• 시큐리티연구
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• 제3호
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• pp.336-384
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• 2000

The current function of 119EMS(Emergency Medical Service) is simply to transport patients to hospitals due to the lack of medical personnel and medical equipments. In order to mark the current 119EMS system, that is to say, more many medical technician and paramedics, medical equipments supplementation, korean EMS communication system simplification and the re-arrangement of the existing fire organization, and so on. Also so various problems involving 119EMS should be solved political and financial support and the change in people's attitude toward the public fire service.

• 한국화재소방학회논문지
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• 제32권5호
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• pp.95-104
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• 2018

119 구급대원은 외상성 사건에 지속적으로 노출되며 이로 인해 다양한 사회심리적 문제와 삶의 질 저하를 경험할 위험이 있다. 이에 본 연구에서는 마음빼기명상 프로그램이 119 구급대원의 외상 후 성장과 회복탄력성에 미치는 효과를 확인하였다. $201^*$년 A소방본부 구급대원 26명을 연구대상으로, 2박 3일간 단기집중 마음빼기명상 프로그램을 적용하기 전과 명상 완료 후에 외상 후 성장과 회복탄력성 설문지를 이용하여 대상자의 상태를 측정하였다. 연구 결과 마음빼기명상 프로그램은 119 구급대원의 외상 후 성장을 $2.85({\pm}.67)$점에서 $3.60({\pm}.72)$점으로 유의하게 증가시켰고, 회복탄력성은 $2.45({\pm}.39)$점에서 $2.83({\pm}.48)$점으로 유의하게 증가시켰다. 결론적으로 마음빼기명상 프로그램은 119 구급대원의 외상 후 성장과 회복탄력성을 향상시키는 효과가 있었으므로, 본 연구에 적용한 마음빼기명상은 119 구급대원의 정신건강관리 프로그램으로 제안될 수 있을 것이다.

• 한국응급구조학회지
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• 제8권1호
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• pp.199-210
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• 2004

Since the 119 fire department was legally permitted to serve in Emergency Medical Service(EMS)Operation of emergency patients in 1983, 119 EMS operation in general has made a big progress in serving the needs for emergency patients. Currently EMS operation is carried out by 119 EMS unit, private ambulance Co.,etc. But due to the public recognition and volunteers, 119 EMS operation carries the major share of the service. This observation is not surprising in that such a trends occured in Japan 20 years ago. This paper compared the 119 EMS operation conducted by the fire department in Korea with that of Japan in order to draw some inferences from the comparison. The results of the study compared to Japan were as follows: 1. Japan was higher 1.5 times in the number of EMS units per population(100,000), 1.1 times in the number of patient transports per unit. 2. Japan was higher 4.54 times in the number of the 119 EMS personnel per population(100,000), 30.6 times in that per square killometers, 30.6 times per 119 EMS unit, in per ambulance 2.48times. 3. Japan was higher 1.83 times in the number of ambulance per population(100,000), 1.26 times in that per square killo meters. 4. Japan was higher 1.7 times in the number of transport patients per population (100,000), but Korea was higher 2.68 times in the transport patients per EMS personal. 5. Compared to Japan, there was no emergency care related to ALS, for example, such as administering dugs orally and intravenously, interpreting elctrocardiograms, performing endotracheal tube or LMA insertion, using monitors and other complex equipments in Korea.

• 대한인간공학회지
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• 제29권2호
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• pp.211-216
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• 2010

Fire service personnel and ambulance paramedics suffer musculoskeletal disorders as they lift and carry patients while performing Emergency Medical Services (EMS). The objective of the current study was performed to examine the association between working environment and musculoskeletal disorders of 119 paramedics and to analysis the EMS activities for them through basic survey (including task characteristics, risk factors, symptoms and illnesses). Observational job analysis of EMS activities indicated the squatting posture during first-aid performed on floor and the abrupt use of force during carrying heavy load including stretcher with patients on as hazard factors, and excessive low back twisting and bending during stairway transfer was observed. In addition, work-physiological assessment revealed various but rather high lumbar muscle usage rate among the study subjects, being 14.6~32.8% compared with Maximum Voluntary Contraction (MVC) during patients transfer work. Resting heart rate showed 65/min, on the other hand, heart rate on mobilization indicated maximum 124~156/min. Therefore, the results of analysis to the EMS activities, rescuer activities and medical tasks were accompanied with high possibility of accident and musculoskeletal disorders. Also, EMS activities indicated high muscle fatigue and energy consumption, and accumulated muscle fatigue with during continued work.

