• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.83-93
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• 2010

Purpose: The purpose of this study is to determine potential differences in pre-hospital cases of cardiac arrest and drug Intoxication between elderly group and non-elderly group on local emergency activity sites of rescue 119 team for those cases, so that it can provide useful reference materials for a system of corresponding emergency medical services. Methods: Patients with cardiac arrest and drug intoxication in the elderly and the non-elderly group were analyzed by analyzing the Ambulance Run Report for 3 years from January 2007 to December 2009. Results: According to analysis on potential differences between elderly and the non-elderly group, it was found that there was no significant difference between elderly cases (evacuated to hospital due to cardiac arrest and drug poisoning) and non-elderly cases in year of onset (p = .247), quarter of onset (p = .813), sex (p = .235), consciousness state (p = .126), place of onset (p = .215) and number of first aid services (applied to emergency cases) respectively, but there were significant differences between elderly cases and non-elderly cases in guardian availability (p = .042), time zone of onset (p = .050), distance from the site of onset (p = .278), type of onset (p = .000), number of first aid services depending on distance of evacuation (p = .008) and effectiveness of emergency care (p = .003) on statistical basis. Conclusion: It is important to establish a system of early emergency case reports for rational emergency case management with lower mortality; shorten distance from the site of onset at each time zone of onset in emergency cases; employ more emergency team members; facilitate firsthand / secondhand medical instructions for emergency teams in specialized emergency care depending on distance of evacuation for each kind of onset (elderly group vs. non-elderly group); and improve rate of resuscitated emergency cases by extending the scope of works for emergency medical technicians into wider applications, so that it will be possible to take timely and appropriate measures for emergency settings of ever-increasing aged population in near future.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.4
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• pp.432-442
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• 2011

Purpose: The purpose of this study was to identify the factors influencing the intention of the reuse in patients admitted in university hospital emergency medical center. Method: The participants were 253 patients admitted to a niversity hospital emergency medical center. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. Results: Patient satisfaction with nursing care service and switching cost were positively correlated with reuse by patients while the perceived risk was negatively correlated. As levels of satisfaction with nursing care services and switching cost increase, intention of reuse increases. Satisfaction with nursing care service, switching cost and perceived risk in emergency medical center influence intention to reuse and explain 68.8% of total variation of intention to reuse. Conclusion: Findings provide strong empirical evidence for importance of atient satisfaction with nursing care service, the switching costs and the perceived risk in explaining the intention of reuse an emergency medical center.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.89-106
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• 2020

Purpose: This study attempts to improve the status of emergency care for major trauma patients transferred by 119 paramedics by analyzing the status of emergency care and the obstacles to the spinal motion restriction (SMR) for major trauma patients. Methods: A total of 600 rescue logs were collected from major trauma patients transported by 119 paramedics in the C fire department from Jan. 1, 2015, to Dec. 31, 2017. And then, 280 questionnaires were collected from the 119 paramedics in C fire department from May 3 to Jun. 3, 2019. Data were analyzed using SPSS 24.0 version. Results: Among 499 spinal motion restriction adaptive patients, the spinal motion restriction rate was 51.1% (255 individuals). Lack of human resources and quality control problems were among the obstacles to spinal motion restriction. Conclusion: The 119 paramedics should improve their activeness and skills in performing emergency care, and since training and experience are of crucial importance, they should expand various education systematized according to demand.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.45-62
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• 2012

Purpose : This study was carried out from September 2011 to September 2012 to indicate improvement and performance schemes and planning strategies by way of scenario based practical examination to inspire adaptable capacity to EMS field for Emergency Medical Technician. Methods : In order to improve the examination, a survey was conducted to EMT-Paramedics (Level 1), EMT-Basics (Level 2), and other expert groups. The researchers visited the National Registry of Emergency Medical Technician (NREMT) headquarter and the psychomotor examination site in Ohio in April, 2011. The 21 EMT professors took part in a workshop experiencing the US psychomotor examinations provided by two NREMT examination experts in October, 2011. Results : The results showed that the general plan of new National Practical Examination for EMTs should consist of integrated emergency care examination based on clinical performance and simple skill examination based on objective structured skill protocol Conclusion : The National Practice Examination consists of two sessions and the examinees select the test number randomly in each session. The future examination should include the critical criteria and this criteria should be the decisive factor for the pass or fail.

