• 한국산학기술학회논문지
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• 제19권12호
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• pp.636-644
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• 2018

본 연구는 응급처치 교육프로그램이 간호대학생의 셀프리더십, 진로결정자기효능감 및 수행능력에 미치는 효과를 파악하고자 시도하였다. 연구방법은 비동등성 대조군 전후설계의 유사실험연구이며, 자료수집 기간은 2017년 6월 1일부터 8월 31일까지였다. 연구대상자는 D시 D대학 간호학과 학생 중 연구참여를 희망하고 동의한 실험군 27명과 대조군 25명으로 총 52명이었다. 대조군은 2017년 6월 1일 사전 설문조사 후 어떠한 처치도 없이 2주 후 사후 설문조사를 시행하였다. 실험군은 7월 25일 실험처치인 응급처치 교육 프로그램 시행 전에 사전 설문조사를 시행하였으며, 중재 후 8월 31일까지 사후 설문조사를 시행하였다. 실험군에게 제공된 응급처치 교육프로그램은 성인심폐소생술과 기도폐쇄, 화상, 출혈 및 골절에 대한 응급처치 교육내용 2시간 수강, 자율적인 동영상 시청, 강사로서 4시간 동안 초등학생 응급처치 교육수행 등으로 진행되었다. 자료분석방법은 SPSS/WIN 20.0 프로그램을 이용하여 기술통계, independent t-test, $x^2$ test 및 paired t-test로 분석하였다. 응급처치 교육프로그램 적용 전후 두 집단 간 차이를 분석한 결과 셀프리더십(t=2.08, p<.05), 진로결정자기효능감((t=4.22, p<.05), 및 수행능력(t=5.02, p<.05)은 통계적으로 유의한 차이가 나타났다. 즉, 본 연구에서 적용한 응급처치 교육프로그램은 간호대학생의 셀프리더십, 진로결정자기효능감 및 수행능력을 증가시키는데 효과적임을 알 수 있다.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2018년도 추계학술대회
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• pp.78-79
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• 2018

최근 시간적, 공간적, 의료기술 적용의 한계를 극복하기 위하여 의료 기술과 IT 기술의 융합을 시도하고 있다. 본 연구에서는 응급 의료 서비스를 위한 원격 의료 지도를 지원하기 위한 앱을 개발하였다. 개발된 스마트 원격 의료 지도 지원 앱은 원격지에 있는 의사가 응급 구조사로부터 응급 환자의 상황을 실시간으로 전달 받을 수 있다. 또한 환자의 상태 진단 및 응급 치료를 지도할 수 있으며 응급실에서의 대응이 신속하게 이루어질 수 있도록 할 수 있다.

• 한국응급구조학회지
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• 제24권2호
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• pp.51-66
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• 2020

Purpose: The purpose of this study was to determine whether, in patients with acute coronary syndrome (ACS), according to the mode of arrival affect the emergency medical process. Methods: The participants of this study were 118 adult patients (46 patients admitted by emergency medical services (EMS), 48 walk-in patients, and 24 transferred from other hospitals) admitted to the emergency departments at one regional-level medical center who underwent coronary angiography between January 1, 2016 and December 31, 2017. To compare treatment courses, the median values of the following variables were compared among groups: symptom to door time; door to triage time; and door to ECG time. All data were analyzed using SPSS program. Results: Based on the initial assessment at triage, there was a significantly greater proportion of Korean Triage and Acuity Stage (KTAS) Level 1 or 2 among patients admitted by EMS than among walk-in patients. All three analyzed variables were lower in patients admitted by EMS than in the other two groups. Conclusion: Our results show that ACS patients who accessed EMS reached the emergency center faster after symptom onset, received initial triage assessment at earlier stages, and underwent sooner important examinations (i.e., the 12-lead ECG).

