• Journal of the Korean Burn Society
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• v.19 no.1
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• pp.12-15
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• 2016

Purpose: Firefighters are vulnerable to burn injury during firefighting. In extensive fires, conducted heat and radiant heat can cause burn injury even though firefighters are not directly exposed to fire. There has been increasing interest in the health problems of firefighters considerably since Hongje-dong fire of 2001, which claimed the lives of six fireman. However, there have been no studies done on the characteristics of firefighter burn injuries in South Korea. Therefore, we investigated the characteristics of firefighter burn injuries in a burn center. Methods: A retrospective, single-center research was performed between Jan 2006 to Dec 2015. 24 firefighters came to the burn center. The electronic medical records of patients were reviewed. Results: Flame burns (87.5%) were the major cause of burn in firefighter. All the patients suffered second-degree or third-degree burns. Mean burn size was 6.1±6.7%. 22 of 24 patients were hospitalized and 2 of 22 hospitalized patients admitted to intensive care unit. Mean length of hospitalization was 29.1±23.7 days and mean length of intensive care unit hospitalization was 6.0±1.4 days. The face was the site most commonly burned, representing 25.8% of injuries. The hand/wrist, upper extremity, and neck were the next largest groups, with 19.4, 12.9, 11.3% of the injuries, respectively. Conclusion: Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. The burn size was small but, admitted patients need about 30 days of hospitalization.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.29-37
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• 2013

Purpose: The purpose of this study is to investigate how empowering leadership effects on growth needs and turnover intentions to emergency medical technicians. Methods: The study was based on seventy six paramedics and seventy EMTs-basic who were working at the fire stations. A survey questionnaire was used to prove connection between empowering leadership, growth needs, and turnover intentions. Results: There was a positive correlation between empowering leadership and growth needs, and negative correlation between empowering leadership and turnover intentions. There was a positive correlation between emergency medical technicians growth needs and turnover intentions. Conclusion: This analysis is empirically applied to study the empowering leadership focused on the empowerment act of leader to a leading role to empowerment in fire service organization.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.125-136
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• 2014

Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinical characteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergency medical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours after return of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Data were analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystanders in 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventricular tachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR duration was 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standard prehospital care for these patients and educational programs regarding CPR for lay rescues should be developed.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.182-195
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• 2017

Purpose: This study explores school nurses' emergency care experiences and their needs for systemic institutional support. Methods: Data were collected in 2016 from the interviews with five focus groups comprising thirty school nurses. Qualitative content analysis was then performed using the collected data. Results: The study found that school nurses were vulnerable to over-reaction in uncertain situations as the school's sole health service provider. The study's findings are divided into ten categories. 1) Major obstacles to overcome as the sole health service provider, 2) Assessing an uncertain situation and making appropriate decisions, 3) Providing limited first aid while maintaining control over the situation, 4) Referring or transferring a student to a hospital that creates tensions and raises cost, 5) Becoming an advocate for information disclosure and treatment, 6) Ensuring follow-up actions and proper transfer of responsibility, 7) Making preparations for future emergency, 8) Responding to conflicts arising from over-reaction as a safeguard and professional expertise, 9) Need for the development of standardized manual for school emergency care, 10) Need for practical case-based training. Conclusion: The findings of this study should contribute to the development of the programs aimed at improving school emergency care and the professional competence of school nurse.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2017.10a
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• pp.279-281
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• 2017

In the recent years, An attempts have been made to convergence medical technology and IT technology to overcome the limitations of temporal, spatial, and medical technology applications. In this study, we established an environment for emergency information services. The developed smart application for emergency rescue activities support can easily identify emergency situation and First Aid. Then, it can be transmitted to a remote medical guidance doctor so that emergency treatment and hospital response can be performed quickly.

• The Korean Journal of Emergency Medical Services
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• v.16 no.2
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• pp.9-22
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• 2012

Purpose : The purpose of this study was to investigate the current status of clinical practice and associated factors with satisfaction among students in the department of emergency medical service. Methods : The study subjects were 498 students who finished clinical practice course in 9 universities. General characteristics, current status of clinical practice, frequency of some medical procedure and practice satisfaction were collected using self-administered questionnaire. The association between clinical practice and satisfaction was tested by t-test, ANOVA and multiple regression analysis. Results : Of 498 students, 257 (51.6%) subjects were male and the mean age was $22.1{\pm}2.01$. The overall satisfaction score of clinical practice was $96.76{\pm}18.04$. Male students had higher satisfaction scores than that of female. The students who were satisfied with the emergency room practice wanted to work in hospital or fire station and they had a tendency to take paramedic as their lifelong career. The students preferred to practicing in the emergency department that hire the paramedic. Conclusion : Gender, grades, future jobs, occupational views, practical places, agency orientation, departments, and educators were associated with educational satisfaction. The practice program considering the results of this study will help to increase the educational satisfaction in students of emergency medical service.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.57-70
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• 2011

