• 한국응급구조학회지
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• 제23권1호
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• pp.35-48
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• 2019

Purpose: This study aimed to explore the rationality for and countermeasures against the use of prehospital patient restraint (PPR) techniques in efforts to limit violent behavior toward 119 emergency medical technicians (EMTs). Methods: Previous countermeasures to limit violent behavior toward 119 EMTs and medical personnel were focused on strict reactive and passive proactive responses. However, those in support of the countermeasures do not believe that violent and criminal behavior can be limited or extinguished by strengthening the punishment unconditionally. Results: When it comes to the far-reaching effects of stigmatization on people who engage in violent and criminal behavior, it is possible that unconditional punishment leads to more crime, increases the costs of imprisonment, and consequently, adds to the financial burden of the government. Conclusion: Thus, we are faced with an urgent need to prepare legal grounds for the use of PPR techniques by 119 EMTs for agitated or combative patients only, with direct medical oversight. Moreover, the legal foundation for the use of PPR techniques also needs to be established for emergency medical personnel. The use of PPR techniques not only ensures the safety of emergency medical services personnel, but also protects patients from injuring themselves and others.

• 한국응급구조학회지
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• 제11권3호
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• pp.119-128
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• 2007

It is happening a lot that the pediatric patients who are offering help in emergency room with background 119 rescuer require emergency care compared to adults. Our study was conducted to have a clear grasp of the status quo of pediatric patients who are offering help in emergency room with 119 rescuer. METHOD & OBJECT pediatric patients under 8 age who were offering help was conducted as objects by 119 cases from January, 2006 to January 2007, with 119 rescuer at C university hospital in Gwangju metropolitan city, which were 87 cases for a boy(73.1%), 32 cases for a girl. Based on emergency diary of emergency members and the medical treatment record of emergency room in C university hospital, a disease and a type of an external wound were analyzed according to ages of these patients, a time zone and season. RESULT In terms of an age, 25 cases(21.0%) have less than 1 age extremelymuch, in case of emergency, 61 cases(51.3%), which were more than non-emergency, in terms of happened places of patients, there were households up to 78 cases(65.5%) extremely much. In terms of happened time, 13:00 to 18:00 have highest data up to 48 cases(40.3%). According to season, there were no big differences in 4 seasons(spring : 30.3%, summer : 24.4%, fall : 29.4%, winter : 16.0%). In case of being offered help at emergency room due to diseases, 1-2 ages have highest estimate with 55.7%, in terms of a time zone, 19:00-24:00 have highest with 33.7%, in terms of season, summer(6, 7, 8) have highest with 32.8%. in case of traffic accident, 7-8 age have highest with 47.1%, according to a time zone, 13:00 to 18:00 have highest with 88.2%, according to season, fall have highest with 64.7%. In case of an external wound, 3-4 age have highest with 38.2%, according to a time zone, 13:00-18:00 have highest with 41.2%, according to season, spring have highest with 38.2%. CONCLUSION It shows that in case of pediatric patients who were offering help at emergency room with 119 rescuer, a pediatric under 1 age was due to a disease, in case of an external wound, there were 3-4 age, in case of traffic accident, 7-8 age have highest, a case for emergency have highest.

• 한국응급구조학회지
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• 제13권1호
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• pp.19-33
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• 2009

Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

• 농촌의학ㆍ지역보건
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• 제34권3호
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• pp.346-358
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• 2009

