• 한국응급구조학회지
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• 제17권3호
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• pp.53-60
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• 2013

Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.

• 한국응급구조학회지
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• 제8권1호
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• pp.19-32
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• 2004

This study was conducted to identify an initial fire station experience of EMT students, so to better understand their' practice experience in fire station. The subjects were 28 EMT students of C department of Emergency Medical technology in C city, who were demonstrating at the fire station in C city. This study was approached by phenomenological method, collected data were analyzed by Colaizzi's method, the results were as a follows. From the protocol, 201 significant statements were organized into 93 formulated meanings. From the formulated meanings, 30 themes were identified, organized into 16 theme clusters, and then 7 categories. EMT students got experienced 'tension' in resulting from new training situation and at the field practice, 'comport and gratitude', in feeling of identity and a bond sympathy with senior EMT, in training environment and heartfelt care, 'stress' from lack of knowledge and skill, difficulties in field practice for 24 hours, in dealing with making interpersonal relationship with patient and staffs and from the insufficiency of instruction, 'confidence feeling' from the participation of field treatment, in improving of learning, in self-esteem of EMT job, 'confusing feeling' of conflict of the path in work, 'disappointment and doubt' by the discrepancy between learning and actuality, and disappointment of actuality, 'feeling of lack' based on the passive attitude. The results of this study are to use as basic data for students attending fire station experience for the first time.

• 임상간호연구
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• 제17권3호
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• pp.399-410
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• 2011

Purpose: This study was conducted to investigate the incidence of blood hemolysis and repeated blood sampling and to identify factors contributing to hemolysis and repeated blood sampling in the emergency department. Methods: A cross-sectional descriptive design was used. Participants were the patients who came to emergency department and are required a blood sampling for electrolyte level. All blood samples were collected by emergency department nurses and determined for hemolysis by experienced laboratory technologists. Data were analyzed using $x^2$-test, Fisher's exact test, Mann-Whitney u test and Binary Logistic Regression to determine significant differences. Results: A total of 402 valid samples were collected. Of these, 30 blood samples (7.5%) were found to be hemolyzed and 9 (2.2%) to be recollected. Statistically significant factors affecting on hemolysis and repeated blood sampling included the time of bloods sampling (night), the time of tourniquet application, and too-fast blood draw into the test tube. Conclusion: We recommend that nurses who take the blood sampling to consider the findings of the study and take the related factors into account as they set up the standardized care protocol in order for nursing quality improvement.

• 대한임상독성학회지
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• 제16권2호
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• pp.165-171
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• 2018

An overdose of antihypertensive agents, such calcium channel blockers (CCBs) and angiotensin II receptor blocker (ARBs), and the antihyperglycemic agent, metformin, leads to hypotension and lactic acidosis, respectively. A 40-year-old hypertensive and diabetic man with hyperlipidemia and a weight of 110 kg presented to the emergency room with vomiting, dizziness, and hypotension following an attempted drug overdose suicide with combined CCBs, ARBs, 3-hydroxy-3-methylglutaryl-coemzyme A reductase inhibitors, and metformins. A conventional medical treatment initially administered proved ineffective. The treatment was then changed to simultaneous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT), which was effective. This shows that simultaneous ECMO and CRRT can be an effective treatment protocol in cases of ineffective conventional medical therapy for hypotension and lactic acidosis due to an overdose of antihypertensive agents and metformin, respectively.

