• 한국멀티미디어학회논문지
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• 제11권9호
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• pp.1267-1276
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• 2008

허혈성 심장 질환자가 급성 심근경색으로 병원에 도착하여 경피적 관상동맥 중재술을 받는데 까지 걸리는 시간(door-to-balloon time)은 환자의 사망률에 매우 큰 영향을 미친다. 본 연구에서는 기존에 병원에서 사용하고 있는 응급서비스시스템을 개선하고자 3단계의 시간 중 보호자에게 연락과 보호자가 병원에 도착할 때까지의 시간(door-to-data time), 이후 시술동의서에 서명할 때까지의 시간(data-to-decision time)을 줄이고자 하였다. 새로운 e-응급서비스시스템은 급성심근경색을 가진 응급시술환자에 대한 병원 내 응급서비스시스템 내의 데이터베이스를 구축하였고 허혈성 심장 질환자로서 부산대학교병원에 주기적으로 내원하는 환자에게 건강카드(health card)를 발급하였다. 아울러 사전시술동의서는 공인된 전자화 문서로 보관하도록 하였다. 새로운 전자화 시스템은 복잡한 진료 및 시술 절차를 획기적으로 감소시킬 수 있다. 그러므로 응급환자에 대한 인명구조를 용이하게 하고 사망률을 감소시키는 효과를 기대할 수 있다. 뿐만 아니라, 기존 시스템의 복잡한 절차로 인한 의료진과 환자의 고충을 동시에 해결하는 효과도 기대할 수 있다.

• 한국응급구조학회지
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• 제23권3호
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• pp.97-110
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• 2019

Purpose: This study aimed to investigate the role of life stress in the relation between health behaviors and bioethics awareness among paramedic students. Methods: This study recruited 238 paramedic students in F and R areas as participants. Multiple regression analysis was performed using Baron and Kenny's three-step procedure. Results: In the first stage, health behaviors had a significant effect on life stress (β=-.202, p<.01). In the second stage, health behaviors had a significant effect on bioethics awareness (β=.240, p<.001). In the third stage, life stress had a significant influence on bioethics awareness (β=-.167, p<.01). In the fourth stage, the regression coefficient of the third stage (β=.137) was less than that of the second stage (β=.159). In addition, when controlling for life stress, health behavior was shown to affect bioethics awareness (β=.206, p<.01). The mediating effect of life stress was found to be significant in the relation between health behavior and bioethics awareness (Z=2.04, p<.05). Conclusion: As health behavior is a factor that affects bioethics awareness through the mediation of living stress, universities should prepare training programs to improve the health behavior and reduce the life stress among students.

• 한국응급구조학회지
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• 제1권1호
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• pp.71-86
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• 1997

This study is to suggest some developmental policies by analyzing the activities of first aid party in Kwangju and Chonnam regions for two years from Jan. 1, 1991 to the end of December, 1995. First, the residents in Kwangju and Chonnam regions have the sufficient benefits of emergency medical center, but it will be desirable that general hospital should be established and managed in Kohung peninsula which forms the wide island area far away from big cities. Second, the classification of the degree of severe case in the field by rescue members should be strengthened as the means which can reduce the number of patients transferred to the emergency room and the legal method which rescue members can select the medical agency. Third, children less than 10 are most frequent emergent patients and it is due to parent's indifference and children's in sensibility to safety. So the safely education in the course of infant and elementary education should be strengthened and the method which can keep the self safety through the legal system. Fourth, to increase the rate of emergency measure by rescue members, the reasons of fail of emergency treatment are suggested, the treatment results of each rescue member are analyzed every year and it is desirable that the system which can evaluate the personal ability should be introduced. Fifth, the medical accidents occurred in the case of medical act, by rescue members must lake the legal responsibility, but such a problem can he solved with the compensation of insurance system by government. Sixth, to reduce the time required for transfer, traveling service system for the fixed period in beach should be complemented and extended more and service system at ordinary times should be examined at mountains, the area of traffic jams and large special industrial park. Seventh, since service system with one team of two members of 119 rescue party in expressway cannot be mobilized when multiple accidents occur at the same time, it is considered that service system of two teams of four members should be extended. Eighth, first-aid service in expressway is conducted with rescue and emergency treatment by the rescue party at the same time, but the professional rescue lacks and it may result in the injury of patients. Therefore the creation of rescue party in expressway is the urgent problem.

