• Journal of Trauma and Injury
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• 제36권4호
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• pp.447-450
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• 2023

Traumatic abdominal wall hernia is a rare presentation, most commonly reported in the context of motor vehicle accidents and associated with blunt abdominal injuries and handlebar injuries in the pediatric population. A 13-year-old boy presented with multiple traumatic injuries and hemodynamic instability after a high-speed motor vehicle accident. His injuries consisted of massive traumatic abdominal wall hernia (grade 4) with bowel injury and perforation, blunt aortic injury, a Chance fracture, hemopneumothorax, and a humeral shaft fracture. Initial surgical management included partial resection of the terminal ileum, sigmoid colon, and descending colon. Laparostomy was managed with negative pressure wound therapy. The patient underwent skin-only primary closure of the abdominal wall and required multiple returns to theatre for debridement, dressing changes, and repair of other injuries. Various surgical management options for abdominal wall closure were considered. In total, he underwent 36 procedures. The multiple injuries had competing management aims, which required close collaboration between specialist clinicians to form an individualized management plan. The severity and complexity of this injury was of a scale not previously experienced by many clinicians and benefited from intrahospital and interhospital specialist collaboration. The ideal aim of primary surgical repair was not possible in this case of a giant abdominal wall defect.

• 한국안전학회지
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• 제29권4호
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• pp.160-167
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• 2014

To determine a proper ASIL for each hazardous event with a proper safety goal, the right classes should first be determined for the three properties of the hazardous event; (i) severity of harm from the resultant accident, (ii) exposure to the relevant operational situation, and (iii) controllability to avoid the induced risks. ASIL can be clearly determined with right classes of these three properties. But no specific methodologies or processes for their classification can be found in ISO 26262, except only a rough guideline with a simplified set of illustrative tables. In this paper, we try to present a systematic model for classifying the three properties of the hazardous event and suggest a refined procedure of ASIL determination. The proposed model provides a specific method to get a more objective ASIL compared with that in the standard. Scrutinizing the current methodology, we develop a refined method and also provide an illustrative example.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.219-221
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• 2015

Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered.

• 대한교통학회지
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• 제22권3호
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• pp.59-67
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• 2004

우리나라의 자동차 관리제도가 2003년 1월 1일을 기하여 국가 형식승인제에서 제작사 자기인증제로 전환되었다. 자동차 리콜제도는 자동차 안전결함의 책임을 제작사에게 묻는 조치로 자기인증제에서는 교통사고로부터 소비자보호를 위하여 꼭 필요한 제도이다. 본 연구에서는 자동차 리콜제도의 시행에 따른 편익을 교통사고 감소편익과 교통사고의 심각도 감소편익으로 구분하여 계량화 할 수 있는 방법을 개발하였으며 개발된 방법을 적용하여 우리나라의 리콜제도의 시행에 따른 편익을 산정하였다. 본 연구에서 개발된 방법을 이용하여 2002년 기준 자동차 리콜의 편익 효과를 분석한 결과 연간 745건의 교통사고가 자동차 리콜로 인하여 감소되었고, 교통사고의 심각도 감소측면에서 12건의 사망사고와 1473건의 부상사고를 경감시키는 효과를 가져 온 젓으로 추정되었다.

• 한국추진공학회:학술대회논문집
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• 한국추진공학회 2010년도 제34회 춘계학술대회논문집
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• pp.129-132
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• 2010

둔감추진기관 개발은 돌발적인 기폭 가능성과 이에 따른 막대한 피해를 최소화함으로써 사고로부터 인명과 장비의 생존성보장을 규정짓는데 중요한 목적이 있다. 열이나 기계적 충격으로 인한 격렬한 반응과 이어지는 반응의 확률을 최소로 줄이고 적재탄, 양산중이나 수송 저장중인 추진기관의 동조폭발로 주위환경에 치명적인 영향을 끼치는 격렬한 연쇄반응을 줄여야 한다. 이에 따라 반응형태도 과압, 파편비산, 열유속과 같은 결과에 평가의 기초를 두고 있다.

• 한국콘텐츠학회논문지
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• 제17권2호
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• pp.258-268
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• 2017

본 연구는 범이론을 적용하여 산업재해 근로자(이하 산재근로자)의 변화동기 수준과, 이에 영향을 미치는 요인을 개인, 가족, 산업재해 요인으로 구분하여 살펴보았다. 산업재해로 요양 치료를 받고 있는 305명의 근로자로부터 자기보고식 설문조사를 통해 수집한 자료를 분석한 결과는 다음과 같다. 첫째, 산재근로자의 변화동기 수준은 초이론 모형에서 대부분 전숙고, 숙고 단계에 머물러 있었다. 둘째, 산재근로자의 변화동기에 긍정적 영향을 미치는 개인 요인은 심리안정성, 장애수용도, 독립성이었고, 가족 요인은 가족의 지지도였으며, 산재 관련 요인은 주관적 재해상태, 재해 당시 직업, 직업 복귀 상태였다. 이러한 결과는 산재근로자의 재활을 위해 개인의 심리와 가족의 지지에 초점을 둔 개입이 필요함을 시사한다.

• 한국방재학회 논문집
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• 제8권4호
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• pp.31-38
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• 2008

본 연구는 어린이 교통사고의 심각성과 현재 활발하게 추진되고 있는 어린이보호구역의 가변속도표출기(drive feedback sign, 이하 DFS) 설치 및 운영을 배경으로 부천시 어린이보호구역의 DFS 사전 사후 속도조사를 통해 평균속도감속이 교통사고 감소율에 미치는 영향을 조사하여 부천시의 각 초등학교 대상지별 평균속도감소에 따른 교통사고 감소율을 예측한다. 그리고 조사 결과를 바탕으로 부천시 어린이보호구역 지정 초등학교의 DFS운영에 따른 교통사고로 인한 인적재난 감소효과를 알아보는데 그 목적이 있다.

