The Journal of Emergency Medicine 925

0.489; CI 0.430–0.556). There was no impact on age as a riskfactor. Alcohol and drugs were more likely to be associatedwith PT post-K than pre-K (OR 1.71, 95% CI 1.16–1.37),(OR 1.28, 95% CI 1.164–1.411). There was no statistically sig-nificant difference in ISS levels. K made New Orleans (NO) res-idence less of a risk factor (OR 0.499, CI 0.449–0.554), andpost-K the impact of being within the city limits was also dimin-ished (OR 0.773, CI 0.701–0.851). There were no differences inthe distribution of dispositions from the ED to the floor, operat-ing room, intensive care unit, step-down unit, or home. Al-though all-cause mortality for victims of PT was significantlyhigher pre-K, the disposition of survivors was not affected byK. Conclusions: Rates of PT actually decreased following K.Mechanism of PT, gender, age, ISS, ED, and hospital disposi-tion were unaffected. Victims of PT had improved overall sur-vival post-K. They were more likely to be intoxicated,suggesting a higher level of post-K substance use, but a higherlevel of disinhibition effect and lower level of intent. Beingblack, living in NO, and being in NO were less of a risk post-K than they were pre-K.

, FACTORS AFFECTING PUBLIC RECOGNITIONAND WILLINGNESS TO PERFORM BYSTANDER CPRIN DAEGU METROPOLITAN CITY. H. W. Ryoo, J. Park,M. Lee, K. Seo, S. Shin, Emergency Department, KyungpookNational University Hospital, Daegu, KOREA.

Objective: Immediate bystander cardiopulmonary resuscita-tion (CPR) is the most essential factor for lifesaving in out-of-hospital cardiac arrest patients. We investigated the factorsaffecting recognition and willingness to perform CPR amongthe general population of Deagu metropolitan city. Methods:We randomly selected 1000 persons from all over Deagu cityby using quota sampling and conducted a questionnaire surveyregarding their knowledge, experiences of, and attitudes towardCPR through face-to-face interviews. We performed descriptivestatistics followed by multivariable logistic regressionanalyses. Results: 89.5% of the subjects answered that theyknow CPR, and 65.0% answered that they know how to performCPR. But correct answers about position, depth, and rate ofchest compression were only 43.7%, 10.2%, and 15.8%, respec-tively. Among them, 55.5% of the subjects were willing to at-tempt CPR for their families and friends and 32.4% werewilling to attempt CPR for strangers. Willingness to attemptCPR was independently associated with men (odds ratio [OR]1.6, 95% confidence interval [CI] 1.2�2.1), awareness of ex-emption clause for the layperson CPR (OR 2.8, 95% CI1.5�5.1), and having trained in CPR (OR 2.1; 95% CI1.5�2.9). Conclusions: Awareness of exemption clause for thelayperson CPR and experience of CPR training closely associ-ated with willingness to attempt CPR. Legal information aboutthe fact that CPR performed by a layperson is excluded from le-gal liability should be emphasized during CPR training.

, CHARACTERISTICS OF SEVERE HEAT RELATEDILLNESS VICTIMS OF EMERGENCY DEPARTMENTVISITS FROM NATION-WIDE REGIONAL IN-DEPTHSURVEILLANCE SYSTEM. S. W. Song, K. J. Song,K. J. Hong, Department of Emergency Medicine, Seoul

National University Boramae Medical Center, Seoul,

KOREA; Sang Do Shin, Department of Emergency Medicine,Seoul National University Hospital, Seoul, KOREA.

