• 한국융합학회논문지
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• 제10권1호
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• pp.371-380
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• 2019

본 연구는 구급대원 12명이 참여하여 나누어 근전도를 측정하였다. 헬멧을 착용하지 않는 경우, 920g 헬멧을 착용한 경우, 1310g 헬멧을 착용한 경우로 나누어 근전도를 측정하였다. 머리와 목의 좌우 움직임에서는 반대쪽(흉쇄 유돌근)는 근 활성도가 높았고, 굴곡과 과신전(흉쇄유돌근, 판상근)시 근 활성도는 유의성이 없었다. 특히 긴척추고정판에 무게를 싣고 들어올리거나 내릴때의 세모근과 척추 기립근은 헬멧 유무에 따라 근전도 활성에 다소 차이가 있는 것으로 나타났다. 구급대원들이 긴척추고정판을 이용하여 환자를 들어올리거나 내릴때는 머리와 목의 각도를 좌우로만 움직이지 않는다면 새로 개발한 스마트 헬멧은 대원들의 목 주위의 근육에 영향을 주지 않는다고 사료 된다. 척추기립근이나 세모긍의 경우는 각도가 커짐에 따라 허리와 등근육은 동작을 좌우하는 근육에서 근전도 활성이 높게 나타났다고 사료된다. 그렇지만 기존의 파워리프팅(들어올리는 동작)동작에서 허리를 가능한 꼿꼿히 세우는 규칙을 지킨다면 요추 주위의 근육 및 골격계 질병에 대한 대처를 할 수 있다고 생각된다.

• 한국콘텐츠학회논문지
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• 제19권3호
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• pp.520-529
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• 2019

이 연구는 부산시 소방공무원들의 건강장애 유해인자에 대해서 실증적으로 살펴봄으로써 향후 소방공무원들의 건강관리에 기초자료를 제공하고자 하였다. 결과적으로, 우선, 화재진압대원의 유해인자를 보면, 아무래도 화재현장에서 근무하기 때문에 업무특성을 반영하여 화재 시 발생하는 유해화학물질의 위험성을 가장 심각하게 인식하고 있다는 것을 확인할 수 있었고, 다음으로 화재 진압시에 추락위험을 높이 인식하고 있다는 것을 확인할 수 있었다. 다음, 구조대원의 유해인자에서는 구조대원이 화재 현장이나 각종 사고현장에서 요구조자를 구조하는 임무를 수행하기 때문에 현장 유해화학물질 위험성을 가장 높게 인식하고 있었고, 또한 구조현장에서의 추락위험을 두 번째로 높게 인식하고 있었는데 이는 업무 특성이 반영된 결과라고 볼 수 있다. 또한, 구급대원의 유해인자를 보면, 구급대원의 교대근무의 위험성을 가장 높게 인식하고 있었다. 이는 기존 연구에서 교대근무가 건강에 유해하다는 것과 일맥상통하는 대목이다. 다음으로, 환자이송 과부하가 큰 유해요소로 꼽았다는 것은 그만큼 구급업무의 특성상 많은 이송환자들이 많아짐으로 인해서 각종 2차 사고가 발생할 가능성이 있기 때문으로 사료되며, 구급현장 이송 중에는 빠르게 구급차량을 이동시켜야하기 때문에 교통사고 유발 가능성도 유해요소로 인식되고 있다는 것을 알 수 있다. 마지막, 유해인자 인식 비교에서는 구조대원이 가장 위험하다고 인식하고 있는 것을 알 수 있다. 이는 업무 특성과도 연관되는데, 구조대원의 경우가 화재 등 각종 위험현장과 가장 근접하게 활동을 하고 있기 때문으로 사료된다.

• 농촌계획
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• 제24권4호
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• pp.147-155
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• 2018

The purpose of this study was to identify vulnerable area of emergency medical care. In the existing method, the emergency medical vulnerable area is set as an area that can not reach the emergency room within 30 minutes. In this study, we set up an area that can not reach within 30 minutes including the accessibility of 119 emergency center. To accomplish this, we obtained information on emergency room and 119 emergency center through Open API and constructed road network using digital map to perform accessibility analysis. As a result, 509 emergency room are located nationwide, 78.0% of them are concentrated in the region, 1,820 emergency center are located, and 61.0% of them are located in rural areas. The average access time from the center of the village to the emergency room was analyzed as 15.3 minutes, and the average access time considering the 119 emergency center was 21.8 minutes, 6.5 minutes more. As a result of considering the accessibility of 119 emergency center, vulnerable areas increased by 2.5 times, vulnerable population increased by 2.0 times, and calculating emergency medical care vulnerable areas, which account for more than 30% of the urban unit population, it was analyzed that it increased from 17 to 34 cities As a further study, it will be necessary to continuously monitor and research the real-time traffic information, medical personnel, medical field, and ambulance information to reflect the reality and to diagnose emergency medical care in the future.

