• Journal of Trauma and Injury
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• v.26 no.4
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• pp.261-265
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• 2013

Purpose: The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type. Methods: Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review. Results: The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038). Conclusion: An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.

• Journal of the Korean Society of Industry Convergence
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• v.22 no.6
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• pp.665-671
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• 2019

The estimated on-site accident rate in Forestry is relatively high. According to statistics of the accident, in the recent 5 years, from 2014 to 2018, forestry accidents have resulted in 98% of injuries and 87% of fatalities. Especially, there are significant geographical constraints to access to the scene in case of an accident. Even though the capacity of first aid capacity is notably emphasized its importance to minimize the scale of damages, the relevant employees have been educated only basic first aid, which is not considered circumstances or geographic limitations, by Occupation Safety and Health Acts. Therefore, the purpose of this study is to derive a direction for a forest emergency service system to increase forestry workers' survival and prevent secondary injury through securing 'Golden Time.' This study conducts analyzing relevant laws and regulations in domestic and international settings as well as looking at several concerned accident cases. The outcome of analysis presents an issue regarding the implementation of onsite first aid in forestry and existing risk factors depending on the working process. Finally, we suggest two ways to improve the forest emergency service that are 1) an appropriate curriculum and kit for forest first aid; and 2) a system for emergency transfer through sharing information between National Fire Agency (NFA) and emergency medical service center, and emergency and rescue mission using helicopter from NFA and Korea Forest Service.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.1-7
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• 2007

Purpose: The aim of this study was to evaluate the characteristics and the prognostic factors of carbamate poisoned patients who visited emergency departments. Methods: From August 2005 to July 2006, we investigated the demographic feature, dose of exposure, time of exposure, alcohol intake, route of exposure, reason of exposure, site of exposure, pre-existing medical condition, time from exposure to emergency department (ED), transfer from other hospitals, vital sign at ED arrival, symptom or sign at ED arrival, and result of care of the patients who visited the ED of thirty-eight hospitals in Korea. According to the result of care, we divided the patients into two groups, the survival and the dead. To evaluated the prognostic factors, we calculated the odds ratio of each factor for the survival. Results: Among the sixty-eight patients, fifty-five patients (80.9%) were survival and thirteen patients (19.1%) were dead. The patients in the dead were older than the patients in the survival. The Glasgow coma scale (GCS) of the patients in the dead was lower than the GCS in the survival. The odds ratio of the GCS at ED arrival for the survival was 1.58 (95% CI; 1.23-2.05). Other factors showed no statistical significances. Conclusion: The GCS at emergency department arrival was the prognosis factor of the carbamate poisoned patients who visited emergency departments. If the carbamate poisoned patients showed altered mentalities, they should be provided intensive care, immediately.

• Journal of radiological science and technology
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• v.43 no.4
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• pp.289-295
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• 2020

This study investigated the feasibility of establishing a college of medicine in the western region of Chungnam to fill the gap in the medical doctor in charge of essential medical care in the region. Currently, the level of medical services in Chungnam is low compared to provinces across the country and in particular, 7 cities and towns, which account for 760,000 people, one-third of Chungnam's population, are located in the western regions of Chungnam. Because of this, in the event of an emergency patients, it is necessary to travel to Cheonan, Daejeon, Seoul, etc. where the regional emergency medical center is located for more than 1 hour and 30 minutes. In the case of critically ill and emergency patients transfer, it is a situation that misses the golden time and causes valuable loss of life. In order to improve the medical environment in the western region of Chungnam and improve the lives of residents in vulnerable areas of medical services, it is believed that establishing a college of medicine in the western region of Chungnam is essential.

• Neonatal Medicine
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• v.18 no.1
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• pp.137-142
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• 2011

Purpose: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. Methods: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. Results: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. Conclusion: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.

• Health Policy and Management
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• v.33 no.4
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• pp.440-449
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• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.10a
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• pp.794-797
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• 2005

The automatic load transfer switch (ALTS), a kind of electric power switch, typically automatically transfers electrical loads from a normal electrical power source to an emergency electrical power source upon reduction or loss of normal power source voltage. It can also automatically re-transfer the load to the normal power source when the normal voltage has been restored within acceptable limits. The transfer operation of ALTS is accomplished by a spring-driven linkage mechanism. In order to control or delay the transfer switching time, the ALTS studied in this paper uses the superposed leaf springs, which are subjected to impact leadings in contacting with electrical contacts. Therefore, to confirm whether the springs has enough mechanical endurance in ALTS, we build a finite element model of the superposed lear springs using LS-DYNA and perform the impact and fatigue analysis.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Journal of the Korean Association of Geographic Information Studies
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• v.10 no.1
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• pp.113-123
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• 2007

This study analyzed the appropriateness of the spatial distribution of fire stations and emergency medical facilities, the main providers of emergency medical care, in Busan. The area over which the 119 emergency medical services were situated in relation to the dispatch and transport of urgent rescue services was examined. Addresses of patients requiring 119 emergency services were obtained and stored as individual units so that they could be analyzed in a Geographic Information System(GIS). The time taken by emergency services to reach patients and transport them to a hospital or other facility was measured in seconds. By inputting additional information such as the location of the 119 dispatch centers, jurisdictions, and emergency medical facilities, the GIS allowed for analyses not only of the temporal but also the spatial aspects of emergency medical services. The results showed that of 16 Gu/Gun and 226 Eup/Myen/Dong in the Busan area, only 41% of Busan's emergency medical services could respond to and transport patients within five minutes. In all districts, most emergency medical services were provided within five to ten minutes. However, the pattern of hospital use to transfer patients to hospitals was inefficient. Based on the temporal and spatial distributions of fire stations and emergency medical agencies, and on their dispatch and transport times, this study sets out and compares ideal dispatch and transportation patterns for the efficient use of Busan's emergency medical services and resources.