Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.
Purpose: We aimed to compare the transport time, the proportion of direct hospital visit and the emergency procedures between the current mountain rescue helicopter emergency medical service (HEMS) and physician-staffed mountain-rescue HEMS. Methods: During weekends from October 2, to November 21, 2010, 9 emergency physicians participated as HEMS staff in the mountain-rescue HEMS program of the Seoul fire department. Patient demographic data, transport time, proportion of direct hospital visits, and emergency procedures were recorded. We also collected data on HEMS mountain-rescued patients from June 1, to September 1, 2010, and we compared them to those for the study patients. After an eight-week trial of the HEMS, we performed a delphi survey to determine the attitude of the physician staff, as well as the feasibility of using a physician staff. Results: Twenty-four(24) patients were rescued from mountains by physician-staffed HEMS during the study period, and 35 patients were rescued during the pre-study period. Patient demographic findings were not statistically different between the two groups, but the transport time and the emergency procedures were. During the study period, the time from call to take-off was $6.1{\pm}4.1min$ (vs. $12.1{\pm}8.9min$ during the pre-study period, p-value=0.001), and the time from call to arrival at the scene was $15.0{\pm}4.8min$ (vs. $22.3{\pm}8.1min$ during the pre-study period, p-value=0.0001). The proportions of direct hospital visit were not different between the two groups, but more aggressive emergency procedures were implemented in the study group. The delphi survey showed positive agreement on indications for HEMS, rapidity of transport and overall satisfaction. Conclusion: A pilot trial of physician-staffed HEMS for mountain rescue showed rapid response and more aggressive performance of emergency procedures with high satisfaction among the attending physicians.
Purpose: This study aims to investigate the operation of continuing education system and continuing education program for emergency medical technician in Korea, Japan and United States and develop reasonable operating scheme of continuing education and curriculum in order to provide the base data for the improvement of continuing education for the improved practice capability and its maintenance, Method: The overall review of continuing education for domestic 1st class emergency medical technician was performed and also the content of continuing education for Emergency Medical Technician - Paramedic in the United States and Paramedics of Fire Department with the license for the paramedic in Japan, have been analyzed through literature, books, articles, agencies' data, laws, and internet date. Result: Hours for domestic continuing education was 4-8 hours and it was only 3-11% compared to 72 hours in the United States and 128 hours in the Japan. And with respect to the types and methods of programs, there were differences both in quantity and quality. Conclusion: As an education, providing and supplementing the changed content and technical information for the improvement of the capability and qualification of emergency medical technician, selection of education hours and various continuing education should be continuously and regularly provided and conducted. The introduction of various continuing education system and programs for this is considered to be required.
It was enacted 'Emergency Medical Act' in January, 1994 and while it was established the emergency medical department in college providing the agenda and curriculum about EMT but not detailed and the regulation relative to the application of a low on the emergency medical act in 1995. The purpose of this study was to provide basic development of information for the development of field practice discipline and to Improve for the appropriateness and the effectiveness of the field practice though comparison study of satisfaction levels on field practice of E.M.T college students by 5 practice fields. The subjects were EMT college students who had practiced from June first to July 11, 1998, at the fire department and 4 departments (emergency dept., delivery dept., operating dept., and intensive care unit.) in the hospital. The data were collected by Questionnaire from september 7 to 10, 1998. The data were analyzed by percentage, mean, T-test, F-test using SAS program, The result were as follow; 1. Mean satisfaction level of 5 departments was to be low as 2.863 of a total score 5,0. 2. Comparing with other departments, emergency dept. and fire dept. were 3.198, 3.109 respectively revealed to be high (mean=2,863), 3. In field content and environment, emergency dept. is the most satisfactory place(3.480, 3,686) respectively, in practice teaching, fire dept was the most satisfactory place(3,567). 4, Satisfaction level according to the 4 variables (religion vs fire dept. practice, motivation vs intensive care unit practice, place of emergency dept. field vs emergency dept. practice, practice problem vs emergency dept. practice) revealed significant differences. There were a lot of problems that we have to improve and correct the field practice curriculum. Though this study, we could guess what the practical matters were.
