• The Korean Journal of Emergency Medical Services
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• v.21 no.3
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• pp.59-71
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• 2017

Purpose: The purpose of the study was to evaluate the ergonomic risk factors of 119 emergency medical technicians (EMT) with musculoskeletal disorders, performing emergency medical services (EMS) procedures in a firefighter combat challenge. Methods: The evaluated EMT procedures were cardiopulmonary resuscitation (CPR) & intubation, trauma patient assessment, and intravenous (IV) injection. Measurement of working posture was done during training. Results: In CPR & intubation, OWAS-score was 2 (mean 1.9, maximum 4), requiring correction action, while REBA-score was 11 (mean 7.28, maximum 11), requiring immediate improvement. In trauma patient assessment & IV injection, OWAS-score was 4 (mean 2.9, maximum 4), requiring immediate correction action, while the REBA score was 7 (mean 7.5, maximum 11), requiring improvement. Conclusion: Both OWAS score and REBA-score showed improvement of posture and high-risk of musculoskeletal disorders. Occupational health management in EMS procedures during combat challenge and effective injury prevention program in fire stations are warranted.

• 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.

• Fire Science and Engineering
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• v.20 no.2 s.62
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• pp.31-43
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• 2006

In Korea, the Emergency Medical Service, EMS is provided by Fire Services with 119 EMS and all the public uses the service for free. Although it appears very successful and is respected nationally, structural problem EMS exist and are worsening. First of all, the "free riding effect" becomes increasingly problematic. Some argue that 30% of the demands is not urgent or emergent. The total number of demands is increasing even without the free riding effect. The Current EMS system itself cannot meet the increasing EMS demand. The medical aspect is so poor that the EMS cannot dispatch a medical specialist to the scene. The cardiac arrest resuscitation rate is only $1.24{\sim}9.9%$, compared to 40% in Boston, MA, USA. But due to the regulations and limitations of the Fire Service organization, it is difficult to secure enough EMS resources. To work out these problems, it needs a structural innovation. To secure enough resources and achieve higher medical performance we should invite the medical sector and the private sector into EMS arena by contracting partnerships with Fire Services and charging a reasonable EMS fee. We found through statistical test that any partnership system is more effective than fire-alone system and most countries around the world have partnership system rather than fire-alone system.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.67-76
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• 2020

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider's essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

• Journal of the Korea Society for Simulation
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• v.26 no.3
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• pp.125-139
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• 2017

Recently, interest in improving the quality of EMS(emergency medical services) has been increasing. Much effort is being made to innovate the EMS process. The rapid progress of ICT technology has accelerated the automation or intelligence of EMS processes. This study suggests an emergency room management method based on real-time data considering resource utilization optimization, minimization of human error and enhancement of predictability of medical care. Emergency room operation indices - Emergency care index, Short stay index, Human error inducing index, Waiting patience index - are developed. And emergency room operation rules based on these indices are presented. Simulation was performed on a virtual emergency room to verify the effectiveness of the proposed operating rule. Simulation results showed excellent performance in terms of length of stay.

• Journal of Trauma and Injury
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• v.34 no.2
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• pp.87-97
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• 2021

