• 종양간호연구
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• 제12권3호
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• pp.230-236
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• 2012

Purpose: This study was to investigate the effect of the application of cancer pain management guidelines on pain management among patients in Cancer Emergency Room. Methods: This study was a retrospective descriptive study. Before application, data were collected by analyzing the Electronic Medical Record in Cancer Emergency Room in September, 2011, and after application in February, 2012. The subjects of this study consisted of 231 patients (pre-application group 83, post-application group 148), who stayed over 24 hours and complained of pain higher than Numeric Rating Scale score 4. The post-test was conducted after educating the nurses about the application of the pain management guidelines in the Electronic Medical Record. Results: This survey showed that, as the cancer pain management guidelines were applied for cancer patients with above moderate pain, the pain intensity decreased, the number of patients reaching the treatment goal score increased. Furthermore, the estimated time to reach the treatment goal decreased significantly. Conclusion: Pain intensity of the cancer patients was decreased through regular pain assessments by nurses and the medication of analgesics according to the cancer pain management guidelines. Therefore, it is necessary to develop the pain management program and to provide the physicians and nurses with intensive education about the pain management guidelines for systematic and effective pain management.

• 한국응급구조학회지
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• 제11권3호
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• pp.93-109
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• 2007

The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

• 한국간호교육학회지
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• 제15권2호
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• pp.274-284
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• 2009

Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company's vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was $372.65{\pm}719.17$ minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.

• 한국컴퓨터정보학회논문지
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• 제24권8호
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• pp.123-129
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• 2019

This study selected all patients with acute poisoning carried by the 119 emergency services in K-Province from January 1 to December 31, 2015 for complete enumeration. The subjects were 1,627 patients who were classified as poisoning suspected in chemicals and animal/insect poisoning by Rescue Emergency Activity Information System(Emergency Statistics) in fire-fighting portal system of K-province fire-fighting officers. The 119 activity journals were analyzed retrospectively. The major results are as follows. Regarding the demographic characteristics of the elderly and the non-elderly, the most people were unemployed in the elderly group, other job, the non elderly group about their occupations and in both groups, the most people lived in rural areas about their living places. Regarding the poisoning characteristics of the elderly and the non-elderly, the most causing substance was bee sting about the poisoning causing substances and most of patients didn't get drunken about drunken state in both group. Regarding the time factors of the elderly and the non-elderly, both groups had the most accidents in afternoon about the poisoning time and in summer about the seasonal distribution.

• Journal of Preventive Medicine and Public Health
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• 제45권3호
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• pp.174-180
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• 2012

Objectives: An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), and vancomycin-resistant $Enterococci$ (VRE) in patients transported by ambulance. Methods: This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection. Results: The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively. Conclusions: A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

• 한국화재소방학회논문지
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• 제30권1호
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• pp.121-129
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• 2016

구급차는 병원 전 응급의료서비스의 중요한 요소이며, 119 구급대원의 업무능률 향상을 위한 중요한 공간이다. 구급대원들이 직무능력을 최대한 발휘할 수 있도록 구급차 내부의 환경을 최적의 공간으로 하여 구급대원들의 책임과 기능적 역할을 제공할 수 있도록 개선되어야 할 것이다. 따라서 본 연구에서는 구급차의 내부 공간에서 환자실에 탑재되어야 하는 응급의료 장비와 약제의 탑재 공간 확보 및 구급차 내에서의 응급처치에 따른 원활한 공간의 배치를 재구성하였으며, 환자의 위치와 응급처치 요원의 배치에 따른 공간 배정에 대한 분석 및 효율적 방법을 제시하고 있다. 또한 본 연구는 구급차 주행 중 처치공간에서 수행하는 119 구급대원 업무의 효율성을 향상시키기 위한 구급대원의 직무수행에 적합한 구급차 내부 수납공간의 디자인 설계 및 사용 환경에 대한 파악 및 문제점 분석을 통하여 응급의료서비스에 대한 안전성과 효율성을 제공하기 위한 새로운 환자실 공간 크기 및 디자인 안을 제시하고자 한다.

• 한국보건간호학회지
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• 제9권1호
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• 한국응급구조학회지
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• 제25권1호
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• pp.23-36
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• 2021

Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.17-25
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• 2019

Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

• 한국응급구조학회지
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• 제23권1호
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• pp.113-123
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• 2019

Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.