• 한국컴퓨터정보학회논문지
• /
• 제23권1호
• /
• pp.103-109
• /
• 2018

The purpose of the study is to investigate the effect of a simulation training of BLS in paramedics in pre-hospital situation. This a nonequivalence control quasi-experimental study. The study subjects were 8 paramedics of experimental group and 8 paramedics of control group in K fire department. An informed consent was written by the subjects after explaining of the purpose of the study. The study methods consisted of conventional education and practice training. The conventional education was done for 30 minutes and the practice training was taken by four trainees of one group and the instructor demonstrated Basic Iife Support (BLS) performance for three minutes. Each trainer peformed BLS for ten minutes. In the beginning of the course, two paramedics got off from the ambulance and performed BLS including 5 cycles of Cardiopulmonary Resuscitation (CPR). Soon after the BLS, another two paramedics performed pre-hospital BLS survey. The education was guided by two professors of emergency medical technology, two Basic Iife Support instructors, and two emergency rescue directors. Pre-hospital BLS was measured by a 5-point Likert scale. Higher score means higher performance skills. The data were analyzed using SPSS/WIN 22.0 program set at significance level of p<05. The effect of simulation education was much more significant than the conventional education in BLS. The simulation education is very important and effective in improving the clinical performance skills of paramedics than the conventional education. The simulation education can provide the virtual environment of cardiac arrest to the paramedics. In conclusion, the simulation education can provide the effective teaching methods for various practice performance skills and solution by critical thinking in the paramedics and healthcare providers in the future.

• Journal of Trauma and Injury
• /
• 제24권2호
• /
• pp.89-94
• /
• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• Journal of Preventive Medicine and Public Health
• /
• 제48권6호
• /
• pp.330-341
• /
• 2015

Objectives: Emergency medical personnel (EMPs) are pre-hospital emergency responders who are at risk of exposure to infections and may also serve as a source for the transmission of infections. However, few studies of infection control have specifically addressed EMPs in the Republic of Korea (hereafter Korea). The goal of this study was to assess the current status of infection prevention and control programs (IPCPs) for EMPs in Korea. Methods: A cross-sectional survey was conducted to quantitatively assess the resources and activities of IPCPs. A total of 907 EMPs in five metropolitan cities completed a structured questionnaire from September 2014 to January 2015. The data were analyzed using descriptive statistics, multi-response analysis, and the chi-square test. Results: The mean age of the participants was $34.8{\pm}15.1years$. IPCPs were found to have weaknesses with regard to the following resources: the assignment of infection control personnel (ICP) (79.5%), hand hygiene resources such as waterless antiseptics (79.3%), the use of paper towels (38.9%), personal protective equipment such as face shields (46.9%), and safety containers for sharps and a separated space for the disposal of infectious waste (10.1%). Likewise, the following activities were found to be inadequately incorporated into the workflow of EMPs: education about infection control (77.5%), post-exposure management (35.9%), and the decontamination of items and spaces after use (88.4%). ICP were found to have a significant effect on the resources and activities of IPCPs (p<0.001). The resources and activities of IPCPs were found to be significantly different among the five cities (p<0.001). Conclusions: IPCPs for EMPs showed some limitations in their resources and activities. IPCPs should be actively supported, and specific IPCP activities for EMPs should be developed.

• 한국응급구조학회지
• /
• 제25권3호
• /
• pp.111-125
• /
• 2021

Purpose: This study aimed to analyze the impact of rapid cycle deliberate practice (RCDP) simulation education on advanced cardiac life support knowledge, confidence, satisfaction, and performance ability among paramedic students, and provide basic data on the appropriate methods of educational instruction. Methods: The 48 subjects to be instructed were divided into the traditional simulation education group and the RCDP simulation education group. Six participants were randomly assigned to each group and pre-surveyed. They were then exposed to a lecture about advanced cardiac life support related theories for 60 min and post-surveyed through questionnaires with the same learning goals and scenarios. Results: The advanced cardiac life support knowledge (t=-4.813, p=.000) and performance ability (t=-2.903, p=.006) were significantly different between the traditional simulation education and RCDP simulation education groups The results also showed a significant difference in attach monitor (z=6.857, p=.009), analyze EKG rhythm (z=11.111, p=.001), and defibrillation (z=12.632, p=.000), indicating differences in performance capabilities between the two groups. Conclusion: To improve advanced cardiac life support knowledge, performance ability, and confidence in the paramedic students who receive RCDP simulation education, simulation education methods that are appropriate for the subjects being taught, and detailed learning goals and feedback are necessary.