• 한국응급구조학회지
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• 제27권3호
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• pp.85-99
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• 2023

Purpose: We aimed to identify the awareness and reporting obligation attitude toward child abuse among paramedic students who will become paramedics in the future and play an important role as those with an obligation to report child abuse. Methods: Data were collected from the paramedic students after consent to this study through online. The period of data collection was from July 10 to August 2, 2023 and 142 questionnaires were analyzed using SPSS 27.0 program. Results: 79.6% of the subjects knew who was required to report child abuse, but only 46.5% knew the reporting agency, and 30.3% knew the reporting procedure. Additionally, 83.8% were willing to report child abuse when discovered. Awareness of child abuse was 4.58±0.29 points out of 5. The reporting obligation attitude toward child abuse was 3.53±0.74 out of 5. Awareness of child abuse was determined by whether one was required to report child abuse (p<.05), whether one was aware of the reporting procedure (p<.05), and whether one was willing to report child abuse (p<.05), there appeared to be a significant difference. Attitude toward reporting obligation regarding child abuse was determined by gender (p<.05), whether one was aware of the obligation to report child abuse (p<.05), and willingness to report upon discovery of child abuse (p<.01), it was found that there was a significant difference. Conclusion: It is necessary to develop realistic educational content that can be linked to suspected abuse sites in hospitals and out of hospitals so that students who will become paramedics in the future can play an active role as mandatory reporters of child abuse.

• 한국응급구조학회지
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• 제28권1호
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• pp.47-62
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• 2024

Purpose: This study aimed to provide basic data for infection control education plans based on infection control awareness and performance of paramedic students during clinical field training. Methods: Data were collected from paramedic students with experience in clinical field training. The data collection period was from May 4, 2023, to June 4, 2023, and 132 copies of the collected survey were analyzed using the SPSS27.0 program. Results: Infection control awareness and performance were 4.80±0.24 points and 4.49±0.55 points out of 5, respectively. The infection control awareness of the participants according to clinical field training-related characteristics differed significantly in university education before clinical field training (t=2.100, p=.038). In addition, there were significant differences in performance in the number of clinical field training sessions (F=9.149, p=.000), hospital education before clinical field training (t=5.365, p=.000), and hospital education during clinical field training (t=3.094, p=.002). Conclusion: Before clinical field training, schools should provide infection control education that combines theory and practice suitable for hospital practice so that students can complete the infection control education organized by the hospital. Furthermore, if a university develops infection control in the clinical field training guidelines, it will have a positive impact on students' infection control performance through prior education.

• 한국응급구조학회지
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• 제24권2호
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• pp.79-88
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• 2020

Purpose: The study aimed to collect the first aid activity log data of patients who were retransferred through paramedics and to analyze the data in the hospital to improve the plan. Methods: We analyzed 434 retransferred patients, out of the 18,197 patients who visited the emergency medical center in the C area in G metropolitan city, from January 2017 through December 2018. The collected data were analyzed using the SPSS software. Results: The patients were retransferred for various reasons: 17.7% (77 cases) due to the absence of specialists, 15.0% (65 cases) required first aid, and 5.3% (23 cases) due to absence of medical department. In addition, the major medical department with the largest number of retransfer was the department of emergency medicine with 38.2% (166 cases). In the prehospital stage, 38.5% (167 cases) were classified as severe, but in the hospital stage, they were classified as mild. In addition, as a result of hospitalization and discharge, 60.4% (262 cases) were discharged. Conclusion: Most of the retransferred patients were non-emergency patients, and were discharged for mild conditions. The overcrowding in the emergency room of a tertiary hospital can be prevented by reducing the retransmission.

• 한국응급구조학회지
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• 제14권3호
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• pp.95-105
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• 2010

Purpose: This study aims to investigate the operation of continuing education system and continuing education program for emergency medical technician in Korea, Japan and United States and develop reasonable operating scheme of continuing education and curriculum in order to provide the base data for the improvement of continuing education for the improved practice capability and its maintenance, Method: The overall review of continuing education for domestic 1st class emergency medical technician was performed and also the content of continuing education for Emergency Medical Technician - Paramedic in the United States and Paramedics of Fire Department with the license for the paramedic in Japan, have been analyzed through literature, books, articles, agencies' data, laws, and internet date. Result: Hours for domestic continuing education was 4-8 hours and it was only 3-11% compared to 72 hours in the United States and 128 hours in the Japan. And with respect to the types and methods of programs, there were differences both in quantity and quality. Conclusion: As an education, providing and supplementing the changed content and technical information for the improvement of the capability and qualification of emergency medical technician, selection of education hours and various continuing education should be continuously and regularly provided and conducted. The introduction of various continuing education system and programs for this is considered to be required.