• 스마트미디어저널
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• 제13권5호
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• pp.33-44
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• 2024

충북은 지역별 인구구성과 산업시설, 응급의료기관의 분포 등에 있어 다양한 지역적 특색을 가지고 있다. 하지만 아직까지 심장정지 환자의 발생 특성과 관련한 지역별 특성 요인을 분석한 연구는 없는 실정이다. 따라서 본 논문은 충북지역의 병원 전 발생하는 심장정지 환자의 특성과 119구급대 이송 현황을 분석하여 충청북도 지역 특성에 적합한 병원 전 심장정지 환자 대응체계를 구축하는데 기초자료를 제공하고 수행하였다. 본 논문은 충북지역 급성 심장정지 조사 원시자료(2020년)를 기초로 구급차로 이송된 심장정지 환자 1,188명을 분석한 후향적 연구이다. 충북 도내 응급의료기관은 총 11개소로 시 단위 지역에 편중되어 있어 군 단위 지역에서의 병원까지 환자 이송 시간이 지연되고 있었다. 군 단위 지역은 특별구급대의 출동 빈도가 상대적으로 적었으며, 심장정지 환자 소생에 도움이 되는 심장정지 약물 투여 빈도도 낮게 나타났다. 결론적으로 응급의료서비스의 접근성 향상(소외지역의 구급차랑 배치, 응급의료기관 적정 배치 등), 외상성 심장정지 환자에 대한 예방 홍보 및 구급대원의 응급처치 전문성 강화를 위한 업무 범위 확대 등의 노력이 필요하다.

• 한국응급구조학회지
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• 제15권3호
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• 한국산학기술학회논문지
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• 제18권11호
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• pp.374-380
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• 2017

본 연구는 시골지역에 위치한 119지구대의 현황을 분석하고 이를 바탕으로 좀 더 효율적인 응급의료서비스를 이용할 수 있도록 공간적 배치의 기초자료를 제공하기 위해 Y시 H면에 소재한 119지구대를 중심으로 2016년1월 1일부터 2016년 12월 31일까지의 119지역대 환자이송 현황을 조사하였다. 수집된 자료는 SPSS 21.0을 이용하여 분석하였으며, 빈도분석을 실시하고, 가상적인 119지구대 배치 후 이송시간 및 거리는 GIS(Geographic Information System)를 이용하여 정보를 분석하였다. 연구결과, 119지구대를 이용율은 대부분 65세가 넘은 고령환자가 전체 이용환자의 57%인 수준이었으며, 실제 출동반응 현황은 현장도착 평균 거리는 6.41km(11.86분)이었으며, 현장에서 의료기관까지 소요되는 거리는 18.24km(21.52분)었다. 현재 위치하고 있는 119지역대를 중심으로 GIS를 이용하여 분석한 결과 장*리 마을로 9.12km(12분)이 소요되었으며, 환자발생지역까지 출동 후 다시 의료기관까지 가는 거리는 36.83km(62분)이 소요되는 것으로 나타났다. 장*리로 가상지구대를 설정한 경우 의료기관까지이 거리는 27.71km(50분)정도 소요되는 것으로 나타났다. 따라서 본 연구의 결과를 분석에 의하면 현재 소재하고 있는 119지역대의 위치는 환자발생지점에서 의료기관까지의 거리를 감안해 볼 때 적절하지 않은 것으로 나타났다. 이에 좀 더 많은 지역의 지구대를 중심으로 활발한 연구를 통하여 환자발생시 119지구대가 출동 시 최단의 거리와 환자 발생 지점에서 의료기관까지의 최단 거리등을 고려하여 현재 설치되어 있는 119지구대의 위치를 재고해야 될 것이다.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.68-74
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• 2010

Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

• 산업경영시스템학회지
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• 제35권4호
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• pp.227-234
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• 2012

In this study, the masking effect of olfactory stimulus on the awakening state due to sound stimuli while driving using Graphic Driving Simulator was observed through the response of autonomic nervous system. The test was conducted for 11 males in their twenties. The siren of ambulance car was presented to them as auditory stimulus for 30 secs while driving in a situation of high way in the condition of both peppermint and control, respectively, and LF/HF ratio of HRV (Heart Rate Variability), the activity index of sympathetic nerve, and GSR (Galvanic Skin Response) response were examined. The test was proceeded in the order of three stages, that is, sound stimuli (test 1), driving performance, and sound stimuli (test 2), and fragrance stimulus, driving performance, and sound stimuli (test 3), and the physiological signal of GSR, HRV was measured in the whole stages. As a result of test, comparing the results of before and after auditory stimulus test (1) (p < 0.01), test (2) (p < 0.05), and test (3) (p < 0.01), driving performance test (2) (p < 0.01), test (3) (p < 0.01), and olfactory stimulus test (3) (p < 0.05), respectively, GSR response increased, showing significant difference in all the tests. It indicates that when auditory stimulus was presented to the subjects, they were in the awakening state as sympathetic nervous system got activated. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was no significant difference in GSR response. The LF/HF ratio of HRV increased, showing a significant difference only in test (2) (p < 0.05), and in driving performance test (2) (p < 0.05) in auditory stimulus, however, it showed no significant difference in olfactory stimulus. As a result of comparing auditory stimulus while driving before and after presenting olfactory stimulus, there was a decrease, showing significant difference (p < 0.05) in LF/HF ratio of HRV. That is, it means that the activation of sympathetic nervous system decreased, and that parasympathetic nervous system got activated. From these results, it was observed that while driving, the awakening level due to auditory stimulus was settled with olfactory stimulus. In conclusion, it was drawn that while driving, olfactory stimulus could have the masking effect on auditory stimulus.