• Child Health Nursing Research
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• 제18권4호
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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.

• 한국응급구조학회지
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• 제16권3호
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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.

• 한국응급구조학회지
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• 제11권2호
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• pp.29-50
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• 2007

Purpose: This study was carried out in order to provide the basic data for the curriculum standardization of emergency medical technology by analyzing the three-year period curriculum of 9 colleges. Method: This is the descriptive analysis of the curricular of 9 colleges. The analyzed variables were the distribution, credit, mean, frequency of the liberal arts, majors, clinical and on-the-job(OJT) training courses, and teaching profession subject. Results: 1. The number of whole subjects was 61.0, the number of liberal arts was 10.3, and the number of majors was 50.7. The completion credit was 128.3, credits of liberal arts were 15.5(12.2%), and credits of majors were 112.8(87.8%). 2. The range of credits of liberal arts was 8 to 21, and most of the liberal arts were done in the first year of college. 3. The distribution of the credits of the national examination for the license was as follows; the itemized emergency care subjects were 27.9 credits, the general emergency care was 18.5 credits, basic sciences were 17.7 credits, emergency patient care was 9.5 credits, and emergency medicine law was 3.2 credits. 4. The number of other major subjects were 10.0 and showed even distribution in each semester. 5. The clinical and on-the-job(OJT) training were 4.5 subjects, the credits of completion were 14.9 and these subjects were not in the first year of college. Conclusion: This results will be helpful data for the advanced development and standardization of the new curriculum by keeping pace with the environmental change, competency improvement and the need of the learners of emergency medical technology.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.37-47
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• 2024

Purpose: This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma. Methods: This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images. Results: When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm. Conclusions: Using the sternum length as a tube thoracostomy indicator might be feasible.

• 한국응급구조학회지
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• 제16권3호
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• pp.29-43
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• 2012

Purpose : The goal of the present study is to provide the basic information to medical control which is the most important improving factor of pre-hospital medical treatment. Method : A total of 749 records of direct medical control were collected from 119 EMTs in emergency medical information center of Daejeon, Chungcheongnam-do and Chungcheongbuk-do from March 1, 2010 to February 28, 2011. Results : The 119 EMTs should record the level of qualification of EMT and general patient history taking precisely when they receive direct medical controls. The doctors should take medical controls within the task range of qualification of EMTs. Conclusion : It is necessary to establish the guideline of medical direction and protocol of prehospital emergency care. The quality improvement of pre-hospital emergency services will be possible by the guideline and protocol.

• 한국응급구조학회지
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• 제24권3호
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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.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.25-30
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• 2011

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

• 한국응급구조학회지
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• 제24권1호
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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.

• Clinical and Experimental Pediatrics
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• 제63권7호
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• pp.237-238
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• 2020

• 한국응급구조학회지
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• 제22권3호
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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.