• 한국전자통신학회논문지
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• 제10권11호
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• pp.1225-1230
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• 2015

WBAN을 위한 MAC 프로토콜은 의료용 센서 노드의 가변적인 데이터를 효율적으로 처리하기 위해서 응급상황에서 발생하는 트래픽을 가장 높은 우선순위로 처리하는 CSMA/CA(: Carrier Sense Multiple Access with Collision Avoidance) 알고리즘을 수행하게 된다. 노드가 전송하는 응급 메시지는 충돌이 발생하게 되고 응급 메시지 재전송으로 인한 전송 지연이 발생할 수 있으며 재전송으로 인한 에너지 낭비를 가져올 수 있다. 본 논문에서는 이러한 문제점들을 개선하기 위해서 우선순위 큐잉을 적용한 CSMA/CA 알고리즘의 경우 MAC 명령어 프레임과 데이터 프레임의 우선순위를 정하여 서로 다른 백오프 파라미터를 적용하고 충돌로 인한 프레임 손실을 최소화하는 알고리즘을 제안하였다. 성능평가 결과 제안한 MAC 프로토콜을 사용했을 때가 IEEE 802.15.6을 사용했을때 보다 충돌 확률이 감소하여 패킷 전송 처리율이 증가하고 패킷 손실량이 감소함을 보였다.

• 전자공학회논문지
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• 제50권2호
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• pp.80-87
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• 2013

본 논문에서는 VANET(Vehicle to vehicle Ad hoc Network)의 V2V 프로토콜을 위한 긴급 메시지 전송을 위한 거리 기반의 동적 CW 할당 기법을 제안한다. 제안된 방법은 트래픽 부하 문제를 해결하기 위해 거리 기반의 존 할당 기법을 통해 특정 존(Zone)을 나누고 동적으로 CW 값을 할당한다. 소스노드와 최외곽의 노드가 최소 CW 값을 할당받아 채널에 접속할 수 있는 확률을 향상시켜 선택적 긴급 메시지를 재방송을 통하여 중복 패킷들의 수를 줄였다. 이로 인해 대역폭의 효율적 사용이 가능하고 패킷 충돌확률의 감소로 긴급메시지를 신뢰성 있게 전송하는 방법을 제시했다. 또한 차량 밀도가 급격히 높아질 경우 전송 구간의 패킷 충돌 확률을 적용하여 CW 값에 적용함으로써 재 충돌 확률을 낮추는 방법을 제시했다. 제안된 방법의 효용성을 증명하기 위해서 고속도로 환경의 시나리오에서 거리 및 확률 기반의 동적 CW 할당 알고리즘을 적용하여 종단 간 지연, 네트워크 부하, 처리량이 향상됨을 보였다.

• 대한전자공학회논문지TC
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• 제43권9호
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• pp.88-98
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• 2006

VANET은 MANET과 달리 노드의 고속 이동성, 노드 밀도, 네트워크 토폴로지의 빈번한 변화와 같은 차량 환경 고유의 특징을 가진다. 이러한 특징들은 MANET의 네트워크 토폴로지 기반 프로토콜을 VANET에 적용할 수 없는 주요 원인이 된다. 본 논문에서는 영역 기반 릴레이 노드 선택 알고리즘을 사용한 긴급경고메시지 브로드캐스팅 프로토콜을 제안하였다. 영역 기반 릴레이 노드 선택 알고리즘은 긴급 경고 메시지를 전달하는 릴레이 노드가 통신 영역의 가장 자리에 위치하지 않더라도 최적의 전달 대기 시간을 부여함으로써 종단간 메시지 전달 지연 시간을 최소화 할 수 있다. 또한, 긴급경고메시지 브로드캐스팅을 위한 제어 메시지 교환이 필요 없기 때문에 낮은 네트워크 부하를 가진다. 제안한 알고리즘은 낮은 노드 밀도와 짧은 전송 거리의 VANET 환경에서도 종단간 메시지 전달 지연 시간을 줄여 줄 수 있다.

