• Fire Science and Engineering
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• v.30 no.2
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• pp.123-132
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• 2016

This study is the result of performing structural analysis in accordance with the new ambulance design of inside space using the new vehicle's bodywork. 3D design works were performed based on international standards and designed ambulance. And then it was tested by a shock of 10G to the ambulance car inside with respect to the vehicle body after that we looked into the consequences. At this time, it was carried out in consideration of its own weight and the weight of components according to the EN regulation. From the result of structural analysis, the internal frame and configured handrail in a variety of pipe did not have a relatively large stress load, but internal panel and cabinets has been interpreted to receive a large stress load at least over 50 MPa. When carried out reinforcement design in accordance with this analysis, the modification of thickness and shape could be necessary. On the basis of these findings, it is also expected that there could be a useful information to produce a more secure vehicle for paramedics and patients using a ambulance inside the vehicle.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.174-180
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• 2012

Objectives: An ambulance can be a potential source of contagious or droplet infection of a community. We estimated the prevalence of positive carriage of tuberculosis (TB), methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), and vancomycin-resistant $Enterococci$ (VRE) in patients transported by ambulance. Methods: This was a retrospective observational study. We enrolled all patients who visited a tertiary teaching hospital emergency department (ED). Blood, sputum, urine, body fluid, and rectal swab samples were taken from patients when they were suspected of TB, MRSA, or VRE in the ED. The patients were categorized into three groups: pre-hospital ambulance (PA) group; inter-facility ambulance (IA) group; and non-ambulance (NA) group. Adjusted odds ratio (OR) and 95% confidence intervals (CI) were calculated using a multivariable logistic regression model for the prevalence of each infection. Results: The total number of patients was 89206. Of these, 9378 (10.5%) and 4799 (5.4%) were in the PA and IA group, respectively. The prevalence of TB, MRSA, and VRE infection were 0.3%, 1.1%, and 0.3%, respectively. In the PA group, the prevalence of TB, MRSA, and VRE were 0.3%, 1.8%, and 0.4%. In the IA group, the prevalence of TB, MRSA, and VRE were 0.7%, 4.6%, and 1.5%, respectively. The adjusted ORs (95% CI) of the PA and IA compared to the NA group were 1.02 (0.69 to 1.53) and 1.83 (1.24 to 2.71) for TB, 2.24 (1.87 to 2.69) and 5.47 (4.63 to 6.46) for MRSA, 2.59 (1.78 to 3.77) and 8.90 (6.52 to 12.14) for VRE, respectively. Conclusions: A high prevalence of positive carriage of TB, MRSA, and VRE in patients transported by metropolitan ambulances was found.

• 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 Journal of the Korea Contents Association
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• v.16 no.1
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• pp.482-492
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• 2016

Purpose This study is to investigate regional characteristics of 119 ambulance dispatch and the relationship between the distance and response time to the scene. Methods This study was retrospectively conducted 119 running sheets with 1,321 patients who had been transferred to the hospital by 119 ambulance during ambulance attendant training. The training was performed at two, five and three fire station in Seoul, Daejeon and Chungnam respectively, from June 24, 2013 to July 19, 2014. Results Almost the emergency medical services provided were no more than basic first aid in all regions. The patients transferred by 119 ambulance in Seoul were more than other region. The time of call to scene and scene to hospital were the slowest in Chungnam. The major reason of call 119 was due to disease in Seoul and Daejeon, however due to injury in Chungnam. Conclusion Our study suggests that learning from ambulance attendant training course could diverse from region to region. It is, therefore, needed that standardization of ambulance attendant training course, appropriate logistics and resource allocation for providing universal quality of emergency medical services.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.65-80
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• 2012

Purpose: The objective of this study was to assess the job satisfaction and turnover intention of the emergency medical technicians (EMT) in the private ambulance service, to examine their job satisfaction and turnover intention, and to provide the solution for the management of the private ambulance service. Methods: The survey was conducted with 121 EMTs (73 paramedics, 36 basic EMTs and 12 nurses) in the private ambulance service in Korea from September 15 to October 14, 2011. In the reliability of the questionnaire, Cronbach's ${\alpha}$ was 0.790 for job satisfaction and 0.796 for turnover intention. Using SPSS 18.0, we obtained Cronbach's ${\alpha}$, frequencies, percentages, means, and standard deviations, and performed independent t-tests, ANOVA, and Pearson's correlation analysis. Results: 1) The mean score with regard to job satisfaction was 2.94 and that of their turnover intention was 4.23. In the area of job satisfaction, the mean score of the job demand area was 4.23; 3.97 for the job itself; 3.07 for the area of interaction; 2.98 for the area of autonomy: 2.67 for the organizational demand area; 2.67 for working conditions area; and 1.73 for the wage area. 2) Statistically significant difference was observed in job satisfaction according to age (F=3.819, p=.006), wages (t=-4.640, p=.000), terms of incumbency (F=3.868, p=.011), and in turnover intention it was according to sex (t=-1.995 p=.048), age (F=9.611, p=.000), education levels (F=6.974, p=.002), marital status (t=4.393, p=.000), wages (t=5.515, p=.000), license types (F=8.481, p=.001), and terms of incumbency ( F=14.115, p=.000). 3) The job satisfaction and the turnover intention had a negative correlation to each other (r=-.56, p<.000) in general, and in the sub-7 areas of job satisfaction, the correlation with turnover intention was high in order of the wage area (r=-.61, p=.000), working conditions area (r=-.52, p=.000), the area of autonomy (r=-.49, p=.000), the area of interaction (r=-.45, p=.000), the organizational demand area (r=-.40, p=.000), the job itself (r=-.24, p=.007) and the job demand area (r=-.24, p=.009). Conclusion: The government must take the charge of lowering the turnover intention among paramedics in the private ambulance service by providing the advantage in wages and fringe benefits. Ultimately, this would bring an improvement in the quality of medical emergency services to hospitals especially in the area of patient transfer and transportation.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.101-113
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• 2013

