• 한국응급구조학회지
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• 제7권1호
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• pp.55-64
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• 2003

The purposes of this study which was conducted by applying three projection formulae to the data from admission quota for paramedic of the Ministry of Education & Human Resources Development the number of ambulances the number of emergency medical centers of the Ministry of Health & Welfare and rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board were to find out demand and supply of paramedic from 2002 to 2045 and to expand scope of practice of paramedic in Korea. The conclusions from this study were summarized as follows; (1) The simple formulae derived from the projection formula of the Economic Planning Board were applied under the present Emergency Medical Services Act including qualifying over 3-years experienced EMT-Basic for paramedic examinee, stationing paramedic or EMT-Basic or physician or nurse per ambulance, stationing paramedic or EMT-Basic per emergency medical center and under the amended Emergency Medical Services Act including qualifying only paramedic graduate for paramedic examinee, stationing 4.5 paramedics per ambulance, stationing 10 to 2 paramedics per emergency medical center. (2) It was estimated that on the American basis of 5.6 EMTs per 10,000 in 1996, the number of paramedics under the present act will reach the basis before 2020, the number of paramedics under the amended act will reach the basis about 2040. (3) It was estimated that on the basis of 22,000 paramedics demanded from the number of ambulances, the number of emergency medical centers in 2001, the number of paramedics under the present act will reach the basis before 2015, the number of paramedics under the amended act will reach the basis about 2030. (4) There was relationship between requirements for emergency medical centers scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic including EMD, instructor, teacher of safety. (5) This study which includes only expanded scope of practice of paramedic and projection for paramedic in the act needs complementary studies such as decision-making process in health manpower policy and so on.

• 조명전기설비학회논문지
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• 제21권1호
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• pp.60-65
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• 2007

구급차에 장착하거나 사고 현장에서 사용할 수 있는 방사선 영상장치를 구현하였다. DC 12[V] 입력 전원에서 X-ray 튜브를 통해서 X-ray를 발생하는 장치를 구성한 후 오실로스코프를 활용하여 특성 실험을 하였다. 그리고 발생된 X-ray에 대해 디지털 디텍터를 이용하여 파일 형태로 저장하는 실험을 하였다. X-ray를 발생시킨 후 디지털 디텍터로 검출한 결과, 파일 크기가 1.67[MB]이고, jpg 형태로 이루어진 방사선정보를 저장할 수 있었다. 구현된 방사선 영상장치는 환자가 의사로부터 공간적으로 멀리 떨어져 있어 시간적으로 진단과 치료가 동시에 이루어지기 어려운 상황에 효율적으로 대처할 수 있는 장점이 있다. 따라서 구현된 방사선 영상장치는 긴박한 상황이 발생한 사고 현장이나 이동 중인 구급차 내에서 X-ray 촬영을 함으로써, 환자의 X-선 정보를 응급의료 센터의 의사에게 전달하고 의사의 처방을 받을 수 있는 의료 선진화를 구현하는 데 기여할 수 있을 것으로 기대된다.

• 성인간호학회지
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• 제29권1호
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• pp.12-21
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• 2017

Purpose: The purpose of this secondary data analysis study was to compare what factors influenced individual's satisfaction with emergency medical services (EMS). Methods: Data were obtained from the Korea Health Panel Survey 2013 with 20,641 participants. A total sample of emergency room (ER) users (n=1,709) aged 20 and over were selected and divided into two age groups, one for 1,046 adults and the other for 663 elderly. Participants' responses were analyzed using descriptive statistics, ${\chi}^2$ test and logistic regression. Results: Among adults and elderly who were transferred to other hospitals instead of being admitted or returned to their homes reported less satisfaction (${\chi}^2=10.18$, p=.006). Further, the adults who perceived their arrival to the ER as not delayed (${\chi}^2=3.74$, p=.049) or visited the ER for treatment for illness (${\chi}^2=5.32$, p=.021) reported more satisfaction than those who perceived their ER service being delayed or visited the ER for accident or poisoning. The elderly who visited ER by non-ambulance reported higher satisfaction than those who arrived by ambulance (${\chi}^2=14.15$, p<.001). Conclusion: In both adults and the elderly, satisfaction of EMS can be increased by avoiding transferring patients to other hospital. For adults to be satisfied with EMS, efficient and rapid EMS might be needed to avoid delay in ER arrival, especially for adults with accidents or poisoning.

• 한국인터넷방송통신학회논문지
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• 제11권6호
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• pp.183-191
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• 2011

본 논문은 하나의 도시가 여러 구역으로 분할되고, 응급환자가 발생하였을 때, 모든 구역에 대해 최대 허용 도착시간 T를 충족시키도록 응급시설을 배치하는 문제에 대한 알고리즘을 제안하였다. 이 문제는 일반적으로 다항시간으로 해를 구하는 알고리즘이 존재하지 않아 두 구역 간 소요시간이 최대허용 도착시간이내이면 1로, 그렇지 않으면 0으로 하는 정수계획법으로 변환시키고, 선형계획법 도구를 활용하여 해를 구한다. 본 논문은 최소차수 노드의 이웃 노드들 중 최대 차수 노드를 응급시설의 위치로 결정하는 집합피복 알고리즘을 적용하였다. 제안된 알고리즘을 텍사스 오스틴 시의 33개 구역에 대한 사례에 대해 $3{\leq}T{\leq}20$ (분)을 적용하고, Swain의 55개 노드 망에 대해 T=15에 대해 응급시설의 위치를 결정할 수 있는지 여부를 검증하였다. 선형계획법을 활용한 전통적인 집합피복 알고리즘은 몇 개의 T에 대해 해를 구하지 못한 반면에, 제안된 알고리즘은 18개의 모든 T에 대해 해를 구하였다.

