• Title/Summary/Keyword: Pre-hospital Emergency Medical

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Analysis on emergency care to the patients with acute myocardial infarction in pre-hospital and in-hospital phase (급성심근경색증 환자에 대한 병원 전 단계와 병원 단계에서의 응급처치 분석)

  • Lee, Han-Na;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.1
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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.

Improvement of the pre-hospital emergency medical service system in China (중국의 병원 전 응급의료체계 개선방안)

  • Wang, Chengying;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.2
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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.

Factors affecting use of the emergency department at superior hospitals on public holidays (상급종합병원 응급실 공휴일 이용의 영향 요인)

  • An, Byeung-Ki
    • Korea Journal of Hospital Management
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    • v.24 no.1
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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.

A Study on the Scope of Practice of Nurses in the Prehospital Emergency Medical Service System (병원 전 응급의료체계에서 간호사의 업무범위에 대한 소고(小考))

  • Bae, Hyuna
    • The Korean Society of Law and Medicine
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    • v.20 no.2
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    • pp.141-171
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    • 2019
  • Nurses are medical personnels under the Medical Service Act and perform medical practice such as medical assistance at medical institutions. The nurse, a medical personnel, provides emergency medical service to emergency patients in the pre-hospital emergency medical system as a 119 rescuer based on the Act on 119 Rescue and Emergency Medical Services. The scope of practice of nurses is comprehensively defined in the Medical Service Act and specified through precedents. In contrast, The scope of work of emergency medical technician is listed in detail. It is understood that nurses in the pre-hospital emergency medical service system have a wider scope of practice than emergency medical technician. In particular, the scope of practice of nurses as emergency medical personnel in the pre-hospital emergency medical system should be interpreted differently within the medical institution, considering the urgency of the patient, being transferred to the emergency medical institution, and the specificity of medical direction through tele-communication.

Comparison of triage and treatment results of abdominal pain patients of pre-hospital and in-hospital conditions (병원전과 병원내의 복통환자 중증도 분류 및 진료결과 비교)

  • Kim, Dong-Hyeon;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.7-22
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    • 2021
  • Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

EMS fund, is it functioning or fumbling? (응급의료기금, 무엇이 문제인가?)

  • Baek, Hong-Seok;Lee, Jun-Ho;Kim, Igic-Sung;Park, Hyun-Suk;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.1 no.1
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    • pp.35-45
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    • 2013
  • Purpose. Based on the comparison and analysis with those of United States, the aim of this research is to find the problems in current management, operation and future directions of emergency medical service (EMS) fund in S. Korea and to provide basic resources and appropriate measures to make a right decision in policies for EMS fund. Methods. Data from Ministry of Health and Welfare and other various sources during 1995 to 2012 were collected and analyzed. Results. From our analyses, several problems are identified in EMS fund operation. In brief, problems discerned are as follows. First, whereas the purpose and direction of EMS fund operations in United States are highlighted and focused on pre-hospital EMS system and associated infrastructures which need to be constructed, those of S. Korea are emphasized mainly on the in-hospital EMS system so far. Second, on the contrary to the fact that the EMS funds in United States are tuned to pre-hospital EMS system to provide prompt and efficient emergency care at the emergency scene of pre-hospital stage and to achieve the development, design, planning and demonstration projects for pre-hospital EMS systems, up to date, our investment of EMS funds demonstrated an excess biased inclination toward the construction of in-hospital EMS system, which is far from the realization of constructive and vital pre-hospital infrastructures. Third, while emergency medical technician is important and principal body in the management of emergency medical funds in United States, so far, no EMS funds in S. Korea existed for EMTs including the job condition, improved treatment and working environment for them. Conclusion. In conclusion, we strongly suggest that the problems pointed out must be revised and corrected. Current usage of EMS fund needs to be redirected predominatly to pre-hospital EMS system. Otherwise, unless current management and investment of emergency medical funds in S. Korea are applied and used for the vital necessities and demands of EMTs, public EMS units and private EMS units as well as related units in pre-hospital EMS system as in the cases of United States, in our consideration, they must be suspended or abolished.

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A Study on the Evaluation of the Emergency Medical System in Seoul (서울시 응급의료체제에 대한 평가 연구)

  • Lee, Teuk Koo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.6 no.10
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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.

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A study of pre-hospital emergency medical system at correctional institutions (교정시설의 병원 전 응급의료체계에 대한 고찰)

  • Kim, Su-Il
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.121-131
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    • 2009
  • The purpose of EMS is to provide emergency patients with prompt and suitable emergency treatments therefore it saves their lives and makes them recover fast to return to normal. The purpose of correctional administration is to return inmates to society as sound citizens after their service by providing various correctional education, reformational programs, vocational training and etc. In this way, the aim of correctional administration and EMS is like mutual agreement by their returning to society safely. Therefore this study makes some propositions like the followings for the safety between many inmates who can have physical injury and exposure to diseases caused by particularity of subculture within correctional institutions and the staffs who work for them. It is said about efficient pre-hospital EMS through various causes of emergency situation in the correctional institution, system, manpower, facility, equipments and problems and so on. 1. Recruit the first-rate EMT(emergency medical technician) as central role of pre-hospital EMS according to each correctional institution and working terms. 2. Equip specialized transference system with symptom of patients and purpose of transference. 3. Emergency medical equipments and first-aid medicines should be equipped for field and ambulance. 4. Educate correctional officers as first responders and inmates within correctional institutions about systematic emergency treatment.

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Analysis of direct medical control conducted to 119 emergency medical technicians in an emergency medical information center (119구급대원에게 시행한 일개 응급의료정보센터의 직접의료지도에 관한 분석)

  • Seo, Ha-Yan;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.3
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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.

Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools (예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석)

  • Kim, Yong-Joon;Sim, Kyoung-Yul;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.7-18
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    • 2022
  • Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.