• Fire Science and Engineering
• /
• v.30 no.1
• /
• pp.121-129
• /
• 2016

Ambulances are an important element of pre-hospital emergency medical services, and also an important space for improving the work efficiency of paramedics. Paramedics use the interior environment to maximize the capabilities of the space, but ambulances need to be improved to help with the responsibilities of paramedics. A Seamless space was constructed in accordance with the placement of first-aid emergency medical equipment and drugs, and a patient room was loaded in the interior space of an ambulance. This study was to improve the treatment space of an ambulance to improve the efficiency of work by paramedics The new design provides safety and efficiency for emergency medical services through planning of interior storage suitable for the duties of paramedics and through identification and analysis of the problems in the environment.

• Journal of Radiation Protection and Research
• /
• v.41 no.4
• /
• pp.344-349
• /
• 2016

Background: Carbon ion therapy has achieved satisfactory results. However, patients have a risk to get a secondary cancer. In order to estimate the risk, it is essential to understand particle transportation and nuclear reactions in the patient's body. The particle transport Monte Carlo simulation code is a useful tool to understand them. Since the code validation for heavy ion incident reactions is not enough, the experimental data of the elementary reaction processes are needed. Materials and Methods: We measured neutron production double-differential cross-sections (DDXs) on a carbon bombarded with 430 MeV/nucleon carbon beam at PH2 beam line of HIMAC facility in NIRS. Neutrons produced in the target were measured with NE213 liquid organic scintillators located at six angles of 15, 30, 45, 60, 75, and $90^{\circ}$. Results and Discussion: Neutron production double-differential cross-sections for carbon bombarded with 430 MeV/nucleon carbon ions were measured by the time-of-flight method with NE213 liquid organic scintillators at six angles of 15, 30, 45, 60, 75, and $90^{\circ}$. The cross sections were obtained from 1 MeV to several hundred MeV. The experimental data were compared with calculated results obtained by Monte Carlo simulation codes PHITS, Geant4, and FLUKA. Conclusion: PHITS was able to reproduce neutron production for elementary processes of carbon-carbon reaction precisely the best of three codes.

• The Journal of the Korea Contents Association
• /
• v.9 no.6
• /
• pp.275-288
• /
• 2009

The research has been investigated to enhance job recognition and satisfaction in Emergency medical information center and to induce some positive suggestions to develop emergency medical information centers in Korea. As a result, the findings found that the tasks which the experts felt are most easily ones are the guidance, counseling, and advice of a patient, while the most difficult tasks are the advice on the first-aid treatment and the guidance of the hospitals. The research has found the findings that most employees feel that they perform their jobs quite well including the guidance and consultation of first-aide patients. They also feel that they are under stress in consulting patients, and in making decisions to visit emergency centers and to observe the patients in limited information without seeing patients in person. They are concerned about the identity of emergency information centers, feeling that it is difficult to construct smoothly the collaboration of such agencies as the administrative, emergency medical centers, 119 resue teams to treat first aide treatments, to provide transportation information, and hospital guidance.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.8 no.2
• /
• pp.113-121
• /
• 2010

Purpose: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. Methods: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. Results: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. Conclusion: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.

• The Korean Journal of Emergency Medical Services
• /
• v.25 no.2
• /
• pp.71-97
• /
• 2021

Purpose: This study aimed to examine the development and improvement direction of university education according to job type and investigate the types of knowledge required for employment after graduation for departments of emergency medical technology in preparation for the era of the fourth industrial revolution in a converged society. Methods: From June 3 to June 10, 2019, data were collected through structured questionnaires from 90 paramedics working in firefighting, hospitals, different industries, and emergency patient transportation. Data were analyzed using the software SPSS version 18.0. Results: For employment after graduation in departments of emergency medical technology, character and sincerity education should be strengthened. To prepare for the fourth industrial revolution, educational innovations such as improving the field practice system and devising a convergence curriculum are needed. Preparation for the fourth industrial revolution should be accomplished through the development of convergence subjects such as forensic science, information and communications technology, and safety engineering. Ninety percent of the study respondents indicated their need for convergence subjects. Conclusion: The demands of future society should be responded to flexibly by holding and conducting convergence subjects. Furthermore, preparations should be made in anticipation of a shortage of 120,000 college freshmen for the 2024-2025 school year by increasing the competitiveness of departments of emergency medical technology.