• 한국응급구조학회지
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• 제15권3호
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.

• 한국응급구조학회지
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• 제24권1호
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• pp.7-24
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• 2020

Purpose: Emergency medical service (EMS) personnel are at high risk of spreading infection. In this study, we used the PRECEDE model to identify the knowledge, status, and barriers to infection control among Korean paramedics to provide basic infection control data. Methods: A total of 164 respondents were analyzed for the study. A questionnaire was administered and collected through an online self-response platform. Descriptive analysis, t-test, ANOVA, multiple regression, and logistic regression analyses were performed to determine infection control practices and associated factors using SAS 9.4. To identify the pathways and direct, indirect, total effects based on the PRECEDE model, we used AMOS 26.0. Results: Highly rated self-efficacy (OR 8.82, 95% CI: 3.23-24.09), awareness (OR 6.05, 95% CI: 2.06-17.72), and enabling factors (OR 3.23, 95% CI: 1.18-8.78) led to superior infection control. As a result of the structural model analysis, the highly rated enabling factors and awareness led to superior practice patterns. Conclusion: Practice is related to self-efficacy, awareness, and enabling factors; however, further research is needed to develop strategies for infection control. In particular, institutional arrangements are needed to improve the enabling factors. Improving infection control performance may lead to better infection control and enhanced protection of EMS personnel and patients against infection risks.

• 한국응급구조학회지
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• 제26권3호
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.

• 의료법학
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• 제24권3호
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• pp.105-124
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• 2023

현대 사회는 뜻밖의 사고와 위험 상황으로 불안정한 환경에 직면하고 있다. 예를 들어 분당 다리 붕괴사고와 이태원 압사사고 등이 그 예가 될 것이다. 이와 함께 급성심정지나 뇌졸중과 같은 중대한 응급상황이 발생하였을 때, 신속한 조치와 전문 의료 기관으로의 원활한 이송이 필요한 경우 또한 빈번하게 발생하고 있다. 이러한 위험 요소에 대응하기 위해 국가는 국민의 생명과 안전을 보호하기 위한 다양한 시스템을 구축하고 있는데, 119구급대는 응급 의료 시스템 중 핵심적인 역할을 수행한다. 중대한 외상 환자나 중증 질환 환자의 응급 상황에 즉각적으로 대응하여 손상을 최소화하고, 응급의료 기관으로 신속하게 이송하여 전문적인 치료를 제공함으로써 환자의 생명과 안전을 보호하는 것이 그 목표이다. 이와 관련된 핵심 활동이 구급활동인 것이다. 특히, 119구급시스템은 응급 환자의 병원 이송을 책임지는 핵심 기관이나, 구급대원들은 업무수행 중 구급활동 방해 사례에 여전히 직면하고 있다. 이러한 방해 사례는 경찰의 협조 노력에도 불구하고 줄어들지 않고 있고, 구급활동은 공무집행 방해죄와 유사한 특성을 지니며, 응급의료 시스템 내에서 근무하는 응급의료 종사자에 대한 폭행 및 장비 파손과 같은 사례와도 유사한 형태를 보인다. 따라서 119구급시스템을 포함한 응급 의료 활동을 수행하는 과정에서 발생하는 방해 문제에 대한 심층적인 이해와 개선 노력이 필요하다. 이러한 문제에 대한 해결책은 "소방기본법"과 "119구조·구급에 관한 법률"을 중심으로 구급활동 방해죄의 조건을 정립하고 개선하는 것이다.

• 한국응급구조학회지
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• 제6권1호
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• pp.55-64
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• 2002

This analysis is accomplished by using 331 rescue and medical evacuation cases performed by KangWonDo Fire Service Department Aviation(KFSA-119 Heicopters) between Jan. 1998 and Oct. 2002. By analysing injury causes, annual differences, sexual, scenic(locaional) distribution and wounded part distribution, this study tried to figure out the general tendency of the helicopter-transported patients in Korea. The results are as follows; 1. The whole population of the patients rescued and transported by helicopters is increasing by the annual rate of 150%~200%. 2. For the locational (scenic) distribution of the patients, 57% (190 cases) of the target population were injured on their mountain-climbing or tracking. 3. 12% (41 cases) of the target population were the Inter-Hospital transport cases. 4. 6% (16 cases) were the expired cases. 5. for the wounded part distribution, 46% (106 cases) were muscular skeletal injuries. 6. The aircraft and personnel of the KFSA were rescue-oriented, so for the EMS operations especially inter-hospital transport missions, different medical equipments and personnels are needed.