• The Korean Journal of Emergency Medical Services
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• v.15 no.1
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• pp.5-23
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• 2011

Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.

• The Korean Journal of Emergency Medical Services
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• v.5 no.1
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• pp.199-212
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• 2001

This research, aiming at analyzing the Emergency Medical Technicians' duties prior to establishing a baseline for question development in the national exams to qualify for the EMTs, investigated the importance and frequency per unit specified in the description with the EMTs to be subjects working on the task spot by means of questionnaires. The EMT duties were classified into 9 items like 1) the notification and response, 2) the scene size-up, 3) the patient assessment, 4) the emergency care, 5) the patient transport, 6) the duties at hospital clinics, 7) the operational management, 8) the receiving and responding to a call, 9) the self-development, and put the functional tasks into 52 items, describing the task elements into 177 items, and then questioned 112 EMTs working on the spot from July 21 through August 30, 2000, which showed the following results. 1) The distribution of subjects' career showed the highest rate with 33.9% for those who careered "less than a year", only 13.4% for those with more than 4 years and the highest rate with 43.8% for those who aged at 20-25. And 70.5% of all those who were questioned was the junior college graduates, 58.9% for those working at fire station and 29.5% working at hospital clinics. 2) Looking at the distribution of frequency and importance for each task element, questioning 'the patients main symptoms', 'accidental type', 'place of the patients identification' showed the highest rate in both frequency and importance in the field of "notification and response". 3) In the "scene size-up", identifying the patients showed the highest rate of frequency and importance, compared to other field of tasks, among which "identifying the patients' state" showed the highest rate of frequency (2.66) and importance (2.81). 4) In the "patient assessment", "identifying the patients" showed the high rate of frequency and importance in most elements of task, especially the importance showed the highest rate with 2.83 for the task of airway management and the cervical immobilization during "the primary assessment", and the frequency showed the highest rate for questioning the past case of the task of grasping the patients' history. 5) In the "emergency care", "the management of the heart attacked patients" and "the advanced cardiac life support" showed a high rate in the importance, whereas the frequency showed a very low rate. The high rate of frequency during the emergent task was the management of "musculoskeletal system injury patients" and of "the gastro-intestinal and urinary genital system injury patient support." In care of the patients with heart attack, the management of the airway showed the highest rate with 2.95, whereas the management of alcoholic abused patients and of dying patients, showed comparatively lower rate of assessment in the importance. The frequency of tasks showed the highest rate with 2.69 in the control of bleeding and the lowest with 0.47 in the management of abnormal delivery of child. 6) As to the patient transport, "the emergency transport" showed the highest rate with 2.74 and the unemergent transport with 2.55 in the importance, and the task importance at hospital showed the highest rate with 2.89 in managing the cardio-pulmonary resuscitation and with 2.60 in identifying the patient state. 7) Of all the tasks related with "operational task", the high importance was to "educate for the management of the first responder", but the frequency of tasks mostly showed a low rate and "receiving and responding to a call" showed relatively a high rate of importance and frequency. And related with "the self-development", "the health care management" and "the stress control" on working spot showed a high rate, but the frequency mostly showed a low rate.

• The Korean Journal of Emergency Medical Services
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• v.13 no.2
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• pp.17-59
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• 2009

