• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.264-271
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• 2018

Objective For patients with acute myocardial infarction (AMI), symptoms assessed by emergency medical services (EMS) providers have a critical role in prehospital treatment decisions. The purpose of this study was to evaluate the diagnostic accuracy of EMS provider-assessed cardiac symptoms of AMI. Methods Patients transported by EMS to 4 study hospitals from 2008 to 2012 were included. Using EMS and administrative emergency department databases, patients were stratified according to the presence of EMS-assessed cardiac symptoms and emergency department diagnosis of AMI. Cardiac symptoms were defined as chest pain, dyspnea, palpitations, and syncope. Disproportionate stratified sampling was used, and medical records of sampled patients were reviewed to identify an actual diagnosis of AMI. Using inverse probability weighting, verification bias-corrected diagnostic performance was estimated. Results Overall, 92,353 patients were enrolled in the study. Of these, 13,971 (15.1%) complained of cardiac symptoms to EMS providers. A total of 775 patients were sampled for hospital record review. The sensitivity, specificity, positive predictive value, and negative predictive value of EMS provider-assessed cardiac symptoms for the final diagnosis of AMI was 73.3% (95% confidence interval [CI], 70.8 to 75.7), 85.3% (95% CI, 85.3 to 85.4), 3.9% (95% CI, 3.6 to 4.2), and 99.7% (95% CI, 99.7 to 99.8), respectively. Conclusion We found that EMS provider-assessed cardiac symptoms had moderate sensitivity and high specificity for diagnosis of AMI. EMS policymakers can use these data to evaluate the pertinence of specific prehospital treatment of AMI.

• Journal of Korean Public Health Nursing
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• v.9 no.1
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• The Journal of Pediatrics of Korean Medicine
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• v.21 no.2
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• pp.35-50
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• 2007

Objectives The purpose of this study was to revitalize pediatric emergency care in oriental medical hospital. Methods The study was composed of 281 pediatric patients who visited emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital, from March 2006 to February 2007. Results The age distribution showed that 1 to 3 year's patients(40.6%) are the most New pediatric patients(59.1%) were more than who received medical treatment in this place. The seasonal distribution of between month's section and the 24 solar terms's section made no differences and pediatric patients who visited in emergency room was most in spring, least in autumn. Moreover the changes of season's patients were more than others. Pediatric patients who visited during the weekends and holidays(50.9%) were more than during the weekdays(49.1%). Systemic division of the major problems were the digestive symptoms(44.5%) and nervous symptoms(30.6%), respiratory symptoms(12.5%), musculoskeletal symptoms(5.3%), dermatological symptoms(1.8%), cardiovascular symptoms(0.7%) and others(4.6%) followed. The time interval between arrival and onset : within 6 hours were the most(54.5%). Pediatric patients who had digestive, nervous, musculoskeletal diseases within 6 hours were the most, but in the case of patients who had respiratory diseases, most of them were visited within 48 hours. Acting and herb-med treatment(77.9%) were the most in medical treatments. Pediatric patients(69.0%) who didn't revisit in this hospital after treatment in emergency room were more than who revisited(29.9%). Conclusions Pediatric patients who visited in emergency room of oriental medical hospital were most not acute form of a serious diseases, patients most visited in disease prefer to oriental medicine; such as dyspepsia, convulsions, crying, ankle sprain. Further studies will be needed for the actual circumstance's reflecion from this hospital and other oriental hospitals nearby or other western emergency rooms for the accurate studies.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.20-27
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• 2003

Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.205-221
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• 2021

Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients' and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

• The Korean Journal of Emergency Medical Services
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• v.27 no.2
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• pp.51-63
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• 2023

Purpose: The study aimed to analyze the occurrence and transfer status of emergency patients at Incheon International Airport in Korea. Methods: This study design included 810 patients for eight years, from July 1, 2014 to June 31, 2022. The collected data were analyzed with SPSS statistics version 25.0. Results: For the demographics, 531 (65.6%) were males, 151 (19.5%) were in the highest age group (in their 50s), and 289 (35.9%) were foreigners. The most common place of occurrence was in protected areas in the passenger terminal, with 341 (42.1%) of cases occurring here. The time of arrival at the site (z=-3.444, p=.001), stay duration at the site (z=-8.145, p=. 001), and transfer time (z=-3.623, p=.000) were all significantly longer. Conclusion: It is necessary to consider a rapid emergency transportation plan, such as developing a system that simplifies immigration procedures when emergency patients move from protected areas to general areas. Moreover, in order to quickly respond to foreign emergency patients, detailed characteristics will need to be identified. Lastly, considering the long transfer time, an instructing doctor should accompany an ambulance and actively perform advanced resuscitation.

• Journal of The Korean Society of Clinical Toxicology
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• v.5 no.1
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• pp.15-20
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• 2007

Purpose: To analyze the general characteristics and clinical aspects of the organochlorine intoxicated patients in Korea. Methods: We prospectively evaluated the organochlorine intoxicated patients visiting to the 38 emergency medical centers in Korea from the 1, Aug. 2005 to the 31, Jul. 2006. Results: There were 38 patients intoxicated by the organochlorine during the study periods. The mean age of patients was 55.1 years old. The mean amount of the organochlorine intoxicated is 246.1 mL. The most frequent place where the patients got and took the organochlorine was their home. Twenty eight patients(73.7%) intended to suicide. Nine patients out of 38 patients(23.7%) were died and they all intended to suicide. Conclusion: There were 38 patients intoxicated by the organochlorine during the study periods. The suicidal attempts and the number of the dead were higher in Korea than the developed countries.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.