• 한국응급구조학회지
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• 제24권2호
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• pp.51-66
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• 2020

Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).

• 간호행정학회지
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• 제13권2호
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• pp.199-207
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• 2007

Purpose: Clinical characteristics and medical cost were analyzed according to the surgical procedures for intertrochanteric fracture in aged patients to assess the appropriateness of treatment expense and to find possibility of reducing the medical cost. Method: Variable for the statistical analysis were; the clinical characteristics, medical cost according to the surgical procedures, the treatment success rate, the total medical expense, and the average expense per case. SAS Package Version 8.02. was used to analyze the relevant data. Results: Operative procedures differ significantly according to the gender and by the location of institution. Only significant clinical variables according to the operative procedure were duration of general anesthesia and amount of blood transfusion. Average cost per treatment was the highest in the bipolar hemiarthroplasty followed by the gamma nail and hip compressing screw. Average cost for bipolar hemiarthroplasty was significantly higher than other surgical procedures. Conclusions: The difference in hospital costs for treatment of intertrochanteric fracture originates from the utilized surgical procedures, mostly by the materials used. The method of surgical treatment should be carefully determined by the purpose of the surgery, in order to improve the quality of medical care and also to reduce the hospital cost.

• 대한한방체열의학회지
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• 제9권1호
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• pp.44-50
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• 2011

Purpose : The purpose of this study is to investigate effect of Hyangsayijoongtang-gamibang on Cold Hypersensitivity and accompanying perspiration. Methods : Hyangsayijoongtang-gamibang was used for a Cold Hypersensitivity patient with accompanying perspiration that was admitted to Kangnam Kyung-Hee Korean Hospital from May 2nd, 2011 to May 14th, 2011. The efficacy of the treatment was evaluated with Digital Infrared Thermal Imaging(DITI). along with objective and subjective observations. Results : After treatments of oriental medicine. the mean body temperature elevated $1.32^{\circ}C$. and the mean temperature difference between different points of the body decreased more than 50%. Subjective observation of Cold Hypersensitivity and accompanying perspiration using Visual Analog Scale(VAS) also showed improvement. Conclusion : Results suggest that Hyangsayijoongtang-gamibang is effective in treating Cold Hypersensitivity patients with accompanying perspiration.

• 한국정보시스템학회지:정보시스템연구
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• 제29권2호
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• pp.243-263
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• 2020

Purpose The purpose of this study is to analyze the causal relationship between user satisfaction, expected satisfaction, quality of service, perceived value, and expertise that should be emphasized in personalized medical information services for the development of personalized medical information services based on big data analysis and the spread of their demand. Design/methodology/approach This study established research models and hypotheses on the basis of the theory of reuse intent, and applied the PLS methodology for analysis, the factors that make it applicable to personalized medical services in the theory of service quality and satisfaction. Findings According to the empirical analysis result, this study confirmed that it can be seen that the expertise, perceived value, and quality of medical services did not directly affect the user's intention to reuse, but formed a direct causal relationship through variables such as whether they met expectations.

• 대한한방부인과학회지
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• 제18권3호
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• pp.242-249
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• 2005

Purpose : The purpose of this paper is to report the effect of oriental medicine to primary infertility caused by uterus unicornis. Methods : The patient in this case, 30 years-old female was treated with herb medication(Sosihotang, Gyejibokryeonghwan) for one month. Before oriental treatment, she had been diagnosed as primary infertility caused by uterus unicornis in Samsung Cheil Hospital and treated medication and injection for IUI(intrauterine insemination) in 2 times. But she had failed in gestation. Results : After taking herb medication she became pregnant. Conclusion : According to this result, we concluded that herb medication could improve fertility rate. After this paper, further study and clinical approach based on oriental medicine will be needed about infertility caused by uterus unicornis.

• 근관절건강학회지
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• 제28권3호
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• pp.293-304
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• 2021

Purpose: The purpose of this study is to describe the experience of medical treatment and management of nursing staffs in long term care settings. Methods: This study is qualitative research. The participants were seven nursing staff (five nurses and two nursing assistants) who had experience over six months in long term care facilities. Data were collected through in-depth interviews using semi-structured research questions. The collected data were analysed using qualitative thematic analysis method. Results: Four main themes were emerged as 'various medical treatments', 'difficulties about managing medical problems', 'lack of regulatory support' and 'strategies for solving medical problems'. Conclusion: The findings of this study provide the nursing staffs' difficulties and opinion about medical treatment and management in long term care settings. To provide more effective health service for the aged, the regulatory complement about medical treatment in long term care facilities should be considered.

• 한국응급구조학회지
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• 제26권3호
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• pp.7-19
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• 2022

Purpose: The purpose of this study was to confirm the exploratory factor analysis and reliability analysis of the burden of 119 emergency medical technicians. Methods: The data collection period was from November 2, 2022 to November 6, 2022. This study had 316 subjects, and the collected data were analyzed using exploratory factor analysis and Cronbach's α coefficient using IBM SPSS statistics 27.0. Results: The reliability was .924. The exploratory factor analysis yielded the following information: the first factor was lack of violence policy, the second factor was conflict between the organization and the paramedics, the third factor was lack of psychological support, and the fourth factor was lack of education and communication. The explanation power of 4 factors was 54.31%. Conclusion: This study is significant as it performs exploratory factor analysis as a preliminary step in the development of a burden measurement tool.

• 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.

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.367-375
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• 2019

Hemifacial spasm (HFS) is due to the vascular compression of the facial nerve at its root exit zone (REZ). Microvascular decompression (MVD) of the facial nerve near the REZ is an effective treatment for HFS. In MVD for HFS, intraoperative neurophysiological monitoring (INM) has two purposes. The first purpose is to prevent injury to neural structures such as the vestibulocochlear nerve and facial nerve during MVD surgery, which is possible through INM of brainstem auditory evoked potential and facial nerve electromyography (EMG). The second purpose is the unique feature of MVD for HFS, which is to assess and optimize the effectiveness of the vascular decompression. The purpose is achieved mainly through monitoring of abnormal facial nerve EMG that is called as lateral spread response (LSR) and is also partially possible through Z-L response, facial F-wave, and facial motor evoked potentials. Based on the information regarding INM mentioned above, MVD for HFS can be considered as a more safe and effective treatment.

• 한국응급구조학회지
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• 제11권3호
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• pp.111-118
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• 2007

Purpose : It was to present strategies on activation of prehospital medical direction in Korea. Methods : This study was conducted by analysing some papers on prehospital medical direction and statistical data from the National Emergency Management Agency. Results : There was no active application of medical direction methods such as Priority Dispatch System, Pre-Arrival Instructions, System Status Management and no data on prehospital medical direction. To estimate direct medical control on emergency patients who were sorted by EMTs in 2006 was only 2.5%. Conclusion : To improve prehospital medical direction, it needed to applicate data collecting & using system and in-direct & direct medical control by medical doctor.