• The Korean Journal of Emergency Medical Services
• /
• v.24 no.1
• /
• pp.67-76
• /
• 2020

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider's essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

• Journal of Korean Public Health Nursing
• /
• v.10 no.1
• /
• pp.106-117
• /
• 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
• /
• v.23 no.1
• /
• pp.35-48
• /
• 2019

Purpose: This study aimed to explore the rationality for and countermeasures against the use of prehospital patient restraint (PPR) techniques in efforts to limit violent behavior toward 119 emergency medical technicians (EMTs). Methods: Previous countermeasures to limit violent behavior toward 119 EMTs and medical personnel were focused on strict reactive and passive proactive responses. However, those in support of the countermeasures do not believe that violent and criminal behavior can be limited or extinguished by strengthening the punishment unconditionally. Results: When it comes to the far-reaching effects of stigmatization on people who engage in violent and criminal behavior, it is possible that unconditional punishment leads to more crime, increases the costs of imprisonment, and consequently, adds to the financial burden of the government. Conclusion: Thus, we are faced with an urgent need to prepare legal grounds for the use of PPR techniques by 119 EMTs for agitated or combative patients only, with direct medical oversight. Moreover, the legal foundation for the use of PPR techniques also needs to be established for emergency medical personnel. The use of PPR techniques not only ensures the safety of emergency medical services personnel, but also protects patients from injuring themselves and others.

• The Korean Journal of Emergency Medical Services
• /
• v.19 no.3
• /
• pp.33-49
• /
• 2015

Purpose: This study aimed to investigate the work and job satisfaction of military emergency medical technicians (EMTs). Methods: We selected 122 military EMTs who participated in the refresher education in 2012. This study was conducted from November 12 to December 21, 2012. Results: The most frequent duties of military EMTs were scene assessment, cardiopulmonary resuscitation, surgical treatment, prehospital first-aid, transfer to the hospital, education, and call response. The air force and navy EMTs had better performance than the army EMTs. As for job satisfaction, the work itself ranked highest, whereas payment ranked lowest. Conclusion: The scope of the work of the military EMTs varied in the 14 fields of work but should be considered for further evaluation. In order to increase the job satisfaction of EMTs, their work conditions should be improved such as through salary increase and extra pay for those with professional certificates.

• The Korean Journal of Emergency Medical Services
• /
• v.19 no.3
• /
• pp.51-68
• /
• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• The Korean Journal of Emergency Medical Services
• /
• v.10 no.1
• /
• pp.23-39
• /
• 2006

In Korea, There are many disasters, like the collapse of Sampung department store, the strike of severe typhoon 'Rusa' and the subway tragedy in Taegu, because of global warming, urbanization, high-density and high-rise of buildings. So, the government made 'The Framework Act' on the safe and management of disaster and 'The National Emergency Management Agency' was established. But emergency medical service systems in Korea is not growing so much. The purpose of this research is to give basic data for the development of emergency medical service systems in Disaster by comparing of disaster management systems and emergency medical systems among the nations of the world, analysing emergency medical systems in disaster in Korea and suggesting some improvement methods. The improvment methods are like this ; First, establishing the National Disaster Medical System in Korea, making the good triage by EMT, expansion of EMT's working area, developing protocols and framing of medical director increasing the working force of EMT, broad inner cavity of ambulance for treatment of patientent, supplement of professional equipments, active using of helicopters are needed in prehospital are. Second, equal establishment of emergency medical center and increase of working force of emergency medical team are needed in hospital area. Finally, enforcement of the dispatcher's qualification, smooth communication among EMSS systems and actualization of medical direction through screen are needed in the Telecommunication system.

• The Korean Journal of Emergency Medical Services
• /
• v.24 no.2
• /
• pp.133-153
• /
• 2020

Purpose: This study aimed to identify the status of emergency care of pregnant women transported by paramedics, to analyze the knowledge of paramedics related to pregnant women and their self-confidence in emergency care, and to provide foundational data to improve the quality of emergency care for pregnant women. Methods: We received a total of 1,798 rescue logs from 119 paramedics, who had transported pregnant women, in I city from January 1, 2016 to December 31, 2018. For survey analysis, we used the 164 questionnaires received from these paramedics from June 15 to August 14, 2019. Results: The analysis of the rescue logs revealed that 85.5% (1,537 individuals) either had disease symptoms or were pregnant, whereas only 14.5% (261 individuals) had traffic accidents or accident-related injuries. The mean knowledge of the paramedics related to pregnant women was 23.73 (±2.98) points, and the mean self-confidence in emergency care was 3.19 (±0.74) points. Knowledge of the paramedics about pregnant women and their self-confidence in emergency care of these women had a statistically significant positive correlation (r=.306, p=.000). Conclusion: Paramedics should be provided theoretical and practical training through various programs about the emergency care of pregnant women.

• The Korean Journal of Emergency Medical Services
• /
• v.24 no.2
• /
• pp.79-88
• /
• 2020

Purpose: The study aimed to collect the first aid activity log data of patients who were retransferred through paramedics and to analyze the data in the hospital to improve the plan. Methods: We analyzed 434 retransferred patients, out of the 18,197 patients who visited the emergency medical center in the C area in G metropolitan city, from January 2017 through December 2018. The collected data were analyzed using the SPSS software. Results: The patients were retransferred for various reasons: 17.7% (77 cases) due to the absence of specialists, 15.0% (65 cases) required first aid, and 5.3% (23 cases) due to absence of medical department. In addition, the major medical department with the largest number of retransfer was the department of emergency medicine with 38.2% (166 cases). In the prehospital stage, 38.5% (167 cases) were classified as severe, but in the hospital stage, they were classified as mild. In addition, as a result of hospitalization and discharge, 60.4% (262 cases) were discharged. Conclusion: Most of the retransferred patients were non-emergency patients, and were discharged for mild conditions. The overcrowding in the emergency room of a tertiary hospital can be prevented by reducing the retransmission.

• The Korean Journal of Emergency Medical Services
• /
• v.14 no.3
• /
• pp.83-93
• /
• 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
• /
• v.22 no.3
• /
• 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.