• 한국응급구조학회지
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• 제9권1호
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• pp.101-109
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• 2005

The purpose of this study which was done by 250 Prehospital Care Reports(PCRs) survey of some squads in Seoul Metropolitan Fire & Disaster Management Department was to improve prehospital emergency care by means of quality management. The data were collected in 3 squads from Jun. 21 to Jul. 18, 2004 and analyzed by using SPSS Win 12.0 Version. The conclusions from this study were summarized as follows. The mean time of Event to treatment interval was $4.6{\pm}4.3$ minutes and 49.2% arrived at patient within 4 minutes. Platinum minute was observed 61.1% of verbal response, 73.3% of painful response, 77.8% of unresponsive. The great majority of patients couldn't receive advanced life support on account of limited scope of practice and strict direct medical control in the Emergency Medical Services Act. Data from quality improvement activity will be useful to expand indirect medical control which is able to activate prehospital care. To utilize PCR for quality improvement. It has to have data elements, run data, patient data, check boxes, narrative including US DOT's minimum data set.

• 한국응급구조학회지
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• 제17권2호
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• pp.9-20
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• 2013

Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

• 한국응급구조학회지
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• 제15권1호
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• pp.79-88
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• 2011

Purpose : Prehospital emergency care for shockable rhythm is one of major concerns of emergency medical services. But, in Korea, prehospital medical service systems are not yet well established. We tried to offer one of the fundamental data to develop of these system. Method : After application of exclusion criteria, 200 patients who had shockable rhythm from January to December, 2008 were included in this study. Restrospective review of Prehospital care Reports of these patients was done. Result : Total 200 cases of shockable rhythm and prehospital arrest were analyzed. The rates of assessment of vital signs were 89.0%, the rate of level of consiousness was 99.5%. Just 6.0% were communicated with medical director providing the prehospital care. The frequency of defibrillation was performed 58.5%. Conclusion : Survival rate was higher in defibrillation group than that of nondefibrillation group(20.5% vs 2.4%, p=0.000).

• 한국응급구조학회지
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• 제9권1호
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• pp.25-32
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• 2005

Purpose: There has been an increase in the number of prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population, We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrest. Methods: We studied 57 victims with prehospilal cardiac arrest by EMT's Reports form January to December, 2004. Results: Fifty-seven of 92 victims were trasported with ECG in prehospital cardiac arrest. Ventricular fibrillation(VF)/ ventricular tachycardia was 56.2%, asystole was 33,3%, and pulseless electrical activity(PEA.) was 10.5% in initial rhythm analysis, There weren't attempt CPR in 14.0%. Twenty of the 32(62.5%) were shocked by AED for the adequacy method. There were no statistical differences the transportation time. Conclusion: With the increase in cardiovascular disease and old age, the number out-of-hospital cardiac arrests has risen accordingly. However, there were lack of CPR by bystander, defibrillation, advanced cardiac life support(ACLS) in prehospital stage. To improve the adequancy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

• 한국산학기술학회논문지
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• 제11권4호
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• pp.1540-1546
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• 2010

본 연구는 심정지 환자에 특성 및 심폐소생술과 제세동 등 응급처치 시행에 관련된 구급활동일지와 심폐정지환자 응급처치 세부상황표를 분석하여 심정지 환자의 소생을 위한 병원전 응급처치의 질향상에 기여할 목적으로 수행하였다. 연구결과는 다음과 같다. 제세동할 수 있는 심실세동과 심실빈맥 리듬은 20.3%이고 이중 제세동기에 의한 쇼크는 66.5%가 시행되었다. 현장일반인 심폐소생술 시행시 소생률은 미시행시에 비해 높았으나 유의한 차이(p=0.10)는 없었다. 심전도 기록을 판독한 결과 심실빈맥이거나 심실세동인 경우가 무수축이거나 무맥성 전기활동인 경우보다 소생률이 높고 유의한 차이(p=0.000)가 있다. 제세동을 적절하게 한 군은 부적절하거나 판단이 불가능한 경우보다 소생률이 높았고 유의한 차이(p=0.000)를 보였다. 이상의 결과를 토대로 병원전 응급구조사의 기록과 제세동 등 적절한 응급처치로 심정지 환자의 소생률을 높이는데 기여하였으면 한다.

• 한국응급구조학회지
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• 제10권2호
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• pp.53-62
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• 2006

Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

• 한국응급구조학회지
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• 제14권3호
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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.

• 한국응급구조학회지
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• 제22권3호
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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.

• 한국응급구조학회지
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• 제18권2호
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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.

• 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.