• Title/Summary/Keyword: Medical Aid

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Analysis of Prehospital Care Report for Improving Emergency Service at Prehospital Phase (병원 전 단계 응급의료서비스 개선을 위한 구급활동일지)

  • Choi, Gil-Soon;Kim, Youn-Kyoung
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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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.

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Remote Patient Monitoring through the Internet (인터넷을 통한 원격환자 모니터링)

  • 박승훈
    • Journal of Biomedical Engineering Research
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    • v.22 no.4
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    • pp.377-383
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    • 2001
  • In this paper, we present an intensive patient monitoring service through the Internet, which enables medical doctors to watch their patients in a remote site, to monitor their vital signs and to give them some advices for first-aid treatment. The service consists of three service objects: Monitoring Information Service(MIS), Vital Sign Monitoring Service(VSMS) and Multimedia Consulting (MCS). Through the MIS, medical doctors can get information about the patients currently under monitoring, including their names, ages, genders, symptoms, current main complaints and current locations. The VSMS enables medical doctors to monitor in real-time patients' vital signs such as electrocardiogram (ECG), respiration, temperature, blood oxygen saturation (SpO$_{2}$), invasive blood pressure (IBP), and non-invasive blood pressure (NIBP). It also generates alarms when the patients are likely to be in a critical situation. The MCS provides a real-time multimedia desktop conferencing facility for watching patients and instructing attendants to administer some first-aid treatment. We carried out some experiments according to two different scenarios. The intensive patient monitoring service was functioning well in a 100Base-T Ethernet LAN environment.

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Comparing the outcomes of out-of-hospital cardiac arrest between national health insurance and medical aid in Seoul before and during COVID-19 pandemic (코로나 전후 보험유형에 따른 서울 지역 병원밖 급성심정지 환자의 결과 비교)

  • Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.3
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    • pp.7-16
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    • 2023
  • Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

Investigating the Effects of Hearing Loss and Hearing Aid Digital Delay on Sound-Induced Flash Illusion

  • Moradi, Vahid;Kheirkhah, Kiana;Farahani, Saeid;Kavianpour, Iman
    • Korean Journal of Audiology
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    • v.24 no.4
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    • pp.174-179
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    • 2020
  • Background and Objectives: The integration of auditory-visual speech information improves speech perception; however, if the auditory system input is disrupted due to hearing loss, auditory and visual inputs cannot be fully integrated. Additionally, temporal coincidence of auditory and visual input is a significantly important factor in integrating the input of these two senses. Time delayed acoustic pathway caused by the signal passing through digital signal processing. Therefore, this study aimed to investigate the effects of hearing loss and hearing aid digital delay circuit on sound-induced flash illusion. Subjects and Methods: A total of 13 adults with normal hearing, 13 with mild to moderate hearing loss, and 13 with moderate to severe hearing loss were enrolled in this study. Subsequently, the sound-induced flash illusion test was conducted, and the results were analyzed. Results: The results showed that hearing aid digital delay and hearing loss had no detrimental effect on sound-induced flash illusion. Conclusions: Transmission velocity and neural transduction rate of the auditory inputs decreased in patients with hearing loss. Hence, the integrating auditory and visual sensory cannot be combined completely. Although the transmission rate of the auditory sense input was approximately normal when the hearing aid was prescribed. Thus, it can be concluded that the processing delay in the hearing aid circuit is insufficient to disrupt the integration of auditory and visual information.

Analysis of patients retransferred to a tertiary hospital through paramedics (119구급대를 통해 3차 병원으로 재이송된 환자분석)

  • Choi, Jun-Won;Mun, Jun-Young;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.2
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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.

Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

A study on the improvement of first-aid activity space within the ambulance for the efficiency of 119 EMT's work (119구급대원의 업무 효율성 향상을 위한 구급차 내 처치공간 개선에 관한 연구)

  • Hong, Sung-Gi
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.73-86
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    • 2013
  • Purpose: The purpose of this study is to provide the basic data for the ergonomic design of first-aid activity space(FAS) for a future ambulance suitable for the performance of 119 EMT. Methods: Questionnaire was filled out by the 124 EMT in 119 centers. The questionnaire consisted of 3 sub factors including the satisfaction and compatibility of the FAS. The satisfaction and compatibility was analyzed based on characteristics of the subjects. Results: The satisfaction rate of the FAS within the ambulance was an average of 2.23, and the compatibility category got an overall average score of 2.26. The lowest ranked criteria in the satisfaction and compatibility factor was the functionality of storage space showing 1.93 and 1.88, respectively. The best position of the paramedic seat was the top side of the patient, near the head, which is suitable for patient assessment and treatment. Conclusion: During patient transportation of 119 EMTs, for efficient work process, a layout design of the FAS should be based on ergonomics that satisfied the performance function.