• 한국응급구조학회지
• /
• 제25권1호
• /
• pp.235-241
• /
• 2021

Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck's triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

• 한국산학기술학회논문지
• /
• 제14권12호
• /
• pp.6461-6468
• /
• 2013

본 연구는 병원 전 응급의료 현장을 담당하고 있는 119 구급대원의 근골격계 질환에 대해 조사하기 위해 2012년 7월 2일부터 7월 31일까지 전북지역의 119 구급대원 216명을 대상으로 설문조사한 결과이다. 조사결과 대상자의 57.9%가 근골격계 질환과 관련한 자각증상을 호소하였으며 신체부위별로는 허리와 엉덩이 부분에 통증이 있다는 응답이 47.2%로 가장 많았다. 또한 이러한 통증의 원인이 구급업무와 관련이 있는 것으로 조사되었다. 또한, 일반적 특성에 따른 근골격계 증상에서 성별(t=16.579, p=.000), 연령(t=102.344, p=.000), 학력(t=5.363, p=.027), 음주(t=6.999, p=.030), 흡연(t=6.266, p=.009)에 따른 유의한 차이가 있었으며 직업적 특성에서는 경력(t=67.684, p=.000), 구급차량 탑승인원(t=7.717, p=.004), 자격 및 면허(t=25.480, p=.000), 직급(t=74.615, p=.000)에서 유의한 차이가 있는 것으로 나타났다.

• 보건의료산업학회지
• /
• 제7권1호
• /
• pp.21-34
• /
• 2013

Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

• Journal of Korean Neurosurgical Society
• /
• 제45권4호
• /
• pp.249-252
• /
• 2009

We report on a case of thrombosis of the left common iliac artery following anterior lumbar interbody fusion (ALIF) of L4-5 in a 79-year-old man with no previous medical problems, including peripheral vascular disease. After completing the ALIF procedure, the surgeon could not feel the pulsation of the left dorsalis pedis artery, and the oxygen saturation ($SaO_2$) had fallen below 90% from pulse oxymetry on the left great toe. Thrombectomy was successfully performed after confirming the thrombus in the left common iliac artery using Computed Tomography (CT) angiography. Thrombosis of the common iliac artery is very rare following ALIF. However, delayed diagnosis can lead to disastrous outcome. Although elderly patients have no cardio-vascular disease or vessel calcification in pre-op evaluation, the possibility of a complication involving L4-5 should be considered.

• 한국컴퓨터정보학회:학술대회논문집
• /
• 한국컴퓨터정보학회 2013년도 제48차 하계학술발표논문집 21권2호
• /
• pp.87-88
• /
• 2013

본 논문에서는 응급 환자가 발생하여 가까운 병원이나 대형 병원에 도착하기 전에 환자의 정보를 이용하여 응급처치가 가능하도록 한다. 그리고 응급 의료 기관에서는 환자 진료 준비를 사전에 갖출 수 있도록 하여 응급 환자 진료의 효율성을 높였다. 우리가 흔히 연락을 쉽게 할 수 있는 119번호를 이용하여 다양한 복합 응급 신고를 접수하고 있고, 유관기관과 통합적 대응 체계를 구축하는 효율적 응급의료서비스 새로운 전략을 제시하고자 한다.

• Journal of Trauma and Injury
• /
• 제28권4호
• /
• pp.248-255
• /
• 2015

Purpose: study of the mutual influence of the individual anatomical regions damage in patients associated with falls from heights. Methods: 561 medical reports of patients associated with falls from heights admitted to Republican Research Center of Emergency Medicine (RRCEM), in period of 2010-2013 yy, were analyzed retrospectively. Patient's age range was from 15 to 89. Treatment of these patients held in three stages: period of acute disorders of vital functions; relative stabilization period; stabilization of vital functions. The scope and content of medical diagnostic procedures performed on pre-hospital and intensive care stages. The severity of each injury was scored according to the AIS scale, the total severity of lesions was scored by points due to ISS. Digital material is treated by methods of mathematical statistics. Results: Falls from heights leads to associated injuries for 4 times more than isolated trauma, and increases according to height of fall and falling surface. Patients with TBI+chest trauma, are most serious contingent that has highest mortality and complications (36.8%). TBI+musculoskeletal system trauma are characterized by high blood loss, traumatic shock and fat embolism, forming a vicious circle. Conclusion: in patients associated with falls from heights clinical manifestations of injuries mutual aggravation syndrome will be seen. TBI leads to complication of chest trauma, delayed diagnostics of abdominal and chest trauma, aggravation of coma condition. Developing of high blood loss and fat embolism in musculoskeletal system trauma leads to shock and pulmonary embolism, which increases probability of death in the presence of abdominal or chest trauma, but abdominal trauma or chest trauma has no significant effect on the severity of the musculoskeletal system trauma.