of lower knowledge points in order to help the teachers learn the accurate theory of child CPR. And there should be VSI programs of diverse conditions to increase the effects of child CPR training among childcare teachers.

• Biomedical Science Letters
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• v.10 no.3
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• pp.299-303
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• 2004

The number of acute drug intoxication who visiting to emergency department which is located near urban and rural area concomitantly is inclined to increase slightly, The purpose of this study was the investigation of methods and strategies of management of acute drug intoxication in emergency department Clinical trials were done on 92 cases of acute drug intoxication visiting to Emergency Department of Chungnam National University Hospital during 4 months from April to July 2003. 1. The total number of acute drug intoxication during this period was 92 patients, which presented 0.95％ of all the emergency department visiting patients during the study. The intentional ingestions were observed in 84 cases (91.3％). 2. The maximal point of age distribution was 4th decade. The number of that was 21 cases (22.8％). 3. The number of patients who had ingested benzodiazepines and doxylamine succinates was 26 cases (28.2％), organophosphorus was 20 (21.7％), paraquat was 10 (10.8％), others were 36 (39.3％). 4. Five kinds of po1ydrug ingestion was observed in 3 cases, four kinds was observed in 3, three kinds was observed in 5 and co-ingestion of alcohol was observed in 28 cases (30.4％). 5. The mortality was occurred in 4 cases, 2 of them were caused by paraquat, 1 of them was caused by organophosphorus (OP), 1 of them was caused by acetic acid. 6. The gastric larvage as a mean of treatment modality was done in 57 cases (61.9％). The use of activated charcoal was done in 8 (8.69％). The maintenance of tracheal intubation was done in 6 (6.52％). 7. The mean observational period in emergency department was 8 hours 42 minutes in benzodiazepine and doxylamine succinate group, 21 hours 46 minutes in OP, 20 hours 39 minutes in other germicidal except OP, 23 hours 9 minutes in paraquat group. Without a drug information and intoxication center in Korea, We should minimize the exhaustion of medical resources by establishment of determinant criteria which can be seen in relatively less-complicated cases of acute drug intoxication. Thus, we should consider the introduction of simple toxicology treatment protocol and toxicologic observation unit in emergency department as possible means to reduce economical and social burdens.

• Journal of the Korean Association of Geographic Information Studies
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• v.14 no.1
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• pp.59-72
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• 2011

The research of psychological supporting systems as safety and welfare for disaster victims damaged psychologically as well as physically by a sudden disaster to return to effectively their social life has been carried. The domestic National Emergency Management Agency(NEMA) is operating the Disaster Victim Psychology Support Center that helps with curing damaged psychology and studies the transmission system of psychology management services, the classification of victims for disaster psychology support, and emergency consultation method to systemically support disaster psychology management. However, current psychology supporting centers provide the simple information for supporting centers such as medical and social welfare organizations. The development research of IT-based management systems to obtain needed information to construct the proposed systems curing psychological damage is still primitive step. Therefore, this paper shall propose a GIS-based integrated management system for victims and managers to effectively share related information one another and to return to victims' social life as soon as possible. Also, we implement a simple prototype system based on the Web. The proposed system supports the spatial search and statistical analysis based on map as well as keyword search, because having the location information on disaster victims, damage occurrence places, welfare and medical institutions, and psychological supporting centers. In addition, this system has the advantage reducing the frequency of disaster damage by providing aids in making efficient policy systems for the managers.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.116-125
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• 2020

Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

• Quality Improvement in Health Care
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• v.19 no.1
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• pp.16-26
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• 2013

Health information technology (HIT) is one of the most familiar tools to healthcare providers. It is used in routine practice to reduce cost, to improve clinical performance, and to improve patient safety. Patient safety is the driving force of recent expansion of HIT industry. But there are many evidences that it can be harmful to patient safety. Role of HIT and HIT-related error became big issues because more and more healthcare providers and healthcare organizations are willing to adopt it. Adoption rate of HIT in Korea is higher than that of United States. But researches of HIT regarding patient safety are rare. In this article, types of HIT, their mechanisms of improving patient safety and HIT-related errors were reviewed. Status of HIT in terms of patient safety in Korea was also reviewed. Knowledge of how HIT can improve patient safety, its' limitation, and how to make it safer is crucial to whom have to use it to improve patient safety. Impact of HIT on patient safety must be evaluated actively in Korea. HIT which was proven to improve patient safety must be widely adopted. Government must prepare a strategic plan to improve HIT quality, support hospitals financially and institutionally to introduce qualified HIT, and develop HIT infrastructures and standard designed for patient safety.

