1.Organization and Roles of the Trauma Team.
Journal of Acute Care Surgery 2016;6(2):46-53
In a narrow sense, the trauma team is intra-hospital organization that perform the initial assessment and resuscitation for the victims. Cooperation with the administrative and governance body of the hospital is essential for the function as a trauma center. The hospital could be as a core of the trauma care system with this support. Essential to this core position is a hospital trauma program that regulates and supports the trauma team activities. This trauma program consists of the hospital governance, administration, the trauma team and leader, trauma program manager, the registrar and the multidisciplinary committee of the performance improvement program. The essential elements of the trauma team include a trauma surgeon, an emergency physician, emergency department nurses, a laboratory and radiology technician, an anesthesiologist and a scribe. The team leader should be a trauma surgeon and coordinate the multidisciplinary professions in the team during the entire trauma care process. Clear criteria for the trauma team activation should be defined in advance. The composition of the team and the activation criteria may vary with the hospital capacity, the severity of injury, and the level of activation. The tiered criteria are based on clinical information from the field: physiologic and anatomic conditions and mechanism of injury and are recommended. The multidisciplinary committee for the performance improvement should monitor and assess trauma program outcomes. These activities will lead to trauma care improvements.
Emergencies
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Emergency Service, Hospital
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Resuscitation
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Trauma Centers
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Triage
2.Proposal for stabilization of regional trauma centers in Korea.
Journal of the Korean Medical Association 2016;59(12):931-937
From 2011 to 2016, 16 regional trauma centers were designated throughout the country and 9 of the 16 centers have been operating their own trauma facilities. At present, there are some differences in treatment experiences and levels according to the type and size of the trauma centers. Treating the trauma system as a part of emergency medical service, while the field of severe trauma is clearly different from the rest of emergency medical service in particular, has become a serious problem in Korea. First of all, the role of trauma centers should have been established before they are added to the trauma care system. Beyond that, manpower is the most important factor in building a trauma center. Pusan National University Hospital offers the ideal environment for a study on the relationship between trauma centers and emergency centers. Pusan National University Hospital has 2 independent emergency rooms: one each in the trauma center and emergency center. Therefore, it is possible to compare the outcomes of 2 different emergency rooms and identify the proportion of the trauma population who is transferred from the emergency center to the trauma center due to trauma severity index. Ultimately, the government and individual hospitals must support personnel in each trauma centers administratively and financially to sustain trauma centers over the long term. The purpose of this proposal is to suggest some resolutions to the problems associated with the trauma care system in Korea.
Busan
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Emergencies
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Emergency Medical Services
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Emergency Service, Hospital
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Korea*
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Trauma Centers*
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Trauma Severity Indices
3.Change of inter-facility transfer pattern in a regional trauma system after designation of trauma centers.
Suckju CHO ; Kyoungwon JUNG ; Seokran YEOM ; Sungwook PARK ; Hyunghoi KIM ; Seongyoun HWANG
Journal of the Korean Surgical Society 2012;82(1):8-12
PURPOSE: The Ministry of Health and Welfare recently designated 35 major trauma-specified centers (MTSC). The purpose of this study is to determine changes in patient flow and designated hospitals, and to describe the role of the emergency medical information center (EMIC) in a regional trauma care system. METHODS: Data of trauma patient inter-facility transfer arrangement by one EMIC were reviewed for 2 months before and after the designation of MTSC. The data included success or failure rates of the arrangement, time used for arrangement, and inquiring and accepting facility. RESULTS: At pre- and post-designation study period, there were 540 and 433 trauma patient inter-facility transfers arranged by EMIC, respectively. The median time used for arrangement decreased from 9.3 to 7.7 minutes (P = 0.007). Arrangement failure rate was 3.5% and 2.5%, respectively, with no significant interval change (P = 0.377). The percentage of inquiring MTSC decreased from 49.1 to 36.9% (P < 0.001). The percentage of accepting MTSC increased from 20.2 to 37.4% (P < 0.001). CONCLUSION: With the designation of MTSC, EMIC could arrange inter-facility transfers more quickly. The hospitals wanted more trauma patients after the designation. There would be a concentration of trauma patients to MTSCs in our region. Further studies are needed for scientific evidence on patient outcome.
Emergencies
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Emergency Service, Hospital
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Humans
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Information Centers
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Information Services
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Referral and Consultation
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Trauma Centers
4.Validation of the Korean criteria for trauma team activation.
Minhyuk BANG ; Yong Won KIM ; Oh Hyun KIM ; Kang Hyun LEE ; Woo Jin JUNG ; Yong Sung CHA ; Hyun KIM ; Sung Oh HWANG ; Kyoung Chul CHA
Clinical and Experimental Emergency Medicine 2018;5(4):256-263
OBJECTIVE: We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. METHODS: This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. RESULTS: Most of the patient’s physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. CONCLUSION: The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a two-tier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.
Emergency Service, Hospital
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Humans
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Observational Study
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Patient Care
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Patient Care Team
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Trauma Centers
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Triage
5.A building database for emergency room and its use.
Joon Yang NOH ; Chang Soon JANG ; Seong Oung LEE ; Kyung Bin ROH ; Kee Chun HONG ; Doo Sun LEE
Journal of the Korean Society of Emergency Medicine 1993;4(1):53-66
No abstract available.
Emergencies*
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Emergency Service, Hospital*
6.Utilization Patterns of Pediatric Emergency Room.
Journal of the Korean Pediatric Society 1989;32(7):897-914
No abstract available.
Emergencies*
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Emergency Service, Hospital*
7.The analysis of discharge against medical advice in the emergency department.
Seung Whan KIM ; Ok Jun KIM ; Seok Joon JANG ; Koo Young JUNG ; Seung Ho KIM
Journal of the Korean Society of Emergency Medicine 1993;4(2):116-122
No abstract available.
Emergencies*
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Emergency Service, Hospital*
8.'Do-no-resuscitate' dicisions in the emergency department.
Young Sik KIM ; Sung Oh HWANG ; Boo Soo LEE ; Moo Eob AHN ; Kyoung Soo LIM ; Sung Jun KANG
Journal of the Korean Society of Emergency Medicine 1993;4(2):108-115
No abstract available.
Emergencies*
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Emergency Service, Hospital*
9.Legal problems in the emergency department.
Keun Jeong SONG ; Moen Joen CHANG ; Hahn Shick LEE
Journal of the Korean Society of Emergency Medicine 1993;4(2):101-108
No abstract available.
Emergencies*
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Emergency Service, Hospital*
10.Clinical analysis of posttraumatic deaths at emergency department.
Hyuk Jun YANG ; Cheol Wan PARK ; Keun LEE
Journal of the Korean Society of Emergency Medicine 1993;4(2):83-90
No abstract available.
Emergencies*
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Emergency Service, Hospital*