• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.130-135
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• 2020

Purpose: Taking large amounts of glyphosate is life-threatening, but the amounts of glyphosate taken by patients for suicide are not known precisely. The purpose of this study was to find the predictors of large amounts of glyphosate ingestion. Methods: This retrospective study analyzed patients presenting to an emergency department with glyphosate intoxication between 2010 and 2019, in a single tertiary hospital. The variables associated with the intake amounts were investigated. The parameters were analyzed by multivariate variate logistic regression analyses and the receiver operating characteristic (ROC) curve. Results: Of the 28 patients with glyphosate intoxication, 15 (53.6%) were in the large amounts group. Univariate analysis showed that metabolic acidosis, lactic acid, and corrected QT (QTc) interval were significant factors. In contrast, multivariate analysis presented the QTc interval as the only independent factor with intoxication from large amounts of glyphosate. (odds ratio, 95% confidence interval: 1.073, 1.011-1.139; p=0.020) The area under the ROC curve of the QTc interval was 0.838. Conclusion: The QTc interval is associated significantly with patients who visit the emergency department after being intoxicated by large amounts of glyphosate. These conclusions will help in the initial triage of patients with glyphosate intoxication.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.4
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• pp.51-60
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• 2021

Purpose: Tuberculosis(TB) care unit in public health center should be carefully considered to be re-designed as an infection safety environment for both patient and healthcare workers. So, for the enhancement, this study analyses the facility requirements for co-using the screening clinic as a TB and other respiratory disease care unit. Methods: Not only screening clinic facility guidelines from "A Study for Standard Triage Design and Construction Document" but also the guidelines of TB care and related medical facility are reviewed; KDCA, CDC, ECDC and WHO as a TB care, and FGI and NHS for facility. The facility requirements are summarized space, approach, and mechanical requirement in order. By comparing the summary and screening clinic facility guidelines, supplementations are proposed for TB care unit setting. Results: The result of this study shows that both the space program and mechanical requirement of the screening clinic and that of TB care unit are almost identical and could be share, which include direct airflow or negative air pressure in an exam room. To increase functional and economical efficiency, however, it is necessary to consider a multi-functional negative pressured room, So care process may be re-designed based on a room type; face-to-face room or glass wall inbetween. Implications: The facility guidelines for TB care unit of a public health center should be developed to build a safe environment for infection control by reflecting its medical plan and budget.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• Korean Journal of Radiology
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• v.21 no.5
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• pp.598-604
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• 2020

Objective: Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancer patients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for US indeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. Materials and Methods: A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or core-needle biopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probably benign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilar vascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs using Mann-Whitney U test and Fisher's exact test. Results: US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), and suspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the US probably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs, there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs (3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). Conclusion: US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancy risk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and node size should be considered for proper triage of US indeterminate LNs in thyroid cancer.

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.97-112
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• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• International Journal of Quality Innovation
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• v.9 no.3
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• pp.1-14
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• 2008

Patient satisfaction with the Emergency Department(ED) in a hospital is related to the length of stay, and especially to the amount of waiting time for medical treatments. ED overcrowding decreases quality and efficiency, therefore affecting hospitals' profitability. This paper presents a forecasting and simulation model for resource management of the ED at Moses H. Cone Memorial Hospital. A linear regression forecasting model is proposed to predict the number of ED patient arrivals, and then a simulation model is provided to estimate the length of stay of ED patients, system throughput, and the utilization of resources such as triage nurses, patient beds, registered nurses, and medical doctors. The near future load level of each resource is presented using the proposed models.

• The Journal of Information Systems
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• v.19 no.3
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• pp.263-278
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• 2010

Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.

• Journal of Home Health Care Nursing
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• v.17 no.1
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• pp.21-27
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• 2010

Purpose: The study evaluated a program to shorten EMC stay time. Methods: The subjects were EMC patients, and comprised a control group of 8,477 and an experimental group of 8,378. Data were collected from June 2006 to August 2007, and analyzed concerning stay time for doctor visit, decision making, and discharge. The data were analyzed by $X^2$-test and ANCOVA using SPSS14.0. Result: The stay time of doctor visit, decision making and discharge of the experimental group was significantly less compared to the control group. Using second and third grade triage criteria, the stay time of experimental group was statistically reduced from the control. Conclusion: The implemented shortening program was effective in reducing EMC stay time and increasing EMC effectiveness.

• The Korean Journal of Emergency Medical Services
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• v.4 no.1
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• pp.31-34
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• 2000

The real Emergency Medical Service (EMS) was introduced into Korea in the 1990s, but the role of the EMT in hospital has not been establish. This report is based on our experience for the purpose of introducing the role of the EMT in hospital. 1) EMT assisted a doctor in emergency department. 2) EMT served as a member of CPCR team in hospital during last 3 years. The survival rate of CPCR in hospital was higher than other result in Korea. 3) EMT performed his duties as a keeper of hemodynamically unstable or severely injured patients very well. 4) EMT transferred patients with safety. 5) EMT ran with rapid triage. We think that EMT will play an important role in hospital from now on.

• Journal of the Society of Disaster Information
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• v.4 no.2
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• pp.106-121
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• 2008

Purpose: This historical research was done to identify disaster nursing activities during the last 60 years through the most serious disasters during the last 60years(1945-2005) in Korea. Method: Fot the data collection, three of main daily newspaper and The Korean Nurses Association News were reviewed and nurses who were called out to the most serious disaster onsite were interviewed. Results: The nurses were positively involved for setup onsite clinic, mobile medical services, triage, CPR, and psychological support during response and recovery phase, while hardly involved during preparedness phase. Conclusion: The clarification of job description for disaster nursing and developing systematic training program should be followed.