• 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.

• 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.

• 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.

• 의료법학
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• 제20권2호
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• pp.141-171
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• 2019

간호사는 의료법 상 의료인으로서 의료기관에서 진료의 보조 등의 업무를 수행한다. 의료인인 간호사는 119 구조·구급에 관한 법률에 근거 구급대원으로서 병원 전 단계 응급의료체계에서 응급환자를 대상으로 응급의료를 제공한다. 병원 전 응급의료체계에서 업무를 수행하는 간호사의 업무범위는 의료법 상 포괄적으로 규정되어 있는 업무를 판례 등을 통해 구체화되어 왔다. 반대로 응급구조사의 업무범위는 응급의료법에 의해 구체적 행위를 열거하는 방식으로 규정되어 있다. 병원 전 단계 응급의료체계에서 응급의료종사자로서 업무를 수행하는 간호사의 업무범위는 대상 환자의 긴급성, 응급의료기관으로의 이송 중이라는 점, 통신 상의 의료지도라는 특수성을 고려하여 간호사의 업무범위를 의료기관 내에서와 달리 적용하여 해석되어야 한다. 따라서 상대적으로 병원 전단계에서 간호사가 응급구조사보다 넓은 업무범위가 인정되고 이것이 정책목표에도 부합된다.

• 한국응급구조학회지
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• 제25권1호
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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.

• 한국임상보건과학회지
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• 제1권1호
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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.

• 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.

• 한국응급구조학회지
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• 제13권3호
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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.

• 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.

• 한국응급구조학회지
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• 제26권2호
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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.