• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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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.

• Health Policy and Management
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• v.16 no.4
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• pp.128-146
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• 2006

The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.19-32
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• 2015

Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.

• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.153-168
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• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.17-37
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• 2017

Purpose: This study describes current curricula for paramedic students in South Korea and proposes a standardization of the curriculum. Methods: Data were collected from 38 colleges and universities from March 1 to 31, 2016. Descriptive statistics were calculated using SPSS 23.0. Results: The proposed standard curriculum was below. Requisite liberal arts consisted of 2 subjects and 6 credits including biomedical ethics, communications and human relationships. Common major subjects were composed of 6 areas, 22 subjects, and 78 credits. The areas of basic medicine consisted of 6 subjects and 16 credits including medical terminology. Introduction to paramedicine consisted of 3 subjects and 7 credits. Emergency patient management consisted of 2 subjects and 9 credits. Particulars to paramedic care consisted of 8 subjects and 31 credits. The law area consisted of 1 subject and 3 credits. Other major areas consisted of 2 subjects and 12 credits including integrated simulation and physician assistance. Common field practice area consisted of 3 to 4 subjects and 9 to 12 credits. Conclusion: It is important to establish and adapt a standardized curriculum for paramedic students in order to ensure competence and to provide high quality emergency medical services.

• The Korean Journal of Health Service Management
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• v.8 no.1
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• pp.27-39
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• 2014

The purpose of this study is to compare and analyze the process of hospital visits according to the characteristics of the elderly visiting to emergency medical centers. The subject of study was 571 patients over the age of 65 who agreed to participate in the study of emergency medical centers from May 1 to 31, 2010. The frequency, percentage and ${\chi}^2$ test of collected data were conducted with SPSS WIN 12.0. As a result, the frequency of the aged with or without urgency revisiting emergency rooms due to chronic degenerative diseases was high. In addition, there were many cases that the aged living only with a spouse or remaining single. It was obscure to classify them into a urgent or non-emergent group which made it longer time to visit a hospital. It may be necessary that the care for urgent elderly patients considering the characteristics of the family environment functions to care the elderly were weakened.

• The Korean Journal of Emergency Medical Services
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• v.20 no.2
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• pp.21-35
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• 2016

Purpose: This study aims to investigate awareness and performance of infection control during ambulance attendant training, and to provide basic data for infection control. Methods: The subjects were 235 paramedic students who completed ambulance attendant training. There were 51 questions. The infection control dimension was divided into hand washing, personal protective equipment use, and environmental management, for each sub-dimension, awareness and performance were measured by a 4-point scale. The collected data were analyzed using SPSS statistics ver. 22.0. Results: A total of 95.3%, of the subjects completed an orientation for ambulance attendant training and 71.7% received education on infection. In all three sub-dimensions, hand- washing (p<.001), personal protective equipment use (p<.001), and environmental management (p<.001), awareness scored higher than performance. The awareness of infection control showed a significantly positive correlation (r=.394) with performance. Conclusion: In order to improve performance of infection control, education to improve awareness should be provided, and paramedics with higher performance levels in hand washing, and use of gloves and masks wearing should be assigned as training advisors.

• Journal of the Institute of Electronics and Information Engineers
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• v.51 no.6
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• pp.50-59
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• 2014

In mobile healthcare service, the accurate detection and the notification of the emergency situation are important to chronic patients' life. In the existing healthcare service, the medical staff or medical service provider always judges patients' health status by monitoring from the measured from bio-data. However, it is difficult to monitor many patients in real-time simultaneously, because the medical staff should monitor the health status continuously. Furthermore, an emergency condition diagnosis based solely on the statistical level of the bio-data may be difficult, since the emergency judgment of the bio-data might differ depending on the health characteristics of each person such as age, history of disease, gender, etc. In order to solve this problem, this article presents an mobile healthcare system for emergency bio-data management using a personalized emergency policy. The salient feature of the proposed mobile healthcare system is that the characteristics of the health status of an unique patient is defined to the policy, which is used to judge the emergency condition of the bio-data measured from the patient. The prototype of proposed mobile healthcare system has been built to demonstrate the design concept.

• Korea Journal of Hospital Management
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• v.10 no.2
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• pp.64-80
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• 2005

The objectives of this study were to identify factors associated with unexpected revisit to an emergency medical center (EMC) located in Seoul and to examine reasons for revisit. During March, June, September and December, 2002, a total of 168 patients had unexpected revisits to the EMC within 48 hours of a previous discharge. As a 1:1 matched control, we included 136 patients who: discharged from the EMC during the same time period: did not return to the EMC; had the same diagnosis and age(${\pm}5$) with the case. In this study, factors associated with unexpected revisits were defined as characteristics of a previous discharge, which were classified into three: sociodemographic, EMC visit-related, and discharge management factors. Reasons for revisit were categorized into disease, physician, patients, and system-related factors. Data were collected by medical chart review with assistance from clinicians of the EMC. Logistic regression results showed that patients who headed home after discharge without follow-up schedule had a 27.6 times higher risk of revisiting EMC than those who were hospitalized following EMC visit. Patients discharged on his own will had a 5.9 times higher risk of revisiting than those discharged following physician's advice. Patients requiring continual observation at the time of discharge were more likely to revisit by 8.7 times than those discharged with improved condition. About 69.13% of the revisits were due to disease-related factors, followed by 13.90% due to patient-related factors, 8.64% due to system-related factors, and 8.34% due to physician-related factors. It appears that the most significant factors influencing revisits are discharge management factors such as patient's condition at discharge, whether the discharge was accorded with physician's advice, and whether returning home without follow-up schedule. Therefore, appropriate discharge management is necessary to prevent EMC revisit.

• The Korean Journal of Emergency Medical Services
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• v.21 no.1
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• pp.45-58
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• 2017

Purpose: This study investigated the health status and health management program of 119 emergency medical technicians (EMTs). Methods: A self-reported questionnaire was completed by 794 EMTs in two cities from November 15 to December 20, 2016. The questionnaire collected the general characteristics of the subjects (10 items) and health-related information from 119 EMTs (14 items). Data were analyzed by using SPSS 23.0. Results: The mean value for the general health status of the 119 EMTs was 2.68. The general health status was lower for female 119 EMTs, older 119 EMTs, and married 119 EMTs; it was higher for 119 EMTs with more than 5 years of experience and for 119 EMTs with diseases. The mean value for work-related fatigue of the 119 EMTs was 3.26. This value was higher for female 119 EMTs (p<.05). 119 EMTs with more than 2 years of experience, and 119 EMTs with diseases (p<.01). The correlation between health program participation and general health status was significantly positive (r=.271), whereas the correlation between health program participation and work-related fatigue was significantly negative (r=-.375). The correlation between health program participation and program satisfaction was significantly positive (r=-.770). Conclusion: It is important to develop health management program for 119 EMTs and to offer them at all times. Moreover, the health status of 119 EMTs can be increased through improvements to working environments.