• Journal of Chest Surgery
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• v.37 no.4
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• pp.335-341
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• 2004

Traumatic cardiac injury is very rare but mortality is very high when the diagnosis and management are delayed. We reviewed our case retrospectively. Material and Method: From March 1995 to July 2003, 17 patients were diagnosed as having traumatic cardiac rupture. Five patients were stabbed, seven patients were motor vehicle accidents, four patients had fallen down, and the cause was unknown in one patient. Emergency operations were done and six patients were operated under CPB. Result: Four patients died during or after operation. The mean ICU stay period was 3.86$\pm$3.35 days and the mean hospital stay was 18.27$\pm$14.99 days. No mortality was observed in those whose vital signs were stable in the operating room. Conclusion: Preoperative vital status was very important and thoracic traumatic patient should be suspected as having cardiac injury.

• Fire Science and Engineering
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• v.31 no.2
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• pp.119-126
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• 2017

This study examined the soundness, vibration, and size of ambulances currently used in Korea as well as the comfort and convenience of ambulancesin Korea. The target vehicles were measured and investigated using the currently used freight type, van type, and Benz ambulance. Currently, the ambulance standards in Korea have only formal production standards, and there is no regulation on safety for ambulances, space regulation for first aid, comfort, and convenience. Therefore, comparative experiments on the comfort and convenience were measured using noise and vibration measurement experiments, and research was conducted on the size and interior rearrangement of ambulances to investigate the areas that can improve the comfort and convenience. The noise measurementsshowed that the noise was large in the order of the van type, Benz type, and freight type. In the case of a speed of 40 km/h or more, the noise measurement result was 60 to 70 dB or more. In the case of vibration, the Benz type and van type ambulance were good, and the vibration of the freight type showed the worst result, highlighting the need for improvement. Lastly, it is not possible to increase the internal size of the structure of domestic ambulance. On the other hand, it is important that through ambulance relocation and the position of first aid personnel, it will be possible to use it more comfortably and conveniently.

• The Korean Journal of Emergency Medical Services
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• v.10 no.2
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• pp.53-62
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• 2006

Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.560-569
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• 2016

Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.65-80
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• 2012

Purpose: The objective of this study was to assess the job satisfaction and turnover intention of the emergency medical technicians (EMT) in the private ambulance service, to examine their job satisfaction and turnover intention, and to provide the solution for the management of the private ambulance service. Methods: The survey was conducted with 121 EMTs (73 paramedics, 36 basic EMTs and 12 nurses) in the private ambulance service in Korea from September 15 to October 14, 2011. In the reliability of the questionnaire, Cronbach's ${\alpha}$ was 0.790 for job satisfaction and 0.796 for turnover intention. Using SPSS 18.0, we obtained Cronbach's ${\alpha}$, frequencies, percentages, means, and standard deviations, and performed independent t-tests, ANOVA, and Pearson's correlation analysis. Results: 1) The mean score with regard to job satisfaction was 2.94 and that of their turnover intention was 4.23. In the area of job satisfaction, the mean score of the job demand area was 4.23; 3.97 for the job itself; 3.07 for the area of interaction; 2.98 for the area of autonomy: 2.67 for the organizational demand area; 2.67 for working conditions area; and 1.73 for the wage area. 2) Statistically significant difference was observed in job satisfaction according to age (F=3.819, p=.006), wages (t=-4.640, p=.000), terms of incumbency (F=3.868, p=.011), and in turnover intention it was according to sex (t=-1.995 p=.048), age (F=9.611, p=.000), education levels (F=6.974, p=.002), marital status (t=4.393, p=.000), wages (t=5.515, p=.000), license types (F=8.481, p=.001), and terms of incumbency ( F=14.115, p=.000). 3) The job satisfaction and the turnover intention had a negative correlation to each other (r=-.56, p<.000) in general, and in the sub-7 areas of job satisfaction, the correlation with turnover intention was high in order of the wage area (r=-.61, p=.000), working conditions area (r=-.52, p=.000), the area of autonomy (r=-.49, p=.000), the area of interaction (r=-.45, p=.000), the organizational demand area (r=-.40, p=.000), the job itself (r=-.24, p=.007) and the job demand area (r=-.24, p=.009). Conclusion: The government must take the charge of lowering the turnover intention among paramedics in the private ambulance service by providing the advantage in wages and fringe benefits. Ultimately, this would bring an improvement in the quality of medical emergency services to hospitals especially in the area of patient transfer and transportation.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.999-1002
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• 2004

