• Journal of Trauma and Injury
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• v.32 no.1
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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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.500-506
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• 2018

This study analyzed current prehospital emergency care for severe trauma patients administered by different number of 119 EMS (emergency medical services) teams. Out of 1,067 severe trauma patients transferred by 119 EMS teams in J province from January 1st to December 31st 2015, 438 were evaluated in this study. IBM SPSS Statistics 21.0 was used to analyze collected data. The number of patients with severe trauma during the period of study was higher in male with two and three ambulance crews of 119 EMS teams with 242 patients (70.6%) and 66 patients (69.5%) respectively. The percentage of transfers made to local emergency medical centers was highest in those two groups, being 44.0% (151 patients) and 49.5% (47 patients), respectively. Total time spent at the scene did not differ between ambulance crews of two and three, nor did the frequency of practicing advanced airway management and IV (intravenous) cannulation, or the success rate of IV cannulation (p=0.253, p=0.362, p=1.000). Overall, the results indicated that merely increasing the number of paramedics does not improve the quality of prehospital care for severe trauma patients. Measures such as securing professional paramedics, simplifying direct medical oversights, activating indirect medical oversights, and expanding the legally allowed work scope are required.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.125-136
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• 2014

Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinical characteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergency medical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours after return of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Data were analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystanders in 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventricular tachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR duration was 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standard prehospital care for these patients and educational programs regarding CPR for lay rescues should be developed.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.17-35
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• 2021

Purpose: This study aimed to investigate basic data on preceptor's core competencies required for junior 119 paramedics to improve the quality of emergency care in the prehospital field. Methods: From February 23 to March 10, 2021, data were collected through structured mobile questionnaires from 163 paramedics working in Sejong, Daejeon, and Chung Nam fire stations. The data were analyzed using SPSS version 25.0. Results: The average score of core competencies for junior 119 paramedics accounted for the importance of core competency (3.92 points), level of competence (3.43 points), educational needs (3.65 points). Among them, the importance of a role model accounted for 4.02 points, the highest among the sub-areas. Additionally, there was a significant correlation (r=.686), which was the highest, between the importance and educational needs of core competency; therefore, higher the importance of core competency, higher are the educational needs. Conclusion: Preceptor's core competencies concern three domains: role model, socialization facilitation, and instructional design. It would be more effective for those with higher professionalism and professional self-development needs to be trained as a prehospital preceptor.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.5-11
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• 2010

Purpose: This study was to clarify correlation between en route distance and role time on call received hours. Methods: Data on en route distance(dependent variable), role time(independent variable) from 387 prehospital care reports documented by EMS in Kyonggi Provincial Fire and Disaster Headquarters and Seoul Metropolitan Fire and Disaster Department between 21 and 10 June 2010 were randomly chosen for simple regression analysis using Windows SPSS 12. OK. This analysis was conducted nine times on unit hour divided to eight call received and overall. Results: Statistically significant regression equations( Y=2.414+1.206X for 09:00~11:59, Y=3.753+.662X for 12:00~14:59, Y=2.215+1.458X for 15:00~17:59, Y=2.600+.822X for 21:00~23:59, Y=5. 445+.263X for overall) were derieved from the data. Conclusion: These equations having linear relationship may be utilized as a method for system status management to effectively response to emergency call.

• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient's side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient's side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

• The Journal of Korean Academic Society of Nursing Education
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• v.15 no.2
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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.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• The Korean Journal of Emergency Medical Services
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• v.24 no.2
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• pp.133-153
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• 2020

Purpose: This study aimed to identify the status of emergency care of pregnant women transported by paramedics, to analyze the knowledge of paramedics related to pregnant women and their self-confidence in emergency care, and to provide foundational data to improve the quality of emergency care for pregnant women. Methods: We received a total of 1,798 rescue logs from 119 paramedics, who had transported pregnant women, in I city from January 1, 2016 to December 31, 2018. For survey analysis, we used the 164 questionnaires received from these paramedics from June 15 to August 14, 2019. Results: The analysis of the rescue logs revealed that 85.5% (1,537 individuals) either had disease symptoms or were pregnant, whereas only 14.5% (261 individuals) had traffic accidents or accident-related injuries. The mean knowledge of the paramedics related to pregnant women was 23.73 (±2.98) points, and the mean self-confidence in emergency care was 3.19 (±0.74) points. Knowledge of the paramedics about pregnant women and their self-confidence in emergency care of these women had a statistically significant positive correlation (r=.306, p=.000). Conclusion: Paramedics should be provided theoretical and practical training through various programs about the emergency care of pregnant women.

• The Korean Journal of Emergency Medical Services
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• v.10 no.1
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• pp.51-60
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• 2006

Background: The toxicity of paraquat has been known to be caused by oxygen free radicals which leads to the lipid peroxidation and multiple organ failure. High dose vitamin C has been known to be a effective antioxidant activities against the paraquat intoxication. This study was designed to evaluate the effect of regular injection of high dose vitamin C on liver damage in paraquat poisoned rat model. Method: Fifty five rats of Sprague-Dawley strain were divided into three groups: control group, only intraperitoneally injected saline; paraquat group, single dose intraperitoneally injected paraquat(24.5%, 40 mg/kg) and every 8 hours injected saline; paraquat and vitamin C group, single dose intraperitoneally injected paraquat(24.5%, 40 mg/kg) and every 8 hours injected vitamin C(72 mg/kg). Rats were sacrificed on the 12 hours, 1st day, 2nd day, 4th day, 7th day after injection and liver tissue was obtained. H&E(Hematoxylin & Eosin) stain and Masson's trichrome stain for collagen fiber detection were undertaken. The results were observed using the microscope. Results: 1. There were no differences between control and experimental group at the 12hours after regular injection of high dose vitamin C. 2. There were significantly decreased liver damage in experimental group in the 1st day after regular injection of high dose vitamin C. 3. There were significantly increased recovery of liver damage with time in experimental group after regular injection of high dose vitamin C. Conclusion: These results suggest that regular injection of high dose vitamin C is effective in decreasing liver damage in paraquat intoxication.