• 한국산학기술학회논문지
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• 제12권9호
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• pp.4075-4082
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• 2011

항공기 승무원은 최초 반응자로 비행기내 환자 발생 시 적절하고 신속하게 응급처치를 시행하여야 한다. 승무원의 기본응급처치 의식조사 결과, 출혈 관리, 소아 고열, 경련, 심근경색, 기도유지, 부분기도폐쇄 등에 대한 대처방법은 80.5%~97.8%로 올바르게 의식하고 있었지만 의식 없는 기도폐쇄, 호흡확인 방법, 영아자동제세동기 사용 등에 대한 대처방법은 3.2%~20.0%로 비교적 낮게 나타났다. 따라서, 본 연구결과를 바탕으로 기내에서 발생되는 환자 중 발생빈도가 높은 유형, 해결하기 어려운 유형, 생명을 위협할 수 있는 유형 등에 대한 응급처치 매뉴얼이 마련되어야 된다.

• 한국응급구조학회지
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• 제12권3호
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• 의료법학
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• 제23권1호
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• pp.37-80
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• 2022

이 논문에서는 현행 응급의료에 관한 법률이 규정하고 있는 응급의료에서의 설명·동의의 원칙과 응급의료거부죄를 검토함으로써 응급의료종사자의 환자에 대한 생명보호 의무가 환자의 자기결정권 보장보다 중요한 경우에 한하여 응급의료거부죄가 성립함을 제시한다. 응급의료에서도 일반 의료상황과 마찬가지로 의료행위 시행 전 환자에게 응급의료의 필요성이나 방법 등에 관하여 설명하고 동의를 받아야 함이 원칙이다. 다만, 설명·동의 절차를 예외적 방법으로 이행하거나 생략할 수 있음에도 그 절차 준수를 이유로 응급의료를 거부·기피한 응급의료종사자는 응급의료거부금지에 따른 행정처분과 행정벌을 부담하게 된다. 즉, 설명·동의 절차 생략 가능성에 관한 판단에 따라 응급의료거부죄가 성립할 수도 있는 것이다. 환자가 미성년이거나 의사결정능력이 없는 경우 그 법정대리인이 환자의 의학적 이익에 반하는 결정을 하더라도 법정대리인의 의견이 무조건적으로 존중되는 것은 아니다. 미성년 환자도 원칙적으로 자신의 신체에 관하여 결정할 권리가 있고, 법정대리인의 결정 역시 환자의 최선의 이익을 위한 것일 때 유효하기 때문이다. 환자가 치료를 거부하는 상황에서도 원칙적으로 응급의료종사자의 생명보호의무가 더 우선한다. 그러나 현행법은 여러 예외 상황에 대해 명문의 규정을 두고 있지 않아 응급의료 현장에서 그 해석에 어려움이 있다. 한편, 우리 대법원 및 하급심 판례는 응급의료종사자의 응급의료의무와 설명의무 사이의 이익형량이 불가피한 상황에서 환자의 생명상실이 문제되는 경우 설명의무보다 응급의료를 시행하여 환자의 생명을 보호하여야 할 의무가 우선이고, 예외적으로 사전에 치료 여부·방법에 대해 환자의 진지한 숙고가 있었던 경우 환자의 자기결정권이 응급의료의무와 대등하게 고려될 수 있다는 취지로 설시하고 있으므로, 이를 체계적으로 정리하고자 한다. 나아가 현행법의 해석만으로 해결이 어려운 부분에 대하여는 1) 미성년자에 대한 응급의료의무 조항 신설, 2) 응급환자의 의사결정능력 판단 기준을 의학적 내용을 중심으로 수정·보완, 3) 응급처치시 의료인의 추가 동의가 불요함을 명시, 4) 복수의 의견 충돌이 있는 경우에 대한 제도적 보완, 5) 응급의료 중단시 벌칙조항 신설 등 입법 과제를 제시한다.