• Title/Summary/Keyword: Emergency Hospital Service

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Comparison of changes in ventilation volume according to fixation method of I-gel during cardiopulmonary resuscitation: a study using a simulated manikin (심폐소생술 시 아이젤의 고정 방법에 따른 환기량의 변화 비교: 시뮬레이션 마네킨을 이용한 연구)

  • Kim, Seon Tae;Shin, Sang-Yol;Choi, Jeong Woo
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.7-16
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    • 2021
  • Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments

  • Jung, Hyemin;Do, Young Kyung;Kim, Yoon;Ro, Junsoo
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.309-316
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    • 2014
  • Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

Improvement Device on Scope of Practice of Paramedic in the Emergency Medical Service's Act (응급의료에관한법률에 따른 1급 응급구조사 업무범위의 개선방안)

  • Koh, Jae-Moon;Kim, Jin-Hwoi;Jo, Jean-Man
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.17-30
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    • 2007
  • Accidents occur frequently and that the date of the emergency situation and the people a good quality of life to actively respond to the emergency scene in the line of business activities and given their lives silently. 1st EMT's is currently the most jobs in the ability to work within a hospital that can be verified by expanding employment opportunities than the rate of youth unemployment and a sharp alleviate part of the current emergency medical institution performing the duties within the contents of this communication in a Emergency patients reflected in the rates for schools that can be revitalized as part of the emergency medical system(part of the emergency medical workers) for the completion of the law concerning emergency care, if you want the current laws and enforcement rules are to be improving. Under the current provisions in law concerning emergency care, and enforceable rules on enforcement issues and identify practical issues for consideration and improvements to enumerate the reasons for the demotion, the following conclusions can be sure until they improve. In addition, the National Assembly recently passed a bill AED use, and enforceable rules to enforce party that can teach AED necessarily a grade, including 1st EMT's to protect people's lives and to actively deal with the emergency situation so that it can be. Resolving these issues in the country where the emergency medical system can create a foundation for the advancement of emergency patients can get a good length of life, opens.

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A Survey on Prehospital Emergency Medical Service for the Improvement of Acute Coronary Syndrome Assessments - Focus on the Jecheon.Danyans Area - (급성관상동맥증후군 환자의 병원 전 119구급의료서비스 실태 및 개선방안 -충북 제천.단양을 중심으로-)

  • Roh, Sang-Gyun
    • Fire Science and Engineering
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    • v.22 no.3
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    • pp.293-299
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    • 2008
  • From January, 2004 to July, 2007, 97 patients were diagnosed with Acute coronary syndrome(ACS) in Emergency Medical Center in Jecheon City in Korea. Among 97 patients, the prehospital assessment rates were as follows ; blood pressure check(27.80%, pulse rate check(33.0%), respiration check(23.7%). In hospital emergency care, oxygen supply was 52.6%, absolute bed rest was 12.4%, electrocardiogram(EKG) check was 4.1%, and nitroglycerin and intravenous fluid therapy was 0%. Therefore, ACS patients have not received sufficient prehospital cares till now. In order to improve the proficiency of the first aid emergency medical technicians(EMTs), it is necessary to provide the continuing On-the-job training(OJT) programs for prehospital emergency care.

An Empirical Study on Emergency Medical Care Transportation Policy (응급의료 이송정책에 관한 실증적 연구)

    • Fire Science and Engineering
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    • v.17 no.4
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    • pp.42-56
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    • 2003
  • This research made a survey to 119 EMT laying stress on general contents connected with job in a frame of mutually organic cooperation system between the processes, composing Emergency Medical Care Transportation Policy in Korea, as a step before hospital, of happening emergency patients, 119 first-aid service of the spot, transportation of patients, construction of communication network etc.. As a result of analysis to that, it is found that there must be systematic devices which makes EMT not to be caught on medical dispute, a modernization of emergency equipments, professional first-aid agents, a proper personnel arrangement. Consequently, it suggests policy plan focusing on structural and functional aspect to improve an Emergency Medical Care Transportation system into a realistic one.

