ABSTRACT
Objective@#The Public Health Disaster Response Team (PHDRT) has been organized by the Community Health Center since 2016 under the National Disaster Response Frame. They are mobilized when a Mass-Casualty-Incident is expected to occur. This study sheds light on the disaster medical system by analyzing the awareness of the PHDRT on the disaster medical management capacity. @*Methods@#To develop the questionnaire, a literature review was conducted. The questionnaire was distributed and obtained after inspecting the survey questionnaire filled out by the PHDRT. There were 254 samples. The data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. @*Results@#Research has proven that the awareness of the disaster medical management capacity was 3.11 (rating 1-5). In detail, organizational capacity received the highest agreement score (3.54±0.84), while the budget and organization management was below the midpoint (2.73±0.83). Significant positive correlations were found between the capacity components, particularly the organizational capacity and cooperation system (r=0.71, P<0.01). The awareness was significantly different according to sex, age, job (type), total career, and task weight. The factors influencing the awareness of disaster medical management capacity included age, total career, and task weight. @*Conclusion@#The findings from awareness analysis suggest that national and systemic supports, as well as personal efforts, are necessary to strengthen the disaster medical management capacity.
ABSTRACT
BACKGROUND: Adequate assessment and control of sedation play crucial roles in the proper performance of mechanical ventilation. METHODS: A total of 30 patients with various pulmonary diseases were prospectively enrolled. The study population was randomized into two groups. The sedation assessment group (SAG) received active protocol-based control of sedation, and in the empiric control group (ECG), the sedation levels were empirically adjusted. Subsequently, daily interruption of sedation (DIS) was conducted in the SAG. RESULTS: In the SAG, the dose of midazolam was significantly reduced by control of sedation (day 1, 1.3+/-0.5 microg/kg/min; day 2, 0.9+/-0.4 microg/kg/min; p<0.01), and was significantly lower than the ECG on day 2 (p<0.01). Likewise, on day 2, sedation levels were significantly lower in the SAG than in the ECG. Significant relationship was found between Ramsay sedation scale and Richmond agitation-sedation scale (RASS; rs=-0.57), Ramsay Sedation Scale and Bispectral Index (BIS; rs=0.77), and RASS and BIS (rs=-0.79). In 10 patients, who didn't require re-sedation after DIS, BIS showed the earliest and most significant changes among the sedation scales. Ventilatory parameters showed significant but less prominent changes, and hemodynamic parameters didn't show significant changes. No seriously adverse events ensued after the implementation of DIS. CONCLUSION: Active assessment and control of sedation significantly reduced the dosage of sedatives in patients receiving mechanical ventilation. DIS, conducted in limited cases, suggested its potential efficacy and tolerability.