• 한국안전학회지
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• 제25권3호
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• pp.118-122
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• 2010

원자력발전소의 운전 유연성 증대, 안전성 및 경제성 향상, 정비 부담을 완화하기 위해 비상디젤발전기의 허용정지시간 연장이 요구된다. 확률론적안전성평가(probabilistic safety assessment) 기법으로 현재의 비상디젤발전기의 허용정지 시간을 3일에서 7일, 10일, 14일로 연장시 안전성 영향을 평가하였다. 종합적으로 평가결과, 비상디젤발전기의 허용정지시간 연장시 EDG 점검 또는 정비기간 중 인적실수으로 인한 발전소 불시정지 예방 및 안전성을 향상 시키는 것으로 분석되었다.

• 한국암반공학회:학술대회논문집
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• 한국암반공학회 2008년도 국제학술회의
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• pp.33-41
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• 2008

The longest tunnel has been halted at Daekwanryung by the failure of the host country of the Winter Olympiad in 2014, but modern High-Power TBM will come to Korea to excavate these long tunnels to establish the better horizontal connection between the western and eastern countries to improve the strong powerful logistic strategy of Korean peninsula. Train operation provides a key function of air movements in a long underground tunnel, and heat generation from transit vehicles may account of the most heat release to the ventilation and emergency systems. This paper indicates the optimal fire suppress services and safety provision for the long railway tunnel which is designed twin tunnel with length 22km in Gangwon province of Korea. The design of the fire-fighting systems and emergency were prepared by the operation of the famous long-railway tunnels as well as the severe lessons from the real fires in domestic and overseas experiences. Designers should concentrate the optimal solution for passenger's safety at the emergency state when tunnel fires, train crush accidents, derailment, and etc. The optimal fire-extinguishing facilities for long railway tunnels are presented for better safety of the comfortable operation in this hard rock tunnel of eastern mountains side of Korea. Since year 1900, hard rock tunnel construction has been launched for railway tunnels in Korea, tunnels have been built for various purposes not only for infrastructure tunnels including roadway, railway, subway, and but also for water and power supply, for deposit food, waste, and oils etc. Most favorable railway tunnel system was discussed in details; twin tunnels, distance of cross passage, ventilation systems, for the comfortable train operations in the future.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.52-55
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• 2011

The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

• 한국농공학회지
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• 제45권6호
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• pp.109-118
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• 2003

As a fundamental research to establish a safety operation plan for irrigation dams, this study presents hydrologic analysis conducted in Sungju Dam watershed based on various rainfall data. Especially those reservoirs without flood control feature are widely exposed to the risk of flooding, a safe and optimized operation program need to be improved against arbitrary flooding. In this study, reservoir routing program was developed and simulated for reservoir runoff estimation using WMS hydrology model. The model simulated the variations of reservoir elevation under the condition of open or closed emergency gate. In case of closed emergency gate, water surface elevation was given as 193.15 m, and this value exceeds the dam crest height by 1.65 m. When the emergency gate is open, the increment of water surface elevation is given as 192.01 m, and this value exceeds dam crest height by 0.57 m. As an alternative plan, dam height increase can be considered for flood control under the PMP (Probable Maximum Precipitation) condition. Since the dam size is relatively small compare to the watershed area, sound protection can be expected from the latter option rather than emergency gate installation.

• Journal of Chest Surgery
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• 제21권2호
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• pp.373-378
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• 1988

Since the introduction of percutaneous; transluminal coronary angioplasty[PTCA] by Grunt-zig in 1977, this is widely used in some patients with coronary artery disease and is an effective alternative to surgery for many patients. Indications for emergency coronary artery bypass graft[CABG] after PTCA are prolonged chest pain, worsening of coronary artery obstruction, "current of injury" by electrocardiogram, cardiogenic shock, and in a lesser incidence, ventricular fibrillation, coronary artery dissection[without obstruction], heart block, and intractable cardiac arrest. Recently, we have experienced one case of emergency CABG following unsuccessful PTCA. The patient was 54 year-old male and admitted with complaint of angina pectoris. The routine electrocardiogram revealed within normal limit. The treadmill test revealed severe chest pain after 2 min. exercise. Coronary cineangiogram revealed 95% segmental stenosis of the proximal right coronary artery. Our cardiologist was planned PTCA. During PTCA, severe chest pain and ischemic pattern on electrocardiogram were developed. But they were not relieved even by morphine and nitroglycerin till 90 min. So we performed emergency single coronary artery bypass graft from aorta to proximal right coronary artery with great saphenous vein. The patient had an excellent postoperative recovery and was free from anginal attack. He has shown striking improvement in general status[NYHA functional class 1] during 6 months after operation.operation.

• 한국철도학회:학술대회논문집
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• 한국철도학회 2009년도 춘계학술대회 논문집
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• pp.457-465
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• 2009

Subway system including light-rail transit system is the representative public urban transportation. Accordingly, Nothing is more important than the safety operation as well as passengers' convenience. Due to the fire disaster of Daegu subway on 2003, more strict regulations of detecting fire and of conducting on emergency circumstances. However, regardless of this improved management, it was reported that installations of lots of fire-detection facilities may be harm than good to operate subway system due to frequent malfunction of some fire-detection facilities. It may cause mis-alarm for fire and induces abnormal operation of subway due to the strict regulation; the train shall be stopped on emergency circumstances. Therefore, in this paper, new scheme on surveiling breaking-out-of fire in the station is suggested with new IT technologies, Wireless Sensor Network(WSN) and CCTVs. which were integrated with an intelligent software. This intelligent system enables to surveil breaking-out-of fire in real time through sensor network technology and watch the emergency site on CCTV as well. Through this system, subway organizers could cope with the emergency circumstance rapidly as well as judge precisely whether fire breaks out or not.

• Journal of Trauma and Injury
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• 제32권3호
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• pp.168-171
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• 2019

The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

• 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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• 제23권1호
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• 한국응급구조학회지
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• 제15권3호
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.