• Title/Summary/Keyword: Emergency Care

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A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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Influential processes for the acceptance of protectors toward emergency care for patient based on an elaboration likelihood model (보호자의 응급처치 수용의도에 관한 연구: 정교화 가능성 모델 중심)

  • Hwang, Ji-Young;Kim, Yun-Kwon;Kim, Ki-Young
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.3
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    • pp.51-68
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    • 2015
  • Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

Importance-Performance Analysis (IPA) to Improve Emergency Care for Novice Nurses (신규간호사의 응급간호 역량 강화를 위한 중요도 - 실행도 분석)

  • Park, Hayoung;Kim, Yoojin;Chu, Sang Hui
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.3
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    • pp.155-165
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    • 2019
  • Purpose: Although emergency care is one of the most important capabilities for novice nurses, many novice nurses have shown difficulty in emergency care in the clinical field. The purpose of this study was to provide evidence data for the future development of educational programs by analyzing the priorities in emergency care of novice nurses using the Importance-Performance Analysis. Methods: This study was designed as a descriptive survey. The participants were 197 novice nurses who worked in general hospitals from August 1 to 31, 2018. The questionnaire consisted of 'common emergency care', 'cardiovascular emergency care', 'nervous system emergency care', 'respiratory system emergency care', 'communication and teamwork competency'. Results: As a result of this study, 'communication and teamwork' among emergency cares was evaluated as the most important capability in the clinical field. In the Importance-Performance Analysis, a total of 12 items were included in the quadrant A, including 5 items related to 'cardiovascular emergency care', 4 items to 'respiratory system emergency care', 2 items to 'nervous system emergency care' and 1 item to 'common emergency care'. The results showed a need for intensive improvement in items included in quadrant A which are the high importance low performance items. Conclusion: In order to improve the emergency care of novice nurses, a variety of emergency care education programs on the nervous system and respiratory system care should be implemented as well as cardiovascular emergency care education.

Analysis on emergency care to the patients with acute myocardial infarction in pre-hospital and in-hospital phase (급성심근경색증 환자에 대한 병원 전 단계와 병원 단계에서의 응급처치 분석)

  • Lee, Han-Na;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.1
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    • pp.21-39
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    • 2013
  • Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

An Analysis on the Prehospital Care of 119 Emergency Medical Service squads in Gyeonggi Area and Improvement Methods - Focusing on Prehospital Care - (경기도지역 119안전센터의 구급활동 현황과 개선방안 - 현장 응급처치 내역을 중심으로 -)

  • Choi, Keun-Myung
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.3
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    • pp.55-69
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    • 2008
  • Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

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Emergency Health Care Utilization according to Income class (소득계층에 따른 응급의료이용)

  • Choi, Ryoung;Hwang, Byung-Deog
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.78-96
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    • 2013
  • The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

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Regionalization of pediatric emergency care in Korea

  • Kim, Do-Kyun
    • Clinical and Experimental Pediatrics
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    • v.54 no.12
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    • pp.477-480
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    • 2011
  • In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

A study on the current status of prehospital emergency care for pregnant women, knowledge related to pregnant women, and self-confidence in emergency care among paramedics (119 구급대원의 임산부 응급처치 실태 및 임산부에 대한 지식과 응급처치 수행자신감에 대한 연구)

  • Park, Jong-Min;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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    • pp.133-153
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    • 2020
  • Purpose: This study aimed to identify the status of emergency care of pregnant women transported by paramedics, to analyze the knowledge of paramedics related to pregnant women and their self-confidence in emergency care, and to provide foundational data to improve the quality of emergency care for pregnant women. Methods: We received a total of 1,798 rescue logs from 119 paramedics, who had transported pregnant women, in I city from January 1, 2016 to December 31, 2018. For survey analysis, we used the 164 questionnaires received from these paramedics from June 15 to August 14, 2019. Results: The analysis of the rescue logs revealed that 85.5% (1,537 individuals) either had disease symptoms or were pregnant, whereas only 14.5% (261 individuals) had traffic accidents or accident-related injuries. The mean knowledge of the paramedics related to pregnant women was 23.73 (±2.98) points, and the mean self-confidence in emergency care was 3.19 (±0.74) points. Knowledge of the paramedics about pregnant women and their self-confidence in emergency care of these women had a statistically significant positive correlation (r=.306, p=.000). Conclusion: Paramedics should be provided theoretical and practical training through various programs about the emergency care of pregnant women.

A Validation Study of Nursing Diagnosis in Emergency Care Unit (응급간호단위에 적용되는 간호진단의 타당도 연구)

  • Choi Kyung-Won;Oh Hae-Gyeong
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.145-153
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    • 2003
  • Purpose: Related factors for 24 nursing diagnoses frequently used in the emergency care unit were validated in this study. Method: A convenience sample of 65 registered nurses who had worked for 2 years or more in emergency care units and received instruction on nursing diagnosis was used for the study. The classification of nursing diagnoses was based on NANDA (1996) and validation, on Fehring (1987)'s DCV model. Result: Differences were found between emergency and general care units for related factors for nursing diagnosis. Newly reported related factors were not found for emergency care units. Conclusion: It is helpful for nurses who work in emergency care to be able to apply the nursing diagnosis validated in this study. These findings can be used as the database to provide a nursing diagnosis system appropriate to improving the emergency nursing practice.

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Development of a Simulation Scenario on Emergency Nursing Care of Dyspnea Patients (간호사를 위한 호흡곤란 응급관리 시뮬레이션 시나리오 개발)

  • Kang, Hye-Won;Hur, Hea-Kung
    • Journal of Korean Critical Care Nursing
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    • v.3 no.2
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    • pp.61-76
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    • 2010
  • Purpose: This study was aimed to construct an algorithm of dyspnea emergency care and develop a simulation scenario for emergency care of dyspnea based on the algorithm. Methods: The first stage of this methodological study was to construct a preliminary algorithm based on a literature review, and content and clinical validity were established. Reflecting the result of content and clinical validity for this preliminary algorithm, simulation scenario was developed based on the modified Bay Area Simulation Collaborative scenario template. The content validity of this scenario was established, and clinical applicability was tested by applying this scenario to nurses. Results: The final simulation scenario of emergency care of dyspnea consisted of scenario overview, curricular integrity, and scenario script. The scenario was proceeded on 7 phases of the algorithm as follows; initial assessment, immediate emergency care, reassessment of dyspnea, monitoring respiratory failure, checking pulse if respiratory failure occurs, decision making on cardiopulmonary resuscitation or intubation, determining a differential diagnosis according to origin of dyspnea. Conclusion: The simulation scenario of emergency care of dyspnea developed in this study may provide a strategy of simulation education for emergency care of dyspnea for nurses.

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