Due to the introduction of Smart Advanced Life Support in 2015, paramedics can provide Advanced Cardiovascular Life Support to patients with out-of-hospital cardiac arrest. Although studies have been conducted to confirm the effectiveness of Smart Advanced Life Support for patients with out-of-hospital cardiac arrest, there is a lack of exploration of the experiences that paramedics face in the field in a changed environment. In this paper, I report two cases experienced by paramedics when using Smart Advanced Life Support, including communication with uncooperative caregivers and the burden felt by paramedics. In addition, to promote Smart Advanced Life Support, I propose enhancing paramedic training, establishing communication guidelines with caregivers, expanding the promotion of Smart Advanced Life Support, and providing customized education for the elderly.

소아 99mTc-DMSA 검사에서 방광의 포함 여부에 따른 신장 섭취율의 차이를 비교 하였다. 팬텀실험과 임상실험으로 진행되었으며 3개의 컵으로 좌, 우측신장 그리고 방광에 위치시키고 좌, 우측 신장의 방사능은 일정한 양( 1.0 )으로 고정하였고 방광에 해당되는 컵에는 0, 0.5, 1, 2배 방사능의 차이를 두어 영상을 획득하였다. 임상환자는 99mTc-DMSA (300uCi, 11MBq)을 주사하여 2시간 뒤 동일하게 영상 획득하여 각각 정량 분석하였다. 통계분석은 SPSS(ver 22.0) 으로 대응표본 T검증(paired T-test)을 사용하여 분석하였고 p<0.05는 통계적으로 유의하다고 판단하였다. 방광의 방사능을 제외한 양측 신장 섭취율은 29.83 ± 8.8%(좌측), 24.29 ± 6.66%(우측)이었고, 방광을 포함했을 때 신장 섭취율은 26.65 ± 8.03%(좌측), 21.78 ± 6.24%(우측)이었다. 신장 섭취율은 방광의 소변(방사능)이 증가할수록 양측 신장의 섭취율은 감소하였다. 이는 99mTc-DMSA 신장스캔 시 좌, 우측 신장에서 방사능을 계수할 때 방광의 소변에 포함된 방사능의 계수가 포함되어 신장 섭취율 공식에서 총 계수가 포함되므로 실제 양측 신장 섭취율의 값이 감소되었다.

In this study, meteorological characteristics concerning the occurrence of fog are analyzed using 4-years (2000-2003) data at Chuncheon. From the analysis of meteorological characteristics, the fog at Chuncheon occurred before sunrise time and disappeared after that time and lasted for 2-4 hours. When fog occurred, on the whole, wind direction was blew the northerly and wind speed was below 2.1 m/s. Especially, about 42 % of foggy day fell on the calm(0～0.2 m/s) conditions. The difference between air temperature and dew point temperature near the surface were mainly less than 2 ℃. For the lack of water surface temperature, the water surface temperature was calculated by using Water Quality River Reservoir System (WQRRS). In Chuncheon, there is close correlation between the frequency of fog day and outflow from Soyang reservoir and high frequency of occurrence due to the difference between air and cold outlet water temperature.