• 한국응급구조학회지
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• 제23권1호
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• pp.61-69
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• 2019

Purpose: The study aims to provide basic data to enhance the health of paramedics responsible for patient transport and treatment by analyzing the exposure level of paramedics to electromagnetic waves generated by electric devices used in ambulances. Methods: The study measured electromagnetic waves in ambulances in N region from July to December 2018. ME3030B produced by German Gigahertz Solutions was used to measure these waves and the maximum value was selected by moving it slowly in various directions. Each measurement part was selected and the mean value was calculated by repeatedly measuring at 10-minute intervals three times in total: $1^{st}$, $2^{nd}$, and $3^{rd}$ phase. Results: Among the electrical devices installed in the patient room of the ambulance measured at distances of 1 cm or 30 cm, results showed a high level of electric waves at the inverter ($26.25{\pm}39V/m$) and high level of electromagnetic waves ($564.00{\pm}31.75nT$) at the ozone sterilizer. According to measurements toward the front near the driver's seat, results indicated high levels of electric waves ($3.67{\pm}1.15V/m$) and electromagnetic waves ($450.00{\pm}19.52nT$) at the black box hard drive. Conclusion: Electromagnetic waves within the ambulance were stable and not beyond the range that might impact human health. However, in the case of the black box hard drive ($3.67{\pm}1.15V/m$, $450.00{\pm}19.52nT$) located under the passenger seat, it may have a direct effect on the human body and, thus it is necessary to move it to a storage area further away from the paramedics to minimized the impact.

• 한국응급구조학회지
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• 제25권2호
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• pp.145-156
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• 2021

Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

• 한국정보통신학회:학술대회논문집
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• 한국해양정보통신학회 2002년도 춘계종합학술대회
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• pp.366-372
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• 2002

Tele-medicine and emergency medical system are necessary for moving from an accidental point or far distance to a hospital and emergency treatment or home treatment before a hospital. Emergency treatment is extremely important in the case of death before arriving a hospital and deformed or disabled by medical treatment delay. A necessary element for this medical system is the emergency communication system. This system is on preparing for an ability of furnishing patient status to a corresponding health service by monitoring the patient at an ambulance of the accident place. This is the transportation of basic biological information of a patient to a medical center by wireless communication system and the corresponding hospital or medical center examine the patient by monitoring, then they can send emergency medical order to the patient for emergency treatment. The TRS is most efficient way of emergency medical communication system, which is currently used with popularity. In this paper studied simultaneously a way of detecting and transporting bio-logical signals, and monitoring of transporting data with communication of voice in the accident place or ambulance.

• 산업경영시스템학회지
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• 제42권4호
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• pp.116-125
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• 2019

The Dynamic Vehicle Routing Problem (DVRP) involves a combinatorial optimization problem where new customer demands become known over time, and old routes must be reconfigured to generate new routes while executing the current solution. We consider the high level of dynamism problem. An application of highly dynamic DVRP is the ambulance service where a patient contacts the service center, followed by an evaluation of case severity, and a visit by a practitioner/ ambulance is scheduled accordingly. This paper considers a variant of the DVRP and proposes a decentralized algorithm in which collaborators (Depot and Vehicle), both have only partial information about the entire system. The DVRP is modeled as a periodic re optimization of VRP using the proposed decentralized algorithm where collaborators exchange local information to achieve the best global objective for the current state of the system. We assume the existence of a dispatcher e.g., headquarter of the company who can communicate to vehicles in order to gather information and assigns the new visits to them. The effectiveness of the proposed decentralized coordination algorithm is further evaluated using benchmark data given in literature. The results show that the proposed method performed better than the compared algorithms which utilize the centralized coordination in 12 out of 21 benchmark problems.

• 한국화재소방학회논문지
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• 제28권3호
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• pp.80-86
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• 2014

본 연구에서는 한국보건사회연구원과 국민건강보험공단(2013)의 한국의료패널 2009년 데이터를 이용해 응급환자 이송 서비스의 이용과 관련된 사회경제적 임상적 특성을 조사하고, 예측 인자를 분석하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등 응급환자 이송 수단을 이용한 경우가 자가용, 택시, 도보 등 응급환자 이송 수단을 이용하지 않은 경우보다 많았다. 둘째, 개인 및 가구 특성 변수 중 연령, 교육 수준, 세대 구성, 주거 형태, 월 평균 가구 소득, 가구주와의 관계 등에서, 응급 상황 특성 변수 중 의료 보장 형태, 장애 유무, 만성질환 유무, 응급실 방문 이유, 응급실 이용 후 조치 등에서 응급환자 이송 수단을 이용한 경우와 이용하지 않은 경우에 통계적으로 유의한 차이를 나타냈다. 셋째, 개인 및 가구 특성 변수 중에서는 연령과 월 평균 가구 소득, 응급 상황 특성 변수 중에서는 장애 유무, 응급실 방문 이유, 응급실 이용 후 조치 등이 응급환자 이송 서비스의 이용에 통계적으로 유의한 예측 인자로 나타났다. 따라서 병원 전 응급환자 이송 단계에서 응급 처치의 적절성 제고와 함께 응급환자 이송 서비스의 이용 특성과 예측 인자를 감안한 효과적 대응이 필요하다.

• 한국응급구조학회지
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• 제11권3호
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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.

• 한국화재소방학회논문지
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• 제28권4호
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• pp.104-111
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• 2014

이 연구는 소방에 근무하는 응급구조사에 의해 시행되는 구급차 내 심폐소생술 방법에 관한 연구이다. 연구 대상은 경기도 관할 780명으로 2012년 보수교육 종료 후 설문을 통하여 수집하였다. 일반적 특성, 가슴압박 방법(한 손 가슴압박 VS 두 손 가슴압박), 심폐소생술 방법(표준심폐소생술 VS 가슴압박소생술) 등에 대하여 Chi-square test, t-test. ANOVA로 분석하였다. 한 손을 이용한 가슴압박 14.0%, 두 손을 이용한 가슴압박 86.0%를 보였고, 표준심폐소생술(가슴압박 VS 인공호흡)은 28.3%, 가슴압박소생술 71.7%를 보였다. 고품질의 심폐소생술을 위해서는 심정지 환자의 구급 출동만이라도 운전자 포함 3명 이상의 응급구조사가 출동할 수 있도록 탄력적인 인력 운영 방안이 필요하며, 역량 강화를 위한 심폐소생술의 정기적인 교육이 필요하다.

• Journal of information and communication convergence engineering
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• 제19권4호
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• pp.284-289
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• 2021

This study attempted to identify the service satisfaction with the 119 emergency service and the factors that affect it based on the responses of subjects who used the service. Data collection was conducted from February 11 to March 11, 2021, using convenience sampling. A total of 1842 subjects who used emergency medical services using 119 ambulance in 2020 participated. For the collected data, frequency, percentage, mean, and standard deviation were calculated, and t-test, analysis of variance, and multiple regression analysis were performed using SPSS 23.0. Based on these results, to further enhance the satisfaction of users of the 119 emergency service and the quality of emergency medical services, it is important to improve the quality of paramedics through education and systems. In addition, to increase user satisfaction, efficient and systematic communication education is required. The quality of emergency medical services will increase only when communication skills required for explanations and promoting understanding are improved.

• 한국응급구조학회지
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• 제13권3호
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• pp.77-90
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• 2009

Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

• 대한응급의학회지
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• 제29권5호
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.