• 한국심리학회지 : 문화 및 사회문제
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• 제23권2호
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• pp.215-237
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• 2017

의료사고 관련 연구들은 의료분쟁 및 피해구제와 관련한 법이론적 연구가 대부분이며 의료사고 환자들의 심리적 경험을 심층적으로 탐구한 연구는 부족한 실정이다. 이에 본 연구는 의료사고를 겪은 환자들의 외상후 스트레스 장애(Post Traumatic Stress Disorder: PTSD) 현황을 알아보고, 의료진의 설명 및 태도와 PTSD 증상의 관계에서 사회적 지지의 조절효과를 검증하였다. 의료사고 단체와 의료사고 관련 온라인 커뮤니티에서 모집된 총 180명의 의료사고 환자의 자료가 분석에 사용되었다. 분석 결과, 연구대상자 중 171명(95%)이 완전 PTSD 증상 수준으로 선별되었으며 다른 외상 경험자들과 비교해도 PTSD 증상의 심각도가 높은 것을 확인하였다. 또한 의료진의 설명 및 태도가 PTSD 증상에 미치는 주효과는 유의미하지 않았지만 의료진의 설명 및 태도와 PTSD 증상의 관계에서 사회적 지지 수준의 조절효과가 유의한 것으로 나타났다. 즉, 사회적 지지 수준이 높을 때는 의료진의 설명 및 태도에 따른 PTSD 증상의 유의미한 변화가 없었으나, 사회적 지지 수준이 낮을 때는 의료진의 설명 및 태도가 미흡할수록 PTSD 증상이 악화되었다. 이러한 연구 결과를 바탕으로 의료사고 환자들의 PTSD 증상을 완화하고 예방하는데 있어 심리적, 사회적, 제도적 방안들을 제언하였다. 마지막으로 본 연구의 제한점과 향후 연구 방향에 대해 논의하였다.

• 한국안전학회지
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• 제34권1호
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• pp.115-121
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• 2019

Background: Due to the diversification and advancement of research, researchers have become to deal with a variety of chemical and biological harmful materials in the laboratories of universities and research institutes and the risk has increased as well. Therefore, it is necessary to strengthen the social safety net for laboratory accidents by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service, when the researchers become physically disabled by laboratory accidents. The purpose of this study is to secure researchers' health rights and to create a research environment where researchers can work with confidence by strengthening the compensation to the level comparable to that of Korean Workers' Compensation & Welfare Service. Method: We analyzed the laboratory accidents by year, injury type, severity of accident and disability grade with the 6 year data from 2011 to 2016, provided by Laboratory Safety Insurance. Based on the analysis result, we predicted the financial impact on Laboratory Safety Insurance if we introduce a compensation annuity by disability grade which is similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service. Result :As of 2011, the insured number of Laboratory Safety Insurance was approximately 700,000. The Average premium per insured was KRW 3,339 and there were 158 claims. Total claim amount was KRW 130 million, whereas the premium was about KRW 2.3 billion. The loss ratio was very low at 5.75%. If we introduce a compensation annuity by disability grade similar to Injury-Disease Compensation Annuity of Korean Workers' Compensation & Welfare Service, the expected benefit amount for 1 case of disability grade 1 would be KRW 1.6 billion, assuming 2% of interest rate. Given current premium, the loss ratio, the ratio of premium income to claim payment, is expected 41.4% in 2017 and 151.6% in 2026. The increased loss ratio due to the introduce of the compensation annuity by disability grade is estimated to be 11.0% in 2017 and 40.4% in 2026. Conclusion: Currently, laboratories can purchase insurance companies' laboratory safety insurance that meets the standards prescribed by Act on the Establishment of Safe Laboratory Environment. However, if a compensation annuity is introduced, it would be difficult for insurance companies to operate the laboratory safety insurance due to financial losses from a large-scale accident. Therefore, it is desirable that one or designated entities operate laboratory safety insurance. We think that it is more desirable for laboratory safety insurance to be operated by a public entity rather than private entities.

• 자동차안전학회지
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• 제10권4호
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• pp.7-12
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• 2018

Injury mechanisms of lower extremity injuries in motor vehicle accidents are focused on fractures, sprains, and contusions. The purpose of this study is to evaluate the analysis of lower extremity injury mechanism in occupant motor vehicle accident by using Hospital Information System (HIS) and reconstruction program, based on the materials related to motor vehicle accidents. Among patients who visited the emergency department of Wonju Severance Christian Hospital due to motor vehicle accidents from August 2012 to February 2014, we collected data on patients with agreement for taking the damaged vehicle's photos. After obtaining the verbal consent from the patient, we asked about the cause of the accident, information on vehicle involved in the accident, and the location of car repair shop. The photos of the damaged vehicle were taken on the basis of front, rear, left side and right side. Damage to the vehicle was presented using the CDC code by analytical study of photo-images of the damaged vehicle, and a trauma score was used for medical examination of the severity of the patient's injury. Among the 1,699 patients due to motor vehicle crashes, 88 (5.2%) received a diagnosis of lower extremity fracture and 141 (8.3%) were the severe who had ISS over 15. Nevertheless during 19 months for research, it was difficult to build up in-depth database about motor vehicle crashes. It has a limitation on collecting data because not only the system for constructing database about motor vehicle crash is not organized but also the process for demanding materials is not available due to prevention of personal information. For accurate analysis of the relationship between occupant injury and vehicle damage in motor vehicle crashes, build-up of an in-depth database through carrying out various policies for motor vehicle crashes is necessary for sure.