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.
Purpose: This study attempts to improve the status of emergency care for major trauma patients transferred by 119 paramedics by analyzing the status of emergency care and the obstacles to the spinal motion restriction (SMR) for major trauma patients. Methods: A total of 600 rescue logs were collected from major trauma patients transported by 119 paramedics in the C fire department from Jan. 1, 2015, to Dec. 31, 2017. And then, 280 questionnaires were collected from the 119 paramedics in C fire department from May 3 to Jun. 3, 2019. Data were analyzed using SPSS 24.0 version. Results: Among 499 spinal motion restriction adaptive patients, the spinal motion restriction rate was 51.1% (255 individuals). Lack of human resources and quality control problems were among the obstacles to spinal motion restriction. Conclusion: The 119 paramedics should improve their activeness and skills in performing emergency care, and since training and experience are of crucial importance, they should expand various education systematized according to demand.
Joo, Seok;Ma, Dae Sung;Jeon, Yang Bin;Hyun, Sung Youl
Journal of Trauma and Injury
/
v.30
no.4
/
pp.166-172
/
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.
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.
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.
Purpose: This study aims to identify the present handover status and the difference in performance and importance of handover between 119 paramedics and emergency department (ED) staff to improve the quality of handover. Methods: The study involved a questionnaire survey of 171 paramedics and 108 ED staff in four regions from August 28 to September 23, 2020. Subsequently, 279 questionnaires were collected and 277 copies were used for this study. Data were analyzed by SPSS 26.0 version. Results: The results showed that most of the paramedics and the ED staff rely on memory and verbally handover, without formal education about the handover process. And there were significant differences in performance in important information of prehospital. Some of the handover items were a difference in performance and importance between the paramedics and the ED staff. Conclusion: The unified education based on required and optional items is necessary to reduce the loss of information between the paramedics and ED staff, and standardized tools need to be developed in the handover process.
This thesis has defined the legal status of 119 rescue who plays a major role in the Korean prehospital emergency medical system and reviewed the various issues that may occur depending on work related legal liabilities. As a result, the purpose of this study was to represent the countermeasures for legal protection of 119 rescue required for the quality improvement of prehospital emergency medical system and as well as the countermeasures for risk management prepared for its related lawsuits. The legal liabilities of 119 rescue officers can be divided largely into public law liabilities and civil and criminal liabilities. In order to decrease the incidences of legal problems and provide the legal protection to rescue officers, the liability of supervising physician should be emphasized when the emergency medical practice is performed by a rescue officer under their supervision by consolidating medical control and the rescue officer should have legal liability on his emergency medical practice. itself Also, the emergency medical service guideline for 119 rescue officers should be prepared and their works should be performed according to such a guideline and procedures. In addition, the accurate legal documentation on emergency medical system from on-site to ER and related mobilization should be framed and preserved. Moreover, it is required to enact a new law such as the Good Samaritan Act or the Rescue Officers Protection Act.
The purposes of this research which was conducted by surveying lost/added unit hours reports, unit hour demand analysis worksheets from prehospital care reports of two squads in Kyonggi Provincial Fire and Disaster Headquarters for 20 weeks (January 1, 2002 - May 20, 2002) are to get Unit Hour Utilizations. Call Demands such as Unit Hour Demand, Simple Average Demand, High Average Demand, Peak Average Demand, the High Actual Demand. The conclusions from this analysis were summarized as follows: (1) By revealing Unit Hour Produced 3223.9, Call Volume 964, Unit Hour Utilization 0.299 at the Squad A and Unit Hour Produced 3328.4, Call Volume 901, Unit Hour Utilization 0.271 at the Squad B induced Korean Squads to chance identification, definition, direction of Unit Hour Utilization. (2) By revealing Simple Average Demand 7.4 on Monday Tuesday, High Average Demand 9.6 on Tuesday Friday. Peak Average Demand 11.5 on Tuesday, the High Actual Demand 12 on Tuesday Wednesday at the Squad A and Simple Average Demand 6.8 on Sunday, High Average Demand 10.4 on Monday, Peak Average Demand 11.5 on Monday, the High Actual Demand 13 on Monday at the Squad B enabled Korean Squads to utilize System Status Management. (3) The Maximum Calls per Unit Hour were 115 for 23:00~23:59, the Minimum Calls per Unit Hour were 46 for 05:00~05:49 in two squads. The Maximum Calls per Unit Hour were 7.4 on Tuesday Saturday, the Minimum Calls per Unit Hour were 6.1 on Thursday at the Squad A. The Maximum Calls per Unit Hour were 7.3 on Monday Saturday, the Minimum Calls per Unit Hour were 5.6 on Thursday at the Squad B. (4) Analyzing demand for EMTs in the optimum emergency medical service of Korea, we have been able to utilize this Unit Hour Utilization in company with the established estimation methods such as international comparisons or the number of ambulances for scientific reasonable estimation. (5) These Call Demands which were limited to the demand time in this study will make us expect some following studies including demand time, demand time, demand map for Strategic Deployment.
