• 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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• 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.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.707-712
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• 2013

급성심근경색환자에서 증상발병후 병원도착지연이 질병과 사망률에 중요한 관련이 있다. 이 연구에서는 환자의 증상 인식 등 응급의료체계 활성화 이전 단계의 의료기관 내원 지연의 원인을 연구하여, 향후 내원지연 시간 감소를 위해 적절한 보건교육 및 치료의 방향을 찾고자 하였다. 연구 샘플은 2009년 6월에서 9월까지 급성심근경색으로 입원한 환자를 대상으로 하였다. 인구통계, 의료기록 및 임상자료는 병원진료기록를 이용하였으며, 병원전 지연은 6시간이전과 이후로 분류하였다. 급성심근경색증 환자들에서 내원시간 지연에 영향을 미치는 요인으로는 고령인 경우, 낮은 사회경제적 위치, 응급의료체계의 이용하지 않고 내원 한 경우와 급성심근경색을 위한 응급처치의 지연등이다. 따라서 사회경제적 위치가 낮은 계층과 고령층에 대한 급성관상동맥 증후군의 증상에 대한 지식을 높이고 증상발생시 의료기관을 빠르게 이용하도록 교육이 필요하다.

• 기본간호학회지
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• 제10권2호
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• pp.154-162
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• 2003

Purpose: The purpose of this study was to investigate factors which can delay hospital arrival for patients with acute stroke. Method: The participants for this study were 102 patients who were admitted to the Department of Neurology in a hospital in Chungnam province. Data were collected from Oct, 2002 to June, 2003. The data were analyzed with frequencies, percentages, and $x^2$ test using the SPSS PC program. Result: The results of this study were as follows: 1. Only 33.8 % of participants arrived at the hospital within 3 hours. 2. Educational level, economic status, people living in same residence, and place of residence were factors which significantly affected prehospital delay time. Also there were significant differences in prehospital delay time according to family history of stroke, day of the week when symptoms began, perception of seriousness of symptoms, type of hospital first used, and transportation. Conclusion: Therefore, to reduce prehospital delay time, educational programs which focus on the above factors need to be developed. Also, a public campaign for utilizing emergency service to reduce transportation time for acute stroke patients need to be facilitated.

• 한국화재소방학회논문지
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• 제26권3호
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• pp.14-20
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• 2012

이 연구는 뇌졸중 환자에게 시행되는 환자평가와 응급처치의 실태를 파악하는 연구이다. 구급대에 의해 이송된 뇌졸중환자 123명을 대상으로 하였으며, 수집된 자료는 SPSS 18.0 프로그램을 이용하여 분석하였다. 분석 결과 뇌졸중으로 진단 받은 123명의 환자 중 환자평가는 혈압 73.2 %, 맥박 73.2 %, 호흡 64.2 %, 산소포화도 79.7 %, 공동반응 88.6 %, 심전도 감시 14.6 %, 혈당측정 19.5 %의 시행률을 보였고, 시행된 응급처치로는 기도유지기 삽입 2.4 %, 손으로 조작하는 기도확보 17.1 %, 기관내삽관 2.7 %, 산소공급 35.4 %, 흡인, 정맥로 확보 및 수액투여가 시행된 환자는 아무도 없었다. 전반적으로 의식상태 평가는 적절하였으나 119구급대원에 의해 시행되는 환자평가 및 응급처치는 전반적으로 적절하지 못하였다.

• 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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• 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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• 제12권3호
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• pp.55-69
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• 2008

Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

• 한국응급구조학회지
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• 제20권1호
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• pp.57-70
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• 2016

Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.172-179
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• 2023

Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.