• Safety and Health at Work
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• 제12권1호
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• pp.66-73
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• 2021

Background: The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants. Methods: A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into "satisfactory" and "unsatisfactory". Univariate, bivariate, and multivariable logistic regression analyses were done. Results: The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10-0.70 and OR = 0.248, 95% CI: 0.08-0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics. Conclusion: The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

• 한국응급구조학회지
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• 제18권2호
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• pp.125-136
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• 2014

Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinical characteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergency medical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours after return of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Data were analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystanders in 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventricular tachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR duration was 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standard prehospital care for these patients and educational programs regarding CPR for lay rescues should be developed.

• 한국응급구조학회지
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• 제11권3호
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• pp.129-138
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• 2007

Purpose : This is a study on the actual state of instructing in cardiopulmonary resuscitation(CPR) in hospitals, so lays its purpose on providing basic materials for instructing in CPR by understanding the actual state of instruction in CPR for paramedics or first aide persons in hospitals. Result : 1. As a result of examining the actual state of instruction in CPR operation during the past 3 months, 89.3% of the subjects answered that they receive regular instruction. 2. As the number of CPR instruction during one year, the majority of them, 96.0% answered that they have instruction more than one time a year. 3. As answers to their desired first-aid instruction to receive by allowing duplicated responses with 4 items, instruction in CPR and respiratory obstruction for adults was 18.2% occupying the highest proportion followed by instruction in first-aide treatment for traumas with 17.7% and in how to use the AED with 16.3%. Suggestion : First, it is thought that instruction in CPR should be conducted on a continuous basis and the number of instruction should increase. Second, one should provide first-aide persons with proper instruction in CPR operation by developing time tables and protocols for instructional programs, and also make it possible that they can learn various skills by increasing the number of instruction.

• 한국응급구조학회지
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• 제15권2호
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• pp.43-54
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• 2011

Purpose: The purpose of this study was to explore EMT-paramedic students' experience of simulation education and analyze the confidence before and after education, learning attitude and course evaluation. Method: Research survey was conducted on 38 EMT-paramedic students during November, 2011 and EMT-paramedic students' experience of simulation education was analyzed after applying head, spinal, and chest injury scenario. The confidence before and after education, learning attitude and course evaluation in gender were analyzed by Mann-Whitny U test and the difference of confidence before and after education was analyzed by Wilcoxon signed rank test and learning attitude & course evaluation were analyzed by evaluating frequency, percentage, mean, standard deviation by using SPSS WIN 17.0 program. Results: 1. Students experienced various advantages such as increasing interest and self-reflection on learning, critical thinking ability, and EMT-paramedic-role experience and recognition of importance of teamwork. Students also pointed out disadvantages such as gap between real situation and simulation, limit of time and equipments, and burden of demonstration. 2. The confidence between before and after education, learning attitude and course evaluation in gender were not significant different statistically. 3. Confidence mean score elevated from 5.53(before education) to 5.87(after education), but the difference in their confidence did not show significant difference statistically. 4. Total mean score in learning attitude after simulation education was 3.70 out of 5.00, which is considerably very high. 5. Total mean score in course evaluation was 3.89 with score of 3.83 in evaluation in learning environment and 3.99 in evaluation of debriefing. Conclusion: The finding of this study demonstrate that the simulation education can provide a safe and repetitive practice environment, improve problem-solving ability and critical thinking, and increase the confidence in prehospital emergency care; therefore, simulation may be the new effective EMT-paramedic education strategy.

• 한국응급구조학회지
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• 제25권1호
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• pp.23-36
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• 2021

Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.

• 한국응급구조학회지
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• 제24권1호
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• pp.103-115
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• 2020

Purpose: This descriptive study investigated the relationship between death awareness and life ethics awareness, according to life stress, among students in the department of paramedics. Methods: General characteristics were identified using means and frequency, and the differences between the two military models were analyzed using the χ²-test and t-test by dividing them into lower and higher groups based on the mean life stress score (99.76 points). Results: Those with high life stress had higher death awareness than those with low life stress at 114.11 points. In contrast, those with low life ethics experienced more severe life stress with a score of 145.61 points (t=-2.609, p=.010)(t=-2.953, p=.003). The death recognition attitude and bioethics according to the degree of living stress-showed a significant correlation between the low and high groups (r=.188, p=.043) (r=.201, p=.042). Conclusion: Paramedic students require education on how to cope with life stress. However, access to education is limited to people living in modern times. As a potential solution to this problem, observing videos on the Internet is recommended. Moreover, we suggest accessing Internet and smart phone applications for advertising/educational purposes.

• 한국응급구조학회지
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• 제26권3호
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.

• 한국응급구조학회지
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• 제15권3호
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• pp.71-80
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• 2011

Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the ease of intubation, the success rate and the time for intubation performed with Macintosh Laryngoscope, Gum Elastic Bougie and Pentax AirWay Scope on the floor and table. Methods : Intubation was performed 30 times in total, including 5 times for each of intubation using Macintosh Laryngoscope, Gum Elastic Bougie and Pentax Airway Scope on the table and floor, only on subjects who passed the practice test of the national exam for paramedics. Data were collected by measuring the ease of intubation, the success rate and the time for intubation, and then analyzed by descriptive analysis, paired t-test, ANOVA using SPSS 18.0. Results : 1. There was a significant difference in the ease of intubation according to intubation devices. 2. There was a significant difference in the ease of intubation according to table height for intubation. 3. There was a significant difference in the success rate according to intubation devices. 4. There was no significant difference in the success rate according to table height for intubation. 5. There was a significant difference in the intubation time according to intubation devices. 6. There was a partially significant difference in the intubation time according to table height for intubation. Conclusion : Sufficient training not only with Macintosh Laryngoscope but also with Gum Elastic Bougie and Pentax Airway Scope could improve the survival rate by intubation in patients with difficult airway.

• Safety and Health at Work
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• 제7권1호
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• pp.32-37
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• 2016

Background: Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration. Methods: A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control. Results: A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/25.2 nmol/L, respectively. Conclusion: The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting aids is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff's personal alarm jackets so they are always in place and ready to be used.

• 한국화재소방학회논문지
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• 제31권3호
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• pp.127-136
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• 2017

우리나라는 1994년 "응급의료에 관한 법률"이 제정되면서 응급처치 교육이 본격적으로 시행되는 계기가 마련되었다. 현재 일반인 대상 AED내용이 포함된 응급처치 교육이 이루어지고 있으나 일반인의 AED사용 실적은 매우 미흡한 실정이다. 이에 대한 원인으로 획일화된 BLS교육에 문제점이 있는 것으로 판단하였다. 선행연구를 통해 AED사용 의향을 저해하는 개인적 사회적 요인을 파악하였으며 이를 개선된 BLS교육에 반영하였다. 연구 결과로 대상자 총 481명 중 기존 AED사용 의향이 없던 대상자는 200명(41.6%)이었으며, 개선된 BLS교육 후 43명(8.9%)으로 감소하였다. AED사용 의향을 높이기 위한 구체적 방안으로 교육 후에는 AED위치 교육에 대한 필요성이 가장 높게 나타났으며, 이를 토대로 AED교육 시 정확한 내용의 전달이 무엇보다도 중요하고, 더불어 생활 주변 AED의 위치인식에 대한 교육도 함께 이루어져야 하겠다.