• 한국응급구조학회지
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• 제17권1호
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제6권10호
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• pp.77-94
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• 2000

The purpose of this thesis is to lay groundwork for the development of emergency care system in metropolitan area. It compares the performance and outcome of the current system with foreign counterparts and investigates the changing aspects of future medical environment. Emergency medical system can be divided into two parts of both pre-hospital care, which refers to the emergency measures taken before arriving at a hospital, and hospital care that is given within a hospital. Pre-hospital care includes on-the-spot expedients, information system and delivery system, whereas hospital care is related to the classification and specialization of medical care facilities. This research focuses on the evaluation of the performance of a rescue party, which is part of pre-historical care system. As a result, it provides valuable material for the development of the emergency medical system in Seoul.

• 한국병원경영학회지
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• 제24권1호
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• pp.11-20
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• 2019

The purpose of this study was to identify the factors affecting the use of superior general hospitals on public holidays by using the medical use model (Dutton's medical use model) with the medical panel data. The study found that 34.2% of superior general hospital emergency rooms were used on public holidays and the factors which made statistically significant influences on the use of superior general hospital emergency rooms on public holidays were whether patients were operated or emergency care and inspection etc. Also, there was a difference depending on whether the type of establishment of the medical insititution is national or private. In other words, patients who received emergency care and examinations were found to make more frequent visit to hospital emergency room on pubic holiday, compared to patients who underwent surgery and those who visited emergency rooms in the private superior general hospital did so, compared to those who visited emergency room in the national general hospital(OR, 4.4, 3.386, respectively). Therefore, it is necessary to consider the introduction of integrated care of health and social care medical service that focuses on primary care in Denmark, which focuses on patients, and pre-The Canadian Triage and Acuity Scale(pre-CTAS) in the UK.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.477-480
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• 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

• 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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• 제16권2호
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• pp.53-66
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• 2012

Purpose : Emergency medical services in China are increase in demand by people and under the greater pressure than ever before. So it is, necessary to advance the pre-hospital system in order to promote the development of emergency medical services. Methods : This is based on China-related articles, books, journals, reports, statistical data and other literature. Results : First, pre-hospital emergency medical care with the introduction of specialist training program should be established. Second, to strengthen pre-hospital emergency services and to develop the EMS guidelines. Third, the "120" reporting systems unification and awareness activation. Fourth, the preparation of the EMS facilities equipment system. Fifth, the rapid transport system establishment to the selected medical institutions. Conclusion : It is necessary to strengthen the emergency medical personnel at the scene, rapid transport, rapid patient triage and to improve the survival rate of the patients.

• 한국응급구조학회지
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• 제9권2호
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• pp.29-38
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• 2005

The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

• 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.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• 한국응급구조학회지
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• 제16권3호
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• pp.29-43
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• 2012

Purpose : The goal of the present study is to provide the basic information to medical control which is the most important improving factor of pre-hospital medical treatment. Method : A total of 749 records of direct medical control were collected from 119 EMTs in emergency medical information center of Daejeon, Chungcheongnam-do and Chungcheongbuk-do from March 1, 2010 to February 28, 2011. Results : The 119 EMTs should record the level of qualification of EMT and general patient history taking precisely when they receive direct medical controls. The doctors should take medical controls within the task range of qualification of EMTs. Conclusion : It is necessary to establish the guideline of medical direction and protocol of prehospital emergency care. The quality improvement of pre-hospital emergency services will be possible by the guideline and protocol.