• 한국응급구조학회지
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• 제17권1호
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• 한국응급구조학회지
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• 제24권2호
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• pp.133-153
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• 2020

Purpose: This study aimed to identify the status of emergency care of pregnant women transported by paramedics, to analyze the knowledge of paramedics related to pregnant women and their self-confidence in emergency care, and to provide foundational data to improve the quality of emergency care for pregnant women. Methods: We received a total of 1,798 rescue logs from 119 paramedics, who had transported pregnant women, in I city from January 1, 2016 to December 31, 2018. For survey analysis, we used the 164 questionnaires received from these paramedics from June 15 to August 14, 2019. Results: The analysis of the rescue logs revealed that 85.5% (1,537 individuals) either had disease symptoms or were pregnant, whereas only 14.5% (261 individuals) had traffic accidents or accident-related injuries. The mean knowledge of the paramedics related to pregnant women was 23.73 (±2.98) points, and the mean self-confidence in emergency care was 3.19 (±0.74) points. Knowledge of the paramedics about pregnant women and their self-confidence in emergency care of these women had a statistically significant positive correlation (r=.306, p=.000). Conclusion: Paramedics should be provided theoretical and practical training through various programs about the emergency care of pregnant women.

• 보건행정학회지
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• 제2권2호
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• pp.152-178
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• 1992

This study focuses on making recommendations for the improvement of poor emergency medical services or EMS in Korea. Problems of the current EMS system is widely reviewed. As an alternative of the current system, a franchises system is introduced to EMS. A feasibility study of the new system is carried out as follows. 1) The current EMS system shows such problem as; - Inadequacy of emergency medical fee schedule, - Shortage of emergency medical resources, - Concentration of emergency medical facilities in metropolitan area, - Unestablishment of training program for emergency personnel, - Inappropriateness of patients' behvaviro pattern in emergency care system. 2) Recommendations for the improvement of EMS are as follows: - Well organized communication and transportation system needs to be established by utilizing all the availabl EMS is to be devised for the provision of appropriate emergency care. - A franchises system can be widly adopted so that private organizations are willing to establish a free standing emergency center. - Emergency care fee schedule of the franchises system needs to be appropriate for the system to provide high standard medical services.

• 한국응급구조학회지
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• 제19권3호
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• 간호행정학회지
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• 제12권4호
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• pp.541-554
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• 2006

Purpose: The purpose of this study is to provide basic data for the improvement of the quality in the emergency nursing services by investigating the expectation level and actual received level with nursing care and identifying the factors that influence patient satisfaction with the emergency nursing care in the military hospitals. Method: Using a self report questionnaire, data were collected from 150 patients who had been admitted in military hospitals emergency department. The data collection was done between April 17 and April 30, 2006. At least, 145 questionnaires were analyzed and used in this study. Results: The average sum score was 61.93 out of 76 with standard deviation 9.590. The mean of the patient's expectation levels with the overall emergency nursing services was $(3.25{\pm}.504)$ out of the highest score 4. the average sum score was 63.27 out of 76 with standard deviation 9.902. The mean score of the patient's actual levels with the overall emergency nursing services was $(3.33{\pm}.521)$ out of the highest score 4. Conclusion: nursing management strategies must be established to remove patient's dissatisfaction factors and to improve the emergency nursing care quality through continuous measurement and assessment of the patient's satisfaction with emergency nursing services in military hospitals.