Accuracy and reliability evaluation of basic CPR application information developed in Korean (국문으로 개발된 기본심폐소생술 애플리케이션 정보의 정확성과 신뢰성 평가)

  • Jung, Eun-Kyung;Kang, Ji-Hun
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.3
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    • pp.41-51
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    • 2019
  • Purpose: This dissertation is a descriptive research study analyzing the accuracy and reliability of the cardiopulmonary resuscitation (CPR) application developed in Korea. Methods: Two faculty members from the emergency medical services department and the emergency medicine department searched applications from July 1 to July 10, 2019 and selected a total of 13 applications. Twelve questions were assessed for information accuracy and three were assessed for reliability. In accordance with application types, the number and mean ± standard deviation were analyzed. The t-test was used to compare the accuracy of CPR information in accordance with information sources. Results: The results revealed the following errors: 7 cases (53.8%) identified the chest center lining from the nipple center-line as the chest pressure point; 5 cases (38.5%) did not provide information on the depth of 6 cm that should not be exceeded; and 4 cases (30.8%) did not provide advise to check respiration. When the CPR information sources were included, the information accuracy score was high; a significant difference was observed (p=.035). Conclusion: In the case of applications providing medical information regarding CPR, it is necessary to provide at least authoritarian, sources of information, and author transparency as well as continuous effort and attention.

Assessing the forensic knowledge of 119 emergency medical technicians (119 구급대원의 법의학 지식에 대한 연구)

  • Lee, Hee-Young;Moon, Jun-Dong
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.2
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    • pp.75-86
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    • 2019
  • Purpose: It is crucial that 119 emergency medical technician (EMT) have adequate knowledge regarding forensic science. This study aimed to assess the forensic knowledge of EMTs in the Republic of Korea. Methods: This study was conducted on EMTs of five fire stations in D metropolitan city between August 6 and August 13, 2018. A questionnaire consisting of items on crime-related incident recognition (i.e., mechanical asphyxiation, trauma, sex crimes, and child abuse), forensic evidence management (i.e., evidence collection, preservation, and recording) was administered to the participants. Finally, 119 questionnaires were analyzed. Results: The ratio of correct answers for crime-related incidents recognition was 55.82%, which was lower than that for forensic evidence management(84.5%). In particular, the scores for the type of neck compression(16.5%) and wound assessment(44.0%) were low. The percentage of correct answers for forensic evidence management was 78.4% for evidence collection, 84.4% for evidence preservation, and 90.6% for evidence recording. Previous forensic education experience was not a significant variable. Conclusion: Specific and practical forensic science education on perception of crime-related incident, including asphyxia and wound identification, and forensic evidence collection is needed.

Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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Usefulness of Korean Version of Behavioral Cue Checklist for Predicting of Patient Violence in Emergency Departments (응급실에서의 폭력 환자 예측을 위한 한국어판 행동신호 사정도구의 유용성 검증)

  • Kim, Jang Mi;Lee, Eun Nam
    • Journal of Korean Academy of Nursing
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    • v.48 no.3
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    • pp.289-297
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    • 2018
  • Purpose: This study aimed to evaluate the usefulness of a behavioral cue checklist (BCC) containing 17 items developed by Wilkes et al. (2010) for identifying potentially violent patients in emergency departments. Methods: This was a prospective observational study to evaluate the usefulness of the Korean version of a BCC (K-BCC) as an assessment tool for predicting patient violence in emergency departments, and was conducted over 4 weeks in a regional emergency medical center located in B City. A total of 1,324 patients were finally analyzed. Results: Logistic regression analysis was performed to investigate whether each item of the K-BCC predicts violence, and a parsimonious set of 8 statistically significant items was selected for the tool. Receiver operating characteristic analysis of the BCC showed that the area under the curve was .97 (95% confidence interval: .94~1.0). The sensitivity, specificity, positive predictive value, and negative predictive value at the cut-off score of 2 were 75.6%, 98.9%, 68.2%, and 99.2%, respectively. Conclusion: The K-BCC was found to be useful in predicting patient violence toward emergency department staff. This tool is simple, and fast to use and can play a significantly role identifying potentially violent patients. Owing to this advance identification, this tool can be helpful in preventing the potential for violence from manifesting as violent behaviors.