• The Korean Journal of Emergency Medical Services
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• v.21 no.3
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• pp.97-107
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• 2017

Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.27-42
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• 2011

Purpose: This study intended to improve quality of prehospital emergency care for trauma patients by figuring out its current situations and problems based on run-sheets and questionnaires of 119 emergency medical technicians (EMTs). Methods: This study conducted a research of 425 trauma patients transferred to the 3rd hospital in G-city by 119 ambulances from July 1, 2008 to June 30, 2009. We aslo utilized 114 copies with questionnaires of 119 EMTs working in J-province. The data were analyzed with SPSS 18.0. Results: There were 425 trauma patients including 272 men and 137 patients with traffic accident. When it comes to types of 119 EMTs who delivered cares to patients, there were 206 (48.5%) advanced EMTs, 101 (23.8%) basic EMTs, 50 (11.8%) nurses and 43 (10.2%) rescue education receivers. The most frequent measured vital sign was pulse rate (54.1%). Regarding assessment of systolic blood pressure, pulse rate and respiration rate, there were some significant differences in accordance with type of 119 EMTs. Among the 317 patients evaluated 'emergency' in field, 137 patients returned to their home. Prehospital emergency cares accounted for 861, around 2.0 treatments per a patient. In view of questionnaire, the 74.6% of 119 EMTs hoped supplement of man power for proper prehospital care to trauma patients. Conclusion: This study suggested that it is necessary to develop detailed guidelines for trauma patients so as to improve quality of trauma patient evaluation and prehospital care. Furthermore, improvement of emergency care systems will reduce mortality of trauma patients and lead to their good outcome.

• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient's side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient's side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.135-146
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• 2003

The purpose of this study was to improve EMS-System in Korea through the research in EMS-System of advanced country. The response time is defined as the interval from the time of call receipt to the time of scene arrival. The important factor was to shorten moving distance of ambulance. It should be considered to accomplish this factor that the vehicle must be increased and the convenient location chosen for optimizing of service area. The transport of emergency patients carried out almost by 119 Emergency Medical Service but out of all the employees at 119 EMS only 11.3% have own qualified EMT degree. They should be employed more and more specially at 119 EMS for a superior level of emergency medical care for civilian. In America, EMT can take care of emergency patients following the order from medical Director at the scene of accident. But in Germany, prehospital care was emphasized from the beginning and, in those days, a medical doctor was sent for treatment of emergency patients at the scene, the so-called a Rendezvous system. Hierby this study makes the suggestion to improve the EMS-System, it is effective to use the medical Director system in America and furthermore a Rendezvous system in Germany. The functional integratin and unification of the report system as well as enough personal and equipmental elements saved together invaluable lives.

• Research in Community and Public Health Nursing
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• v.30 no.2
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• pp.234-242
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• 2019

Purpose: This study tries to comprehend older adults' perspectives of community supports and health services in a South Korean city and identify important sociodemographic and health characteristics that affect their perspectives. Methods: 166 older adults were involved in this cross-sectional study. Questions on background characteristics and community supports and health services criteria (categorized as service accessibility, offer of services, voluntary support, or emergency care planning) based upon the WHO's Age-Friendly Cities Guide were used. The data were analyzed using paired and independent t-tests, one-way ANOVA, and hierarchical multiple regression analyses. Results: emergency care planning was rated as the most important by the participants (mean age=76.24 years, 22.9% male), while its current level of performance was lowly appraised (p<.001). The rated importance for each category differed based on individual characteristics. Depression (p=.016), older age (p=.012), and restricted network type (p=.039) were significantly related to ascribing a higher degree of importance to community services. Conclusion: Community initiatives are warranted to optimize emergency care for older adults. This planning must be based on the unique characteristics of older adults in coordination with supportive resources. In addition, comprehensive assessments are warranted before implementing action plans to ensure that the multi-dimensional problems of older adults are incorporated.