• 한국응급구조학회지
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• 제14권3호
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• pp.13-28
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• 2010

Purpose: In this study, we investigated the better application of the law which is about the AED installation and more effective ways of emergency medical care system, to understand the law and to research the current condition of public facilities which belong to local governments, and to seize the aspect of safety guards who currently work in order to provide the installation of AED in the public facilities and to provide more efficient emergency medical service with the effectuation of the immunity law of the good intention of first-aid treatment. Methods: In Gwang-ju, 234 public facilities have been identified by 31 December, 2008. With the exception of the duplication, we researched 158 facilities and received the answers from 95 of them. Results: In the research, 53% of them have had internal emergency first-aid education, and 55% of them didn't have this education and a CPR education manual, and 30% of the facilities even didn't know how to connect with the manager of the company for the first-aid department. On the other hand, most of them were highly interested in CPR and AED education on the ratio of 91% and 93%. 88% of them have been trained about first-aid, 51% of them haven't been retrained, 17% have never been trained. so, the reality of emergency system at public facilities is serious. 78% of them knew they are working at public facilities, though 49% of them didn't know about AED installation. 57% of them didn't know the fact there is the immunity law related with good intentions for first-aid treatment. 63% of the facilities have security guards, and 30% of them didn't answer the questions. Also, many of them agreed to the opinion that all employees should have first-aid training. At representative survey report of participator of public-facility, emergency treatment is 61%, 16% of patients calling. Accordingly they importantly think better doing an on-site first-aid than evacuating the patient. And the rates show that 57% of them answerers tend to call Fire-Office(119) for evacuating the patients, and 28% of them EMIC(1339) for the first-aid. Conclusions: In this study, we are suggest to improve the details of the efficient operations and management after the grasp of the uninstallation, indifference, and unreliable conditions of AED. 1) Need a publicity of AED install cognition which is an emergency medical instrument at public facilities. 2) Arrangement of safety agents at facilities and concerns about them for good management from the parties concerned. 3) Need a designation of legal details according to the decision of the AED installation and the standard of the AED installation. 4) Training about first-aid of safety guards and the persons concerned in the facilities should be practiced participation with the positive and through this, first-aid treatment could be done by anyone who knows the immunity law related to medical emergency. 5) The brochures for the potential users and the results form practicing the instructions need to be improved in many ways through recording the emergency cases that have happened.

• 한국화재소방학회논문지
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• 제28권3호
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• pp.80-86
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• 2014

본 연구에서는 한국보건사회연구원과 국민건강보험공단(2013)의 한국의료패널 2009년 데이터를 이용해 응급환자 이송 서비스의 이용과 관련된 사회경제적 임상적 특성을 조사하고, 예측 인자를 분석하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등 응급환자 이송 수단을 이용한 경우가 자가용, 택시, 도보 등 응급환자 이송 수단을 이용하지 않은 경우보다 많았다. 둘째, 개인 및 가구 특성 변수 중 연령, 교육 수준, 세대 구성, 주거 형태, 월 평균 가구 소득, 가구주와의 관계 등에서, 응급 상황 특성 변수 중 의료 보장 형태, 장애 유무, 만성질환 유무, 응급실 방문 이유, 응급실 이용 후 조치 등에서 응급환자 이송 수단을 이용한 경우와 이용하지 않은 경우에 통계적으로 유의한 차이를 나타냈다. 셋째, 개인 및 가구 특성 변수 중에서는 연령과 월 평균 가구 소득, 응급 상황 특성 변수 중에서는 장애 유무, 응급실 방문 이유, 응급실 이용 후 조치 등이 응급환자 이송 서비스의 이용에 통계적으로 유의한 예측 인자로 나타났다. 따라서 병원 전 응급환자 이송 단계에서 응급 처치의 적절성 제고와 함께 응급환자 이송 서비스의 이용 특성과 예측 인자를 감안한 효과적 대응이 필요하다.

• Clinical and Experimental Emergency Medicine
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• 제5권4호
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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.

• 대한산업공학회지
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• 제36권1호
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• pp.59-68
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• 2010

The medical emergency departments are suffering from the crowdness of patients, hence the quality of medical service the patients are receiving are getting poorer. Overcrowding of medical emergency departments may incur the waiting time for the treatment, and the improper treatment in time. For the operational control of the emergency department, the crowding index is commonly used to identify the crowding intensity, with which the operation process is managed, and future process can be expected. In this study the composite crowding index is suggested, in which the trend of inpatients rate, the age and acuity of patients, and resource of ED are considered. The validity of the suggested crowding index is discussed by the regression analysis for the index and the actual number of inpatients, and by the simulation study using the process model and the real data.

