• 한국응급구조학회지
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• 제12권3호
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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.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.477-480
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• 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

• 한국응급구조학회지
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• 제7권1호
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• pp.5-28
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• 2003

The purpose of this study which was conducted by framing of standardized advanced emergency care instructor qualification course outline and training competent instructor Course development based on following educational principle and it would be expected more improved aspect. Advanced Emergency care Instructor Qualification Course Development (1) based on advanced emergency care instructor job analysis and paramedic job description. (2) Learning of emergency care instructor qualification course is continuous. It is important to begin at the learner's level of knowledge and to relate new learning to information the learner needs. (3) Learning of emergency care instructor qualification course is purposeful and must make sense to the learner. Progress in learning must make sense to the learner. Progress in learning must be constantly appraised through feedback. The purpose of learning BLS information and skills must be kept in sharp focus. (4) Learning involves as many senses as possible. The more stimulating a learner activity is to the senses, the longer the information will be retained. Conservative figures indicate that 75% of what is heard is for-gotten after 2 days. It has been said that learners remember (5) Learning activities must be appropriate for the emergency situation through the PBL educational method. In BLS lecture skill learning, the greatest proportion of class time should be spent in manikin practice, using performance sheets as a learning tool or guide. (6) Learning must be stimulating. Instructors can motivate learners by helping them achieve higher levels of proficiency and encouraging other levels of course completion, such as instructor and instructor trainer. (7) Learning is affected by the physical and social environment. The physical environment should be conducive to both the kind of learning taking place and the activities used for learning. Advanced emergency care instructor qualification course organized educational psychology, educational methodology I,II,III, educational material making skill, lecture & conversational skill, BLS theory & pratice lecture skill, minic lecture designed PBL module. test of minic lecture & pratice lecture skill. Advanced emergency care instructor qualification course continued to active instructor training and motivated to active EMS system.

• 한국응급구조학회지
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• 제17권1호
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• pp.63-78
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• 2013

Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.

• 한국응급구조학회지
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• 제3권1호
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• pp.91-101
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• 1999

The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

• 한국응급구조학회지
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• 제16권2호
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• pp.53-66
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• 2012

Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the "120" reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

• 한국산학기술학회논문지
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• 제13권5호
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• pp.2117-2124
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• 2012

이 연구는 119구급대의 병원 전 응급처치 실태와 교육현황을 파악하기 위해 2010년 5월 1일부터 8월 31일까지 구급대원 299명을 대상으로 하였으며, 수집된 자료는 SPSS 12.0 program으로 분석하였다. 119구급대원들의 전공분야는 응급구조학이 124명(41.5%)으로 가장 많았고, 소방관련학이 46명(15.4%), 간호학이 30명(10.0%), 보건관련학이 3명(1.0%), 기타가 96명(32.1%)이었다. 119구급대원들이 소지한 자격증으로는 1급 응급구조사가 114명(38.1%), 2급 응급구조사가 101명(33.8%), 소방 교육이수자가 42명(14.0%), 간호사가 28명(9.4%), 기타 14명(4.7%)순으로 나타났다. 시행한 응급처치 빈도로는 산소흡입(274건), 사지 고정(229건), 척추고정(229건), 외부출혈의 지혈(223건), 약물투여(7건), 정맥로 확보(4건)순으로 나타났다. 병원 전 응급처치 능력 향상을 위해서는 잘 훈련된 전문 인력의 구급차 탑승이 반드시 필요하고, 이를 위하여 응급구조사의 지속적인 충원이 이루어져야 하며, 실무중심의 교육훈련 프로그램 운영이 필요하다.

• 한국응급구조학회지
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• 제17권3호
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• pp.115-137
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• 2013

Purpose: The purpose of this study was to investigate the extended job of paramedic after the 1st job description in 2000 by the National Health Personnel Licensing Examination Board. Methods: This study was carried out from May 2012 to July 2013 on the Developing A Curriculum (DACUM) method to analysts 330 responses among 400 questionnaires (response rate 82.5%) after analysing 30 pilot questionnaires. In order to enhance validity and reliability of this job description, 2 job analysts in universities and 10 EMT-Paramedics in hospitals and fire stations were recruited. Results: There were differences between 166 (year 2000) and 240 (2012) in task element. There were higher answering at triaging patient(2.64 frequency, 4.15 importance), calling for help(2.68 frequency, 4.07 importance) in disaster emergency care. There were higher answering at measuring vital sign (3.95 frequency, 4.22 importance), measuring ECG(3.84 frequency, 4.14 importance), wound care(3.48 frequency, 3.86 importance), bleeding control & wound care(3.46 frequency, 3.86 importance), applying $O_2$(3.40 frequency, 3.94 importance) in physician assistant. Conclusion: Scope of extended practice as a physician assistant in hospital setting recommended us to replace the present curriculum and national exam with new curriculum and national written & skill test.

• 한국응급구조학회지
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• 제17권1호
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• pp.41-50
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• 2013

Purpose : This study intended to improve the quality of prehospital emergency care for patients with dyspnea by figuring out the current situations and problems based on run-sheets of 119 emergency medical technicians (EMTs). Methods : A total of 336 dyspnea patients were transferred to G university hospital by 119 ambulances from January 1, 2011 to December 31, 2011. Results : The data were analyzed by SPSS 19.0. Patients over 60 years old accounted for 57.2% and 48.4% had the history of heart disease. Among the heart disease patients, 31.7% complained of dyspnea and chest pain. The vital sign measurement performance by 119 EMTs increased compared to previous study. The number of prehospital treatment by 119 EMTs significantly increased depending on the mental state of the patients. Conclusion : 119 EMTs should remind the heart disease and other past history of the patients when they perform the dyspnea patient care.

• 한국응급구조학회지
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• 제10권2호
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• pp.35-42
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• 2006

Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.