Purpose: The purpose of this study is to identify the compliance with the first standardization of the paramedic curriculum and suggest a second standardization to cultivate competent paramedics. Methods: This study was conducted by collecting 38 curricula, and responses to questionnaires, including those on the current status of prehospital field practice, from departments of emergency medical technology of 36 institutions. Data were collected between September 1 and November 30, 2019 via e-mail. Data were analyzed using SPSS v24.0 and NVivo 12.0. Results: Compliance with the first standardization of the paramedic curriculum was over 70% in only 11 on the 26 major subjects. The second standardization of the paramedic curriculum consists of 27 subjects requiring 76~79 credits for the 3-year course and 78~82 credits for the 4-year course. Conclusion: We suggested a minimum number of essential subjects to cultivate competent paramedics following the second standardization of the paramedic curriculum, and we hope colleges comply with this curriculum. Twenty to twenty-five percent of major subjects can be determined by the discretion of the college to maximize competency of paramedic students.
Background : The causes of chest pain vary but the leading cause of chest pain is ischemic heart disease. Mortality from ischemic chest pain has increased more than two fold over the last ten years. The purpose of this study was to determine the data necessary for rapid treatment of patients with signs and symptoms of ischemic chest pain in the emergency department (ED). Materials and Methods : We interviewed 170 patients who had ischemic chest pain in the emergency department of Yeungnam University Hospital over 6 months with a protocol developed for the evaluation. The protocol used included gender, age, arriving time, prior hospital visits, methods of transportation to the hospital, past medical history, final diagnosis, and outcome information from follow up. Results : Among 170 patients, there were 118 men (69.4%) and the mean age was 63 years. The patients diagnosed with acute myocardial infarction (AMI) were 106 (62.4%) and with angina pectoris (AP) were 64 (37.6%). The patients who had visited another hospital were 68.8%, twice the number that came directly to this hospital (p<0.05). The ratio of patients who visited another hospital were higher for the AMI (75.5%) than the AP (59.4%) patients (p<0.05). The median time spent deciding whether to go to hospital was 521 minutes and for transportation was 40 minutes. With regard to patients that visited another hospital first, the median time spent at the other hospital was 40 minutes. The total median time spent before arriving at our hospital was 600 minutes (p>0.05). The patients who had a total time delay of over 6 hours was similar 54.8% in the AMI group and 57.9% in the AP group (p>0.05). As a result, only 12.2% of the patients with an AMI received thrombolytics, and 48.8% of them had a simultaneous percutaneous coronary intervention (PCI). In the emergency department 8.5% of the patients with an AMI died. Conclusion : Timing is an extremely important factor for the treatment of ischemic heart disease. Most patients arrive at the hospital after a long time lapse from the onset of chest pain. In addition, most patients present to a different hospital before they arrive at the final hospital for treatment. Therefore, important time is lost and opportunities for treatment with thrombolytics and/or PCI are diminished leading to poor outcomes for many patients in the ED. The emergency room treatment must improve for the identification and treatment of ischemic heart disease so that patients can present earlier and treatment can be started as soon as they present to an emergency room.
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