• 한국응급구조학회지
• /
• 제22권3호
• /
• pp.177-187
• /
• 2018

Purpose: The purpose of the study was to investigate the causes of non-transport in 119 ambulance services and to describe the difference in response time according to the reason for non-transport. Methods: This study analyzed 42,415 non-transport cases out of 123,158 cases using prehospital care reports in a metropolitan city. The Kruskal-Wallis test and the Wilcoxon-Mann-Whitney test were used to 6,857 cases for which time was recorded. Results: Non-transportation in 20${\bigcirc}{\bigcirc}$ comprised 33.1% of all ambulance services. The reason for non-transport were other reasons (25.5%), cancellation (23.8%), and moving to other vehicles (21.7%). There were differences in ambulance service times according to the reasons for non-transport. The activation interval was the longest (2.68 minutes) in the absence of the patient, and the response interval was the shortest (4.96 minutes) among the cancelled case. The total interval was the shortest time (21.97 minutes) in the cancellation cases and the longest time among the death cases (32.23 minutes). Conclusion: It is important to suggest the direction of development of emergency services by identifying the reasons for non-transport by ambulance services and describing the response time according to the reason for non-transport.

• 한국응급구조학회지
• /
• 제15권3호
• /
• pp.45-55
• /
• 2011

Objective : The purpose of this study was to investigate the perception of death in paramedic student. The results of this study will help develop education program for death orientation, paramedic students education and practice. Methods : A total of 201 paramedic students filled out the questionnaire. The perception of death was examined using questionnaires designed for examining Death Orientation. The data were analyzed with SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, t-test, ANOVA, cronbach alpha coefficient, factor analysis. cronbach alpha coefficient was .866. Results : The paramedic students' got a score of $2.35({\pm}.48)$ on the Orientation on death as average. The reason is that death is not yet pressing them at all and ahead of their lives they have many days to live. With respect to the Death Orientation, significant differences was found in experience of death(t=2.318, p=.021). Group of death experience was higher than group of no death experience. In view of the attitude on afterlife, students responded no afterlife(24.9%), unknown after death(22.4%). Conclusion : The results of this study suggest that paramedic curriculum should include education program on death and improve quality of prehospital care. Additional studies are needed to establish death education for paramedic.

• 한국응급구조학회지
• /
• 제15권2호
• /
• pp.55-66
• /
• 2011

Purpose: The purpose of this study was to develop a scenario and evaluate the performance of paramedic students in head trauma simulation education. Method: This study selected a refined head trauma scenario that was developed by graduate students during class from september to November, 2010. Evaluation on implementation of head trauma simulation was conducted on seventeen paramedic students divided into four groups during November, 2010. Results: 1. The head trauma scenario was developed according to the patient assessment for approximately 10 minutes. It contained scene size-up, initial assessment and intervention, rapid trauma assessment and intervention, and decision of transfer. 2. The average time turned out to be 9 min and 36 sec after simulation learning. Total mean score in simulation performance was 2.20, the highest score was 2.44 in initial assessment and intervention, and the lowest score was 1.5 in decision of transfer. 3. Confidence mean was high with the score of 1.0. Conclusion: The finding of this study demonstrate that the simulation education can improve problem-solving ability and critical thinking, and increase the confidence in prehospital emergency care; therefore, simulation may be the new effective paramedic education strategy and simulation learning is needed for further development of various scenarios.

• Journal of Trauma and Injury
• /
• 제21권1호
• /
• pp.1-7
• /
• 2008

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

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

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

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

• 디지털융복합연구
• /
• 제11권9호
• /
• pp.229-238
• /
• 2013

병원외 심정지는 오늘날 우리나라의 중대한 보건문제로서, 환자의 퇴원 시 생존율은 3.5%이며, 이 중 1%만이 신경학적 기능을 회복하는 것으로 나타났다. 이처럼 낮은 병원외 심정지 환자의 생존율을 높이기 위해서는 병원 도착 전 환자의 자발적 순환을 회복시키는 것이 매우 중요하다. 따라서 본 연구에서는 질병관리본부의 2009년도 심정지 의무기록 조사 자료를 활용하여 병원외 심정지 환자의 자발적 순환 회복률을 향상시킬 수 있는 요인들에 대한 심층 분석을 수행하였다. 심정지 환자의 자발적 순환 회복에 영향을 미치는 요인은 의사결정나무기법을 적용하여 분석하였으며, 그 결과 도착전 CPR여부, 병원 도착전 심정지 목격여부, 심정지시 활동, 과거력(암/심장질환/뇌졸중), 심정지 발생 장소, 병원전 일반인 CPR여부, 신고~현장 도착까지 걸린 시간, 연령 등이 중요한 요인으로 밝혀졌다. 이 요인들의 조합을 통해 의사결정나무모형으로 분류된 심정지 환자는 총 16개 유형이었으며, 그 중 유형 1의 특징을 갖는 집단의 자발적 순환 회복률(29.6%)이 가장 높게 나타났다. 더불어 비공공장소에서 심정지가 발생한 환자에게 일반인이 CPR을 시행하였을 경우, 심정지 환자의 자발적 순환 회복률이 향상된 것으로 보아 지역주민들에 대한 CPR교육이 중요함을 파악할 수 있었다.

• 한국응급구조학회지
• /
• 제6권1호
• /
• pp.77-86
• /
• 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.

• 임상간호연구
• /
• 제19권2호
• /
• pp.218-232
• /
• 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.