• Journal of Trauma and Injury
• /
• v.35 no.2
• /
• pp.92-98
• /
• 2022

Purpose: Critically ill patients are frequently transferred from one point of care to a hospital that can provide a higher level of care. To achieve optimal treatment within the targeted window of time necessary for time-sensitive cases like major trauma, rapid transportation and decision making are essential. Transferred patients have often undergone radiologic imaging at the referring hospital. Examining these outside images is paramount. Therefore, this study was conducted to estimate the upload time of outside images. Methods: This retrospective study was conducted from January to April 2020. Patients transferred from other hospitals with digitally recorded CDs or DVDs of radiologic or diagnostic images were included. When the patients were registered at the emergency department reception desk, the digital images were transmitted to our picture archiving and communication system using transmission software. The time of upload and the numbers of digital images were recorded. The time interval from patient registration to the time of upload was calculated. Results: The median number of images was 688 in the trauma team activation (TTA) group (688 in the TTA group, 281 in the non-TTA trauma group, and 176 in the nontrauma group, respectively; P<0.001). The median upload time was 10 minutes. The longest upload time was 169 minutes. The upload time was more than 20 minutes in 12 cases (19.4%). Conclusions: Patients with major trauma bring more images than patients with other diseases. Unexpected delays (>20 minutes) were noted in approximately 20% of cases. It is necessary to minimize this time.

• Journal of Trauma and Injury
• /
• v.36 no.4
• /
• pp.376-384
• /
• 2023

Purpose: The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity. Methods: In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients' mode of transport. Results: This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder. Conclusions: This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

• Journal of Trauma and Injury
• /
• v.37 no.2
• /
• pp.106-113
• /
• 2024

Purpose: Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation. Methods: This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared. Results: The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences. Conclusions: DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.

• Smart Media Journal
• /
• v.13 no.1
• /
• pp.60-66
• /
• 2024

The Internet of Things, which began by connecting sensors through a network, is developing into an intelligent IoT by combining it with artificial intelligence technology. Elevators are essential for high-rise buildings in the city, and elevators move from floor to floor and perform the functions of transporting goods and moving users. It is necessary to provide safe and convenient services for elevator users in high-rise buildings or special environments (hospitals, etc.). In an environment where rapid patient transportation is important, such as large hospitals, there is a problem that hospital staff and the general public often use the elevator for patients. In particular, when moving patients where golden time is important, the waiting time to board the elevator is a major hindrance. In order to solve this problem, this study proposes an intelligent IoT system for elevator calling using smartphone Bluetooth. First, we experimented with the elevator calling IoT system using smartphone Bluetooth, and as a result of the experiment, it was confirmed that it can authenticate elevator users and reduce unnecessary waiting time for boarding. In addition, we propose an intelligent IoT system that connects with intelligent IoT.

• Journal of Korean Academy of Nursing
• /
• v.28 no.4
• /
• pp.958-969
• /
• 1998

In this study, we attempted to investigate the needs and problems of the terminal cancer patients and their family caregivers to provide them with nursing information to improve their quality of life and prepare for a peaceful death. Data was collected from August 1, 1995 to July 31, 1996 at the internal medicine unit of S hospital in Seoul area with the two groups of participants who were family members of terminal cancer patients seventy four of them were in-patients and 34 were out-patients who were discharged from the same hospital for home care. The research tool used in this study has been developed by selecting the questionnaires from various references, modifying them for our purpose and refining them based on the results of preliminary study. While general background information about the patients was obtained by reviewing their medical records, all other information was collected by interviewing the primary family caregivers of the patients using the questionnaire. The data collected were analyzed with the SPSS PC/sup +/ program. The results of this study are summarized as follows ; 1) Most frequently complained symptoms of the terminal cancer patients were in the order of pain(87%), weakness(86.1%), anorexia(83.3%) and fatigue (80.6%). 2) Main therapies for the terminal cancer patients were pain control (58.3%), hyperalimentation(47.2%) and antibiotics(21.3%). 3) Special medical devices that terminal cancer patients used most were oxygen device (11.1%), and feeding tube(5.6%). Other devices were used by less than 5% of the patients. 4) The mobility of 70.4% of the patients was worse than ECOG 3 level, they had to stay in bed more than 50% of a day. 5) Patients wanted their medical staffs to help relieve pain(45.4%), various physical symptoms(29.6%), and problems associated with their emotion(11.1%). 6) 16.7% of the family caregivers hoped for full recovery of the patients, refusing to admit the status of the patients. Also, 37% wished for the extension of the patient's life at least for 6 months. 7) Only 38.9% of the family members was preparing for the patient's funeral. 8) 45.4% of family caregivers prefer hospital as the place for the patient's death, 39.8% their own home, and 14.8% undetermined. 9) Caregivers of the patients were mostly close family members, i.e., spouse(62%), and sons and daughters or daughter-in-laws(21.3%). 10) 43.5% of the family caregivers were aware of hospice care. 46.8% of them learned about the hospice care from the mass media, 27.7% from health professionals, and the rest from books and other sources. 11) Caregivers were asked about the most difficult problems they encounter in home care, 41 of them pointed out the lack of health professionals they can contact, counsel and get help from in case of emergency, 17 identified the difficulty of finding appropriate transportation to hospital, and 13 stated the difficulty of admission in hospital as needed. 12) 93.6% of family caregivers demanded 24-hour hot line, 80% the visiting nurses and doctors, and 69.4% the volunteer's help. The above results indicate that terminal patients and their family caregivers demand help from qualified health professionals whenever necessary. Hospice care system led by well-trained medical and nursing staffs is one of the viable answers for such demands.