Objective: With climate change/global warming, the signif-icant heat wave event has increased, and extreme heat waveevents have a negative impact on public health. The purposeof this study was to identify characteristics of severe heat-re-lated victims through the in-depth Surveillance system of Se-vere Heat-related Illness (SSHI) based on EmergencyDepartment (ED) visits. Methods: We developed a nation-wide regional in-depth surveillance system based on EDs andimplemented in 14 EDs chosen by regional cluster random sam-pling method in Korea. Suspected severe heat-related illnesscases, including heat stroke and heat exhaustion, were watchedand the information reported using a Web-based registry. Dailyheat-index was calculated using daily maximal temperature andrelative humidity at that time of national climatic database. Weused Poisson analysis in analyzing the association between se-vere heat-related illness and heat index, and chi-squared testfor identifying risk factors. Results: Between June 1 and August11 of 2012, 28 severe heat-related cases were reported by 13 ofthe 14 EDs participating in the SSHI; 22/28 (79%) were male,and mean age was 53.4 (range 14–82) years. Of 28 cases, 12were heat stroke (43%) and 16 were heat exhaustion (57%),with about 79% of all cases occurring between 9:00 a.m. and6:00 p.m. Seven of 28 (25%) were outdoor working status and5/28 (18%) were unemployed status. The ED outcomes werenormal discharge (54%), ward admission (18%), intensivecare unit (14%), transfer (11%), and death (4%). The Poisson re-gression for association between daily heat index and severeheat-related illness was statistically significant (incidence rateratio 1.52, 95% confidence interval 1.29–1.82). Conclusions:Outdoor working conditions and unemployed status may be as-sociated with severe heat-related disease, and there was signif-icant association with climate change. A surveillance systemthat monitors ED visits may be useful in assessing adversehealth effects of summer heat waves.

, DEVELOPMENT OF PUBLIC HEALTH ASSESS-MENT TOOLKIT FOR EMERGENCY RESPONSE TOREGIONS WHERE CLIMATE DISASTERS FRE-QUENTLY OCCUR. S. W. Song, K. J. Song, K. J. Hong,Department of Emergency Medicine, Seoul NationalUniversity Boramae Medical Center, Seoul, KOREA;Y. J. Lee, Department of Emergency Medicine, InjeUniversity College of Medicine, Gyungnam, KOREA;S. S. Hwang, Department of Social and Preventive Medicine,School of Medicine, Inha University, Incheon, KOREA.

Objective: Meteorological disasters can significantly affectpublic health, and we need a rapid, feasible, and reliable publichealth assessment toolkit to respond to and meet the needs ina timely manner. The purpose of this study was to create a PublicHealth Assessment toolkit for Emergency Response (PHASER)for regions where climate disasters frequently occur. Methods:From March through August 2012 we undertook four tasks. 1)Reviewing national climate disaster database, we selected thefour potential candidates where there was a high possibilitythat a climate disaster would occur. 2) We discussed the meth-odology of collecting Geographic Information Systems

926 Abstracts

(GIS)-based census data with a core member of the Korean cen-sus office. 3) Conducting a literature review, we created a fram-ing document of sample selection, training, and data collectionto survey public health after a climate disaster. 4) We introducedand educated the community partners on the PHASER toolkit infour candidates. Results: Geoje, Jeju, Ulsan, and Paju were se-lected for the potential candidates. We developed the PHASERtoolkit with seven process phases: 1) Decision to conductPHASER; 2) Collecting census data; 3) Two-stage cluster sam-plingmethod; 4)Selected clustersmapping andassessment appro-priateness of its locations; 5) Filed interview and reporting usingGIS-based mobile PHASER application; 6) Weighted analysis;7) Writing report and disseminating the results. We solved themethod of collecting census data with the cooperation of the Ko-rean statistical information service, and household census data ofcommunity levelwill be offered online.ThePHASER toolkit con-tains interview items for eight levels of engagement. Conclusions:We developed the PHASER toolkit to prepare for climate disasterand we planned to apply this toolkit soon after a climate disasterdoes happen. We expect that the PHASER toolkit can be usedby public health practitioners and emergency management offi-cials to determine the public health status and basic needs of theaffected community in a quick and low-cost manner.

, PRESENT SITUATION OF HELICOPTER EMER-GENCY MEDICAL SERVICES (HEMS) IN KOREA.C. Lee, J. Cho, H. Yang, J. Kim,W. Park, G. Lee, Department ofEmergency Medicine, Gil Hospital/Gachon University,Incheon, KOREA.