Purpose : This study is to provide the basic data for developing the curriculum standardization of emergency medical technology by analyzing the three-year and four-year period curriculum and high-advanced major course to bring up highly qualified paramedics. Method : This study was analyzed, divided in 3 sections, majors, teaching profession subjects and liberal arts of 18 three-year curriculum universities and 7 four-year curriculum universities. Majors were analyzed, departmentalized in the national examination for license, the clinical and on-the-job training(OJT) and other major-related subjects. It is descriptive study, analyzed by dividing high-advanced major course into majors and liberal arts. Result : 1) The average number of subjects established in three-year-course college were 58.1. The completion credit was 130.1 in average. Also, the average number of established subjects at four-year-course were 61.1. The average completion credit was 141. 2) Three-year-course college professors give lecture in theory for 95.4 hours on average, which account for 59.9% of overall lecture, and 63.8 hours for practical training that takes 40.1% of the hours lectures are given. Meanwhile, four-year-course give lecture in theory for 111 hours on average, taking a part of 59.5%, and 76.5 hours for practical training, 40.5%. 3) In regard to liberal arts, at three-year-course college, the average credit was 16 but the proportion that liberal arts charge among the completion credit was 11.6. Meanwhile, at four-year-course universities, the average credit was 28.4 and the percentage that the liberal arts took part in the completion credit was 20.1. 4) Looking over national examination subjects among majors at three-year-course college, basic medicine's average credit was 17.2, introduction to advanced emergency care's average credit was 15.5, Special advanced emergency care's average credit was 28, emergency patient management's average credit was 9.2 and emergency medicine statute's average credit was 3.6. Meanwhile, in case of four-year-course universities, basic medicine's average credit was 14.3, introduction to advanced emergency care's average credit was 12.7, special advanced emergency care's average credit was 31, emergency patient management's average credit was 8.3 and emergency medicine statute's average credit was 2.9. 5) Among national examination subjects, in case of three-year-course, the range of basic medicine credits was 6 to 23, the average credit showed 17.2. The range of introduction to advanced emergency care credits was 9 to 21, the average credit showed 15.5. The range of special advanced emergency care credits was 19 to 36, the average credit showed 28. The range of emergency patient management credits was 5 to 12, the average credit was 9.2. The range of legal medicine credits was 3 to 6, the average was 3.6 credit. In case of four-year-course the range of basic medicine was 12 to 17, the average of the credit was 14.3. The range of introduction to advanced emergency care was 9 to 19, and the average of the credit was 12.7. The range of special advanced emergency care was 18 to 41, and the average of the credit was 31. The range of emergency patient management was 7 to 12, and the average of the credit was 8.3. The range of legal medicine was 3 to 4, and the average of the credit was 2.9. So except special advanced emergency care, all the other subjects had higher score in three-year-course than four-year-course. 6) About the other major-related subjects, the completion credit was 23 on average at three-year-course and 13.5 at four-year-course. 7) The clinical and on-the-job training(OJT), In the case of three-year-course, the average completion credit was 13.5 and 13.5 at four-year-course. 8) The teaching profession subject, In the case of three-year-course, the average credit was 3 and the percentage that the teaching profession subject took part in the completion credit was 2.3% on average. Four-year-course established the subject only at one university. 9) In high-advanced major process, the entire established subjects on average were 12.8 and the average completion credit was 36.3. In liberal arts, the average established subjects were 6.5 and the completion credit was 19.5. The number of majors were 9.5 on average and the credit was 26.5 Conclusion : According to the aforemention results, the curriculum for emergency medical technology needs to be developed and standardized.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.7-19
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• 1999

Background : We are in the edge of some human made disasters such as hazardous materials and air pollution, for example, the world news reported that the city of Bhopal, India had serious victims related with a leaking out of the chemical materials, Methyl Isocyanate and many people in India were killed by. These situations many people who live in this world are world are worrying about are not others, but just ours and people consider about that kind of the disasters are the possible situation to happen to all the people. Therefore, we performed this basic study to recognize the risk of Methyl Isocyanate leak accident and to prepare local disaster plan with EMS system. Method : Trace 8.0, a simulation software made by the U.S. company Safer System was used as a tool to estimate the diffusion distance, area and its victims at the concentrations of 0.02ppm, 0.2ppm 5ppm respectively for an assumed B-city of 2 hundred thousands population count in which was presumed 500kg Methyl Isocyanate gas to leak out. Results : 1. During 1 hour, maximum diffusion distances of 0.02ppm 0.2ppm and 5ppm were 5.41km, 1.61km and 0.29km respectively on the plume impact. 2. Maximum population counts influenced by Methyl Isocyanate gas at the concentrations of 0.02ppm 0.2ppm and 5ppm were 40838, 4346 and 222 on the plume impact, while those were 138238, 17261 and 1588 on the vulnerability impact, respectively. 3. Therefore, 17261 persons must put on respiratory device and 138283 persons must be evacuated to safety place within 1 hour. Conclusions : Only small amount leak of Methyl Isocyanate may cause tremendous chemical disaster in urban area, so its disaster plan must be prepared with an accident simulation program and Material Safety Data Sheets(MSDS). Especially, nearby emergency center of an industrial complex must have a strong position about preparation of chemical disaster plan and perform a disaster dill of hazardous material accident annually.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.65-76
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• 1999

