• International Journal of Advanced Culture Technology
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• v.10 no.4
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• pp.434-443
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• 2022

CPR in High-rise building is one of the challenging tasks to 119 paramedics, evacuating patient from the narrow and vertical area. This study was built to compare the method of mechanical CPR and manual CPR is to maximizing on-scene treatment time, and minimizing the hand-off time in cardiac arrest, transporting patient as fast as possible. The electronic data research (Science, Pubmed, Medline, Medline and 55 academic DB interworking) was conducted, and five articles were included by reviewing and excluding through the Covidence program and Review Manager version 5.4(Cochrane Collaboration). OHCA occurring on the higher floor indicates lower in survival. A total studies uniformly reported mechanical CPR is more effective during the high-rise building evacuation, than manual CPR in rate, depth, and hands-on time of chest compression. Use of mechanical CPR device is more suitable in case of High-rise building OHCA to improve the survival rate which is affected by high-quality CPR.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.1
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• pp.31-37
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• 2021

Purpose: Acetaminophen (APAP) is a widely available drug responsible for a large part of drug-induced hepatotoxicity in developed countries. Although acetaminophen overdose cases in Korea are being continuously reported, there are no reports related to the level of this drug in the patient's blood or of laboratory analysis at emergency departments (ED). This study sought to analyze the acetaminophen overdose cases at a toxicological laboratory and to survey APAP analysis services offered at select EDs. Methods: We analyzed the demographic and analytic data at a toxicological laboratory run by the National Emergency Medical Center (NMC) in 2019-2020. We surveyed the APAP laboratory service in the 38 regional emergency medical centers (EMCs) and 68 local EMCs near the toxicological laboratory. Results: We studied 175 acute poisoning cases (112 women) with positive blood APAP results (mean age 47.0±24.1 years). Suicide attempts comprised 40.0% of the cases and 30.3% APAP overdose events. In the univariate analysis, we observed that patients were significantly younger, with fewer underlying medical diseases. There were a higher number of APAP overdose events, more favorable initial mental status, more toxic quantity intake in the above treatment line group (p<0.05), In multivariate analysis, the toxic amount intake was significantly more frequent in the above treatment line group (p<0.01). Hospital APAP analysis services were available in six EMCs (3/38 regional and 3/68 local). The hospital blood APAP level reporting intervals were shorter than outside-hospital laboratory services (p<0.01, regional 7.0±3.0 vs. 40.6±27.5, local 5.3±3.1 vs. 57.9±45.1 hours). The NMC toxicological laboratory reporting interval was shorter than the other outside-hospital laboratories (p<0.01, regional 5.7±0.6 vs. 50.2±22.7 local 7.5±3.0 vs. 70.5±41.5 hours). Conclusion: Over the treatment line group, toxic amount intake was significantly more frequent. Only six of 106 EMCs have their own APAP analysis service in their hospitals.

• The Korean Journal of Emergency Medical Services
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• v.1 no.1
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• pp.42-53
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• 1997

To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

• The Korean Journal of Emergency Medical Services
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• v.21 no.1
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• pp.59-73
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• 2017

Purpose: This study aimed to enhance the efficiency of clinical training education by understanding paramedic students' perceptions of their hospital clinical training experiences. Methods: The subjects were 31 third paramedic students who participated in a population survey from June 25 to August 13, 2016. A Q card and Q sample distribution chart were created, and the P sample was selected by Q classification. The collected data were analyzed by factorial analysis using PC QUANL. Results: Four different perceptions were identified from the survey, which explained 44.1% of the variables. The four types were classified as Self-improvement-oriented (Type 1), Training-site avoidant (Type 2), Confidence acquiring (Type 3), and Over-willed (Type 4). Conclusion: Paramedic instructors and clinical training managers may want to consider these four perception types when planning clinical training and education programs to improve job performance.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.21-27
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• 2019

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

• Journal of The Korean Society of Clinical Toxicology
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• v.15 no.1
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• pp.17-23
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• 2017

Purpose: Activated charcoal (AC) has been widely used as a universal antidote. Currently, emergency medical centers in Korea cannot administer AC due to discontinuation of the supply of commercial ready-mixed AC suspension. This study was conducted to investigate the proportion of emergency medical centers that administer AC to poisoning patients and provide basic information for emergency physicians and toxicologists. Methods: A prospective telephone survey of all of the included emergency medical institutions was conducted. The type of emergency medical institution, average annual number of patients admitted to the emergency department, annual average number of patients who were poisoned and whether the hospital currently utilizes gastric lavage and administration of AC were determined. Results: AC was administered to poisoning patients in 40% of regional emergency medical centers, 59.3% of local emergency medical centers, and 45.9% of local emergency medical rooms. Overall, 37% of total emergency medical institutions did not administer AC due to discontinuation of the commercial ready-mixed AC suspension. Additionally, 77% of emergency physicians in institutions without AC knew AC is necessary for poisoning patients. The rate of vomiting experienced by the medical staff according to types of charcoal showed that the average rate of vomiting was 33% for commercial ready-mixed activated charcoal suspension and 51% for self-prepared charcoal powder (p=0.02). Conclusion: AC should be secured promptly in emergency medical institutions. Before the supply of commercial ready-mixed AC suspension becomes again it is essential to develop a standardized regimen for self-preparation of charcoal powder and to educate emergency physicians and toxicologists to its use.

• Journal of the Korean Operations Research and Management Science Society
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• v.37 no.4
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• pp.111-124
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• 2012

Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

• The Korean Journal of Health Service Management
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• v.5 no.2
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• pp.147-155
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• 2011

The purpose of this study was to investigate self-esteem and job stress which might influence job satisfaction of the emergency medical technicians. The partcipants were 135 emergency medical technicians in hospital. Data were collected from August 15 to September 10, 2009. The collected data was analyzed with the SPSS win 15.0 version. The average self-esteem score was 3.47, job stress 3.16, job satisfaction 3.14. The score for job satisfaction. showed significant difference motivation of desire(F=3.169, p=.016) and region(F=3.414, p=.011). Self-esteem had significant positive correlation to job satisfaction(r=.296, p=.000). Job stress had significant negative correlation to job satisfaction(r=-.327, p=.000). Self-esteem and job stress were significant predictor and accounted for 16% of the variance in job satisfaction of the emergency medical technicians. Future job satisfaction management program for the emergency medical technicians should be considered their self-esteem and job stress.

• Journal of Korean Clinical Nursing Research
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• v.24 no.3
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• pp.303-312
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• 2018

Purpose: The purpose of this study was to identify the relationship between response to violence, resilience and burnout and to investigate the factors that affect burnout in emergency room nurses. Methods: Data from 237 nurses in 15 emergency rooms were collected using a structured questionnaire. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, t-test, Mann-Whitney test, ANOVA, Kruskall Wallis test, Pearson correlation, and hierarchical multiple regression. Results: Burnout was positively correlated with response to violence and negatively correlated with resilience in emergency room nurses. Response to violence (${\beta}=.466$, p<.001), resilience (${\beta}=-.308$, p<.001), and religion (${\beta}=-.131$, p=.011) were significant predictors of burnout, and they explained 39.9% of emergency room nurses' burnout. Conclusion: Response to violence and resilience were identified as significant factors affecting burnout in emergency room nurses. Therefore, it is necessary to develop strategies to cope effectively with violence and to develop programs that can strengthen resilience.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.21-34
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• 2013

Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.