• Journal of Trauma and Injury
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• v.30 no.4
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• pp.120-125
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• 2017

Purpose: The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS). Methods: Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis. Results: Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05). Conclusions: The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.37-48
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• 2021

Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.

• Journal of Korean Clinical Health Science
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• v.7 no.1
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• pp.1215-1223
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• 2019

Purpose: This study is to figure out not only the characteristics relating to transfer time of inter-hospital transfer patient which is transferred by a private ambulance, but also factors influencing the transfer time. Methods: In this study, an analysis of 750 patients with high severity levels among those transferred to another hospital by a private ambulance in Busan for whole year of 2017. Results: The results showed that the following factors significantly influence the total inter-hospital transfer time: Ambulance crew (${\beta}=10.525$, p=.001) and patient and carer (${\beta}=37.606$, p<.001) when setting a doctor (selecting a medical institution) as a criterion; availability of the specialized care (${\beta}=12.435$, p=.008) when setting the near distance (reason for selecting a hospital for transfer) as a criterion. The explanatory power of this analysis was R2=0.423, whereas the explanatory power of calibration was R2=0.411. Conclusions: Factors that increase the total inter-hospital transfer time were the ambulance crew, and patient and carer's selecting a medical institution, and the reason for selecting a hospital where enables to offer the specialized care services.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.93-102
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• 2020

Purpose: The purpose of this study was to investigate the ethical values of paramedics and their awareness and practice of medical information protection protocols. Methods: A survey was conducted involving 300 university students majoring in a four-year paramedical education program at two universities in Daejeon and Chungnam. Ultimately 220 surverys were subjected to analysis. Results: There was a significant difference in students' perception of medical information protection according to the need for education on medical information protection protocol (p=0.022); however, there were no significant differences in the practice of these protocols. The idealism tendency was positively correlated with the awareness of medical information protection (r=.332, p=.000) and the practice of medical information protection (r=.309, p=.001). A tendency toward relativism was significantly associated with the awareness of medical information protection (r=.138, p=.040) and not significantly related to the practice of medical information protection protocols. The tendency toward idealism tended to have a significant positive effect on the awareness of medical information protection protocols (β=.318, t=4.777, p=.000) and the degree of practice (B=.369, t=3.456, p=.001). Conclusion: Appropriate educational programs for medical information protection are needed. These programs should adhere to the characteristics of the department by linking with the training institution.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.59-71
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• 2014

Purpose: This study aimed to examine the degree of paramedics' professional self-concept, empowerment, and burnout and to verify the effects of empowerment and burnout on their professional self-concept. Method: The study subjects were 116 in-hospital paramedics who completed a structured questionnaire. Data were collected between June 18 and 25, 2013. Results: The results were as follows. First, the paramedics' mean score for professional self-concept was 2.93 (range: 1-4), and the mean scores for empowerment and burnout were 2.87 (range: 1-4) and 2.48 (range: 1-5). Second, in terms of the general characteristics of the paramedics, professional self-concept showed significant differences based on sex, religion, work experience, and medical institution classification. Third, professional self-concept had a positive correlation with empowerment, and professional self-concept and empowerment had negative correlations with burnout. Fourth, the main variables affecting paramedics' professional self-concept were gender and total years of work experience. Conclusion: It is necessary to develop program to reduce paramedics' burnout and qualitatively improve paramedic services.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.240-247
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• 2022

Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m². An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

• The Korean Journal of Emergency Medical Services
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• v.14 no.1
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• pp.19-29
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• 2010

Purpose : This study was conducted to examine the degree of recognition of safety education and its execution for child-care teachers at daycare center for the disabled children in Jeollanam-do. Ninety six child care teachers filled out the questionnaire and the results were as follows. Results : 1. The possibility of accident prevention by the day care teachers was a little higher in case of nearby education institution. The most appropriate period of safety education was within one month. 2. Majority of child care teachers had received safety and first-aid educations before and the education was done for less than 2 hours. 3. The best educational method was practice-centered education of off-duty time. The contents of first-aid education were bleeding, fall, shock, and burn. 4. The education material and book should be available to the teachers when they need the knowledge. 5. By the annual schedule, safety education should be conducted and provided to the parents. Conclusion : This study suggested that reinforcement of contents related to emergency situation and actual first-aid as well as theory education in the process of parent and teacher education should be conducted on the basis of information of general conditions related to safety and first-aid education at the daycare center for the disabled children.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.105-124
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• 2023

