중증응급환자 이송체계의 문제점과 개선방향

차명일 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2

전원조정의 필요성과 개선방향 : 취약지와 비취약지 비교

차명일 대한응급의학회 2023 대한응급의학회 학술대회초록집 Vol.2023 No.2

경주 마우나 오션 리조트 내 체육관 붕괴사고의 재난의료대응체계 고찰

차명일,김기운,김주현,좌민홍,최대해,왕순주,유인술,윤한덕,이강현,조석주,허탁,홍은석,김인병 대한응급의학회 2017 대한응급의학회지 Vol.28 No.1

Purpose: To investigate and document a disaster medical response during the collapse of the Gyeongju Mauna Ocean Resort gymnasium, which occurred on February 17, 2014. Methods: The official records of each institution were verified to select the study population. All the medical records and emergency medical service records were reviewed by an emergency physician. Personal or telephonic interviews were conducted without a separate questionnaire if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. Results: One hundred fifty-five accident victims, who were treated at 12 hospitals mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of the collapse was disseminated in 4 minutes, it took at lease 69 minutes for a dispatch of 4 disaster medical assistance teams to take action; 4.5% of patients were treated on-site, 56.7% were transferred to 2 nearest hospitals, and 42.6% were transferred to hospitals with poor preparation to handle disaster victims. Conclusion: In the collapse of the Gyeongju Mauna Ocean Resort gymnasium, the initial triage and distribution of patients were inefficient, with delayed arrival of medical assistance teams. These problems had also been noted in prior mass casualty incidents. Government agencies are implementing improvements, and this study could aid the implementation process.

일개 3차병원 응급의료센터의 가임기 여성에 대한 기형유발가능약제 처방현황

차명일,윤재철,오범진,김원,임경수,이재호 대한응급의학회 2008 大韓應急醫學會誌 Vol.19 No.5

Purpose: The purpose of this study is to survey the prescription status of potentially teratogenic drugs to women of childbearing age in an emergency department (ED). In addition, the frequency of documentation of patient’s pregnancy status was also evaluated. Methods: A retrospective study was conducted through the use of warehouse data at a tertiary care center. Women aged 20~39 years who were prescribed drugs that the U.S. Food and Drug Administration (FDA) identifies as class D or X were evaluated. The frequency of prescription of potentially teratogenic drugs and the rate of pregnancy tests performed at the ED were analyzed. Results: Among the 7,742 women of childbearing age with ED visits, 1,962(25.3%) patients received at least one potentially teratogenic drug during 2006, based upon the FDA risk classification system. The most frequently prescribed drugs were non steroidal anti-inflammatory drugs (NSAID) (50.8%), opioid drugs(26.3%), and benzodiazepines( 10.3%). The number of pregnancy tests performed before prescribing potentially teratogenic drugs was 838 (39.0%). Among patients for whom a pregnancy test was not performed, only 87(7.6%) patients were advised by their doctors of drug teratogenecity. Conclusion: The frequency of prescription of potentially teratogenic drugs to women of childbearing age was 1 in every 4 visits at the ED. In addition, the rates of documentation of pregnancy status and explanation of teratogenecity were relatively low. Introducing a pregnancy information system and a pregnancy alerting system, as well as increasing the frequency of pregnancy tests before prescribing are necessary, not only for pregnant women and fetuses but also for emergency medical personnel at the point of care.

심포지엄 11 : 재난현장의 응급의료지원 통신체계

차명일 대한응급의학회 2016 대한응급의학회 학술대회초록집 Vol.2016 No.1

A study on the disaster medical response during the Mauna Ocean Resort gymnasium collapse

차명일,김기운,김주현,좌민홍,최대해,김인병,왕순주,유인술,윤한덕,이강현,조석주,허탁,홍은석 대한응급의학회 2016 Clinical and Experimental Emergency Medicine Vol.3 No.3

Objective To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. Methods Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. Results One hundred fifty-five accident victims treated at 12 hospitals, mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of collapse was disseminated in 4 minutes, dispatch of 4 disaster medical assistance teams took at least 69 minutes to take the decision of dispatch. Four point five percent were treated at the accident site, 56.7% were transferred to 2 hospitals that were nearest to the collapse site, and 42.6% were transferred to hospitals that were poorly prepared to handle disaster victims. Conclusion In the Gyeongju Mauna Ocean Resort gymnasium collapse, the initial triage and distribution of patients was inefficient and medical assistance arrived late. These problems had also been noted in prior mass casualty incidents.

The development and application of active RFID entrance management system for emergency patient safety

차명일,오범진,민성우,이상욱,김원,임경수,이재호 대한의료정보학회 2008 Healthcare Informatics Research Vol.14 No.3

Objective: Unauthorized exit of emergency patients could cause serious safety problems in the emergency room. If the entry and exit of emergency patients can be monitored by RFID (Radio Frequency Identification) technology, such safety issues may be resolved. Method: We determined the fundamental requirements of the system for emergency patient safety, and chose an active RFID tag to conduct the recognition test. Subsequently, we performed the entrance recognition rate test and safety test using pacemakers. After developing the entrance management programs, we implemented the system in the emergency room and collected data for 6 months. Result: The overall success rate of the entrance recognition test was 99.5%, and during the safety test, pacemaker oversensing due to noise did not occur. We intended to fulfill the fundamental requirements in developing entrance management programs. A total of 508 patients were given RFID tags for the study period, and the recognition failure rate was 4.7%. “Alert” pop‐ups occurred 62 times. Conclusion: An active RFID entrance management system would be very useful for safety management in emergency room because the system enables detection of the unauthorized exit of emergency patients in real‐ time.