Objectives: This study sought to examine the impact of alcohol use and misuse on mortality in korea during the 1991-l997. Methods: Alcohol-Related Disease Impact estimation software and Korea vital statistics data were used to calculate alcohol related-mortality, mortality rates, and YPLL(years of potential life lost). The major findings are as follows : An estimated 23,528 Korean died during 1997 from causes related to alcohol. Such deaths accounted for 17,052(12.60%) of all deaths for men and 6,206(5.88%) for women. Motor vehicle accidents were major contributors to the total estimated number of alcohol related deaths and years of potential life lost before age 65. Alcohol related mortality rates were significantly higher for men. For men, major causes of the deaths were motor vehicle accidents(4,147 deaths, 17.90 per 100,000 population), cancer of the stomach(1,467 deaths, 16.60 per 100,000 population) and chronic liver diseases and cirrhosis(1,233 deaths, 13.10). For women, the largest contributors to alcohol related mortality were motor vehicle accidents(1,509 deaths, 6.61), cerebrovascular diseases(1,114 deaths, 11.3) and cancer of the stomach(810 deaths, 8.24). Kleinman's method was used for obtaining on regional(Dongs, ups and Myons) differential of the alcohol related mortality in 1995. In general, The alcohol-related death rate for men was significantly higher than that for women, and the rate for ups and myons was significantly higher than that for dongs During 1997, approximately 356,667(male: 282, 510, female: 74, 157)YPLL to age 65 and 572,708(male:424,338, female:148,370)YPLL to life expectancy were attributable to alcohol related causes. Men accounted for 79% of the total YPLL to age 65 and 74% of the total YPLL to life expectancy The major contributors to these alcohol related years lost were the diagnostic categories of unintentional injuries. Particullary, In male, Motor vehicle accidents and accidental drowning-YPLL are considerably higher for other causes. Male-female YPLL differentials were greatest for mental disorder. Male-female mean-YPLL to age 65, accidental drowning(male;36.47, female;37.67) is higher for other causes. In both sexes, The YPLL and M-YPLL to life expectancy was significantly higher than the YPLL and M-YPLL to life expectancy.

• The Korean Journal of Emergency Medical Services
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• v.11 no.3
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• pp.93-109
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• 2007

The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.87-96
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• 2009

Purpose : To grasp the mental burden for legal responsibility that rescue members have in the performance of job. Method : Questionnaire was presented to rescue members serving in 2 direct control safety centers of fire station located in Seoul, Daejon, Incheon, Kwangju, Busan, Daegu and Ulsan. Results : 1. Questioned whether they have mental burden for legal responsibility while performing job on the site, the rescue members responded : very burdensome in 38.0%, burdensome in 56.0%, moderate in 4.5%, not burdensome in 1.0%, no burden at all in 0.5%. 2. Questioned on the first aid treat for which they have the most mental burden, the rescue members responded : intubation into trachea laryngeal mask airway(LMA) in 40.4%, automatic external defibrillator in 16.3%, securing vein providing sap(medicine) in 10.8%, basic cardiopulmonary resuscitation in 7.2%, eliminating foreign matters inserted into body in 5.4%, stanching external bleeding and treating injury in 5.4%, fixing extremities and spine by using splint in 1.8%, measuring the symptom of vitality in 1.2%, providing oxygen in 0.0%. 3. Questioned whether experiencing legal problem or firm petition(complaint) raised by patient while serving as rescue members, they responded : experiencing a complaint in 41.6%, experiencing no complaint in 58.4%. Asked to indicate the stress level in the scale of which they suffered when lawsuit or firm petition was raised, 0(weak)-10(strong), they answered 8.8 in average. 4. Questioned whether 119 rescue members put the legal responsibility in case that they cause damage to patients intentionally in performing, they responded to the inquiry 3.66 in average(of 5.00). It represented meaningful differences (F=2.874, p=.024) whether they had license or not. 5. In future, legal action will raise against the rescue member by 99% because of people's rights improvement(63.1%), high expectations for the rescue system(29.5%), non-licensed rescue members(5.1%). Conclusion : It was found that the rescue members had severe mental burden for advanced life support which was investigated to have low enforcement rate in the preceding research, for instance, intubation into trachea securing vein management by using automatic external defibrillator. To improve the qualitative level of rescue service in the fire fighting, it may be required to construct the environment that eliminates the mental burden of rescue members for legal responsibility.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.115-127
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• 2009