• 한국정보통신학회논문지
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• 제18권7호
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• pp.1589-1598
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• 2014

IEEE 802.15.6 표준화 문서에서 WBAN을 위한 MAC 프로토콜은 의료용 센서 노드의 주기적인 데이터를 효율적으로 처리하기 위해서 8단계로 나누어진 트래픽 우선순위를 기준으로 응급 상황에서 발생하는 트래픽을 가장 높은 우선순위로 처리하는 CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) 알고리즘을 수행하게 된다. 노드가 전송하는 응급 메시지는 충돌이 발생하게 되고 응급 메시지 전송을 위한 전송 지연을 만족하지 못하는 상황이 발생할 수 있으며 재전송으로 인한 에너지 낭비를 가져올 수 있다. 본 논문에서는 이러한 문제점들을 해결하기 위해서 다음과 같이 WBAN 환경에서 데이터 종류와 전송률을 고려한 CSMA/CA 알고리즘 요소기술을 제안하였다. 성능평가 결과 제안한 MAC 프로토콜을 사용했을 때가 IEEE 802.15.6을 사용했을 때 보다 충돌 확률이 감소하여 패킷 전송 성공률과 에너지 효율이 개선된 것을 확인할 수 있었다.

• Korean Journal of Radiology
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• 제20권1호
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• pp.148-157
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• 2019

Objective: To evaluate the current status of managing adverse reactions to iodinated contrast media (ICM) for computed tomography in referral hospitals in South Korea compared with hospitals in other countries. Materials and Methods: This survey investigation involved 59 Korean and 15 overseas hospitals using guideline-based questionnaires consisting of 24 items in 7 main categories related to managing adverse reactions to ICM. Results: Informed written consent with risk factor evaluation was appropriately performed in most of the Korean hospitals. There was considerable variability in assessing renal function across the hospitals; serum creatinine level was used as a reference in 76.4% of Korean hospitals. The Korean hospitals preferred a more stringent approach to determining normal renal function (p = 0.01), withholding metformin (p = 0.01), and fasting before ICM exposure (p < 0.001) compared with overseas hospitals. All the Korean hospitals had an emergency protocol and in-hospital system for adverse reactions to ICM. The Korean (87.7%) and overseas hospitals (100%) were similarly equipped with epinephrine (p = 0.332), but only 38.6% of Korean hospitals were equipped with a bronchodilator (p = 0.004). For patients with a previous hypersensitivity reaction to ICM, 62.3% of Korean hospitals pre-medicated with anti-histamine and corticosteroid according to the severity of the previous reaction, and changed the culprit ICM in 52.8%, while skin test was performed in 17%. Conclusion: In general, Korean referral hospitals were well-prepared regarding informed consent, protocol, and an in-hospital system for managing adverse reactions to ICM. Nevertheless, there was considerable variability in details and management, thus requiring standardization by reflecting current guidelines.

• 대한임상독성학회지
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• 제10권2호
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• pp.103-110
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• 2012

Purpose: The aim of this study was to evaluate the cardiovascular manifestations and clinical course in patients with acute carbon monoxide poisoning. Methods: A retrospective study was conducted over a 36 month period on consecutive patients who visited an emergency medical center and were diagnosed with acute carbon monoxide poisoning. A standardized data extraction protocol was performed on the selected patients. Results: A total of 293 patients were selected during the study period. Cardiac manifestations were observed in 35.2% (n=103) of the patients: hypotension in 11 patients (3.8%), ECG abnormalities in 44 patients (15.0%) and cardiac enzyme abnormalities in 103 patients (35.2%). Echo cardiography was performed on 56 patients with cardiac toxicity: 12 patients had abnormal results (5 patients with global hypokinesia and 7 patients with regional wall akinesia). Five patients died within 3 hours after ED admission, and the remaining patients were discharged alive. At 3 months after discharge, none of these patients had died.The SOFA scores in the severe cardiac toxicity group and non-severe cardiac toxicity group at the time of arrival were $2.53{\pm}2.29$ and $2.19{\pm}2.12$, respectively (p=0.860). Conclusion: Cardiovascular manifestations occur after acute CO poisoning at arateof 35.2%. Even those with severe cardiovascular toxicity recovered well within 10 days after admission. Therefore, the importance of cardiac toxicity after acute CO poisoning is not significant in itself in the clinical course, and the short-term prognosis of cardiac toxicity is unlikely to be unfavorable in acute CO poisoning.