창조에 대한 예배신학적 고찰과 적용

차명호 한국실천신학회 2009 신학과 실천 Vol.0 No.18

자연 환경에 대한 위기감은 이제 압도적이고 지속적으로 인간을 짓누르고 있다. 하지만 창조론에 입각한 복음의 실천은 이러한 위기감 앞에서 특별한 반성과 해결의 성과를 거두지 못하고 있다. 특히 한국 기독교 예배는 이 점에서 취약한 모습을 보여주고 있다. 하지만 예배학 입장에서 비록 초기 기독교 문서들이 창조에 대해 무관심했다는 사실이 창조에 대한 예배의 무관심을 정당화 할 수는 없다. 왜냐하면 예배는 그 자체로 반복되는 창조의 사건이며, 생명에 대한 존귀와 보존의 실천이기 때문이다. 탐욕적 성장에 대한 집착으로 황폐화 된 교회 현장에서 실천적 운동으로서의 창조에 대한 이해와 구체적인 방안들이 논의되는 일은 기독교 현주소에서 시급하다. 본 논문은 창조에 대한 초기 교회의 문서들의 접근들을 살펴보고, 창조에 대한 자연, 인간, 사회의 종합적 이해를 정리했다. 그리고 신학적인 면에서 창조의 시각을 성례에 접목시켜, 개신교에 주어진 세례와 성찬을 각각 자연과 인간/사회 생명이라는 주제로 분석했다. 세례의 물은 단지 예식적 상징물이 아니라 하나님의 뜻이 창조 때부터 같이 한 실재적 힘이며, 현대 교회는 힘을 잃어버린 세례의 회복을 위해선 자연에 대한 하나님의 창조를 다시 회복해야 한다. 또한 초기 교회에서 성찬은 단지 음식을 섭취하는 종교적 의식이 아니라 음식을 특별한 방식으로 나누는 사회적 제도였다. 그러한 사회적 제도는 당대의 다양한 만찬들 중에서 기독교의 정체성을 가장 잘 드러내는 표징이었다. 현대의 성찬 역시 세례와 마찬가지로 교리화 되거나 허식화 된 예식으로 전락해버렸다. 죄인과 사회적 약자들과 함께 한 예수가 보여준 식사 전통은 현대의 양극화 되어진 경제/사회 구조에서 인간에 대한 하나님의 창조의 뜻을 회복할 적절한 실천방안이다. 자연과 인간에 대한 참된 생명 회복이 교회의 목회 프로그램으로 적용되기 위해선 예배와 설교의 영역 안에서 하나님의 창조가 회복되어야 한다. 이를 위해서 절실하게 요구되는 방법 중의 하나는 목회의 지침이 되는 교회력과 렉셔너리의 수정이 필요하다. 현재 그리스도 중심적인 교회력에 창조의 절기를 삽입함으로써 삼위일체적 교회력을 회복해야 하며, 거기에 맞춰 창조와 관련된 다양한 목회 프로그램들이 활성화 되어야 할 것이다. This writing is a work to reflect the crisis of creation in terms of “nature” and “human life” from a liturgical perspective. Even though this topic has been discussed throughout the various areas of theology, the protestant churches in Korea have virtually ignored it in the field of ministries. In this writing, I research the data about creation from the early fathers' documents, from Old Testaments to 4th century. Even though most scholars of liturgical studies agree that since 3rd century we cannot find concrete and consistent resources regarding the topic of creation in early churches, this writing will give an effort to providing some evidences on the topic in the early church fathers' liturgical documents, especially of sacramental prayers. In the next step, I devide the subject of creation into the two areas of “nature” and “human” in terms of life. Whereas the former area is high- lightened in the baptism, the latter in the eucharist from the theological point of view. In the final and applied step, this writing suggests Korean churches with trinitarian time concept recovering “creation” and “rest.” Particularly, we can optimize the trinitarian time by applying “the season of creation” in the church calendar as liturgical setting as well as ministerial vision. By celebrating the season, the faithful will remind that all creation is sacred, but Earth is sacred in a special way. Earth is a sanctuary, a sanctuary chosen by God. This sanctuary is pulsating with God's presence and open for all to worship. It is in this sanctuary that we invoke the presence of our Creator. It is this sanctuary we enter to celebrate a Season of Creation.

안토니오 그람씨의 국가론과 문화 개념

차명제 한국인문사회과학회 1991 현상과 인식 Vol.15 No.3

不正腐敗 防止와 NGOs의 役割

車明齊 한국행정연구원 1998 韓國行政硏究 Vol.7 No.4