• 한국응급구조학회지
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• 제17권1호
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• 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.

• 한국병원경영학회지
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• 제18권4호
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• pp.78-96
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• 2013

The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

• 한국응급구조학회지
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• 제23권3호
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• pp.17-27
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• 2019

Purpose: To provide legislative data for the amendment of Article 36 of the Emergency Medical Service Act on the qualifications of emergency medical technicians. Methods: The study was drafted based on the Emergency Medical Service Act; data on the emergency medical technicians (EMT) system and curriculum in Korea, United States. Japan, and Taiwan; and previous studies on the EMT system in Korea. Results: The length of education. work scope. amd role of level 1 EMTs vary significantly depending on the type of qualifications they have as emergency medical professionals, while the supply of level 1 EMTs has already reached a point of saturation. Accordingly, the current regulation on allowing level 2 EMTs with at least three years of experience to take the level 1 EMT test presents serious inequity for students just graduating from their emergency medical services program. It is also a factor that degrades the professionalism of level 1 EMTs. Conclusion: Article 36, paragraph 2. subparagraph 3 of the Emergency Medical Services Act pertaining to regulations on "EMTs who have worked as level 2 EMTs for at least 3 years" needs to be removed.

• 한국응급구조학회지
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• 제25권1호
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• pp.159-175
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• 2021

Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers' perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: "Considerate of emergency situations," "Identifying emergency patients," "Trusting emergency vehicles," and "Sympathizing with emergency patients." Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

• 한국응급구조학회지
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• 제17권2호
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• pp.9-20
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• 2013

Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

• 간호행정학회지
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• 제12권4호
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• pp.541-554
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• 2006

Purpose: The purpose of this study is to provide basic data for the improvement of the quality in the emergency nursing services by investigating the expectation level and actual received level with nursing care and identifying the factors that influence patient satisfaction with the emergency nursing care in the military hospitals. Method: Using a self report questionnaire, data were collected from 150 patients who had been admitted in military hospitals emergency department. The data collection was done between April 17 and April 30, 2006. At least, 145 questionnaires were analyzed and used in this study. Results: The average sum score was 61.93 out of 76 with standard deviation 9.590. The mean of the patient's expectation levels with the overall emergency nursing services was $(3.25{\pm}.504)$ out of the highest score 4. the average sum score was 63.27 out of 76 with standard deviation 9.902. The mean score of the patient's actual levels with the overall emergency nursing services was $(3.33{\pm}.521)$ out of the highest score 4. Conclusion: nursing management strategies must be established to remove patient's dissatisfaction factors and to improve the emergency nursing care quality through continuous measurement and assessment of the patient's satisfaction with emergency nursing services in military hospitals.

• 한국시뮬레이션학회논문지
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• 제26권3호
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• pp.125-139
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• 2017

최근 응급의료 서비스의 질 제고에 관심이 높아지고 있는 가운데 응급의료 프로세스의 혁신에 많은 노력을 기울이고 있다. ICT기술의 급속적인 진전에 의해 응급의료 프로세스의 자동화 또는 지능화가 가속화되고 있다. 본 연구는 자원 활용 최적화, 인적오류 최소화 그리고 진료 예측가능성 제고를 고려한 실시간데이터 기반 응급실 운영 방안을 제안한다. 응급실 운영지수-응급 케어지수, 체류 단축지수, 인적오류 유발지수, 대기 인내지수-를 개발하고, 이를 기반으로 한 응급실 운영규칙을 제시한다. 가상의 축소 응급실을 대상으로 시뮬레이션을 실시하여 제안한 운영규칙의 효과성을 검증하였다. 시뮬레이션 결과 응급실 체류시간에서 우수한 성능을 보였다.

• 한국응급구조학회지
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• 제20권1호
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• pp.41-55
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• 2016

Emergency statistics for cities and provinces are currently derived using simple results of comparative numerical data, but there is a limit to the ability to analyze and compare deviations relevant to a specific city and province. This study aims to derive various correlations through statistical analysis of emergency and rescue data for Gwangju Metropolitan City and to develop an analytical model that can be applied nationwide. With the new statistical model, further detailed analysis is possible beyond simple evaluation of rescue data, through links to other institutions and analyses using keywords from Internet portal sites and social networks. Second, a system which that can analyze data that are not shared is required. Through this system, a large amount of data can be automatically analysed in real time. Third, the results should flow back for application in various policies. A real-time monitoring and management system should be created for abnormal patterns of disease. In addition, the results should be available to tailor services for individuals, communities, or specific organizations.

• 한국응급구조학회지
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• 제9권1호
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• pp.101-109
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• 2005

The purpose of this study which was done by 250 Prehospital Care Reports(PCRs) survey of some squads in Seoul Metropolitan Fire & Disaster Management Department was to improve prehospital emergency care by means of quality management. The data were collected in 3 squads from Jun. 21 to Jul. 18, 2004 and analyzed by using SPSS Win 12.0 Version. The conclusions from this study were summarized as follows. The mean time of Event to treatment interval was $4.6{\pm}4.3$ minutes and 49.2% arrived at patient within 4 minutes. Platinum minute was observed 61.1% of verbal response, 73.3% of painful response, 77.8% of unresponsive. The great majority of patients couldn't receive advanced life support on account of limited scope of practice and strict direct medical control in the Emergency Medical Services Act. Data from quality improvement activity will be useful to expand indirect medical control which is able to activate prehospital care. To utilize PCR for quality improvement. It has to have data elements, run data, patient data, check boxes, narrative including US DOT's minimum data set.