Purpose : The purpose of this study was to reveal some factors of ROSC & survival for cardiac arrests from sport & leisure activities(CASLs). Methods : A retrospective study of the 1,341 out of hospital cardiac arrests(OHCAs) treated by EMS in Gyeonggi Provincial Fire and Disaster Headquarters from January to December in 2008 was conducted. The primary end-point was admission to emergency room. To clarify the factors through comparison of CASLs(n=58) with ROSCs & survivals(n=58), Answer Tree analysis for data mining with the CHAID algorithm was performed and alpha was set at .05. Mean, median, and percentile of time intervals, distances, and age on the 58 CASLs, 75 ROSCs, and 27 survivals(patients admitted to emergency room) were analysed. Results : Fourteen CASLs(24.1%), 41 ROSCs(54.7%), 16 survivals(59.3%) were treated with CPR within 5 min., and only 2 CASLs(3.4%), 11 ROSCs(14.7%), 10 survivals(37.0%) were treated with defilbrillation within 10 min. from arrest. If time recording from arrest to defilbrillation, the patients were classified 81.0%($X^2=9.83$, p=.005) into ROSCs & survivals. And the patients with no history, 100.0%($X^2=5.44$, p=.020). The other patients with no intention, 87.5%($X^2=7.00$, p=.024). Whereas the other patients with intention, treated with CPR after 4 min. from arrest were classified 67.2%($X^2=3.99$, p=.046) into CASLs. Conclusion : CPR within 4 minutes was the most important factor that discriminates between CASLs and ROSCs & survivals to record cardiac arrests-defilbrillation time. CPR within 4 min. from arrest, no history, and no intention were factors for improved ROSC & survival.

• 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.

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.1
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• pp.26-33
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• 2020

Purpose: Agent Orange (AO) is a herbicide and defoliant used by the United States and its military allies during the Vietnam War. Pneumonia is a common cause of death among Vietnam veterans in our hospital. There have been no previous studies researching any association between AO exposure and the prognosis for pneumonia. The primary objective of this study was to investigate associations between AO exposure and 30-day mortality due to pneumonia. The secondary objective was to examine the clinical factors associated with therapeutic outcomes in veterans with pneumonia, and to assess the prevalence of combined diseases in AO-exposed veterans. Methods: This study retrospectively included veteran patients diagnosed with pneumonia in the emergency department and hospitalized between February 2014 and March 2018. The enrolled patients were grouped according to their defoliant exposure history, and the clinical information of defoliant-exposed and non-defoliant-exposed groups were compared. Patients were divided according to 30-day mortality, and significant factors influencing mortality were evaluated by using univariate analysis and multivariate analysis. The final multivariate model revealed the effect of AO exposure on therapeutic outcomes of pneumonia. Results: A total of 1006 patients were analyzed. Of these, 276 patients had a history of AO exposure, whereas 730 patients had not been exposed. Factors positively associated with 30-day mortality were malignancy, respiratory rate, blood urea nitrogen, and albumin which was negatively associated with mortality. Conclusion: Exposure to defoliant is not associated with 30-day mortality in patients with pneumonia. However, veterans with defoliant exposure are associated with a high prevalence of diabetes mellitus, hypertension, cerebrovascular accident, malignancy, and chronic kidney disease.

• Fire Science and Engineering
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• v.26 no.5
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• pp.54-60
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• 2012

This study is the analysis of the actual state of hospital-based training in level 1 emergency medical technicians (EMTs) in fire station. The survey was carried out to 42 fire fighters having level 1 emergency medical technician certification from May 11 to 12 in 2012. The results showed 56.5 %, that the level 1 EMTs of roles had direct experienced. Level 1 EMTs performance frequency of clinical practice that endotracheal intubation 66.9 %, laryngeal mask airway 8.4 %, intravenous access 76.6 %, nitroglycerin sublingual 61.2 %, bronchodilator inhalation 50.0 %, fluid loading 73.8 %, ventilator apply 57.6 %, dextrose injection 57.6 %. It is necessary to investigate the continuous study on the education among the level 1 EMTs and the continuous evaluation and analysis of problems, supplemented of guidebook, practical education programs and regulation upon the operation and management of a hospital-based skill training.