Purpose: This study was carried out in order to provide the basic data for the curriculum standardization of emergency medical technology by analyzing the three-year period curriculum of 9 colleges. Method: This is the descriptive analysis of the curricular of 9 colleges. The analyzed variables were the distribution, credit, mean, frequency of the liberal arts, majors, clinical and on-the-job(OJT) training courses, and teaching profession subject. Results: 1. The number of whole subjects was 61.0, the number of liberal arts was 10.3, and the number of majors was 50.7. The completion credit was 128.3, credits of liberal arts were 15.5(12.2%), and credits of majors were 112.8(87.8%). 2. The range of credits of liberal arts was 8 to 21, and most of the liberal arts were done in the first year of college. 3. The distribution of the credits of the national examination for the license was as follows; the itemized emergency care subjects were 27.9 credits, the general emergency care was 18.5 credits, basic sciences were 17.7 credits, emergency patient care was 9.5 credits, and emergency medicine law was 3.2 credits. 4. The number of other major subjects were 10.0 and showed even distribution in each semester. 5. The clinical and on-the-job(OJT) training were 4.5 subjects, the credits of completion were 14.9 and these subjects were not in the first year of college. Conclusion: This results will be helpful data for the advanced development and standardization of the new curriculum by keeping pace with the environmental change, competency improvement and the need of the learners of emergency medical technology.
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.
Purpose: This study aimed to examine the development and improvement direction of university education according to job type and investigate the types of knowledge required for employment after graduation for departments of emergency medical technology in preparation for the era of the fourth industrial revolution in a converged society. Methods: From June 3 to June 10, 2019, data were collected through structured questionnaires from 90 paramedics working in firefighting, hospitals, different industries, and emergency patient transportation. Data were analyzed using the software SPSS version 18.0. Results: For employment after graduation in departments of emergency medical technology, character and sincerity education should be strengthened. To prepare for the fourth industrial revolution, educational innovations such as improving the field practice system and devising a convergence curriculum are needed. Preparation for the fourth industrial revolution should be accomplished through the development of convergence subjects such as forensic science, information and communications technology, and safety engineering. Ninety percent of the study respondents indicated their need for convergence subjects. Conclusion: The demands of future society should be responded to flexibly by holding and conducting convergence subjects. Furthermore, preparations should be made in anticipation of a shortage of 120,000 college freshmen for the 2024-2025 school year by increasing the competitiveness of departments of emergency medical technology.
Purpose: This study aims to compare 119 emergency medical services (EMS) in South Korea and Japan to provide essential data for EMS improvement in South Korea. Methods: Recent data and regulations on firefighting and EMS in South Korea and Japan were analyzed and compared. Results: South Korea follows a centralized approach to EMS, whereas Japan operates with autonomous bodies that establish their own criteria. Japan considers more regional variables than South Korea. In South Korea, there are shortages in fire station deployment among the 119 emergency medical resources in certain regions, leading to significant regional disparities. South Korea has a larger population served by its 119 emergency medical resources with a higher workload and dispatch numbers than Japan. The percentage of non-transported patients among the total number of dispatches was higher in South Korea. Conclusion: Increasing the number of medical professionals and ambulances per population to the level of Japan to reflect local conditions and include various underlying variables such as daytime population, aging, and emergency dispatch conditions in the deployment of 119 emergency resources, and to reduce the deployment gap between regions, will contribute to improving the performance of the South Korea EMS system.
Purpose: The purpose of this study was to prevent the Aged from encountering a sudden accident in an emergency situation caused by drinking, help them have better awareness of drinking problems, and provide basic data for forming sound drinking. Method: A descriptive approach was made to the occurrence of emergency situations caused by drinking for the aged by reviewing literature concerning the subject, along with the analysis of the actual condition through the cases of emergency situations. Result: The Aged had a drink to drown their loneliness due to the loss of social belonging and solitude and attempt suicide, relied on drinking due to the loss of economic roles and reduced income to cause emergency situations, drove when drunken to bring emergency situations to themselves and others, and committed incendiarism after drinking due to social dissatisfaction and mental problems. Conclusion: It is necessary to develop leisure management programs positively and provide an opportunity for sound living culture to old people so that they can have sound entertainment culture other than drinking; such educational programs will serve to form healthy society with no emergency situation caused by the Aged drinking.
Background: The purpose of this study was to examine the impact of the regional characteristics on the accessibility of emergency care and the impact of emergency medical accessibility on the patients' prognosis and the emergency medical expenditure. Methods: This study used the 13th beta version 1.6 annual data of Korea Health Panel and the statistics from the Korean Statistical Information Service. The sample included 8,119 patients who visited the emergency centers between year 2013 and 2017. The arrival time, which indicated medical access, was used as dependent variable for multi-level analysis. For ordinal logistic regression and multiple regression, the arrival time was used as independent variable while patients' prognosis and emergency medical expenditure were used as dependent variables. Results: The results for the multi-level analysis in both the individual and regional variables showed that as the number of emergency medical institutions per 100 km2 area increased, the time required to reach emergency centers significantly decreased. Ordinal logistic regression and multiple regression results showed that as the arrival time increased, the patients' prognosis significantly worsened and the emergency medical expenses significantly increased. Conclusion: In conclusion, the access to emergency care was affected by regional characteristics and affected patient outcomes and emergency medical expenditure.
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