Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.
The purpose of this study is to analyze the effect on satisfaction after education of cardiovascular pulmonary resuscitation(CPR) in Daejon Emergency Medical information Center in Korea. The major instruments of this study were Korean Self-Analysis Student Opinionnaire. Questionnaire contains 12 items which measure student's satisfaction or attitude factor. To take the analysis of data, the total of 308 students were investigated in Medical Information Center in Dae-jon Metropolitan City from 2004. 2. September to 2004. 16. September. The data were analyzed by the path analysis SPSS program. The result are as follows: 1. After education of CPR, there was significant satisfaction of CPR knowledge P=0.0011). 2. After education of CPR, there was significant satisfaction of CPR skill(P=0.00001).
Purpose: This study was conducted to identify the effects of educational intervention on pre-test and post-test tidal volume, endotracheal peak pressure, and ventilation interval measurements during single-rescuer respiratory-assistant therapy by paramedic students. Methods: The present study, with a quasi-experimental design, included a pre-test and post-test nonequivalent control group. A total of 62 paramedic students (31, experimental group; 31, control group) participated in this study. The intervention lasted 80 minutes. Data were collected from each student before the intervention and two weeks after the intervention, between September 3 and 21, 2018. The collected data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Results: Tidal volume (p<.001) and endotracheal peak pressure (p=.002) measurements after the intervention were significantly different between the two groups. Analysis of covariance was used to control the variance (the pretest value of endotracheal peak pressure) in order to identify the effect of the intervention in the two groups. Endotracheal peak pressure was not significantly different between the two groups. Conclusion: Education and training of paramedic students in emergency medical services on single-rescuer respiratory-assistant therapy is necessary for the emergency care of patients with respiratory arrest.
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.
Purpose: This study aimed to investigate the awareness and direction of paramedics work and image in hospitals. Methods: From April 16 to May 5, 2015, data were collected through structured questionnaires from 45 paramedics and 81 nurses working in emergency medical institutions. The data were analyzed using SPSS version 18.0. Results: The work of paramedics is evaluated to be highly worthy at the in-hospital level rather than at the injury first-aid treatment level. It appears that paramedics are often forced to do what their hospitals tell them to do concerning matters related to conflicts with them and nurses. Paramedics stated that they experienced greater mental stress than those engaging in other professions, a finding similar to those of other studies. There was no statistically significant difference in opinions between the two groups about a desirable direction for the development of first-aid services at hospitals. More than two thirds of the respondents said that paramedics should be given the right to enter acting check for patients. Conclusion: Paramedics work is shown to differ in the opinions of paramedics themselves and nurses. Paramedics need for reform is associated with expanding the work of the law.
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The purposes of this study which was conducted by inquiring into some curricula for Emergency Medical Dispatchers(EMDs) are to introduce a curriculum into Korea and develop a textbook for training of the EMDs in Korea. The conclusions from this study were summarized as follows; (1) There are some professional demands in our Emergency Medical Dispatch field therefore, now it is necessary to set up an education system for the EMDs in Korea and give them a suitable name to this change. (2) Some historical turning points which are condensed from the developmental process in the USA. including "Medical Self Help" with no formal dispatch protocols, Medical Priority Dispatch System, Practice Standard, Dispatch Protocols will serve as a good reference for establishing and education system for the EMDs. (3) To effectively train the EMDs in Korea, we needed to be introduced to Emergency Medical Dispatch : National Standard of Curriculum from the U.S. Department of Transportation & the National Highway Traffic Safety Administration which is made up Basic Emergency Medical Concepts, Information Gatherin & Dispatch, Introduction to the Emergency Medical Dispatch Protocol Reference System(EMDPRS) & 32 Chief Complaint Types. (4) The introduced curriculum closely related to the medical director, the direct indirect medical control, the scope of practice in the USA, should be revised for the Emergency Medical Service System of Korea. But to reduce the developmental process & time, it is necessary to postpone the consideration on these factors until publishing a new textbook. (5) This study which gives the cornerstone about some developmental methods on textbook for EMDs will be helpful to build up an education system for EMDs such as Curriculum, EMD Certification, National Academy of Emergency Medical Dispatch to fit the Emergency Medical Service System of Korea in the future.
Purpose: This descriptive research study aimed to investigate the knowledge and perception of the natural disaster medical system by relevant disaster medical response teams in Jeonnam region, and provide baseline data for a disaster education program based on analysis of priorities of educational demand. Methods: Online questionnaires were distributed to 200 research participants including paramedics from five fire stations in J province, 22 public health centers, two disaster base hospitals, ERU (Emergency Response Units), and DMAT (Disaster Medical Assistance Team). The questionnaires elicited basic information about respondents, their knowledge and perception on disaster preparation and response, cooperation system, and educational and training needs. Results: The top priority items selected were: other disasters for paramedics, first aid for the rapid response team, and command system for DMAT. Conclusion: Customized education and training programs must be developed to suit each organizational need. Detailed operational guidelines must be established and with them a unified educational curriculum should be put into practice.
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.
Purpose: This study aimed to provide fundamental data for the development of a human management strategy depending on the followership type in 119 EMTs. Methods: The subjects were thirty eight 119 EMTs working out of hospital in Y, D, S, G city. Data were collected from June 25 to August 10, 2017. The Q sample was selected as 40 statements in total and analyzed using the PC QUANL program. Results: As a result of the study, three followership types explained 67.59% of all the variables. Three different types were identified from the examination. The types were labeled as 'Responsible helper type', 'Quick response type', and 'Enterprising self-development type'. Conclusion: For each type, a leader and follower should develop a team management strategy for 119 EMTs to provide high-quality emergency medical services.
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