Thirteen year old boy who had been stabbed in his left chest by the knife was transferred to our department from a general hospital, because of the massive bleeding from the intercostal tube drainage. Chest X-ray showed homogeneous density in the left lung field. He was confused and his vital signs were unstable. He was moved into a operating room as soon as possible. After resuscitation, his lacerated left ventricle wound was sutured through median sternotomy. The interventricular shunt was detected with intraoperative transesophageal echocardiography. The traumatic ventricular septal defect was closed via left ventricle using Dacron patch. His postoperative course was uneventful, and he was discharged with small residual shunt.

• Proceedings of the KIEE Conference
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• 2006.07d
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• pp.2163-2164
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• 2006

It is desirable to monitor the vital signals, such as ECG, of a emergency patient during transfer in the hospital as well as in the ambulance. The purpose of this study is to develop a system which provides a real-time and wireless ECG to the medical staff nearby patient during transfer in hospital. In this context, we developed a low-power, low-cost and portable ECG system consisting of 1) ECG measurement and RF transmission module and 2) RF receiving and LCD display module. The developed system is expected to be useful in monitoring ECG of a patient during transfer in the hospital.

• Health Policy and Management
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• v.24 no.4
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• pp.357-366
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• 2014

Background: The objective of this study was to evaluate the efficiency of an emergency ambulance system and to investigate socio-economic and clinical characteristics associated with emergency ambulance service. Methods: Based on 2011 Korea health panel, unmet need and inappropriate use of emergency ambulance service were measured by Gibson in 1977. Furthermore, the factors associated with unmet need and inappropriate use of emergency ambulance service were identified by Fisher's exact tests and multiple logistic regression models. Results: Unmet need, defined as the proportion of emergency patients who clinically need ambulance transportation but do not receive it, was found to be 59.8%. Inappropriate use, defined as the proportion of emergency patient receiving ambulance care who did not clinically need it, was found to be 37.2%. There were statistically significant differences between appropriate and inappropriate groups in overall variables of socio-economic and clinical characteristics. Specifically, gender, age, relationship to household, and reasons of visiting emergency department (accident/disease) were statistically significant factors associated with appropriate use of emergency ambulance service. Conclusion: Unmet ambulance need is a useful measure for patients needs assessment, and inappropriate ambulance use is a valid criteria in judging the efficiency of emergency ambulance system. To improve and understand emergency ambulance system, unmet need and inappropriate use of emergency ambulance service should be more concerned.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.2
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• pp.744-750
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• 2013

This study is to collect a basic data of how Cardiopulmonary Resuscitation (CPR) procedure can influence to cardiac arrest patient with and without the Depth Device during the average transport time period. The data has achieved by comparing result sheet of CPR procedure by hands only versus with Depth Device by twenty 1st and 2nd class Emergency Medical Technician (EMT) from five different fire stations in city of Chong-Ju, and twenty Emergency Rescue major students who completed the BLS provide course. The experiment participators experienced loss of compression depth and rate increase over time. However, the CPR procedure with Depth Device shows that both EMT and students to allow maintaining both the compression depth and rate. The experiment leaves a positive result for CPR operators and considers being valuable domain for cardiac arrest patient.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.05a
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• pp.381-383
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• 2022

This study evaluated the completeness of emergency medical service (EMS) activity reports. In all, 67,830 cases of normal transfers were statistically analyzed using IBM SPSS Statistics version 22, and statistical significance was set at p <0.5. The 119EMT_2 certificate was omitted in 50,037 (73.8%) cases, followed by time-related items in 1,227 (1.8%) cases. In the primary assessment of vital signs, systolic blood pressure was omitted and erroneous in 1,218 (1.9%) and 1,129 (1.8%) cases, respectively. In the secondary assessment, the completeness of all vital sign items was approximately 70%. As the severity of the patient's condition increased, the errors in the EMS activity report also increased, at a significant level (p=.00). Paramedics must be aware of the importance of completing the activity report.