• Childhood Kidney Diseases
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• v.19 no.2
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• pp.148-153
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• 2015

Purpose: We investigated trends in antibiotic resistance for gram-negative bacteria in infants with a urinary tract infection (UTI) over 15 years at a single institution. Methods: A retrospective chart review was conducted for children younger than 24 months who visited the emergency room and were diagnosed with a UTI between January 2000 and December 2014. We selected urine culture data that grew Escherichia coli and Klebsiella pneumoniae. Baseline clinical information and results of antimicrobial susceptibility tests were analyzed by dividing the 15-year study time frame into three periods (A: 2000-2004, B: 2005-2009, and C: 2010-2014). Results: During the study period, 478 applicable children were identified (E. coli, 89.7% and K. pneumoniae, 10.3%). Antibiotic resistance to third-generation cephalosporins was increased from period A to period C (A, 2.1%; B, 8.3%; C, 8.8%; P=0.025). Resistance to quinolones also showed a steady pattern during periods A to C, although it was not statistically significant (A, 7.9%; B, 9.7%; C, 12.4%; P=0.221). The incidence of Extended-spectrum ${\beta}$-lactamase (ESBL)-producing gram-negative bacteria increased from period A to period C (A, 1.4%; B, 7.6%; C, 8.2%; P=0.012). Conclusion: This study revealed that the common uropathogens E. coli and K. pneumoniae experienced increasing resistance rates against third-generation cephalosporins and a constant antibiotic resistance to quinolones in children younger than 24 months. We also showed a recent increased incidence of ESBL-producing gram-negative bacteria in patients with community-acquired UTIs. Therefore, it is necessary to actively surveil resistance in order to properly select empirical antibiotics.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.10a
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• pp.514-516
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• 2022

Busan Metropolitan City runs Community Health Center which aims to health care service based on the community, besides the established health medical service towards people with low-income. 71 centers are run in 2021, therefore, this papear explores the way of digital transition of these centers. Digital Technologies possibly adopted inside the centers are: First, smart devices to advance the management system of chronical diseases based on health index; Second, IoT with mobile tech to manage health index; Third, AI Robot to care lone elderly people and to warn the emergency.

• Journal of Korean Neurosurgical Society
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• v.64 no.1
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• pp.51-59
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• 2021

Objective : Several studies have reported inconsistent findings among countries on whether off-hour hospital presentation is associated with worse outcome in patients with acute stroke. However, its association is yet not clear and has not been thoroughly studied in Korea. We assessed nationwide administrative data to verify off-hour effect in different subtypes of acute stroke in Korea. Methods : We respectively analyzed the nationwide administrative data of National Emergency Department Information System in Korea; 7144 of ischemic stroke (IS), 2424 of intracerebral hemorrhage (ICH), and 1482 of subarachnoid hemorrhage (SAH), respectively. "Off-hour hospital presentation" was defined as weekends, holidays, and any times except 8:00 AM to 6:00 PM on weekdays. The primary outcome measure was in-hospital mortality in different subtypes of acute stroke. We adjusted for covariates to influence the primary outcome using binary logistic regression model and Cox's proportional hazard model. Results : In subjects with IS, off-hour hospital presentation was associated with unfavorable outcome (24.6% off hours vs. 20.9% working hours, p<0.001) and in-hospital mortality (5.3% off hours vs. 3.9% working hours, p=0.004), even after adjustment for compounding variables (hazard ratio [HR], 1.244; 95% confidence interval [CI], 1.106-1.400; HR, 1.402; 95% CI, 1.124-1.747, respectively). Off-hours had significantly more elderly ≥65 years (35.4% off hours vs. 32.1% working hours, p=0.029) and significantly more frequent intensive care unit admission (32.5% off hours vs. 29.9% working hours, p=0.017) than working hours. However, off-hour hospital presentation was not related to poor short-term outcome in subjects with ICH and SAH. Conclusion : This study indicates that off-hour hospital presentation may lead to poor short-term morbidity and mortality in patients with IS, but not in patients with ICH and SAH in Korea. Excessive death seems to be ascribed to old age or the higher severity of medical conditions apart from that of stroke during off hours.