• Journal of Trauma and Injury
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• 제22권2호
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• pp.179-183
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• 2009

Purpose: This study was conducted to determine the level of medical care required for mass-gatherings and to describe the types of illness and injury that may occur during demonstrations. Methods: We conducted a retrospective review of the medical records for patients injured during demonstrations. Results: From May to August at 2008, a total of 932,000 participants attended demonstrations. Most patients were occurred from June to July, a total of 126 patients were evaluated and treated at the emergency center of our hospital. The mean patient age was $31.8{\pm}9.8$ years, and men predominated over women. The vast majority of patients were experienced trauma (88.9%). The diagnostic categories were contusion (49.2%), laceration (20.6%), fracture (6.3%), syncope/dizziness (5.5%), ocular injuries (3.9%), dyspnea (3.9%), other trauma (3.1%), and abdominal complaints (1.5%). Two patients were admitted. Conclusion: The rate and the acuity of patients seen at these demonstrations was low. Nevertheless, a full on-site physician and transportation system is recommended during similar incidents.

• 한국응급구조학회지
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• 제19권2호
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• pp.51-69
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• 2015

Purpose: This study aimed to identify the effects of job insecurity and job engagement on turnover intention of paramedics who work in emergency medical institutions. Methods: From October 14 to 28, 2014, data were collected by structured questionnaires from 171 paramedics who were working in emergency medical institutions. The data were analyzed by using SPSS/WIN 21.0. Results: Of the 171 subjects, 57.3% were temporary employees, of whom 87.5% were working in regional emergency medical centers. The mean scores were 3.19 for job insecurity, 4.58 for job engagement, and 3.28 for turnover intention. The correlation between the variables showed that the higher the job insecurity of the participants, the higher their turnover intention (r = .397, p <.001). Moreover, the higher their job engagement, the lower their turnover intention (r = -.354, p <.001). The variable that most significantly affected turnover intention was job insecurity. The coefficient of determination ($R^2$) of job insecurity and job engagement was 24.3%. Conclusion: A law should be enacted to involve paramedics as required personnel for emergency medical institutions in order to enhance the quality of emergency medical services and provide prompt and professional emergency medical services to emergency patients.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.230-240
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• 2012

Purpose: We aimed to compare the transport time, the proportion of direct hospital visit and the emergency procedures between the current mountain rescue helicopter emergency medical service (HEMS) and physician-staffed mountain-rescue HEMS. Methods: During weekends from October 2, to November 21, 2010, 9 emergency physicians participated as HEMS staff in the mountain-rescue HEMS program of the Seoul fire department. Patient demographic data, transport time, proportion of direct hospital visits, and emergency procedures were recorded. We also collected data on HEMS mountain-rescued patients from June 1, to September 1, 2010, and we compared them to those for the study patients. After an eight-week trial of the HEMS, we performed a delphi survey to determine the attitude of the physician staff, as well as the feasibility of using a physician staff. Results: Twenty-four(24) patients were rescued from mountains by physician-staffed HEMS during the study period, and 35 patients were rescued during the pre-study period. Patient demographic findings were not statistically different between the two groups, but the transport time and the emergency procedures were. During the study period, the time from call to take-off was $6.1{\pm}4.1min$ (vs. $12.1{\pm}8.9min$ during the pre-study period, p-value=0.001), and the time from call to arrival at the scene was $15.0{\pm}4.8min$ (vs. $22.3{\pm}8.1min$ during the pre-study period, p-value=0.0001). The proportions of direct hospital visit were not different between the two groups, but more aggressive emergency procedures were implemented in the study group. The delphi survey showed positive agreement on indications for HEMS, rapidity of transport and overall satisfaction. Conclusion: A pilot trial of physician-staffed HEMS for mountain rescue showed rapid response and more aggressive performance of emergency procedures with high satisfaction among the attending physicians.

• 한국응급구조학회지
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• 제24권1호
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• pp.57-66
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• 2020

Purpose: The purpose of this study was to test the effect of simulation-based learning on knowledge, confidence, and critical thinking of paramedical students enrolled in the Korean Advanced Life Support (KALS) program. This study used a one group, pre-post test design. Methods: The subjects of this study were 79 paramedical students in D city. Data were collected before and after the simulation-based training using a structured questionnaire. The data were analyzed using SPSS version 22.0. Results: After the simulation-based KALS education, knowledge (t=-6.88, p<.001) and confidence (t=-10.12, p<.001) increased among paramedical students. There was a positive correlation between confidence and critical thinking disposition (r=0.37, p=.001). Conclusion: A practical module for simulation-based education that can improve knowledge, confidence, and critical thinking disposition related to professional resuscitation is needed for use with paramedical students. Additionally, follow-up studies should be conducted to verify the educational effects of such a program.

• 한국응급구조학회지
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• 제24권1호
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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.

• 한국응급구조학회지
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• 제24권3호
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• pp.117-128
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• 2020

Purpose: This study analyzed the information and accessibility of toxic substances provided to Internet websites. Methods: From August 1, 2020, to August 31, 2020, we analyzed eight internet websites regarding toxic pharmaceuticals, pesticides, and chemicals. The website-evaluation criteria were divided into five categories for information and five categories for website convenience. Results: All eight websites about toxic substances were hosted by reliable institutions or organizations and provided accurate information in terms of informational relevance. The website run by the Safety and Health Corporation scored the highest with 100points. Analysis of the websites' accessibility to non-members' revealed that six (75.0%) were accessible, but two (12.5%) provided only limited information. Access to information through mobile apps was only available in three of the eight cases (37.5%). Conclusion: This study can be used as a reference for Internet websites about toxic substances. Toxicological information that can be viewed only with membership and manager approval requires membership in advance of viewing. In addition, emergency medical personnel working at a site or hospital should be familiar with the characteristics of toxicity information retrieval.

• 한국응급구조학회지
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• 제6권1호
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• pp.185-197
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• 2002

Today, the basic problem of functional safe management of Korean Disaster Control system was separately administrated 33 acts that are relating to safe management in 13 ministries. Because of the facts that the fire service is not provided practically, the control system and risk management for safe administration are not operated, the information can not be shared with each other, and the various laws have the lacks of linkage, the National Safe System was appeared unsteady. The roles and functions of fire service have started with restriction to operate structurally and institutionally, which operational structure of fire service is becoming weak. As a result, the federal and local fire organizations have not reached yet to the institutionalization and the local fire service agencies have bias with the task regarding the fire service because of the relation between organizational structure and the local fire agency. With the enforcement of the federal and local fire system, professionality and autonomy for making policy, and dealing with changes of fire service positively, the national fire service on the policy performance can be established. Promotion of research and development and education training to strengthen innovation in technology and competition in fire industry will contribute to the firmly establishment of control system to prevent from fire, flood, terror and national disaster. This article proposed that (a) the established law and administration, agency are required efforts to effectively operate fire service system; (b) the national fire service agency, national college of fire, national institute of science fire, and national fire service hospital should be early established to make firmly policy to operate effectively and practically. These kinds of innovational acts are known the best ways of operating solid policy of national fire service system.

• 한국지리정보학회지
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• 제10권1호
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• pp.113-123
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• 2007

본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

• 한국병원경영학회지
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• 제25권4호
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• pp.94-102
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• 2020

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.

• 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.