Purpose: The purpose of this study was to provide an appropriate direction for effective field practice program by analyzing the influencing factors on satisfaction of field instructor in ambulance ride practice of paramedic students in Korea. Methods: The questionnaires were filled out by 204 paramedic students from July 22 to September 13, 2013. The collected data were analyzed with SPSS WIN 19.0 program. Results: The stepwise multiple regression analysis revealed that the most powerful predictor of satisfaction of field instructor was sincerity of directions. A combination of sincerity of directions (38.2%), achievement(15.4%), improvement of knowledge(3.9%) 4-week field practice(3.0%), 2 week field practice(1.6%), 4 grade(1.8%) pre-expectation of field practice(1.8%) accounted for 65.6% of the variance in paramedic students. Conclusion: We proposed the effective field practice program as well as sincerity of directions of field instructors. It is necessary to discuss before ambulance ride practice within the faculty and the field instructors.

• The Korean Journal of Emergency Medical Services
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• v.18 no.1
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• pp.67-81
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• 2014

Purpose : The purpose of the study is to provide the basic data for preceptorship education program development by analyzing the recognition and acceptance concerning the introduction of preceptorship to ambulance ride practice of 119 EMT-paramedics in Korea. Methods : A self-reported questionnaire was filled out by 157 paramedics in the fire fighters from December 21, 2013 to February 12, 2014. The questionnaire consisted of 31 questions and the data were analyzed by SPSS version 21.0. Results : Most of the subjects answered the positive choice and were very interested in the introduction of preceptorship in the prehospital settings. Mean of preceptorship acceptance level was 3.64 points in 5 points Likert scale and 75.4% of the subjects were able to explain the preceptorship. 57.4% of the subjects considered that preceptorship was an effective training method. Conclusion : Most of the subjects agreed that the preceptorship is very important to the education of paramedic students. The preceptorship education program development will be the basis of ambulance ride practice.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.125-134
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• 2019

Purpose: The aim of this study was to evaluate the usefulness of video communication with medical staff located at a remote location, through a communication application connected to a long term evolution (LTE) mobile communication network in a moving ambulance. Methods: In this study, we recruited patients who were transferred by mobile intensive care unit ambulance from one hospital to another. In the moving ambulance, the information of the patient was transferred to a physician using the application in real time. Recorded video files were evaluated by emergency physicians with experience in video direct medical control. Results: A total of 18 patients were evaluated, and the average score was 5.9 out of a possible 9. It was expected that applying the use of the technology to actual clinical sites would enable the sites to provide assistance. Conclusion: In this study, we confirmed the possibility of benefiting from the clinical field when using the video-audio communication application which is connected to the remote location in real time through the current LTE mobile communication network in the ambulance.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.9-20
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• 2013

Purpose: This research project addressed the need to designing more safe and efficient interior of the future ambulance in Korea. Methods: The study sample contained 760 paramedics in 4 districts. Data was collected by using a revised and complemented questionnaire based on literature review. Results: In relation to the efficacy and safety of work, answers related to storage closet showed to be the highest, and the most difficult part of paramedic work in an ambulance was lurching. CPR is the most frequently used emergency care inside an ambulance, but 66% of the paramedics responded that accurate CPR is not possible during vehicle transfer. Safety belts are not worn for 82.8% of the time, because of discomfort (51.3%). 13.8% of the paramedics responded that stretchers are unstable, 29.5% had an experience of having patients fall off the stretcher inside an ambulance. There were comments on installing equipments to prevent noise, and assist communication. Conclusion: The suggested practical layout contains five main modifications 1. Developing specially designed belt is needed for paramedic safety & efficient work. 2. The seats are molded to be ergonomically friendly. 3. Equipments to secure the body and safety devices for CPR are needed. 4. System improvement for communication between the driver seat and paramedics is needed. 5. The stretchers are molded to be maximize efficiency and minimize injury.

• The Korean Journal of Emergency Medical Services
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• v.14 no.1
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• pp.5-18
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• 2010

Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.