• 한국응급구조학회지
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• 제3권1호
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• pp.20-32
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• 1999

The purpose of this retrospective research of 603 patients who were transferred to the emergency medical center of university hospital from 1 Jan, 1998 to 31 Jan, 1998 was making of basic data for emergency medical transfer system improvement countermeasure and the point at issue of overlapping reexamination ststus of patients transfered to emergency medical center of university hospital from 1,2 level hospital. The data analysis was done by SPSS, t-test, ANOVA, Pearson correlation. The results were as follows: 1. Male to female ratio was 1.7:1 and peak age group was patients over forties and under nine years of age(70.5%) 2. Traumatic patients were 17.8%, motor vehicle accident patients were 16.7% and Non-traumatic patients were 65.3%. Transferring hospital was divided into 2groups: primary hospital, secondary hospital. The majority was secondary hospital(73.3%). The result of symptom severity classification of patients transferred to 3rd emergency medical center was urgent patients 32.5%, emergency patients 33.58%, non-emergency patients 34.0% 3. Most highest score items amoung overlapping reexamination of patients transfered to emergency medical center of university hospital from 1,2 level hospital were CBC test, simple X-ray (0.93점), CBC test(0.97점), urin test(0.88점), chemistry test(0.94점), simple X-ray(0.98점), CT(0.42점), EKG(0.89점) amoung overlapping reexamination of motor vehicle accident patients were more higher reexamination score than traumatic patients and non-traumatic patients 4. CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.001), CT(P<0.01), EKG(P<0.001) amoung overlapping reexamination of patients in 2 level hospital were more higher reexamination score than 1 level hospital patients 5. About symptom severity classification of patients transferred to 3rd emergency medical center, CBC test(P<0.001), urin test(P<0.001), chemistry test(P<0.001), simple X-ray(P<0.01), CT(P<0.001), EKG(P<0.001) amoung overlapping reexamination items in urgent patients were more higher reexamination score than other patients 6. Influencing variation for overlapping reexamination in hospital was CBC test(P<0.001), CT (P<0.001), MRI (P<0.05).

• 한국지리정보학회지
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• 제10권1호
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• pp.113-123
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• 2007

본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

• 한국응급구조학회지
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• 제19권2호
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• pp.51-69
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• 2015

Purpose: This study aimed to identify the effects of job insecurity and job engagement on turnover intention of paramedics who work in emergency medical institutions. Methods: From October 14 to 28, 2014, data were collected by structured questionnaires from 171 paramedics who were working in emergency medical institutions. The data were analyzed by using SPSS/WIN 21.0. Results: Of the 171 subjects, 57.3% were temporary employees, of whom 87.5% were working in regional emergency medical centers. The mean scores were 3.19 for job insecurity, 4.58 for job engagement, and 3.28 for turnover intention. The correlation between the variables showed that the higher the job insecurity of the participants, the higher their turnover intention (r = .397, p <.001). Moreover, the higher their job engagement, the lower their turnover intention (r = -.354, p <.001). The variable that most significantly affected turnover intention was job insecurity. The coefficient of determination ($R^2$) of job insecurity and job engagement was 24.3%. Conclusion: A law should be enacted to involve paramedics as required personnel for emergency medical institutions in order to enhance the quality of emergency medical services and provide prompt and professional emergency medical services to emergency patients.

• 한국응급구조학회지
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• 제9권2호
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• pp.89-100
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• 2005

Due to the improvement in life, we, human beings, are living in the more convenient world. However, as society gets complex, it comes to be faced a dangerous situation that needs to request a help due to an unexpected accident. The promptly emergency relief and emergency treatment from this accident, can be said to be extremely important in increasing a rate of resuscitation. This study analyzed on a case study and problems about the Emergency Medical System out of hospital in our country. The contents in the results of a study can be summarized as follows. 1. given the occurrence of medical disputes in a situation of emergency treatment, the regulation in the legal protection 'Will need to be reinforced. 2. in relation to the mobilization of ambulance, the preferentially passage right in ambulance needs to be guaranteed. In general, the preferentially passage right in ambulance is secured, but it will need to be supplemented by improving the education in civic consciousness and the social system. 3. in case of emergency duties in the emergency medical technician, the countermeasure will need to be strengthened in terms of abusive language and violence from a citizen. 4. in terms of emergency duties in the emergency medical technician, aiming to keep safety from a sudden situation, the possession of the protective equipments will need to be completely provided. 5. the limitation of activity will need to be eased by expanding the range of duties in the emergency medical technician within the ambulance, and the opening of duties will need not to be allowed to the similarly job category. 6. it needs to be reinforced the safety of the emergency medical technician from infectious diseases. Aiming at these emergency medical technicians whose service spirit is thoroughgoing, the nation and the local government will need to form all the conditions in which emergency medical technicians can be active passionately.

