• 한국임상보건과학회지
• /
• 제1권1호
• /
• pp.35-45
• /
• 2013

Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

• Journal of Trauma and Injury
• /
• 제20권2호
• /
• pp.65-71
• /
• 2007

Purpose: In the Korean armed forces, vaccination against tetanus is done when personnel join the military service, but we do not know how many military personnel are vaccinated and how many soldiers have protection against tetanus. We performed a qualitative analysis of the tetanus antibody in Korean military personnel by using the TQS (Tetanus Quick Stick) Methods: This study used a prospective collection method for military personnel visiting to the emergency department of a tertiary armed forces hospital from July 2005 to January 2007. We performed an analysis by using the TQS and asked whether the personnel had been inoculated during military service. Results: The number of enrolled military personnel was 474. Among them, 412 had been vaccinated against tetanus after entering the military service. The positive rate of TQS was 91.3% (373 patients) after vaccination for tetanus. Conclusion: Many military personnel were inoculated with tetanus toxoid during military service and have protective antibodies for tetanus. According as TQS should be used for military personnel who visit the emergency department of an armed forces hospital. Also, anti-tetanus immunoglobulin should not normally be used a positive TQS for tetanus prophylaxis.

• 보건의료산업학회지
• /
• 제13권2호
• /
• pp.67-79
• /
• 2019

Objectives: The purpose of this study was to analyze the factors affecting the utilization of emergency medical services and characteristics of emergency medical services according to age group among elderly individuals. Methods: This study conducted t-test and linear regression analysis on data of 1,960,575 participants to achieve the objective. Results: Analysis of the factors affecting the use of emergency medical services showed statistically significant correlation in all age groups. As the age of elderly people increased, the use of emergency medical service increased. Conclusions: Emergency medical policies are needed, such as coordinators with expert knowledge of medical and health administration and specialist emergency room operations that can provide specialized medical service for older patients.

• 한국컴퓨터정보학회논문지
• /
• 제16권12호
• /
• pp.265-271
• /
• 2011

고품질의 맞춤형 서비스는 사회가 고령화, 초핵가족화, 재난 취약 계층의 증가로 인하여 급격히 늘어나게 되었다. 급성 질환, 심뇌혈관 질환, 자살 등 예방 가능한 사망률이 선진국에 비해 높으므로 빠르고 전문적인 구조 및 구급 서비스가 요구된다. 본 논문에서는 응급 환자가 발생하여 병원에 도착하기 전에 환자의 정보를 이용하여 응급처치가 가능하도록 한다. 그리고 응급 의료 기관에서는 환자 진료 준비를 사전에 갖출 수 있도록 하여 응급 환자 진료의 효율성을 높였다. 사회적 인지도가 높은 119번호를 이용하여 다양한 복합 응급 신고를 접수하고 있고, 유관기관과 통합적 대응 체계를 구축하는 효율적 응급의료서비스 선진화 전략을 제시하고자 한다.

• 한국응급구조학회지
• /
• 제25권1호
• /
• pp.7-22
• /
• 2021

Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

• 의료법학
• /
• 제10권1호
• /
• pp.389-420
• /
• 2009

Main Issue of Supreme Court Decision 2005Da16713 Delivered on June 24, 2005 is about the duty of medical care in the interhospital transfer of patients. According to the above Supreme Court Decision, in the interhospital transfer of patients, the decision to transfer should make from the aspect of medical treatment. The hospitals and doctors keep the duty of medical care. In addition to the duty for hospitals/doctors to check the capacity and availability of the hospital to which the patient is transferred, there are also duties to inform about emergency medical service and to sufficiently explain the need for the transfer, the medical conditions of the patient to be transferred and the hospital from which the patient is transferred. The hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer. including information upon referral, completeness of medical records, patient monitoring and so on. The interhospital transfer requires the consent of doctor belonging to the hospital to which the patient is transferred after the consideration of capacity and availability of the hospital and the informed consent of patients or legal representatives.

• 한국멀티미디어학회논문지
• /
• 제11권9호
• /
• pp.1267-1276
• /
• 2008

허혈성 심장 질환자가 급성 심근경색으로 병원에 도착하여 경피적 관상동맥 중재술을 받는데 까지 걸리는 시간(door-to-balloon time)은 환자의 사망률에 매우 큰 영향을 미친다. 본 연구에서는 기존에 병원에서 사용하고 있는 응급서비스시스템을 개선하고자 3단계의 시간 중 보호자에게 연락과 보호자가 병원에 도착할 때까지의 시간(door-to-data time), 이후 시술동의서에 서명할 때까지의 시간(data-to-decision time)을 줄이고자 하였다. 새로운 e-응급서비스시스템은 급성심근경색을 가진 응급시술환자에 대한 병원 내 응급서비스시스템 내의 데이터베이스를 구축하였고 허혈성 심장 질환자로서 부산대학교병원에 주기적으로 내원하는 환자에게 건강카드(health card)를 발급하였다. 아울러 사전시술동의서는 공인된 전자화 문서로 보관하도록 하였다. 새로운 전자화 시스템은 복잡한 진료 및 시술 절차를 획기적으로 감소시킬 수 있다. 그러므로 응급환자에 대한 인명구조를 용이하게 하고 사망률을 감소시키는 효과를 기대할 수 있다. 뿐만 아니라, 기존 시스템의 복잡한 절차로 인한 의료진과 환자의 고충을 동시에 해결하는 효과도 기대할 수 있다.

• 한국응급구조학회지
• /
• 제24권3호
• /
• pp.161-169
• /
• 2020

Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

• 한국응급구조학회지
• /
• 제26권2호
• /
• pp.7-18
• /
• 2022

Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

• 한국의료질향상학회지
• /
• 제10권1호
• /
• pp.20-27
• /
• 2003

Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.