• Journal of Yeungnam Medical Science
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• 제39권1호
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• pp.39-45
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• 2022

Background: The current guidelines for the diagnosis of acute pyelonephritis (APN) recommend that APN be diagnosed based on the clinical features and the presence of pyuria. However, we observed that some of the patients who are diagnosed with APN do not have characteristic clinical features or pyuria at the initial examination. We performed this study to investigate the characteristics of APN without pyuria. Methods: A retrospective, cross-sectional study was conducted on 391 patients diagnosed with APN based on clinical and radiologic findings, between 2015 and 2019. The clinical features, laboratory results, and computed tomography (CT) findings were compared between patients with normal white blood cell (WBC) counts and those with abnormal WBC counts (WBC of 0-5/high power field [HPF] vs. >5/HPF) in urine. Results: More than 50% of patients with APN had no typical urinary tract symptoms and one-third of them had no costovertebral angle (CVA) tenderness. Eighty-eight patients (22.5%) had normal WBC counts (0-5/HPF) on urine microscopy. There was a negative correlation between pyuria (WBC of >5/HPF) and previous antibiotic use (odds ratio, 0.249; 95% confidence interval, 0.140-0.441; p<0.001), and the probability of pyuria was reduced by 75.1% in patients who took antibiotics before visiting the emergency room. Conclusion: The diagnosis of APN should not be overlooked even if there are no typical clinical features, or urine microscopic examination is normal. If a patient has already taken antibiotics at the time of diagnosis, imaging studies such as CT should be performed more actively, regardless of the urinalysis results.

• 한국응급구조학회지
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• 제17권3호
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• pp.39-51
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• 2013

Purpose: The purpose of the study is to investigate the influencing factors of turnover intention in hospital paramedics. The factors included the job condition, job stress, and turnover intention. Methods: The subjects were 200 paramedics in hospital. Data were analyzed using frequency, t-test or one way ANOVA, Pearson's correlation, and multiple regression analysis with SPSS WIN 20.0 program. Results: Job stress was 3.59 points; job condition, 2.96 points; turnover intention 3.64 points. When the job stress was high, the satisfaction with job condition was very low and the turnover intention increased. When the job satisfaction was high, turnover intention decreased. factors affecting the turnover intention were annual income, turnover frequency, workload, and working department, role conflict, and personal relationship. Conclusion: It is necessary to establish the job description of paramedics and improve the working condition in the hospitals.

• 국제학술발표논문집
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• The 3th International Conference on Construction Engineering and Project Management
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• pp.310-315
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• 2009

Large hospitals such as medical centers provide not only medical services, but also carry the responsibilities for emergency refuges, medical researches and education. The function of large hospitals is as important as other infrastructure systems such as highways, bridges, and utilities. When disasters occur, the hospitals have to provide emergency medical services for victims and support the patient's needs of health. In order to keep a smooth operation of hospitals, the maintenance management of hospital buildings should be carefully investigated. However, there are few researches focused on maintenance management issues of hospital buildings. This paper investigated the National Taiwan University Hospital (NTUH) and established a maintenance cost database. The NTUH is the best-known and most high-renowned medical center in Taiwan in which more than 4,000 employees serving approximately 2,000 in-patients and 7,000 out-patients daily. The data were collected from the NTUH which consisted of 16,228 maintenance records in the past ten years. This paper analyzed these data to obtain various characteristics of maintenance records, and revealed the key items of maintenance cost for large hospital buildings, which can provide the facility manager of hospital buildings to execute a proper maintenance policy for hospital buildings.

• 한국융합학회논문지
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• 제10권5호
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• pp.111-117
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• 2019

본 연구는 차량 사고에서 병원 전 응급의료 대응시간을 단축시키기 위한 방안을 모색한 융합연구이다. 연구방법은 한국형 교통사고 심층조사 분석 체계(Korea In-Depth Accident Study)에서 2011년 1월 1일부터 2016년 7월 30일까지 3개의 응급의료센터에 119구급대로 내원한 차량 탑승자 353명을 대상으로 날씨, 도로유형, 사고유형, 구조대 출동 여부를 활용하여 병원 전 응급의료 대응시간에 대해 요인 분석하였다. 연구결과에서 고속도로는 병원 전 응급의료 대응시간을 가장 많이 소요하였고 전체시간에 영향을 주는 요인으로 확인되었다(${\beta}=.543$, p<.001). 따라서 고속도로에서 소요되는 시간을 단축시키기 위해 고속도로 119구급대의 운영과 비상회차로의 적극적인 사용, 개별 장치를 부착한 자동 긴급구조신호 서비스의 제공을 제시하였다.