• 한국응급구조학회지
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• 제9권1호
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• pp.111-119
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• 2005

Glucose is the most importantenergy source in the central nervous system. Because the central nervous system cannot synthesize or store glucose. low blood glucose even for a short period results in no functionally normal activity of the brain. In addition, continuous low blood glucosecan cause irreversible brain damage and brain death. Therefore, the current status of emergency care by first aid staffs during transfer of patients with hypoglycemia has been investigated in this study, 114 patients who have visited the hospital using 119 Emergency Medical Service from January 1, 2004 till December, 2004 and shown blood glucose of 2.8 mmol/L and less on arrival have been involved. In case of nurses, assistant nurses, first aid staffs receiving first aid training and second-class emergency medical technicians(EMTs), they provided basic life support (BLS). In case of first-class EMTs, they measured blood sugar and then they orally administered glucose to conscious patients or provided simple first aids and prompt transfer for unconscious patients. As a result of analysis, it is suggested that first aid retraining is required.

• 한국응급구조학회지
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• 제26권3호
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• pp.71-91
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• 2022

Purpose: This study aimed to provide baseline data for implementing advanced life-support for 119EMTs. This is done with an in-depth examination of the emergency care experiences of the 119EMTs on-site and during transportation. Methods: Interviews were conducted with twelve 119EMTs, and the data were analyzed using the phenomenological method. Results: The 34 topics had 19 sub-components and were analyzed according to seven categories: 'A work environment where you cannot focus only on emergency care on-site and during transportation', '119EMTs struggling with manpower shortage', 'Current status of education blocking the upward standardization of 119EMT', 'Implementation of professional emergency care was held back due to the limited legal scope of 119EMT', 'Medical oversight makes it difficult to implement emergency care due to low flexibility', '119EMTs who cannot choose hospital selection and find it difficult to receive help', 'An evaluation system not reflecting reality at all that only leaves high scores'. Conclusion: This study was undertaken to implement specialized emergency care for 119EMTs; not only the necessity of reviewing the expansion of the work scope of 119EMTs but also the necessity of effective 'Medical Oversight system' reorganization raised as well.

• 한국응급구조학회지
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• 제11권3호
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• pp.163-174
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• 2007

Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.

• 한국응급구조학회지
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• 제25권1호
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• pp.223-234
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• 2021

Purpose: The purpose of the study is to check up the status of 119 emergency control centers usage. Therefore, the status of use of 119 emergency control centers and the incidence of pre-hospital cardiac arrest patients were investigated. Methods: The emergency activity daily reports and first aid diaries of 119 emergency control centers from January to December 2018 were reviewed. For more accurate status analysis, Among the first aid guidance received in the emergency rescue standard system, the cardiopulmonary resuscitation guide log was reviewed. Results: In 2018, the total usage of the 119 emergency control centers was 1,358,356 calls, hospital guidance werethe most commom (n=629,676, 46.4%), followed by first aid (n=428,027, 31.5%), disease consultation (n=170,238, 12.5%), medical oversight (n=111,188, 8.2%), and interhospital transfer (n=5,052, 0.4%). Regarding the user number per 1,000 persons, Jeju was the greatest at 48.0, whereas Changwon was the lowest at 13.0. A total number of dispatcher-assisted cardiopulmonary resuscitation was 12.181. The time from report to chest compression were 156.2±80.8 seconds for those with previous cardiopulmonary resuscitation training and 168.0±79.3 seconds for those without such training (p<.05). Conclusion: The ratio of first aid instructions, including dispatcher-assisted cardiopulmonary resuscitation, among total usage of the 119 emergency control centers increased. Therefore, additional efforts are required to improve the quality and expertise of information provided through the 119 emergency control centers.

• 한국응급구조학회지
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• 제3권1호
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• pp.91-101
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• 1999

The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

• 한국응급구조학회지
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• 제7권1호
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• pp.127-134
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• 2003

An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.