• 한국응급구조학회지
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• 제24권2호
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• pp.27-38
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• 2020

Purpose: Stroke is a time-sensitive disease that could have reduced complications and mortality with timely diagnosis and treatment. This study aimed to analyze the causes of delay in detecting the clinical signs and symptoms of stroke. Methods: This retrospective observational study analyzed the emergency medical services reports of suspected stroke patients with positive predictive values on the Cincinnati Prehospital Stroke Scale. The study was conducted in Daejeon, Republic of Korea from January 1, 2016 through December 31, 2017. Results: Prolonged prehospital time was associated with high blood pressure, history of cerebrovascular disease, and incidences during daily activities, and sleep. High blood pressure and complications from a previous stroke strongly associated with the prolonged stroke-detection phase (p<.05). Total prehospital time was shortened when patients had evident stroke symptoms, such as decreased level of consciousness, dysarthria, and hemiplegia (p<.05). There was no significant difference in gender or age as a factor that delayed the total prehospital time of the suspected stroke patients. Conclusion: Many patients did not recognize the early clinical symptoms and signs of a stroke. Furthermore, risk factors, such as high blood pressure and history of stroke, prolonged the total prehospital time. Therefore, we need targeted interventions that educate about warning symptoms of stroke, along with emphasis on the importance of emergency calls to substantially reduce the prehospital delays.

• 한국응급구조학회지
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• 제11권3호
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• pp.111-118
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• 2007

Purpose : It was to present strategies on activation of prehospital medical direction in Korea. Methods : This study was conducted by analysing some papers on prehospital medical direction and statistical data from the National Emergency Management Agency. Results : There was no active application of medical direction methods such as Priority Dispatch System, Pre-Arrival Instructions, System Status Management and no data on prehospital medical direction. To estimate direct medical control on emergency patients who were sorted by EMTs in 2006 was only 2.5%. Conclusion : To improve prehospital medical direction, it needed to applicate data collecting & using system and in-direct & direct medical control by medical doctor.

• 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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• 제18권3호
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• pp.19-35
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• 2014

Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.

• 한국응급구조학회지
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• 제14권1호
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• pp.31-46
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• 2010

This study was intended to analyze the clinical characteristic of the patient with hypoglycemia and the status of prehospital treatments by 119 emergency medical technicians well as the cause of inappropriate emergency treatment by 119 emergency medical technicians in a bid to seek the measures for improvement, thereby enhancing the emergency medical services before medical treatment at hospital. Examination of the daily work log on 430 patients suffering with hypoglycemia who were sent to the university hospital in Gyunggi-Province by 119 emergency medical technicians, beginning on Jan 1, 2004 till Dec 31. 2008 was carried out and the survey of 206 119 emergency medical technicians working at the region of Gyunggid-Province was conducted from Sep 19 through Oct 6, 2009. Evaluation of the frequency and percentage and ANOVA analysis using SPSS WIN 14.0 program was carried out. In view of the examination of daily emergency work log and questionnaire, prehospital treatment for the patients with hypoglycemia needs to be further improved in general, and to provide the emergency treatment in accurate and timely manner, improvement of the system such as assignment of licensed rescue members and development of protocol that will replace the medical consultant system, mandatory emergency treatment, constant and efficient training and maintenance of emergency rescue records shall be implemented, and furthermore, social recognition to 119 emergency medical technicians shall be improved to encourage them to perform more positive way and manner.

• 한국응급구조학회지
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• 제7권1호
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• pp.127-134
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• 2003

An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.

• 한국응급구조학회지
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• 제19권1호
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• pp.19-33
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• 2015

Purpose: The purpose of this study was to improve the quality of prehospital care provided to infants and toddlers (preschoolers) based on questionnaire findings. Methods: A total of 1,634 running sheets from 119 centers of D city from patients older than 1 month and less than 7 years of age from January 1, 2013 to December 31, 2013 were reviewed for 119 emergency medical technicians (EMTs) activity analysis. And a self-reported questionnaire about knowledge and competency in prehospital care of preschoolers was completed by 159 EMTs at fire stations in D city. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: Of 1,634 patients, 58.6% were call to 119 due to disease, 33.8% due to injuries and 7.5% due to traffic accident. Knowledge and confidence in treating preschoolers was significantly higher among paramedic EMTs than basic EMTs. The 119 EMTs surveyed indicated that training for preschooler prehospital care was most needed. Conclusion: In order to provide high quality prehospital care for preschoolers transported to emergency rooms, it is necessary to equip ambulances with the proper equipment. In addition, EMTs should be provided educational opportunities and clinical training.

• 한국응급구조학회지
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• 제10권2호
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• pp.35-42
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• 2006

Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.

• 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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• 제17권1호
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• pp.63-78
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• 2013

Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.