• 대한응급의학회지
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• 제29권6호
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• pp.624-635
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• 2018

Objective: This study examined whether emergency department (ED) crowding influences the timing of the initial assessment and treatment in severe trauma patients, as well as their mortality rates. Methods: This retrospective, observational study was conducted between January 2015 and October 2016, and included adult severe trauma patients who presented to the ED. The emergency department occupancy rate (EDOR) was used to measure ED crowding. The patients were divided into four groups using the EDOR quartile. The timeliness of the initial assessment and treatment in the four groups as well as the mortality rates were compared. Results: This study investigated 307 patients. The timing of the first computed tomography (CT) and laboratory test order, CT and laboratory test result acquisition, first transfusion, and patient transfer from the ED to the operating room were similar in the four groups. Multivariable logistic regression analysis did not show a significant difference in mortality between the groups. Conclusion: ED crowding was not associated with delays in the initial assessment and treatment of severe trauma patients, or in their mortality rates.

• 한국간호교육학회지
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• 제2권
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• pp.32-55
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• 1996

It was enacted 'Emergency Medical Act' in January, 1994 beginning the emergency medical service system from 1982, and while it was established the emergency medical department in junior college providing the detailed agenda about emergency medical technician and the regulation relative to the application of a law on the emergency medical act in 1995, the fire school and the National Medical Center are enforced the curriculum. It is very important subject faced for the construction of emergency medical system to produce a number of emergency medical technicians to be sufficient to the role of emergency aid. In this study it is analysed the training curriculum for the emergency medical technician and presented the improvement plans. 1. Though it needs the qualification level of first and second class in the selection process, the more important thing needs the detailed qualification level by term of one's service and the skills of business accomplishment. 2. In the examination management, (1) written examination is composed of the questions to understand how much faithfully they carry out the practical business as the emergency medical technicians, (2) it is added practical examination as the item to appraise the situation disposal ability. 3. It is necessary to prescribe the activity in the medical institution and ambulance arrangement through the development of 'Business Treatment Guide'. 4. For the regional balanced disposition of emergency medical personnel it is selected balanceably the educational institution by eight medical service areas, and considering the characteristics of region it is necessary to manage, in the practical business training course, another special course such as the mountains medical aid and sea medical aid. 5. In the period of education the first class needs the practical business training period of a certain period after passing examination, and the second class needs the extension of the period. 6. As the problems to improve in the curriculum [1] in the first class course (1) intensification of practical educaiton (2) reinforcement of curriculum (3) the development of standardized curriculum etc., [2] in the second class course (1) varieties of curriculum (2) intensification of basic first aid treatment education.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2012년도 추계학술대회
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• pp.414-417
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• 2012

최근 전문의 응급의료센터 당직을 규정하는 것을 골자로 응급의료법이 개정되면서 응급의료센터 시스템에 많은 변화가 생길 것 이다. 응급환자가 응급의료센터를 찾을 경우 응급실 근무의사 ${\rightarrow}$ 해당과 인턴 ${\rightarrow}$ 1 2년차 전공의(레지던트) ${\rightarrow}$ 3 4년차 레지던트를 거쳐야 전문의 진료를 받을 수 있던 것을 응급실 근무의사 ${\rightarrow}$ 해당과 당직전문의 진료 또는 호출로 그 절차가 간소화됐다. 문제는 이런 시스템을 하려면 모든 진료과목에 대해 당직전문의를 배치해야 한다. 하지만 모든 병원이 모든 진료 과목에 대해 전문의를 배치하는 것은 어렵다. 본 논문에서는 모바일 기기를 이용하여 사용자 근처의 응급의료센터가 있는 병원과 해당 병원이 어떤 전문의가 있는지와 병원의 정보와 응급실의 사용현황을 개정되는 응급의료법을 위해 통합 응급실 관리 시스템을 설계한다.