Modern society is facing an unstable environment due to unexpected accidents and hazardous situations. For example, incidents such as the collapse of the Bundang Bridge and the crushing accident in Itaewon could serve as examples. In addition to these, critical emergencies like sudden cardiac arrests and strokes frequently occur, requiring swift actions and smooth transfers to specialized medical institutions for effective responses. In response to these risks, the country has been establishing various systems to protect the lives and safety of its citizens. Among these, the 119 First Aid Activities plays a crucial role within the emergency medical system. Its goal is to promptly respond to critical emergency situations involving severe trauma patients or patients with serious illnesses, minimizing damage and safeguarding lives by swiftly transferring them to emergency medical institutions for specialized treatment. The core activity related to this is emergency rescue operations. In particular, the 119 First Aid system serves as a crucial institution responsible for the hospital transportation of emergency patients. However, rescue personnel still encounter cases of interference with their activities during their duties. Despite efforts from the police, these interference cases persist, and they share similarities with the crime of obstructing official duties. Interference with emergency activities exhibits a comparable nature to instances such as physical assaults and equipment damage against emergency medical practitioners working within the emergency medical system. Therefore, a comprehensive understanding and improvement efforts regarding the issues of interference that arise during the process of emergency medical activities, including the 119 First Aid system, are necessary. The solution to these problems is to establish and improve the conditions for obstruction of first aid activities, focusing on the "Framework Act on Firefighting" and the "Act on 119 Rescue and Emergency."

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.656-662
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• 2018

Objective: Acute appendicitis is one of the most urgent surgical problems. Several factors have been considered as predictors of perforation, but this study focused on the change in pain pattern. The degree of pain and progression of appendicitis were analyzed assuming that the pain intensity would increase until the perforation and the degree of pain would decrease immediately after the perforation occurred. Methods: In this study, 385 out of 467 patients, who were diagnosed with appendicitis in a single institution and aged between 15 and 65 years, were reviewed retrospectively. The patients' pain scores and the diameters of appendices were analyzed along with the accompanying complications. Correlation analysis and a Student's t-test were performed. Results: In patients with complicated appendicitis, the mean numerical rating scale (NRS) was slightly higher than that of simple appendicitis, but there was no significant difference in the absolute value. Only the size of the appendix showed meaningful differences according to the combined computed tomography findings. The NRS distribution or appendiceal size did not correlate with the time duration from symptom onset. Conclusion: The appendiceal size tended to increase with progressing appendicitis. No significant correlation was observed between the patient's pain level and complications. The time duration from symptom onset did not show a relationship with the progression of appendicitis.

• Journal of Convergence for Information Technology
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• v.10 no.12
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• pp.126-131
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• 2020

This study analyzed the inflow and outflow patterns of emergency department patients, to identify changes in regional types in cities, counties, and districts in Jeonlado, Korea. Data of areas in Jeonlado for 2014 to 2018 were extracted from the National Emergency Department Information System. The extracted data includes the patients' and emergency medical institution addresses, which were used to calculate the relevance index (RI) and commitment index (CI). The calculated indices were classified into regional types by applying cluster analysis. A non-parametric method, Kruskal-Wallis test, was employed to examine the differences between years for RI and CI by regional types. The results of cluster analysis using the relevance and commitment indices revealed three regional types. Regions in cluster 1 were classified as outflow type, in cluster 2 as inflow type, and in cluster 3 as self-sufficient. RI and CI were calculated for each cluster or regional type. There were no significant differences between years in cluster 2 (inflow type) and cluster 3 (self-sufficient type). In cluster 1 (outflow type), there were no significant differences in CI between the years; however, there were significant differences in RI between 2014 and 2017, and 2014 and 2018. It is difficult to see that the emergency medical environment has improved due to the increased concentration of emergency medical care.