우리나라 여러 기관에 근무하는 응급구조사들의 응급처치 시행내용과 관련요인을 파악코자 2008년 6월 대한응급구조사협회에서 주최하는 보수교육에 참여한 자중 80명과 특정지역 119구급대 소속 53명, 총 133명에게 설문조사를 시행하였다. 본 연구 결과 조사대상 응급구조사들의 응급처치 내용별 빈도를 보면 생체징후감시가 가장 많았고 그다음이 산소포화도 측정, 산소투여, 지혈 및 창상처치, 심전도 감시 순으로 많았다. 응급처치 23개 전체항목 시행횟수에 통계적으로 유의한 관련요인은 거주지 구분과 자격종류이었으며 단일 응급처치항목으로서 정맥로 연결 시행횟수의 유의한 관련요인은 대상자의 성별, 정맥로 연결에 대한 중요성 인식도이었고 근무기관의 종류도 경계역에서 유의한 관련요인으로 선정되었다. 심전도 감시 시행횟수의 유의한관련요인은 대상자의 성별로 남성보다 여성이 시행횟수가 많았다. 따라서 응급구조사들의 응급처치 시행횟수를 상황에 따라 적절하게 유지케 하기 위해서는 응급구조사들의 응급처치에 대한 중요성 인식도, 응급처치에 대한 자신감 등을 향상 시킬 수 있는 노력이 이루어져야 하며 특히 남성 응급구조사, 2급 응급구조사, 중소도시에 거주하는 응급구조사들에 대한 관리 노력이 이루어져야 할 것으로 사료된다. 또한 응급구조사들의 응급처치 시행에 대한 적절성 평가와 더불어 응급구조사 역할 발전에 대한 지속적인 연구가 이루어져야 한다고 사료된다.

• 한국응급구조학회지
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• 제6권1호
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• pp.153-168
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• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• 한국콘텐츠학회논문지
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• 제12권12호
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• pp.345-355
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• 2012

심뇌혈관 질환의 초기 처치가 지연되면 예후가 불량하고, 치료 후 심각한 후유증이 남으므로. 신속하고 적절한 처치를 위해 병원 전 단계 응급의료전화상담원에 의한 적절한 환자 분류와 병원 선정이 중요하다. 여러 선진국에서는 현장에 출동시킬 구급대 자원의 결정이나 각 병원에의 환자분산을 위해 응급의료전화상 담원이 표준화된 환자분류 지침을 사용하고 있다. 하지만, 우리나라의 경우 응급의료전화상담원의 심뇌혈관 환자 중증도 분류를 위한 표준화된 지침이 개발되어 있지 않다. 저자들은 영국의 NHS direct와 캐나다의 CTAS 체계에 기반하여, 뇌졸중 증상과 흉통 환자 분류를 위한 표준화 지침을 개발하였다. 환자가 내원한 응급실에서 시행된 중증도 분류를 기준으로 표준화된 지침을 사용한 군과 사용하지 않은 군을 비교하였다. 흉통환자에서 표준화된 지침을 사용한 군의 정확도가 높았다.(70.0% VS 94.0% p<0.01). 뇌졸중 환자에서도 같은 결과를 보였다. (64.2% VS 84.6% p<0.01). 결론적으로 응급의료정보센터의 응급의료전화상담원에 의한 뇌졸중 증상과 흉통 항목의 중증도 판단에 있어, 응급의료전화상담원의 주관적인 판단보다는 표준화된 지침을 이용한 판단이 병원에서 시행한 중증도 분류와 보다 일치하였다.

• 한국응급구조학회지
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• 제8권1호
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• 한국응급구조학회지
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• 제11권1호
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• pp.27-40
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• 2007