Purpose : This study is descriptive correlation research aimed to examine knowledge and performance ability of cardiopulmonary resuscitation of student attending the college and provide basic materials in developing cardiopulmonary resuscitation program. Methods : Data collection was conducted with the 1st, 2nd and 3rd grade college students sampled randomly by giving them questionnaire from Sep. 1 to 4, 2008. It used the research instrument used by Choi Hyang Ok(2006) and revised and complemented by the researcher and 200 data excluding questionnaire showing unfaithful responses were used for analysis. Data collected were verified with technical statistics using SPSS/PC(version 12.0), t-test, ANOVA, and Pearson's correlation coefficient. Results : The results of this study are as follows. 1. Subjects' knowledge score of cardiopulmonary resuscitation was average .40(out of 1) and their performance ability score was average 2.39. 2. In the knowledge of cardiopulmonary resuscitation according to subjects' general characteristics, score was higher between over thirty and below twenty in age and in male subjects by sex and there were statistically significant differences(t=3.069, p=.029). 3. In the knowledge of cardiopulmonary resuscitation related to subjects' cardiopulmonary resuscitation, there were statistically significant differences in such variables as 'have you ever heard about cardiopulmonary resuscitation' (t=3.685, p=.000), 'presence or absence of education of cardiopulmonary resuscitation'(t=3.764, p=.000) and 'experience of observing cardiopulmonary resuscitation'(t=4.747, p=.000). In the performance ability of cardiopulmonary resuscitation by subjects, there were also statistically significant differences in such variables as 'have you ever heard about cardiopulmonary resuscitation' (t=2.269, p=.024), 'presence or absence of education of cardiopulmonary resuscitation' (t=3.541, p=.000) and 'experience of observing cardiopulmonary resuscitation' (t=8.118, p=,000). 4. Relation between the knowledge and the performance ability of cardiopulmonary resuscitation showed positive correlations as the more knowledge, the higher performance ability(r=.570, p=.000). Conclusion : Consequently, it was found that the knowledge and the performance ability of cardiopulmonary resuscitation by subjects were below the average and their levels of knowledge and performance ability were varied. Therefore, if 1 : 1 education with theory and practice considering knowledge and performance ability of each student in performing cardiopulmonary resuscitation education with college students is conducted, more lives can be saved by applying cardiopulmonary resuscitation not to be embarrassed when they encounter cardiac arrest case and contribute to the increase of survival of cardiac arrest patients.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.35-48
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• 2009

Purpose: Firefighters were subjected to be exposed to 24-hour shiftwork and high level of job stress, but there is little study of fire fighters about between Job Stress and Psychological stress in Korea. This study was performed to evaluate job stress of fire fighters grouped by different job types and analyze the health effect of job stress by using a PWI-SF(Psycho-social Well-being Index, Short Form). Methods : This study was to measure the degree of job stress and socio-psychological stress of firefighters working at 119 safety center and analyze the relationship between job stress and mental health, through self-administered questionnaire survey on 918 fire fighters working at fire department located in Korea, during October in 2008. Question items of the questionnaire consist of general characteristics, job stress, and socio-psychological stress. Job Stress Measurement Scale for Koreans was used to measure job stress, while PWI-SF used for socio-psychological stress. Collected data was analyzed through frequency analysis, ${\chi}^2$ test, one-way ANOVA, correlation analysis, multi-regression analysis using a statistic program, SPSS/10.0 Ver for Windows, and statistical significance level was 0.05. Result : Accordingly, this paper is written for the purpose of scrutinizing the reason of 119 rescuers' job stress and Socio-Psychological stress. This thesis tries to analyze a problem and provide contents through many variables concerned and theoretical investigation with the actual research of questionnaire. The results of the study are summarized as follows : Fire fighters feel relatively high stressful in their performance. Job stress, organizational commitment and burnout did not have been influence upon by individual cases such as economic condition, regular exercise etc. Finally, as a result of step by step regression analysis, the variable that can explain Socio-Psychological stress the best was negative emotion scale(NE). Conclusions : It is necessary to conduct repeated studies in the future, since the study implied that there was a contrary relationship between job stress and socio-psychological stress. In order to reduce job stress and maintain better mental health, it is more important than anything else to help firefighters have willingness and efforts to sustain a healthy life, so the development of various programs and education to raise their awareness should be implemented.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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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.