• 한국정보통신학회논문지
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• 제22권1호
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• pp.49-53
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• 2018

최근 시간적, 공간적, 의료기술 적용의 한계를 극복하기 위하여 의료 기술과 IT 기술의 융합을 시도하고 있다. 구급 활동은 초기에 환자에 대한 1차적인 치료와 안정을 주어 병원에서 치료하기까지 환자의 생명을 구하고 위험을 최소화하는 것이다. 본 연구에서는 응급 의료 서비스에 적용할 수 있는 구급 활동을 지원하기 위한 앱을 개발하였다. 구급대원은 스마트기기의 구급활동지원 앱을 통해 구급활동 일지를 쉽게 작성하고, 환자의 상태를 실시간 모니터링이 가능하다. 특히 응급 환자의 정보화 응급 상태 그리고 의료신호를 측정하거나 환부를 촬영할 수 있으며, 이를 원격지 의료 지도 의사에게 전달하여 응급조치 및 병원 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• 한국응급구조학회지
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• 제27권2호
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• pp.7-17
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• 2023

Purpose: This study aimed to identify the factors that contribute to head injuries among drivers of personal mobility devices and provide insights into safety perceptions. Methods: This retrospective study analyzed data of 221 trauma patients obtained from electronic medical records and the National Emergency Department Information System (NEDIS) over one year, from August 1, 2021, to July 31, 2022. The patients, all in their 20s and 30s, presented to a single emergency medical center following personal mobility device accidents (motorcycles, electric scooters, and bicycles). Results: Among motorcycle riders, 18.2% were not wearing helmets, while the percentage of e-scooter riders not wearing helmets was 87.5%. Wearing a helmet was associated with a 71.2% lower likelihood of head injuries (OR=0.288, CI=0.163 to 0.509, p=0.000). Of the personal mobility devices, motorcycles had a 0.431 times lower odds ratio for head injury compared to e-scooters (p=0.009), and there was no significant difference between e-scooters and bicycles (p=0.776). Conclusion: It is imperative to strengthen safety regulations by mandating helmet use for riders of personal mobility devices. A system to enhance driving enforcement for electric scooters, which are increasingly popular among young adults, should also be established.

• 보건행정학회지
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• 제32권2호
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.272-277
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• 2018

Objective While the effect of typhoons on emergency medicine has been evaluated, data are scarce on their effects on the emergency medical service (EMS). This study evaluated the effect of typhoons on EMS patients and performance. Methods The study period was January 2010 to December 2012. Meteorological data regarding typhoons were provided by the Korean Meteorological Administration. EMS data were retrieved from the EMS database of the national emergency management agency. The database includes ambulance run sheets, which contain clinical and operational data. In this case-crossover study, the cases and controls were EMS calls on the day of typhoon warnings and calls one week prior to the typhoon warnings, respectively. Results During the study period, 11 typhoons affected Korea. A total of 14,521 cases were selected for analysis. Overall, there were no obvious differences between the case and control groups. However, there were statistically significant differences in age, place, and time requests. There were fewer patients between 0 and 15 years of age (P=0.01) and more unconscious patients (P=0.01) in the case group. The EMS operational performance, as measured by the times elapsed between call to start, call to field, and call to hospital did not differ significantly. There was also no significant difference in the time from hospital arrival between the cases (28.67, standard deviation 16.37) and controls (28.97, standard deviation 28.91) (P=0.39). Conclusion Typhoons did not significantly affect the EMS system in this study. Further study is necessary to understand the reasons for this finding.

• 한국응급구조학회지
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• 제17권1호
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• pp.63-78
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• 2013

Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.

• 한국응급구조학회지
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• 제10권2호
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• pp.35-42
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• 2006

Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.