Even now, 119 rescue services have dissatisfactory aspects in operation, system and equipments as discussed above, It is the most urgent subject to systemize rescue services so that they can be suitable for our status, for we will make 21C welfare state come true before long. So, this author suggest that the followings have to be raised to activate 119 rescue service. 1) Bring up experts and offer high-quality rescue service 2) Prepare more up-to-date equipments 3) Operate transfer joint organizations 4) Promote the ability to meet with a press at the time of rescue service activities 5) Adjust regulations related to rescue services 6) Make up for a countermeasure to traffic accidents of ambulances 7) Adjust regulations making it mandatory to establish heliport at the target on hospitals more than a defined scale 8) Install more rescue service teams 9) Educate and train officials belonging to briefing rooms, where the officials with long experiences are arranged 10) Minimize the time for rescue team to reach fields 11) Establish legal protection system for rescue the team Nowadays, our country operates the department of fire fighting and rescue services without great difficulty, even though the circumstances are bad - insufficient members and the inferior circumstances. All of the fire fighting officials are given heavy duties in bad circumstances, and so are the team of rescue service. The rescue service team, taking charge of some emergency medical system, do a fire fighting inspection as a non-duty service, though they are scanty of sleep due to prevention and protection services of the fire fighting service team. But, they can not engage in rescue services completely and have to deal with miscellaneous duties. So they can not offer professional emergency medical services. But now, almost every fire fighting organization, belonging to National Emergency Management Agency, are separating rescue services, which shows a lot of good results. People recognize rescue services to get better and better gradually and the demands for this rescue services increase. So, this is the best time when rescue service teams should offer qualitative services rather than quantitative services. The people will recognize this rescue service team to be an organization sacrificing and serving for them. However well institutes and operation systems should be established, the rescue service team can not come true their aim without strong wills that they will serve and sacrifice themselves for people from their hearts. In addition, it is essential for the officials in charge of policies about emergency medical services to have a concernment on and practice the policy without failure.

• 한국화재소방학회논문지
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• 제31권3호
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• pp.106-118
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• 2017

본 연구의 목적은 의용소방대 태동기부터 2014년 의용소방대법 제정까지의 변천과정 고찰을 통해 의용소방대의 역사적 정체성을 구현하고 기본 이론적 개념을 변화된 관점으로 새로이 정립하며 발전방안을 모색하고자 하였다. 이를 위해 문헌조사 연구방법을 토대로 기술적 접근방법이 활용되었다. 연구결과, 정의는 "의용소방대는 화재진압, 구조 구급 등을 비롯한 각종 재난상황에 대비하고자, 자원한 지역주민들이 자주적이고 자발적인 의지로 의기투합하여 구성한 법률상의 보조 조직체", 설치이념은 '주민 참여의 한 형태로서 안전의 선도적 봉사조직체', '자율적 조직운영을 바탕으로 한 주민친화적 조직활동', '사회복지 실현과 각 지역별 여건에 따르는 요구를 보완해 주는 활동'으로 정립하였다. 그 특성에 관해서는 '자발적 참여성', '사회적 확장성', '사회복지 실현 및 보완성', '전문성 및 발전성'으로 기본 이론적 개념을 새로이 정립하였으며 향후, 의용소방대 연구에 기초자료로 활용될 수 있을 것으로 기대한다.

• 한국재난정보학회 논문집
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• 제17권4호
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• pp.667-673
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• 2021

연구목적: 본 연구는 2015년부터 5년 동안 부산광역시의 기온과 시기에 따른 119구조대의 벌집 제거 출동 경향을 분석하고자 하였다. 연구방법: 2015년 1월부터 2019년 12월까지 부산의 11개 소방서 출동 건수를 확인하고 구조 및 구급 활동의 원자료를 수집하였다. 5년간 부산광역시소방재난본부 산하 소방서의 벌집 제거 출동 건수를 파악하고, 그 결과를 바탕으로 온도와 월별, 행정구역별 벌집 제거 출동을 빈도와 백분율로 분석하였다. 연구결과: 월 평균기온이 20℃ 이상부터 출동 빈도가 증가하기 시작하여, 23℃ 이상 29℃ 미만에서 출동 빈도가 가장 높은 것으로 나타났고 월별 출동 건수 중 2017년 7,900건이 가장 높은 것으로 관찰되었다. 특히 벌집 제거 출동 시기가 해가 지날수록 빨라지는 것을 알 수 있었다. 부산광역시 행정구역별로 출동 건수를 비교한 결과, 기장군이 가장 많았으며, 해운대구, 금정구, 남구순으로 출동 빈도가 높은 것으로 나타났다. 결론: 기온 변화에 따른 벌집 제거 출동이 점차 빨라지고 있는 것을 확인할 수 있었고, 본 연구의 결과가 차후 도시 내 말벌 연구에 활용될 수 있을 것으로 여겨진다.