• The Korean Journal of Emergency Medical Services
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• v.26 no.3
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.179-183
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• 2009

Purpose: This study was conducted to determine the level of medical care required for mass-gatherings and to describe the types of illness and injury that may occur during demonstrations. Methods: We conducted a retrospective review of the medical records for patients injured during demonstrations. Results: From May to August at 2008, a total of 932,000 participants attended demonstrations. Most patients were occurred from June to July, a total of 126 patients were evaluated and treated at the emergency center of our hospital. The mean patient age was $31.8{\pm}9.8$ years, and men predominated over women. The vast majority of patients were experienced trauma (88.9%). The diagnostic categories were contusion (49.2%), laceration (20.6%), fracture (6.3%), syncope/dizziness (5.5%), ocular injuries (3.9%), dyspnea (3.9%), other trauma (3.1%), and abdominal complaints (1.5%). Two patients were admitted. Conclusion: The rate and the acuity of patients seen at these demonstrations was low. Nevertheless, a full on-site physician and transportation system is recommended during similar incidents.

• Journal of the Society of Disaster Information
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• v.19 no.1
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• pp.44-59
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• 2023

Purpose: In the event of mass casualties, triage must be done promptly and accurately so that as many patients as possible can be recovered and returned to the battlefield. However, medical personnel have received many tasks with less manpower, and the battlefield for classifying patients is too complex and uncertain. Therefore, we studied an artificial intelligence model that can assist and replace medical personnel on the battlefield. Method: The triage model is presented using reinforcement learning, a field of artificial intelligence. The learning of the model is conducted to find a policy that allows as many patients as possible to be treated, taking into account the condition of randomly set patients and the medical capability of the military hospital. Result: Whether the reinforcement learning model progressed well was confirmed through statistical graphs such as cumulative reward values. In addition, it was confirmed through the number of survivors whether the triage of the learned model was accurate. As a result of comparing the performance with the rule-based model, the reinforcement learning model was able to rescue 10% more patients than the rule-based model. Conclusion: Through this study, it was found that the triage model using reinforcement learning can be used as an alternative to assisting and replacing triage decision-making of medical personnel in the case of mass casualties.

• Journal of the Society of Disaster Information
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• v.14 no.1
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• pp.28-35
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• 2018

The following research has focused and implemented on designing a system that classifies the severity of mass casualty situations across both normal and disaster levels. The system's algorithm has implemented requirements such as accuracy as well as user convenience. The developed e-Triage System has applied various severity classification algorithms implemented from IoT concepts. In order to overcome flaws of currently used severity classification systems, the e-Triage System used electronic elements including the NFC module. By using the mobile application's severity classification algorithm the system demonstrated quick and accurate assessment of patient. Four different LED lamps visualized the severity classification results and RTS scores were portrayed through FND(Flexible Numeric Display) after a two wave classification.

• Journal of The Korean Society of Clinical Toxicology
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• v.9 no.2
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• pp.39-48
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• 2011

In mass casualty situation due to radiological accidents, it is important to start aggressive management with rapid triage decisions. External contamination needs immediate decontamination and internal contamination should be treated with special expertise and equipment to prevent the rapid uptake of radionuclides by target organs. Acute radiation syndrome shows a sequence of events that varies with the severity of the exposure. More severe exposures generally lead to more rapid onset of symptoms and severe clinical findings. After the massive exposure, various systems of the body reflect their severe damages that can lead to death within hours or up to several months. The disease progression has classically been divided into four stages: prodromal, latent, manifest illness, and recovery or death. Three characteristic clusters of symptoms including the hematopoietic syndrome, the gastrointestinal syndrome and the cerebrovascular syndrome are all associated with the acute radiation syndrome. The standard medical management of the patients with a potentially survivable radiation exposure includes good medical, surgical and supportive measures. Specific treatment with cytokines and bone marrow transplantation should be considered. The management of internal contamination is much the same as the treatment of poisoning. The standard decontamination should be applied to reduce uptake, and the chelating agents can be administered to enhance the clearance of radioisotopes. Radioactive iodine ($^{131}I$) as one of the nuclear fission products can increase the incidence of thyroid cancer in children. Potential benefit of potassium iodide prophylaxis is greater especially in neonates, infants and small children.

• Journal of Trauma and Injury
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• v.37 no.3
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• pp.214-219
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• 2024

Purpose: The aim of this study is to present the causes and numbers of hospital admissions and deaths at hospital of Korean soldiers including civilian worker during the Korean War. Methods: The War History of Rear Troops of the Korean War (confidential) published in 1955 by the Republic of Korea Army Headquarters was reviewed. Results: During the war, 397,519 patients were admitted to hospitals (wounded in action, 53.9%; wounded on duty, 5.2%; due to disease, 40.9%). Most of the admitted patients were service members (92.4%), while the remaining were non-soldiers (7.6%). Among the 397,519 patients admitted to hospitals, 11,537 patients (2.9%) died. Most of the patients who died were service members (87.9%), and the remaining were non-soldiers (12.1%). The yearly numbers of died on duty did not vary much. The yearly number of deaths from diseases was lower in 1950, but suddenly increased in the next year and continued thereafter. Injuries accounted for more than three-fifths of the causes of death (n=7,444, 60.1%). Respiratory diseases corresponded to almost a quarter (n=2,799, 22.6%; 1,611 pulmonary tuberculoses and 1,188 other respiratory diseases). The most common category of causes of death was wounds (gunshot or stab; n=3,199, 25.8%), followed by wounds from fragments (n=3,173, 25.6%), pulmonary tuberculosis (n=1,611, 13.0%), and other respiratory diseases (n=1,188, 9.6%). Among the common causes of death, percentages of wounds and wound by fragments decreased over time; however, the deaths from respiratory disease increased. Conclusions: These findings reflect several aspects of the public health and social situation during the Korean War.

