Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.
Purpose: The purpose of this study was to investigate both the occurrence status of emergency vehicles traffic accidents and contents of the experiences of emergency medical technicians (EMTs) in fire station. Methods: A self-reported questionnaire was completed by 451 EMTs in fire stations in 6 cities provinces from February 9, 2017 to February 27, 2017. Results: Of 451 EMTs, 207 (45.9%) had traffic accidents experience. Regarding environment-related features, results indicated hour (12~18 hours), place (national highway), traffic flow (smooth), weather (clear), season (winter), and day (Friday). Regarding correlation analysis of differences in the number of ambulance traffic accidents pursuant to general features of accident-experienced drivers as a human factor, there were no significant differences in recruitment, driving careers of regular cars, driving careers of fire engines, and class but there were significant differences in fire-fighting careers. Accident experience in the group with careers over 6 years and less than 10 years higher than in the other groups. Conclusion: Efforts to expand fire engine driving education programs for the prevention of traffic accidents involving 119 emergency vehicles are required.
As a result of analyzing problems in field practice and its effects, the following conclusions can be obtained. Man students were more satisfied with their choice of this department than woman students and woman students recognized the importance of hospital practice although they felt the need of fire fighting station practice and man students felt the necessity of hospital practice, but they answered the fire fighting station practice was important. Departments of field practice are emergency and nurse departments in hospitals and emergency aid section in fire fighting stations. And it is found that field practice was performed well in relation to major subject. Areas of practice included emergency room, operation room and extensive cure unit and the experience of ambulance was more in fire fighting station than in hospital. Clinical guidance of professor was preferred to once a week and the students answered they felt satisfaction with practice through conference. Answer that field practice was helpful in understanding class was very high as 96.8% and its connection with employment was low as 12.8%. It is found that a proper timing of field practice was winter vacation for hospital practice after completing the second semester of the first year and summer vacation for fire fighting station practice after the first semester of the second year. The most difficult department in field practice was nurse department in hospital because 'respondents were practice students' and administrative department in fire fighting stations because 'they lacked recognition of paramedic'. In making practice diary, 'describing measure results' was difficult most and the respondents wanted to keep the diary in their custody.
Purpose: Job satisfaction, spouse support, parenting stress, and the factors that influence parenting stress in female fire fighters with preschool-aged children were examined. Methods: Data were collected from 180 female fire fighters who worked at the fire station from June to July 2013 and had preschool-aged children. Data were analyzed using SPSS WIN 21.0. Results: Average job satisfaction was 2.81, spouse support was 3.54, and parenting stress was 3.61. Parenting stress was negatively correlated with spouse support and job satisfaction. Job satisfaction and spouse support were positively correlated. Factors influencing parenting stress included employment period (${\beta}$=0.093, p <.05), a husband who is not a fire fighter (${\beta}$=-8.971, p <.05), having three children (${\beta}$=27.395, p <.05), delegating childcare to relatives (${\beta}$=9.605, p <.05), income (${\beta}$=-0.920, p <.05), and spouse support (${\beta}$=-0.589, p <.05). Conclusion: To reduce parenting stress and increase job satisfaction, female fire fighters with preschool-aged children should be assigned to stable administrative work instead of stressful on-site work. Husbands who are fire fighters should take advantage of paternity leave, implemented by the Ministry of Public Safety and Security, to increase their active participation in parenting.
Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.
본 연구는 응급구조(학)과 대학생을 대상으로 코로나19에 대한 지식 및 태도와 감염관리 수행도 간의 관련성을 알아보기 위해 시행하였다. 연구 대상은 전라남북도, 광주광역시에 소재한 3-4년제 응급구조(학)과에 재학 중인 대학생 154명이고, 수집된 자료는 SPSS/WIN 16.0을 이용하여 빈도와 백분율, 합(Sum), 평균 및 표준편차, t-test, ANOVA(Scheffe), Pearson's Correlation Coefficient, Multiple Linear Regression으로 분석하였다. 응급구조(학)과 대학생들의 감염관리 수행도에 코로나19에 대한 태도와 지식 순으로 영향을 미쳤다. 따라서 응급구조(학)과 대학생들의 감염관리 수행도를 높이기 위해 코로나19에 대한 지식 및 태도를 향상시킬 수 있는 정규 또는 비정규 교육과정, 다학제적 교육과정 개발 및 적용이 필요하다.
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.
Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.
Purpose: The purpose of this study was to improve the quality of prehospital care provided to infants and toddlers (preschoolers) based on questionnaire findings. Methods: A total of 1,634 running sheets from 119 centers of D city from patients older than 1 month and less than 7 years of age from January 1, 2013 to December 31, 2013 were reviewed for 119 emergency medical technicians (EMTs) activity analysis. And a self-reported questionnaire about knowledge and competency in prehospital care of preschoolers was completed by 159 EMTs at fire stations in D city. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: Of 1,634 patients, 58.6% were call to 119 due to disease, 33.8% due to injuries and 7.5% due to traffic accident. Knowledge and confidence in treating preschoolers was significantly higher among paramedic EMTs than basic EMTs. The 119 EMTs surveyed indicated that training for preschooler prehospital care was most needed. Conclusion: In order to provide high quality prehospital care for preschoolers transported to emergency rooms, it is necessary to equip ambulances with the proper equipment. In addition, EMTs should be provided educational opportunities and clinical training.
Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.
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