A Study on Direction for the Development of Global Health Education in Korea (국제보건의료교육과정 개발을 위한 방향성 고찰)

  • Oh, Seung Min
    • Korean Medical Education Review
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    • v.15 no.2
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    • pp.93-99
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    • 2013
  • As a result of the globalization of diseases and the delivery of health care, physicians today are required to understand global health (GH) including the global burden of disease, health inequities, and effective medical aid. Interest in GH among medical students has also increased significantly. To meet these needs and to reflect an increasing focus on social accountability in medical education, global health education (GHE) programs have already been well-established, particularly in North America. Korea's official developmental aid (ODA) volume almost tripled from 2006 to 2011. Korea has committed to double its ODA/gross national income ratio over the next three years. With these increases, interest in GH among medical students has significantly increased. Despite significant interest among medical students, GHE programs have not been properly established in Korea. To develop GHE programs in Korea, proposed GHE curriculum frameworks were reviewed and core values, guiding principles, and GH competencies were identified in the context of the current literature. To identify key themes essential to the development of GHE programs in Korea, the curriculum frameworks should be focused on a global context and should be taught from the perspective of the social, political, and economic causes of ill health.

Actual Survey of College Students' Knowledge of First Aid (대학생의 응급처치 지식수준 실태 조사)

  • Kwon, Hayrran;Chong, Ji-Yon
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.81-94
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    • 2003
  • This study tries to examine the level of safety consciousness and first aid knowledge of 124 college students who attend non-public health departments in Gwangju from April 1 to 30, 2003 and apply the results of the study to curriculum. The results of this study are as follows; 1. On experiences of need of first-aid, 87.5% of respondents said 'yes' and there was a significant difference in the number of their siblings($x^2$ = 7.482, p = .048). 2. Sources of education of first aid were mostly at school(46.8%), no education(23.4%), through mass communication(22.6%) and by themselves(7.3%). There were significant differences by characteristics in sex($x^2$ = 30.230, p = .000), year($x^2$ = 10.821, p = .013) and mother's education($x^2$ = 18.932, p = .025). 3. Sources of information of first aid were mostly through TV(46.8%), followed by others (42.7%), newspapers(7.3%) and magazines(3.2%). 4. On the opinions of the most suitable period for educating first aid, elementary school was highest(41.9%), followed by kindergarten(29.0%), middle school(21.0%) and high school (8.1%) and there were significant difference by characteristics of subjects in sex($x^2$=9.689, p= .021) and year($x^2$=19.661, p= .000). 5. Score of knowledge level of safety consciousness was mean $71.58{\pm}12.05$ based on Likert 5-point scale with a full mark of 100 points and there was a significance only in current residence of subjects' general characteristics(F or t=3.894, p=.023). 6. Score of knowledge level of first aid was mean $62.73{\pm}13.29$ based on Likert 3-point scale with a full mark of 90 points and there was a significance only in residential type of subjects' general characteristics(F or t=3.058, p= .031). Although college students felt needs of first aid more than middle and high school students, it was found that their actual safety consciousness and knowledge level of first aid were low. Therefore, knowledge and ability should be developed to save human life from all kinds of emergencies and safety accident and first aid subjects should be separated in college curriculum and opportunity for actual education should be given.

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The Contributing Factors to Surplus Medicine by Long-Term Users of Medical Aid in Korea (의료급여 장기이용 수급권자의 잉여약물 실태와 관련요인)

  • Shin, Sun-Mi;Kim, Eui-Sook;Lee, Hee-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.403-407
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    • 2009
  • Objectives : The amount of medical utilization by Medical Aid recipients was 3.7 times that of patients with Korean Medical Insurance. This study aims to describe the surplus medicine and the medication-related utilization, and to determine factors contributing to surplus medicine. Methods : Among those who used copayment-free Class I Medical Aid in 2005, 146,880 subjects who were $\geq19$ year-old and received >365 days medical treatment per year were studied with their case managers by conducting face-to-face interviews. The analytic methods were description, chi-square, t-tests, ANCOVA and multiple logistic regressions. Results : Most subjects were female (68.6%), the elderly (62.5%), and the separated (61.6%), had an elementary graduation or less (74.8%), and had disabilities (33.2%). The percentage of subjects with surplus medicine was 18.5%. However, the percentage of females, the elderly, those with non-disabilities, the separated, the uneducated, those with a very poor perceived health status and those with an economical burden for medical treatment was 19.3%, 18.9%, 19.0%, 19.3%, 19.0%, 20.2% and 24.3%, respectively. For subjects with surplus medicine, averages for the number of used pharmacies, the pharmacy-visit days and the medication costs were 4.6 drugstores, 34.9 days and approximately 1,124 thousand Won(₩). These values were higher than those without surplus medicine (4.4 drugstores, 33.8 days, and ₩1,110 thousand, respectively). The odds ratios of the contributing factors to surplus medicine were female 1.11 (95% CI=1.07-1.14), the elderly 1.06 (95% CI=1.02-1.10), those with non-disabilities 1.08 (95% CI=1.05-1.12), the separated 1.14 (95% CI=1.10-1.18), the unmarried 1.12 (95% CI=1.07-1.18), the uneducated 1.03 (95% CI=1.01-1.08), those with a very poor perceived health status 1.04 (95% CI=1.01-1.08) and experiencing an economical burden for medical treatment 2.33 (95% CI=2.26-2.40). Conclusions : 18.5% of subjects had surplus medicine with a higher mean of medication cost. Therefore, health education and health promotion programs to prevent surplus medicine and to improve the appropriate usage of medication are necessary.