Purpose: This study examined emergency medical service (EMS) transportation patterns for adult trauma patients before and after establishing a level 1 regional trauma center (RTC) and to evaluate the transportation approach after prehospital severity screening. Methods: This was a retrospective observational study of trauma patients aged ≥18 years admitted via EMS to the emergency department or a level 1 RTC, 1 year before to 3 years after RTC establishment. Patients with an Injury Severity Score (ISS) in the patient registration system were selected. Analyses were performed to determine transportation pattern changes by comparing patients pre- and post-RTC establishment and by yearly comparisons over the 4-year study period using the Mann-Whitney U test and chi-square test. Results: Overall, 3,587 patients were included. The mean ISS was higher in the post-RTC group (n=2,693; 10.63±8.90, median 9.00) than in the pre-RTC group (n=894; 9.44±8.20, median 8.00; p<0.001). The mean transportation distance (9.84±13.71, median 5.80 vs. 13.12±16.15 km, median 6.00; p<0.001) was longer in the post-RTC group than in the pre-RTC group. Furthermore, proportionally fewer patients were transported from an area in the same city as the RTC after establishment (86.1% vs. 78.3%; p<0.001). Yearly comparisons revealed a gradually increasing trend in the hospital death rate (ptrend=0.031). Conclusions: After establishing a level 1 RTC, the EMS transportation of severe trauma patients increased gradually along with the long-distance transportation of minor trauma patients. Therefore, improved prehospital EMS trauma severity assessments and level 1 RTC involvement in patient classification in the prehospital phase are necessary.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.159-175
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• 2021

Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers' perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: "Considerate of emergency situations," "Identifying emergency patients," "Trusting emergency vehicles," and "Sympathizing with emergency patients." Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

• Journal of the Korean Association of Geographic Information Studies
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• v.10 no.1
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• pp.113-123
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• 2007

This study analyzed the appropriateness of the spatial distribution of fire stations and emergency medical facilities, the main providers of emergency medical care, in Busan. The area over which the 119 emergency medical services were situated in relation to the dispatch and transport of urgent rescue services was examined. Addresses of patients requiring 119 emergency services were obtained and stored as individual units so that they could be analyzed in a Geographic Information System(GIS). The time taken by emergency services to reach patients and transport them to a hospital or other facility was measured in seconds. By inputting additional information such as the location of the 119 dispatch centers, jurisdictions, and emergency medical facilities, the GIS allowed for analyses not only of the temporal but also the spatial aspects of emergency medical services. The results showed that of 16 Gu/Gun and 226 Eup/Myen/Dong in the Busan area, only 41% of Busan's emergency medical services could respond to and transport patients within five minutes. In all districts, most emergency medical services were provided within five to ten minutes. However, the pattern of hospital use to transfer patients to hospitals was inefficient. Based on the temporal and spatial distributions of fire stations and emergency medical agencies, and on their dispatch and transport times, this study sets out and compares ideal dispatch and transportation patterns for the efficient use of Busan's emergency medical services and resources.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.93-109
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• 2021

Purpose: This study aims to investigate the knowledge and attitudes regarding adverse drug reactions (ADR) of emergency medical services (EMS) students, so that suggestions for further education on ADR can be made. Methods: A survey on knowledge and attitude was created and modified according to Lee's and Kim's test tool. In total, 149 students' data were collected and compared with previous studies. Results: Knowledge of ADR was relatively low (54%) but attitude was relatively high (75%). Clinical experience was important in knowledge and attitude. Knowledge and attitude showed a positive correlation. Conclusion: Increased knowledge of ADR leads to a more active attitude towards it. Hence, modification of the education system to provide a more personalized education is required.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.137-145
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• 2014

Purpose: The emergency medical service (EMS) system in Japan is similar to that in Korea. This study reviewed the development of paramedics who are major personnel in the respective EMS system of their country. Methods: We searched law for paramedics and publications in J-stage, MEDLINE and the webpage of Japan's Fire and Disaster Management Agency. Results: Paramedic training had started in Japan in 1991, and most paramedics were employed in fire departments. In Japan, ambulances belonging to fire department are staffed by a three-person unit, including at least one paramedic. Medical control advisory boards were established in all Japanese prefectures in 2003 with the purpose of upgrading the activities of ambulance personnel, including paramedics. The scope of paramedics' work has been widened owing to the continued efforts of medical control advisory boards. This allows them to perform invasive procedures including tracheal intubation, intravenous line placement, and epinephrine administration under medical control of a physician. Conclusion: As paramedics' responsibilities expand, further development of the paramedic role and an effective medical control advisory board system are imperative both Korea and Japan.