• Title/Summary/Keyword: Emergency care services

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An Analysis of Prehospital Care for Major Trauma Patients depending on the number of 119 Ambulance Crews (119 구급대 편성 인원에 따른 중증외상환자의 병원 전 응급처치 실태 분석)

  • Kim, Jong-Ho;Lee, Hyo-Ju;Lim, Yong-Deok;Han, In-Deuk;Lee, Jae-Gook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.500-506
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    • 2018
  • This study analyzed current prehospital emergency care for severe trauma patients administered by different number of 119 EMS (emergency medical services) teams. Out of 1,067 severe trauma patients transferred by 119 EMS teams in J province from January 1st to December 31st 2015, 438 were evaluated in this study. IBM SPSS Statistics 21.0 was used to analyze collected data. The number of patients with severe trauma during the period of study was higher in male with two and three ambulance crews of 119 EMS teams with 242 patients (70.6%) and 66 patients (69.5%) respectively. The percentage of transfers made to local emergency medical centers was highest in those two groups, being 44.0% (151 patients) and 49.5% (47 patients), respectively. Total time spent at the scene did not differ between ambulance crews of two and three, nor did the frequency of practicing advanced airway management and IV (intravenous) cannulation, or the success rate of IV cannulation (p=0.253, p=0.362, p=1.000). Overall, the results indicated that merely increasing the number of paramedics does not improve the quality of prehospital care for severe trauma patients. Measures such as securing professional paramedics, simplifying direct medical oversights, activating indirect medical oversights, and expanding the legally allowed work scope are required.

Relationship among Task Interruption and Task Performance and Burn-out in Emergency Room Nurses (응급실 간호사의 업무중단과 업무중단으로 인한 업무상 문제 및 소진과의 관계)

  • Rhu, Eun-Jung;Lee, Eun-Nam
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.34-43
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    • 2013
  • Purpose: This study was conducted to examine the relationship among task interruption, task performance, and burn-out in nurses working at emergency room. Methods: The subjects of this study were 225 working at emergency rooms of 19 hospitals. Data was collected by using the structured questionnaire, including frequency of task interruption. problems in task performance due to interruption, and burn-out. Results: The average scores of task interruption were 2.06 due to communication, 1.49 due to treatment and record, and 1.39 due to other services (range 1-4). Frequency of task interruption was significantly correlated with task performance and burn-out. Conclusion: Emergency room nurses experienced some task interruption. The task interruption can influence upon task performance and burn-out of emergency room nurse.

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Temporal and Spatial Distributions of Emergency Medical Services: Busan (부산시 응급의료서비스의 시공간적 분포특성)

  • Nam, Kwang-Woo;Kim, Jeong-Geon
    • 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.

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Development of Evidence-based Nursing Practice Guidelines for Febrile Children in Emergency Room (응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발)

  • Jeong, Min-Jin;Shin, Hyun-A;Kim, Yun-Hee;Lee, Jee-Hyang;Lee, Seung-Ja;Song, Mi-Ra
    • Child Health Nursing Research
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    • v.18 no.4
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    • pp.214-221
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    • 2012
  • Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

Effects of educational intervention on single-rescuer respiratory-assistant therapy using a bag valve mask (백-밸브-마스크를 이용한 1인 호흡보조요법 교육의 효과)

  • Lee, Yong-Jae;Uhm, Dong-Choon
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.3
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    • pp.29-40
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    • 2019
  • 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.

The Study of Critical Indicators Development for Establishing Patient Classification System in the ER (응급실의 환자분류체계 확립을 위한 결정지표 개발 연구)

  • Seong, Young-Hee;Seong, Il-Sun;Lee, Seung-Ja;Kim, Jeong-Ha;Moon, Yu-Jeong;Choe, Yeong-Mi;Lee, Jee-Hyang
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.444-453
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    • 2006
  • Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, IV route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, $O_{2}$ inhalation, suction, fluid infusion, IV bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, $O_{2}$ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

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Performance Evaluation of Emergency Medical Center (응급의료센터 성과 평가 기준개발과 적용)

  • Kang, Chul-Hwan;Kim, Yoon;Lee, Pyung-Soo;Kwon, Young-Dae;Kim, Chang-Yup;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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Comparison of the characteristics of patient who cancel after presentation to an emergency department by 119 ambulance (119 구급차를 통해 응급의료센터에 내원한 접수취소 환자들의 특성 비교)

  • Yong-Joon Kim;Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.3
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    • pp.47-58
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    • 2023
  • Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

Factors influencing burnout of health care provider in emergency medical center - Focused on nurses - (응급의료센터에 근무하는 보건의료인의 소진에영향을 미치는 요인)

  • Choi, Yeon-Sook;Choi, Yeon-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.2
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    • pp.91-102
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    • 2012
  • Purpose : This study was designed to identify factors influencing burnout of nurses in emergency medical center. Methods : Data were collected by questionnaires from 178 emergency room nurses randomly selected from 6 general hospitals in two metropolitan cities. Measures were burnout, QEC, depression, decision latitude and job demand. Data were analysed using frequencies, means, standard deviation, t-test or one way ANOVA, Pearson's correlation coefficients and multiple regression with SPSS/win 18.0 version. Results : The mean score for burnout in emergency room nurses was 2.59 out of possible 4. There were significant differences in burnout according to exercise, leisure, position, job demand and depression. Burnout correlated negatively with exercise and leisure, and positively with job demand and depression. Factors influencing burnout in emergency room nurses were identified as exercise(${\beta}$=-.399, p<.001), leisure(${\beta}$=-.354, p<.001), job demand(${\beta}$=.301, p=.006) and depression(${\beta}$=.189, p=.021). These factors explained 49.8% of burnout reported by emergency room nurses. Conclusion : The result indicate which factors are major factors influencing burnout in emergency room nurses in general hospitals. Therefore, these factors may serve as predictors of burnout in emergency room nurses.

A Study on Operation Problems for the Emergency Medical Process Using Real-Time Data (실시간데이터를 활용한 응급의료 프로세스 운영에 관한 연구)

  • Kim, Daebeom
    • 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.