• 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.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.4
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• pp.1540-1546
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• 2010

In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.

• Journal of Korean Public Health Nursing
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• v.10 no.1
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• pp.106-117
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• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• 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.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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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.

• The Korean Journal of Emergency Medical Services
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• v.2 no.1
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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.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.166-172
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• 2017

Purpose: Thoracic traumas represent 10-15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI. Methods: This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed. Results: The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4). Conclusions: This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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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.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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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.