• Journal of the Society of Disaster Information
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• v.1 no.1
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• pp.3-26
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• 2005

In recent years, there is growing concern about the potential use of biological agents in war or acts of terrorism accompanied an increased realization that rapid preparedness and response are needed to prevent or treat the human damage that can be caused by these agents. The threat is indeed serious, and the potential for devastating numbers of casualties is high. The use of agents as weapons, even on a small scale, has the potential for huge social and economic disruption and massive diversion of regional and national resources to combat the threat, to treat primary disease, and to clean up environmental contamination. Biological weapons are one of weapons of mass destruction (or mass casualty weapons, to be precise. since they do not damage non-living entities) that are based on bacteria, viruses, rickettsia, fungi or toxins produced by these organisms. Biological weapons are known to be easy and cheap to produce and can be used to selectively target humans, animals, or plants. Theses agents can cause large numbers of casualties with minimal logistical requirements (in wide area). The spread of disease cannot be controlled until there is awareness of the signs of infection followed by identification of agents; and if the organism is easily spread from person to person, as in the case of smallpox, the number of casualties could run into the tens of thousands. Biological weapons could be used covertly, there can be a lot of different deployment scenarios. A lot of different agents could be used in biological weapons. And, there are a lot of different techniques to manufacture biological weapons. Terrorist acts that make use of Biological Agents differ in a number of ways from those involving chemicals. The distinction between terrorist and military use of Biological Weapon is increasingly problematic. The stealthy qualities of biological weapons further complicate the distinction between terrorism and war. In reality, all biological attacks are likely to require an integrated response involving both military and civilian communities. The basic considerations when public health agencies establish national defence plan against bioterrorism must be 1) arraying various laws and regulations to meet the realistic needs, 2)education for public health personnels and support of concerned academic society, 3)information collection and cooperative project with other countries, 4)Detection and surveillance(Early detection is essential for ensuring a prompt response to biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines) and 5) Response(A comprehensive public health response to a biological or chemical terrorist event involves epidemiologic investigation, medical treatment and prophylaxis for affacted persons, and the initiation of disease prevention or environmental decontamination measures). The purpose of this paper is providing basic material of preparedness and response for biological terrorism in modern society.

• Fire Science and Engineering
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• v.31 no.2
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• pp.61-73
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• 2017

The Fukushima Nuclear Disaster in 2011 and California Power Failure in 2001 are examples of the importance of the power plant safety management that caused huge national loss with a power-related mass casualty incident. In a situation where humans cannot live without electricity, efforts to strengthen the systematic firefighting safety management in power plants that produce electricity with large amounts of hazardous materials as fuel, such as nuclear energy, coal and gas, are essential to protect life and prevent property loss and stable economic growth from fire explosion accident or radiation leak due to the negligence of safety management and natural disasters such as earthquakes, which has recently become an issue. This study examined the operating situation of firefighting safety management in power plants with firefighting officials employed by five power generation companies including Korea Southern Power Co., Ltd. and Korea Hydro & Nuclear Power Co. Ltd., which are in charge of the domestic power supply. As a result, for the systematic firefighting safety management of power plants, improvement plans were drawn, including the development of an effective business manual and a comprehensive management system, the substantiality of firefighting safety education, and the strengthening of seismic designs to prepare for earthquakes.

• Journal of Korea Entertainment Industry Association
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• v.13 no.4
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• pp.229-240
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• 2019

Korea is experiencing various disasters both natural and artificial. This study is descriptive research designed to examine the perception of the disaster response ability of fire-paramedics during the response stage of disaster management. The subjects of this study were EMT-P's who had more than 2 years of experience in the field at a fire station in G Province. The questionnaire, including the items for the sub-factors of the field response ability, were prepared and 161 final questionnaires were collected and analyzed with the SPSS program. The mean scores of triage ability, patient treatment ability, patient transfer ability, disaster support ability, and disaster response speed were 3.53, 3.68, 3.66, 2.95, and 3.44, respectively. As a result of multiple regression analysis, variables affecting the speed of disaster response were in the order of patient treatment ability, patient transfer ability, and disaster support ability. In conclusion, fire-paramedics will have to consider the ability to treat patients, transfer patients, and disaster support to improve disaster response speed, and, ultimately, disaster response guidelines should be developed to improve disaster response capabilities.

• Journal of the Society of Disaster Information
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• v.20 no.1
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• pp.206-212
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• 2024

Purpose: This study conducted research on the sharing of information to enhance the survival rate of emergency patients by swiftly transferring them to appropriate hospitals through sharing the patients' conditions, treatment histories, and transportation information with the Maritime Police Agency and relevant agencies when emergencies occur in the marine environment. Methods: In this study, emergency patient information classified in a smartphone app was received, stored, and transmitted using the LoRa communication method by electronic triage tags, and the transmitted emergency patient information was implemented to be collected in real-time through a hybrid triage system along with LoRa receivers. Results: Through the hybrid triage system, it was possible to receive emergency patient information according to the distance or confirm delayed reception. It was observed that most data were received when the distance was short, while data reception was unsuccessful in relatively longer distances. Conclusion: It was confirmed that in mass disaster environments where internet communication is impossible, rapid and accurate understanding of casualty information at disaster sites and appropriate disaster responses can be achieved using self-networking methods such as LoRa communication. However, limitations inherent in communication methods were also recognized. Further research on various communication methods is required to collect emergency patient information and transfer them to appropriate hospitals in situations where internet communication is unavailable.