Objective
Emergency department (ED) physicians face substantial cognitive and physical demands, yet workload data applicable to real-world staffing and operational decisions remain limited. This study aimed to quantify perceived workload across diverse ED tasks using the NASA Task Load Index (NASA-TLX) and to determine how workload varies by physician experience, patient acuity, and clinical context. A secondary aim was to generate practical insights that may inform resource allocation and experience-based task distribution in the ED.
Methods
We conducted an observational survey of interns, residents, and specialists working in the ED of a tertiary hospital between June and July 2022. NASA-TLX questionnaires were administered to assess workload across common procedures and patient-care tasks. Analyses were stratified by physician experience, Korean Triage and Acuity Scale (KTAS) level, and chief complaint. Nonparametric methods were used to evaluate differences in workload patterns.
Results
Sixty physicians participated (30 interns, 30 residents/specialists). Procedures with high technical complexity, such as thoracentesis and lumbar puncture, showed the highest workload among interns. Among residents, workload decreased from postgraduate year 1 to 3 but rose again in year 4, reflecting increased supervisory responsibilities. Higher patient acuity (KTAS 1–2) and neurological chief complaints were consistently associated with elevated workload across all experience levels.
Conclusion
Perceived workload in the ED varies significantly by task type, experience level, and patient acuity. These findings provide actionable data that may support evidence-based staffing decisions, workload redistribution, and training strategies to optimize physician performance and mitigate cognitive overload in resource-limited emergency departments.

Objective
Trauma is one of the leading causes of obstetric morbidity and mortality, and incorrect seat belt use is a major determinant of adverse outcomes. This study evaluated the impact of structured education on proper seat belt use during pregnancy and examined preferences for future interventions.
Methods
This prospective pilot study was conducted at a single center in Korea, over an 8-week period. Pregnant women between 20 and 37 weeks of gestation who visited the outpatient obstetrics and gynecology department were enrolled. A pre-education survey assessed baseline seat belt practices. Participants then received structured education, and a post-education survey 1 month later evaluated changes in awareness and behavior.
Results
Sixty participants were included in the final analysis. Most reported obtaining seat belt information from unverified sources, particularly online communities. Many indicated a preference for structured education delivered by obstetricians, especially early in pregnancy. After the intervention, knowledge of proper seat belt use increased from 21.7% to 85.0% (P<0.001), and correct seat belt usage rose from 16.7% to 88.3% (P<0.001). Seat belt use while driving also improved markedly, increasing from 19.5% to 78.0% (P<0.001), demonstrating the program’s effectiveness in enhancing awareness and behavior.
Conclusion
Education on seat belt use during pregnancy significantly improved both knowledge and correct usage among pregnant women. Routine, formal educational programs are recommended to promote maternal and fetal safety.

Objective
Sepsis remains a major clinical challenge because of its complex, heterogeneous, and multidimensional clustering patterns. This study aimed to investigate the association between vasopressor administration and machine learning–derived clusters based on initial vital signs and lactate measurements obtained in emergency department (ED) and intensive care unit (ICU) settings.
Methods
A retrospective cohort analysis was performed using data from the Korean Shock Society Septic Shock (KOSS) Registry (septic shock in the ED) and the Marketplace for Medical Information in Intensive Care (MIMIC)-IV database (ICU patients with suspected infection). To derive clusters, k-means clustering was applied to six initial vital signs and serum lactate measurements. The primary outcome was vasopressor administration. Secondary outcomes included second vasopressor administration and 28-day mortality.
Results
A total of 17,500 patients were included in the analysis (KOSS cohort, n=7,130; MIMIC-IV cohort, n=10,370). K-means clustering identified three distinct clusters in each cohort. In the KOSS cohort, Cluster 3 was characterized by the lowest mean arterial pressure (MAP) (62 mmHg [IQR, 53–71]) and the highest diastolic shock index (DSI) (2.6 [2.3–3.0]). This cluster was associated with the highest rates of vasopressor administration (93.9%), second vasopressor administration (33.5%), and 28-day mortality (25.3%) (all p<0.001). Comparable physiological and clinical patterns were observed in the MIMIC-IV cohort, in which Cluster 3 likewise demonstrated the lowest MAP (68 mmHg [60–76]) and highest DSI (2.0 [1.8–2.3]). This group similarly exhibited the poorest outcomes, including vasopressor administration (41.0%), second vasopressor administration (16.7%), and 28-day mortality (29.0%).
Conclusion
Machine learning–derived clusters based on initial vital signs and serum lactate levels demonstrated different patterns of vasopressor use and mortality. The clinical utility of this approach for guiding timely or targeted vasopressor therapy requires prospective validation.

Objective
This study aimed to describe the relationship between sex and survival in patients experiencing unintentional trauma.
Methods
This retrospective, national population–based observational, case-control study involved a cohort of Korean trauma patients who were transferred to an emergency department by a Korean emergency medical service from January 1 to December 31, 2018. Propensity score matching was used. The primary outcome was survival until hospital discharge.
Results
Of 25,743 patients with severe unintentional trauma, 17,771 were male and 7,972 were female. Prior to propensity score matching, there was no significant difference in survival among male and female patients (92.6% vs. 93.1%, P=0.105). After using propensity score matching to adjust for confounders, there was still no sex difference in survival (male, 93.6% vs. female, 93.1%; P=0.270).
Conclusion
Survival after severe trauma was not influenced by the sex of the patient. Further studies with patients of reproductive age and a larger study population are needed to analyze the effects of sex on survival in patients with trauma.