• 한국응급구조학회지
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• 제15권3호
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• pp.45-55
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• 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
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• 제15권2호
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• pp.55-66
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• 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.

• 한국화재소방학회논문지
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• 제30권4호
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• pp.128-134
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• 2016

구급서비스의 소요 시간, 특히 반응시간은 생존 확률을 향상시키고 후유 장해를 감소시킬 수 있다는 점에서 구급서비스의 품질 관리를 위한 중요한 지표로 활용되고 있다. 이에 본 연구에서는 2011년부터 2014년까지 4년 동안 ${\bigcirc}{\bigcirc}$시의 신고 접수, 출동, 구급활동 자료를 이용해 환자 특성, 주증상 등을 고려한 구급서비스의 시간(time interval)을 분석하였다. 구급서비스의 시간에 대한 정의를 세분화하고 각각의 소요 시간에 미치는 다양한 경제사회적 요인이나 지역적 특성을 분석하여 효율적으로 관리할 수 있다면 구급서비스의 품질은 크게 제고될 것으로 기대 된다.

• 한국응급구조학회지
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• 제22권3호
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• pp.177-187
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• 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
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• 제25권2호
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• pp.99-112
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• 2021

Purpose: The study aimed to analyze the current status of traffic accident victims who were transported by 119 ambulances within the administrative district of Chungnam province and provide essential data for accident prevention. Methods: The pre-hospital care records of patients who called the 119 emergency service in 2019 were obtained from the Chungnam Fire Department. Data pertaining to 13,663 traffic accident victims who were transported to hospitals were analyzed. Results: Patients in those aged ≥60 years accounted for 49.8% of the total cases. In patients aged ≥80 years(n=2,154), motor cycle accidents were highest as 28.3%. In addition, cultivator (n=135) and buggy car (n=79) accident victims were the highest in aged ≥80 years as 66.7% and 67.1%, respectively. Traffic accident victims-population ratio in Chungnam was 0.65%, wherein 2.03% included population aged ≥80 years. Conclusion: It was clear that accidents varied across administrative districts depending on the age group of population distribution. Thus, safety measures for preventing motorcycle, cultivator, and buggy car accidents are necessary for areas with many older people aged ≥80 years.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.1-5
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• 2024

The aim of this paper was to review the biomechanics of knife injuries, including those that occur during stabbing rampages. In knife stab attacks, axial force and energy were found to be 1,885 N and 69 J, respectively. The mean velocity of a stabbing motion has been reported to range from 5 to 10 m/sec, with knife motions occurring between 0.62 and 1.07 seconds. This speed appears to surpass the defensive capabilities of unarmed, ordinarily trained law enforcement officers. Therefore, it is advisable to maintain a minimum distance of more than an arm's length from an individual visibly armed with a knife. In training for knife defense, particularly in preparation for close-quarter knife attacks, this timing should be kept in mind. Self-inflicted stab wounds exhibited a higher proportion of wounds to the neck and abdomen than assault wounds. Injuries from assault wounds presented a higher Injury Severity Score, but more procedures were performed on self-inflicted stab wounds. Wound characteristics are not different between nonsuicidal self-injury and suicidal self-wrist cutting injuries. Consequently, trauma surgeons cannot determine a patient's suicidal intent based solely on the characteristics of the wound. In Korea, percent of usage of lethal weapon is increasing. In violence as well as murders, the most frequently used weapon is knife. In the crimes using knife, 4.8% of victims are killed. Therefore, the provision of prehospital care by an emergency medical technician is crucial.

• 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.

• 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.

• 한국응급구조학회지
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• 제27권3호
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.74-78
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• 2024

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second- and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC injuries.