• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.37-55
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• 2020

Purpose: The purpose of this study was to provide basic data for improving the response capacity of 119 EMS systems by analyzing the effects of particulate matter on cardio-cerebrovascular and respiratory symptoms in the pre-hospital stage. Methods: We examined 46,389 patients who transferred to the hospital with complaints of cardiopulmonary arrest and cardio-cerebrovascular and respiratory symptoms by 119 ambulances in Incheon from 2016 to 2018. Results: The probability of 119 emergency dispatch for patients with cardiopulmonary arrest increased 2.8-4.0% from the day of symptom onset until two days before hospital presentation as particulate matter 10㎛ or less in diameter(PM₁₀) increased by 10㎍/㎥ (OR=1.028; 95% CI=1.014-1.041, p=0.000, lag 0), (OR=1.040; 95% CI=1.024-1.056, p=0.000, lag 1), (OR=1.032; 95% CI=1.016-1.049, p=0.000, lag 2). Meanwhile, emergency dispatch increased 3.6-6.1% for PM_2.5 in creased by 10㎍/㎥ (OR=1.046; 95% CI=1.024-1.068, p=0.000, lag 0), (OR=1.061; 95% CI=1.035-1.088, p=.000, lag 1), and (OR=1.036; 95% CI=1.010-1.063, p=0.006, lag 2). Conclusion: Emergency medical technicians (EMTs) who respond to 119 calls should rapidly and accurately evaluate patients and provide professional emergency care by identifying the characteristics of the vulnerable groups relative to particulate matter size. To prevent the occurrence and exacerbation of symptoms caused by particulate matter, EMTs should be prepared and equipped with a response system for high particulate matter in the EMS system.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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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.

• The Korean Journal of Emergency Medical Services
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• v.19 no.2
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• pp.99-115
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• 2015

Purpose: This study aimed to provide basic data for clinical training program development by analyzing the operating conditions and satisfaction in a clinical training program for 119 emergency medical technicians (EMTs) in South Korea. Methods: Data from 84 EMTs were collected on June 19, 2014. We administered a 64-item questionnaire about operating conditions and satisfaction in the clinical training program, and analyzed data (SPSS v 21.0). Results: The degree of performance in the field, importance of the item in the field, and level of difficulty were 3.36, 4.23, and 3.21, respectively. In the number of times that an item was directly performed according to the subjects' general characteristics a statistically difference in sex (p = .000), duty (p =.021), and total working time of trainees (p = .002). The subjects' total satisfaction score was 3.77. The difference in satisfaction according to the subjects' characteristics was a statistically significant in terms of sex (p = .016) and clinical training area (p = .005). Conclusion: A more efficient training system for hospital clinical training courses should be developed. The operation condition analyzed in this research may contribute to the improvement of the performance of EMTs.

• Fire Science and Engineering
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• v.20 no.3 s.63
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• pp.42-47
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• 2006

Direct medical control by medical doctors is an essential part of emergency medical services system (EMSS). However, the indications are not specifically defined, even in 119 system with their own medical control team. The Seoul Metropolitan Fire and Disaster Management Department has operated internal medical consultation services on its own since January 2004. Based on the experiences from these services, we reviewed the cases of the direct medical consultation and establish the indications for direct medical control. And we presumed the demand of direct medical control with the established indications. The crews of 119 in Seoul made 793 calls to Medical Control Team during November 2004. We reviewed all of the calls according to the level of consciousness (AVPU), the kinds of emergency care done by crews during transport (10 categories), and the mechanisms of injuries (9 categories). The need for direct medical control was judged by authors with reviewing the records reported by the crews and control teams. Among 23 items, 14 items assigned as the indications, which were abnormal level of consciousness (VPU), 6 kinds of emergency care, and 5 mechanisms of injures. The sum of the three of them, 7,782 cases (45.9%), was in need of direct medical control. In conclusion, about half of the patients transported by 119 crews in Seoul require direct medical control. The need for the direct medical control in Seoul was estimated as many as 260 calls per day. To fulfill the need for direct medical control and to provide a effective medical control, the direct medical control should be accomplished through the communications between the crews and the medical staffs in the local hospitals.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.127-139
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• 2004

This study aims to examine the relative importance of various tasks of EMT and to examine knowledge level and problems associated with AED. It is based on the survey of paramedics and 119 rescures. The results for this study were as follows ; Among the tasks of EMT, 'foreignbody removal from mouth' were rated as the most important, followed by '$O_2$ supply', 'CPR', 'Intubation for CPR', '$O_2$ supply' were rates as the most necessary, followed by 'foreignbody removal from mouth', 'external bleeding control'. In terms of the knowledge level about AED, survey respondents are most knowledgeable about 'role of other rescures during the preparation for AED' and 'treatment after 3 AEDS. The most important reason that the uses of AED is delayed is 'unclear boundary of treatment directed by medical control'. The results of the study suggest that we need guideline for EMT's tasks, efficient communication system between 119 and emergency health are center for prompt AED, and training and education program for AED.

• The Korean Journal of Emergency Medical Services
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• v.11 no.3
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• pp.163-174
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• 2007

Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.105-124
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• 2023

Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.11
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• pp.374-380
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• 2017

In this study, we analyzed the situation of the 119 emergency medical service zone of H town, countryside of Y city from January 1st, 2015 to December 31st, 2016 and then, on the basis of this analysis, we investigated the present condition of the patient-transportation service of the 119 emergency medical service to provide the basic data in order for patients to use the emergency medical service more efficiently. We analyzed the data with SPSS 21.0 using frequency analysis and, after positioning the virtual 119 emergency medical service, we analyzed the data of the transportation time and transportation distance by using GIS. The results of this study show that the use of the 119 emergency medical service for people over 65 years old represents approximately 57% of the total number of patients transported, The average distance and time of the real moving reaction are 6.41 km and 11.86 min, respectively. The distance and time from the pick-up location to the hospital are 18.24 km and 21.52 min, respectively. Given the present position of the 119 emergency medical service, the results of this analysis using GPS show that the (average) distance and time from the 119 emergency medical service to Jang * Ri town are 9.12 km and 12 min, and the (average) total distance and time to arrive at the hospital after the emergency medical service picks up the patient are 36.83 km and 62 min, respectively. In the case of the virtual emergency medical service, the total distance and time required to arrive at the hospital after the emergency medical service picks up the patient are 27.71km and 50min, respectively. The results of this study showed that the present position of the 119 emergency service does not provide the optimum distance and time from the patient's location to the hospital. Therefore, we consider that the repositioning of the 119 emergency medical center is necessary, in order to reduce the time required for the emergency medical service to move to the patient's location and then bring the patient to the hospital.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.19-32
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• 2015

Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.