• Journal of Trauma and Injury
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• v.31 no.3
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• pp.135-142
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• 2018

Purpose: When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision. Methods: This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017. Results: Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226). Conclusions: Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.161-169
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• 2020

Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.125-134
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• 2021

Purpose: The purposes of this study were to determine the changes in the pattern of patients who were transferred to the emergency room through inter-hospital private institutions and to determine how long transport takes following the COVID-19 outbreak. Methods: This retrospective observational study analyzed the emergency medical services reports of private institutions following the COVID-19 outbreak in South Korea. The study was conducted in Busan between January 19, 2019 and January 18, 2020, and between January 19, 2020 and January 18, 2021. Results: Upon comparing the patient transport times during the "Pre-COVID-19 period" and "COVID-19 period," a significant delay was noticed in the preparation for transfer of patients during the "COVID-19 period" (p<.05). There were significantly more patients with respiratory infections and patients who complained of general symptoms during the "COVID-19 period." Moreover, there was a higher frequency of patients who were transferred to a 'Level I' emergency room during the "COVID-19 period" compared to during the "Pre-COVID-19 period" (p<.05). Conclusion: Following the COVID-19 outbreak, there is a delay in patient transport to the emergency room through private institution inter-hospital transport and an increase in the number of patients complaining of respiratory infection symptoms. Thus, emergency medical services need additional administrative and economic support to transport infected patients.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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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.

• Journal of the Korea Convergence Society
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• v.10 no.5
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• pp.111-117
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• 2019

The purpose of this study was a convergence study to find a way to shorten pre-hospital emergency medical response time in vehicle accident. This study analyzed the factors of hospital emergency response time by utilizing weather, road type, accident type, and rescue response to 353 vehicle passengers who visited the three emergency medical centers from January 1, 2011 to July 30, 2016 in Korea In-Depth Accident Study. The results of the study showed that the highway used the most time to prehospital emergency medical response time and was a factor affecting the overall time (${\beta}=.543$, p<.001). In order to shorten the emergency medical response time in highway, the operation of emergency services on the highway, the active use of emergency turn road and the automatic emergency rescue service with individual devices were proposed.

• Journal of Advanced Navigation Technology
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• v.15 no.4
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• pp.646-654
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• 2011

Recently, the task in which the number of people of the emergency medical technician whom it boards the ambulance is unreasonably insufficient and in which the fire fighter one person gets in the ambulance and which transfers the patient comes into question often. When the emergency patient is generated, it has to transfer to the special hospital in which above anything else, the measure which is quick and exact is needed and where there is the medical device which is suitable for particularly, the patient. This paper implementations the emergency medical system by the smart phone. The implemented system monitors the heart beat of the patient the monitoring among the patient transport with the real-time type. It can grasp the medical history information of the patient, and etc. in the past. And the system provides the emergency hospital which the patient requires and the pre-hospital phase provides the environment in which the disposition which is quick and efficient is possible to the emergency patient.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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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.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.83-93
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• 2010

Purpose: The purpose of this study is to determine potential differences in pre-hospital cases of cardiac arrest and drug Intoxication between elderly group and non-elderly group on local emergency activity sites of rescue 119 team for those cases, so that it can provide useful reference materials for a system of corresponding emergency medical services. Methods: Patients with cardiac arrest and drug intoxication in the elderly and the non-elderly group were analyzed by analyzing the Ambulance Run Report for 3 years from January 2007 to December 2009. Results: According to analysis on potential differences between elderly and the non-elderly group, it was found that there was no significant difference between elderly cases (evacuated to hospital due to cardiac arrest and drug poisoning) and non-elderly cases in year of onset (p = .247), quarter of onset (p = .813), sex (p = .235), consciousness state (p = .126), place of onset (p = .215) and number of first aid services (applied to emergency cases) respectively, but there were significant differences between elderly cases and non-elderly cases in guardian availability (p = .042), time zone of onset (p = .050), distance from the site of onset (p = .278), type of onset (p = .000), number of first aid services depending on distance of evacuation (p = .008) and effectiveness of emergency care (p = .003) on statistical basis. Conclusion: It is important to establish a system of early emergency case reports for rational emergency case management with lower mortality; shorten distance from the site of onset at each time zone of onset in emergency cases; employ more emergency team members; facilitate firsthand / secondhand medical instructions for emergency teams in specialized emergency care depending on distance of evacuation for each kind of onset (elderly group vs. non-elderly group); and improve rate of resuscitated emergency cases by extending the scope of works for emergency medical technicians into wider applications, so that it will be possible to take timely and appropriate measures for emergency settings of ever-increasing aged population in near future.

• The Korean Journal of Emergency Medical Services
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• v.26 no.3
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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.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.75-82
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• 2010

Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.