• Journal of Chest Surgery
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• 제36권6호
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• pp.451-455
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• 2003

심폐소생술 지침은 과거에 미국심장학회 지침과 유럽소생학회 지침으로 크게 양분되어 있었으나, 2000년 8월에 국제심폐소생술 위원회에 의한 공동 지침으로 ‘심폐소생술과 응급심장 처치에 관한 지침 2000’이 완성되었다. 현재까지 심폐소생술로써 환자의 생존율에 괄목할 만한 향상이 없으므로 보다 새로운 지식으로써 적절히 임상에 적용하는 것이 최선의 방법이라 할 수 있다. 새 지침의 특징은 알고리듬의 단순화와 과학적인 결과를 바탕으로 하였으며,성인 심정지 환자의 기본소생처치에서 심장 마사지 : 인공 호흡을 15 : 2로 통일하고 일반인에게는 경동맥 촉지법과 하임리히법을 가르치지 않는다는 것이다. 흡입 산소농도에 따라 호흡 흡입량의 차이를 두었으며, 기관 삽관의 튜브 크기를 8.0mm로 통일하였고, 심실빈맥/심실세동의 알고리듬에서 epinephrine대신에 vasopressin을 사용할 수 있게 하였으며, 자동 제세동기의 사용을 권장하였다. 또 급성 관상동맥 증후군에서는 병원 도착 전에 심전도를 중요시하고 혈전용해제를 조기에 사용할 수 있게 하였으며 급성 허혈성 뇌졸중에서도 병원 도착 전에 적절한 평가와 빠른 혈전용해제 사용이 추가되었다.

• 한국화재소방학회논문지
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• 제29권4호
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• pp.95-104
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• 2015

본 연구는 병원 전 단계에서 발생한 화상환자의 유형별 특수성을 이해하여 초기 환자 상태의 어떠한 차이점이 있는지를 파악하고자 한다. 이를 위해 2013년도 경기도 소방구급대 출동 내역 중 화상환자 이송 자료 1,223건을 분석하였다. 화상사고는 10세 이하(26.0%)에서 가장 많았으며, 대부분 가정(51.3%)에서 발생하는 것으로 나타났다. 화상 유형별 환자의 상태는 평균적으로 안정적이었으나 전기로 인한 화상은 의식 상태 U(무반응)가 10.7%로 타 화상 유형보다 U(무반응)의 비율이 매우 높은 것으로 나타났으며 체온 $35.90^{\circ}C$, 화상 깊이 3도(39.28%) 등 타 유형과 달리 초기 환자의 상태는 심각한 것으로 나타났다. 이에 따른 화상 유형별 초기 환자 상태를 파악하여 병원 전 단계의 효과적인 대응이 필요하겠다.

• 한국응급구조학회지
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• 제14권3호
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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.

• 한국응급구조학회지
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• 제2권1호
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• pp.26-35
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• 1998

This study was to exhibit the effective emergency care method for the drowning and non-drowning who are reached two-thousand peoples every year in our country. For investigate the effective emergency care, this study was discussed as follows ; Pathophysiology of the water submersion, Fresh-water & sea-water drowning, Factors affecting survival, and Prehospital management. The conclusions from this study were summarized as follows; 1. Remove the patient from the water. If you suspect neck or spinal injuries, Always support the head and neck level with the back and, begin rescue breathing. 2. Maintain the airway and support ventilation in the water use the jaw-thrust technique to avoid farther injury to the neck or spine. We might encounter more resistance to ventilations than you expect because of water in the airway. Once you have determined that there are no foreign objects in the airway, apply ventilations with more force; adjust ventilations until you see the patient's chest rise and fall but not until you see gastric distention. Do not attempt to remove water from the patient's lungs or stomach. 3. If there is no pulse, begin CPR. 4. Administer high-flow supplemental oxygen; suction as needed. 5. Once the patient is breathing and has a pulse, assess for hemorrhage; control any serious bleeding that you find. 6. Cover the patient to conserve body heat, Handle the patient very gently, and, Transport the patient as quickly as possible to Emergency Department, Continuing resuscitative measures during transport. If the patient have the hypothermia, follow hypothermia management.

• 한국응급구조학회지
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• 제15권2호
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• pp.43-54
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• 2011

Purpose: The purpose of this study was to explore EMT-paramedic students' experience of simulation education and analyze the confidence before and after education, learning attitude and course evaluation. Method: Research survey was conducted on 38 EMT-paramedic students during November, 2011 and EMT-paramedic students' experience of simulation education was analyzed after applying head, spinal, and chest injury scenario. The confidence before and after education, learning attitude and course evaluation in gender were analyzed by Mann-Whitny U test and the difference of confidence before and after education was analyzed by Wilcoxon signed rank test and learning attitude & course evaluation were analyzed by evaluating frequency, percentage, mean, standard deviation by using SPSS WIN 17.0 program. Results: 1. Students experienced various advantages such as increasing interest and self-reflection on learning, critical thinking ability, and EMT-paramedic-role experience and recognition of importance of teamwork. Students also pointed out disadvantages such as gap between real situation and simulation, limit of time and equipments, and burden of demonstration. 2. The confidence between before and after education, learning attitude and course evaluation in gender were not significant different statistically. 3. Confidence mean score elevated from 5.53(before education) to 5.87(after education), but the difference in their confidence did not show significant difference statistically. 4. Total mean score in learning attitude after simulation education was 3.70 out of 5.00, which is considerably very high. 5. Total mean score in course evaluation was 3.89 with score of 3.83 in evaluation in learning environment and 3.99 in evaluation of debriefing. Conclusion: The finding of this study demonstrate that the simulation education can provide a safe and repetitive practice environment, improve problem-solving ability and critical thinking, and increase the confidence in prehospital emergency care; therefore, simulation may be the new effective EMT-paramedic education strategy.