• 성인간호학회지
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• 제12권3호
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• pp.323-333
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• 2000

The purpose of this study was to determine the impact of situational, clinical and psychsoical factors on treatment-seeking behavior among those with acute myocardial infarction(AMI). This study used a retrospective, descriptive design. The sample consisted of 72 patients aged over 30 and who were diagnosed with an acute myocardial infarction at two large university-affiliated medical centers from July 1, 1998 to March 30, 2000. But of 72, patients 5 who were an outlier in treatment-seeking time were deleted. Data were collected by using questionnaires, which included demographic data, situational, clinical and psychosocial data. Also patient interviews and chart review were used to obtain information related to treatment-seeking time. The results of this study were summarized as follows ; 1. Mean time from the onset of AMI symptoms to arrival at the hospital was $12.09{\pm}11.44$ hours; 2. Treatment-seeking time was not significantly different by age, gender, or education; 3. Most(44 or 65.78%) patients were at home when they began having AMI symptoms. The remaining patients were either in a public area, workplace or in a car. Patients at home delayed longer than those who had their first symptoms elsewhere, but not significantly different. Also, most patients were with another person when they began to experience AMI symptoms: a spouse(25 or 37.3%), other family member(31 or 46.3%); the remaining 11 were alone. There were no significant differences in treatment-seeking time based on whether alone or with others. Most patients(46 or 68.7%) used an ambulance rather than taking private transportation, and patients who used an ambulance were delayed longer than those who used private transportation, but there were no significant differences; 4. Time to treatment-seeking was not significantly different by blood pressure, heart rate on admission and the peak CK-MB, CPK and Cholesterol level, Killips class; 5. There were no significant statistical differences in treament-seeking times by anxiety level, mood status or control ability.

• 한국응급구조학회지
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• 제11권2호
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• pp.87-101
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• 2007

Health and disease related characteristics of 226 selected by systematic sampling from 452 personal emergency response system(PERS) beneficiaries and actual conditions of using PERS by them are as follows. Over 86% of PERS beneficiaries have not good health conditions and 70.7% of them have chronic diseases. On social supports family was highest as 52.2% and cases having social workers' assistance were 15.2%, but 53 as 23.7% had not visit or call from anyone and showed very low social supports. 86.2% was given PERS within 3years and 79.1% had it by the recommendation from related agencies and 4.0% was by their demand. On wearing it, 78.3% didn't bring it with them and 92% of them answered they were not sick and then it was found that they didn't use it because they had not special emergency. On satisfaction with paging system's operation, 81.3% answered they were satisfied with it, 48.8% used it for 'acute and emergency diseases' and 29.3% called ambulance for 'appointed medical treatment'. Time required for ambulance to arrive at the field was within 10 min. in 87.8% and after 10 min. in 12.2% and emergency service for beneficiaries by fire service was very good. On satisfaction with use of PERS, 85.4% were satisfied with it, 81.9% who requested repair or replacement of radio paging got it back after one or two days of their request and they answered they were satisfied with A/S. 45.5% answered they powered off it because 'they didn't use it' and 12.1% had 'economical reason of phone charge'.

• Child Health Nursing Research
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• 제5권2호
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• pp.136-150
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• 1999

The subjects, under 18 old, 2,694 children who visited ER during 1998, were surveyed by the Triage and other statitical data. The results were as follows 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage ; critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER ; 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting : the 20:00 - 22:00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%), Mar. and May(9% respectively, Dec. and July(6.7%) respectively. The children who visted ER in spring and autumn showed higher portion than those of summer and winter. 6. Results ; admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%), The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER ; 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped. was 34.4%, PS was 20.8%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visting ; the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means . by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.

• 대한응급의학회지
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• 제29권5호
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• pp.399-407
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• 2018

Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

• 한국응급구조학회지
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• 제26권3호
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.

• 보건행정학회지
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• 제33권4호
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• pp.440-449
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• 2023

Background: This study aimed to analyze the prehospital process and reperfusion therapy process of acute ischemic stroke in Busan metropolitan area and examine the impact of living arrangement on the early management and functional outcomes of acute ischemic stroke (AIS). Methods: The patients who diagnosed with AIS and received reperfusion therapy at the Busan Regional Cardiovascular Center between September 2020 and May 2023 were selected. We investigated the patients' hospital arrival time (onset to door time) and utilization of 119 emergency ambulance services. Additionally, various time matrices related to reperfusion therapy after hospital were examined, along with the functional outcome at the 90-day after treatment. Results: Among the 753 AIS patients who underwent reperfusion therapy, 166 individuals (22.1%) were living alone. AIS patients living alone experienced significant delays in symptom detection (p<0.05) and hospital arrival compared to AIS patients with cohabitants (370.1 minutes vs. 210.2 minutes, p<0.001). There were no significant differences between the two groups in terms of 119 ambulance utilization and time metrics related with the reperfusion therapy. Independent predictors of prognosis in AIS patients were found to be age above 70, National Institutes of Health Stroke Scale score at admission, tissue plasminogen activator, living alone (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.155-2.760) and interhospital transfer (OR, 1.898; 95% CI, 1.152-3.127). Delay in identification of AIS was shown significant correlation (OR, 2.440; 95% CI, 1.070-5.561) at living alone patients. Conclusion: This study revealed that AIS patients living alone in the Busan metropolitan region, requiring endovascular treatment, face challenges in the pre-hospital phase, which significantly impact their prognosis.