• 한국응급구조학회지
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• 제9권2호
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• pp.29-38
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• 2005

The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

• 간호행정학회지
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• 제4권2호
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• pp.405-418
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• 1998

The purpose of this study was to describe patients satisfaction with nursing care in the emergency department and factors influencing satisfaction rates. 1. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety: 2.67 for technical competence: 2.49 for information giving: and 1.35 for discharge teaching. 2. Patient satisfaction with nursing care services provided. according to the general characteristics of the patients. was revealed as being significantly high for the groups of patients made up of those who were male. those over 51years of age. married subjects. those with an education level of high school or below level. housewives. Buddhists. and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine. neurology or psychiatry. those admitted for the first time. those for whom the distance from the department to home was less than 30 minutes. patients who visited between monday and Friday and between 8AM and 4PM. patients who did not have to wait to be seen and those who stayed in the department less than 24 hours. 3. The correlation between the patients' general characteristics. nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service. 4. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included 'over worked nurses' and 'too many patients' in the emergency department. In conclusion. the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments: and the need for adequate support from hospital administrators to improve patients' service utilization.

• 한국응급구조학회지
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• 제15권1호
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• pp.79-88
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• 2011

Purpose : Prehospital emergency care for shockable rhythm is one of major concerns of emergency medical services. But, in Korea, prehospital medical service systems are not yet well established. We tried to offer one of the fundamental data to develop of these system. Method : After application of exclusion criteria, 200 patients who had shockable rhythm from January to December, 2008 were included in this study. Restrospective review of Prehospital care Reports of these patients was done. Result : Total 200 cases of shockable rhythm and prehospital arrest were analyzed. The rates of assessment of vital signs were 89.0%, the rate of level of consiousness was 99.5%. Just 6.0% were communicated with medical director providing the prehospital care. The frequency of defibrillation was performed 58.5%. Conclusion : Survival rate was higher in defibrillation group than that of nondefibrillation group(20.5% vs 2.4%, p=0.000).

• 도시과학
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• 제8권1호
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• pp.51-58
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• 2019

본 연구의 목적은 노인들의 응급의료이용에 영향을 주는 요인들을 알아보고 의료접근의 형평성을 조사하는 데 있다. 2014년 한국의료패널조사 자료를 사용하여 기술분석과 로지스틱회귀분석이 행하여졌으며 인터뷰에 참여했던 1,313명의 노인들이 표본으로 선정되었다. 연령, 성별, 교육수준 등의 인구변수들이 응급의료이용의 중요한 결정요인이었다. 의료요구는 노인 계층 간 응급의료이용의 차이를 충분히 설명하지 못한 걸로 나타났으나 건강상태는 응급의료서비스를 사용하는 노인들의 중요한 결정요인이었다. 의료비지출은 응급의료서비스이용의 계층 간 차이를 개선하지 못했으나 응급의료이용의 중요한 예측요인으로 남았다. 한국에서 의료개혁은 의료요구를 가진 노인들이 효과적인 진료혜택을 받을 수 있도록 전국민 응급의료 보장을 확대하는 방향으로 계속 이루어져야 한다. 앞으로 연구도 75세 이상의 교령노인과 여성 및 교육수준이 낮은 노인, 그리고 높은 의료비 지출을 하는 노인과 같은 인구계층들에게 혹시 있으지 모르는 의료접근의 장애들을 허무는 방향으로 이루어질 필요가 있다.

• 한국응급구조학회지
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• 제9권1호
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• pp.101-109
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• 2005

The purpose of this study which was done by 250 Prehospital Care Reports(PCRs) survey of some squads in Seoul Metropolitan Fire & Disaster Management Department was to improve prehospital emergency care by means of quality management. The data were collected in 3 squads from Jun. 21 to Jul. 18, 2004 and analyzed by using SPSS Win 12.0 Version. The conclusions from this study were summarized as follows. The mean time of Event to treatment interval was $4.6{\pm}4.3$ minutes and 49.2% arrived at patient within 4 minutes. Platinum minute was observed 61.1% of verbal response, 73.3% of painful response, 77.8% of unresponsive. The great majority of patients couldn't receive advanced life support on account of limited scope of practice and strict direct medical control in the Emergency Medical Services Act. Data from quality improvement activity will be useful to expand indirect medical control which is able to activate prehospital care. To utilize PCR for quality improvement. It has to have data elements, run data, patient data, check boxes, narrative including US DOT's minimum data set.