• 한국응급구조학회지
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• 제6권1호
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• pp.77-86
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• 2002

The purposes of this research which was conducted by surveying lost/added unit hours reports, unit hour demand analysis worksheets from prehospital care reports of two squads in Kyonggi Provincial Fire and Disaster Headquarters for 20 weeks (January 1, 2002 - May 20, 2002) are to get Unit Hour Utilizations. Call Demands such as Unit Hour Demand, Simple Average Demand, High Average Demand, Peak Average Demand, the High Actual Demand. The conclusions from this analysis were summarized as follows: (1) By revealing Unit Hour Produced 3223.9, Call Volume 964, Unit Hour Utilization 0.299 at the Squad A and Unit Hour Produced 3328.4, Call Volume 901, Unit Hour Utilization 0.271 at the Squad B induced Korean Squads to chance identification, definition, direction of Unit Hour Utilization. (2) By revealing Simple Average Demand 7.4 on Monday Tuesday, High Average Demand 9.6 on Tuesday Friday. Peak Average Demand 11.5 on Tuesday, the High Actual Demand 12 on Tuesday Wednesday at the Squad A and Simple Average Demand 6.8 on Sunday, High Average Demand 10.4 on Monday, Peak Average Demand 11.5 on Monday, the High Actual Demand 13 on Monday at the Squad B enabled Korean Squads to utilize System Status Management. (3) The Maximum Calls per Unit Hour were 115 for 23:00~23:59, the Minimum Calls per Unit Hour were 46 for 05:00~05:49 in two squads. The Maximum Calls per Unit Hour were 7.4 on Tuesday Saturday, the Minimum Calls per Unit Hour were 6.1 on Thursday at the Squad A. The Maximum Calls per Unit Hour were 7.3 on Monday Saturday, the Minimum Calls per Unit Hour were 5.6 on Thursday at the Squad B. (4) Analyzing demand for EMTs in the optimum emergency medical service of Korea, we have been able to utilize this Unit Hour Utilization in company with the established estimation methods such as international comparisons or the number of ambulances for scientific reasonable estimation. (5) These Call Demands which were limited to the demand time in this study will make us expect some following studies including demand time, demand time, demand map for Strategic Deployment.

• 한국화재소방학회논문지
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• 제32권4호
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• pp.103-109
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• 2018

119 종합상황실의 상황 요원은 화재, 구조, 구급 등의 위기 상황을 처음으로 인지하고 대응 체계를 가동시켜야 하는 중요한 역할을 수행하고 있다. 특히 119 구급 신고와 관련하여 상황 요원의 신속하고 정확한 수보 활동은 환자의 생명은 물론 예후를 결정할 수 있다. 이에 본 연구에서는 2014년 4월 8일부터 12월 31일의 ${\bigcirc}{\bigcirc}$시 신고 접수, 출동, 구급활동 자료를 이용해 상황 요원과 신고자의 대화 회전 수와 대화 시간, 그리고 대화 구조 및 순서의 시간 등을 접수 경로와 중증도에 따라 분석하였다. 상황 요원과 신고자의 대화 분석은 향후 상황관리단계에 따른 조치 사항 또는 행동 매뉴얼의 개발이나 개선에 활용할 수 있을 것으로 기대된다.

• 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.

• Journal of Acupuncture Research
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• 제30권1호
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• pp.35-41
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• 2013

Objectives : This study aimed to perform descriptive analysis on demographic characteristics and symptom distribution of 199 marathon participants in Pusan, Korea. Methods : Brief medical charts of 199 marathon participants in 11 marathon rallies who had visited the emergency medical support team of Korean Medicine Hospital, Pusan National University were collected. Participants' demographic and clinical characteristics were descriptively analyzed. Results : More than two third of participants who have visited the support team was male(71.9 %) and their mean age was 44.0(years). The main intervention was manual acupuncture with vigorous stimulation techniques. Most of treated symptoms were lower extremity pain(77.0 %). Knee pain was the most frequently recorded symptoms, following the ankle pain. No information on the safety of acupuncture treatments were reported in the records. Conclusions : Symptom distribution of marathon participants who have visited the emergency medical support team of Korean Medicine Hospital was similar to previous literatures of acute injuries of marathon athletes and runners. The role of acupuncture for emergency support care of acute injuries in marathon participants should be further explored in well-designed clinical studies.

• 임상간호연구
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• 제19권2호
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• pp.218-232
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• 2013

Purpose: This study was aimed to describe Helicopter Emergency Medical Services (HEMS) and analyze the flight nurses' activities in HEMS. Methods: Data were collected retrospectively from the air transportation reports that contained data of 168 patients transported by aircraft to G University medical center in Incheon since June, 2012 to March, 2013. Data were analyzed using descriptive statistics, and Mann-Whitney U test. Results: Average distance of flights was 44.0 km, duration of field treatment took 13.6 minutes, and duration of a flight from scene to hospital was 14.5 minutes. Nursing activities were categorized into 12 direct nursing activities and 5 nursing management activities, and a total number of 7806 nursing activities were occurred in HEMS. The most frequently performed nursing activity was measurement and monitoring (27.9%) followed by medication (11.5%) and respiratory management (8.7%). The most frequent nursing management were information management (11.0%). Nursing activities performed were significantly different depending on the patient's level of consciousness, cause of illness, crew configuration, and type of transportation. Conclusion: This study described HEMS nursing activities performed by flight nurses. Difference in nursing activities according to patient characteristics, crew configuration and type of transportation requires flight nurses to be prepared through educational programs to improve nursing activities and nursing management during air transportation.