Korea Institute Radiological Medical Sciences operates an emergency medical response system in case of a radiological accident or disaster. A radiation accident or disaster can affect large-scale patients and destroy medical infrastructure. However, there is currently a lack of specialized education for treating large-scale patients or high-dose exposure patients. This study aimed to evaluate the efficiency of radiological mass casualty triage education programs and present a new training method to improve the ability of 119 emergency medical teams in the event of a radiological accident or disaster.

The results of mass casualty triage for radiological events were analyzed using the audience response system and questionnaire for paramedics who participated in the radiation accident response training program. For 25 paramedics, a pre-post evaluation was conducted on two items: understanding the mass triage and understanding the radiological mass triage. The data were analyzed using the SPSS WIN 23.0 program.

Thirty simulated patient scenarios were developed with the addition of clinical symptoms of radiation exposure based on the four trauma classifications: immediate, urgent, delayed, and death. The triage results of 30 cases conducted by 119 emergency medical teams were evaluated, and the trainees were asked to respond to the level of improvement in their knowledge of triage through pre- and post-training questionnaires. As a result of the pre- and post-education questionnaire, the degree of understanding of the mass triage was 3.8 before education and 4.4 after education, showing a significant difference (p=.003/MAX=5). The pre- and post-education questionnaire results of radiological mass triage showed a difference between 2.3 before education and 4.1 after education (p=.000/MAX=5).

For effective radiation medical response, 119 emergency medical teams are required to have a repetitive mass triage education program for radiological events. It is especially important to provide a radiological triage system for field application.

In Korea, there are various medical and industrial researchers who use radiation as part of their research. But radiation can cause extensive long-term damage in case of an accident. Therefore, national-level policy and training for the response workforce have been established for a professional response. Since 2002, the KIRAMS has been providing emergency medical response education based on the five mandatory contents (including legislation, protection measures, and emergency medicine).

The training content can be divided into theoretical and practical courses. Early education included theoretical courses on cases of accidents and their effects on the human body, as well as practical courses on treatment for contaminated patients. The current education program offers group practice using a HPS and mobile learning. As for the future of national radiation emergency education, the paradigm of education will change with the fourth industrial revolution, the advancement of the IT industry, and the advent of the ‘untact’ era. Therefore, research and development on XR technology–based educational content that can overcome reality’s constraints, is being conducted. Simulation-based education courses to increase effectiveness and immersion will be implemented.

Currently, there are approximately 900 radiation emergency medical personnel, and more than 30 new and supplementary education contents are provided each year to improve their proficiency and response abilities. Approximately eight types of content using XR technology will be developed and tested (2021-2023) before being implemented in actual education programs (2024). Advancements in education reflecting special conditions, such as COVID-19, and technological advancements will continue indefinitely.

Efforts are ongoing to improve the educational content and to train excellent radiation emergency medical personnel. With the implementation of XR technologies and new education trends, the future of national Korean radiation emergency medical education is expected to advance and diversify, and further improvements in the educational content can be expected.

The KIRAMS establishes radiological emergency institutions and provides training for emergency medical agents. However, because of the uniqueness of radioactive accidents, the current training program has a limitation in the realistic description. Therefore, training programs based on virtual augmented reality technology that can describe radiological emergencies are required. In this study, the contents of practical training for decontamination of radiation-contaminated patients as a part of radiation disaster prevention personnel training using VR simulator are developed.

Environments and devices required for treating patients with complex radiation damage are made visible using VR simulator to enable practical training of techniques and practices that will be required in actual radiation emergencies or training. The VR decontamination training content uses three Point tracking techniques to calculate the location of the head-mounted display device and the hand to visualize the movements. Additionally, Universal Render Pipeline technology was used to develop realistic visualizations of situations.

In this study, VR decontamination treatment practice content was developed, which allows a single trainee to go through the entire treatment process of treating radiation-contaminated patients. The radiation-exposed patient’s treatment process is composed of nine subprocesses, including wearing personal protective equipment, obtaining samples from openings, taking measurements, cleaning contaminated injuries, and so on. A checklist user interface was used to enable trainees to check their progress. The trainee can practice patient treatment with a controller while using VR decontamination treatment content. Additional functions such as narration, sound effects, animation, and so on were added to high educational effects.

In this study, VR decontamination treatment content was developed using VR training simulator to practice the treatment of radiation-contaminated patients. The results of this study will contribute to fostering the workforce response to radiation through efficient education using a VR training simulator, as well as promoting the use of radiation safety regulations.

Opioid use disorder (OUD) is a serious public health threat. Pharmacotherapy, commonly known as medications for opioid use disorder (MOUD), is established as the cornerstone of OUD treatment. MOUDs reduce likelihood of relapse, promote recovery, and save lives. However, many clinicians are still reluctant to use these medications, in part due to inadequate training and experience. In light of the ongoing opioid overdose epidemic, it has become ever more important for clinicians to confidently and thoughtfully deploy these medications to help patients struggling with OUD. To aid busy clinicians, we have put together a review of the extant literature on three FDA-approved pharmacotherapy options—methadone, buprenorphine, and extended-release naltrexone—with a heavy focus on practical clinical application. We discuss how to effectively engage patients with OUD and initiate them on MOUDs—especially when their primary misused drug is fentanyl. We also review novel strategies, such as buprenorphine microinduction, as well as suggested best practice to effectively transition between MOUDs. Finally, we synthesize our review and recommendations in an algorithmic flowchart to provide visually compelling information.

No Funding

In this study the authors focus on reviewing imaging studies that used resting state functional magnetic resonance imaging for individuals with a history of heroin use. This review study compiled existing research addressing the effect of heroin use on decision making by reviewing available functional neuroimaging data. Systematic review ofthe literatures using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Eligible articles were retrieved through a computer-based MEDLINE and PsycINFO search from 1960 to December 2015 using the major medical subject headings “heroin, fMRI” (all fields). Only English language was included. Thirty-seven articles were initially included in the review. Sixteen were excluded because they did not meet the inclusion criteria. The results of 21 articles that met all the inclusion criteria were presented. Based on the 21 studies included in the current review, there is evidence that heroin use may have a direct and damaging effect on certain brain functions and that these changes may be associated with impulsive and unhealthy decision making. From the review of these studies, the authors understand that a longer duration of heroinuse may be associated with more damaging effects on brain functions. The authors also understand that these brain changes could last long after abstinence, which may increase the risk of relapse to heroin use. More research is needed to create a biomarker map for patients with heroin use disorder that can be used to guide and assess response to treatment.

No funding.