Objective: In Korea, resources of emergency medical ser-vices were concentrated in metropolises and metropolitan areas.So, establishment of an efficient medical transport system isneeded for emergency patients in a rural area. And HelicopterEmergency Medical Services (HEMS) is expected to shortentransportation time to advanced facilities and advanced treat-ment at the scene. The aim of our study was to investigate thepresent situation of the HEMS pilot project of inKorea. Methods: Between September 23, 2011 and March 22,2012, emergency patients in islands and vulnerable areas weretransported by helicopter to Incheon and Jeollanam-do. Themedical team, including an Emergency Physician, boarded a he-licopter with advanced medical equipment and rushed to thescene. The operation time of the helicopter was from sunrise tosunset. Target diseases were acute myocardial infarction, stroke,severe trauma, and post-resuscitation state. Results: During thisperiod, the number of total requests was 209, transport numberwas 138, cease number was 14, and reject number was 57. Theaverage daily transport number was 0.4 times/helicopter. In theEmergency Department, 50 patients (37%) were admitted tothe intensive care unit, 40 patients (30%) were admitted to thegeneral ward, 18 patients (14%) underwent an operation or inter-vention, 10 patients(8%) transferred to another hospital, and nopatients died. Mean call to take-off time was 8 min, and mean oftotal transport time was 44 min. Mean of back-and-forth trans-port distant was 90 km. Conclusions: For the past 6 months,transport number was relatively low, but that has gradually in-creased. Fortunately, there were no accidents. Research and de-velopment of a more efficient HEMS system is needed.

, POST-ANOXIC SEIZURE WAS NOT RELATED TOMORTALITYANDNEUROLOGICOUTCOME IN POST-CARDIAC ARREST SYNDROME: A RETROSPECTIVECOHORT STUDY. J. J. Kim, H. S. Lee, W. J. Kim, H. J. Yang,S. Y. Hyun, Emergency Department, Gachon University GilHospital, KOREA.

Purpose: The aim of this study is to evaluate relevance ofpost-anoxic seizurewith prognosis in case of out-of hospital car-diac arrest (OHCA) patients who were treated with therapeutichypothermia (TH) and research prognostic role of portable EEGin post-cardiac arrest syndrome (PCAS) patients withseizure. Methods: One hundred-eighty OHCA patients admittedto our emergency intensive care units during July of 2008 andJune of 2011, and 147 patients who had been treated with ther-apeutic hypothermia were included. Portable EEG had beentaken after 24 h after induction of TH and classified by attendingneurologist. As outcome variables, overall mortality and neuro-logical outcome at 6 months after hospital discharge were eval-uated. (Good neurological outcome; Cerebral performancecategory (CPC) 1, 2: Poor neurological outcome; CPC 3-5.) Results: Among 147 patients, 94 patients (63.9%) weremale, mean age was 51. Eighty-three patients (56.5%) survivedand almost 30% (43/147) of patients had a good neurologicaloutcome. Sixty-five patients (44.2%) had seizures and amongthis group, 19 patients (29.2%) were discharged with good neu-rological outcome. There was no statistical relevance betweenseizure group and non-seizure group. With multiple logistic re-gression analysis, initial rhythm, APACHI II score, time frombasic life support to return of spontaneous circulation (OR2.169; 95% CI 1.158 -4.063, OR 1.107; 95% CI 1.064 -1.152,OR 1.014; 95%CI 1.006 -1.022, respectively) had statistical im-portance, but seizure group (OR 0.67, 95% CI 0.356 -1.032, p =0.065) had no statistical relevance with mortality. Factors asso-ciated with good neurological outcome was VF/VT initialrhythm (p = 0.005), cardiac cause of arrest (p = 0.001), high ini-tial body temperature (p < 0.001), low APACHI II score (p =0.010), shorter time interval between arrest from basic life sup-port (p = 0.005). Conclusion: In our study, post-anoxic seizuregroup showed no statistical relevance with mortality and neuro-logic outcome. We should treat aggressively in PCAS with sei-zure. Larger, prospective studies are needed to evaluate post-anoxic seizure activity in PCAS.

, COMPLAINTS LODGED BY EMERGENCY DE-PARTMENT PATIENTS IN A TEACHING HOSPITAL.Abraham Wai, Accident & Emergency Medicine AcademicUnit, The Chinese University of Hong Kong, Hong Kong,CHINA.

Objective: Emergency Departments (EDs) are notorious forits high complaint rate by patients. This is because EDs are usu-ally congestedwith a large number of patients, thewaiting time islong, and consultation time for each patient would be very lim-ited. Short consultation and limited availability of diagnostic in-vestigations are two major contributing factors for diagnosticchallenges and errors. Complaints are defined as feedbackfrom Emergency patients or their representatives requiringreplies. Methods: Retrospective case review of complaints re-ceived by the ED in 2009–2010. Demographics of patients and