Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

An Analysis of Prehospital Care for Major Trauma Patients depending on the number of 119 Ambulance Crews

119 구급대 편성 인원에 따른 중증외상환자의 병원 전 응급처치 실태 분석

  • Kim, Jong-Ho (119 EMS Team, Paju Fire Station) ;
  • Lee, Hyo-Ju (Department of Emegency Medical Services, Sun Moon University) ;
  • Lim, Yong-Deok (Department of Emergency Medical Technician, Chonman National University) ;
  • Han, In-Deuk (Department of Emegency Medical Services, Gachon University) ;
  • Lee, Jae-Gook (Department of Emegency Medical Services, Sun Moon University)
  • Received : 2018.05.29
  • Accepted : 2018.06.01
  • Published : 2018.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study analyzed current prehospital emergency care for severe trauma patients administered by different number of 119 EMS (emergency medical services) teams. Out of 1,067 severe trauma patients transferred by 119 EMS teams in J province from January 1st to December 31st 2015, 438 were evaluated in this study. IBM SPSS Statistics 21.0 was used to analyze collected data. The number of patients with severe trauma during the period of study was higher in male with two and three ambulance crews of 119 EMS teams with 242 patients (70.6%) and 66 patients (69.5%) respectively. The percentage of transfers made to local emergency medical centers was highest in those two groups, being 44.0% (151 patients) and 49.5% (47 patients), respectively. Total time spent at the scene did not differ between ambulance crews of two and three, nor did the frequency of practicing advanced airway management and IV (intravenous) cannulation, or the success rate of IV cannulation (p=0.253, p=0.362, p=1.000). Overall, the results indicated that merely increasing the number of paramedics does not improve the quality of prehospital care for severe trauma patients. Measures such as securing professional paramedics, simplifying direct medical oversights, activating indirect medical oversights, and expanding the legally allowed work scope are required.

본 연구는 119 구급대 편성 인원에 따른 중증외상환자의 병원 전 응급처치 실태를 분석하고자 2015년 1월 1일부터 12월 31일까지 J도 소속 119 구급대원에 의해 이송된 중증외상환자 1,067명 중 438명을 대상으로 수행하였으며, 수집된 자료는 IBM SPSS Statistics 21.0으로 분석하였다. 연구기간 동안 발생한 중증외상환자는 성별로는 남성이 2인 및 3인 구급대에서 각각 242명(70.6%), 66명(69.5%)으로 더 많은 빈도를 보였으며, 이들 환자가 이송된 의료기관별로는 지역응급의료센터로 이송된 비율이 각각 44.0%(151명), 49.5%(47명)로 가장 높았다. 119 구급대 편성 인원에 따른 현장 체류시간은 2인 및 3인 구급대 두 군 간에 유의한 차이를 보이지 않았으며(p=0.071), 전문기도유지술 및 정맥로 확보 시행빈도, 정맥로 확보 성공률에서도 각각 유의한 차이를 보이지 않았다(p=0.253, p=0.362, p=1.000). 본 연구 결과 단순한 양적 충원만으로는 중증외상환자의 병원 전 처치에 대한 질 향상에 영향을 주지 못하는 것으로 판단되며, 전문 인력의 확보와 함께, 직접의료지도의 단순화 및 간접의료지도의 활성화, 법적 업무범위의 확대 등이 필요하다.

Keywords

References

  1. Simons R, Epiopoulos V, Laflamme D, Brown DR. Impact on Process of Trauma Care Delivery 1 Year After the Introduction of a Trauma Program in a Provincial Trauma Center. J Trauma Vol.46, No.5 pp. 811-816, 1999. DOI: https://doi.org/10.1097/00005373-199905000-00008
  2. S.W. Yun, K.Y. Lee. Prehospital Care of 119 Emergency Medical Technician to Trauma Patients. Korean J Emerg Med Ser, Vol.15, No.2, pp. 22-42, 2011.
  3. S.G. Rho, J.G. Lee, J.H. Kim. A Research on the Actual Condition of the Prehospital Emergency Care and Education in 119 Emergency Medical Service. Journal of the Korea Academia-Industrial Vol.13, No.5, pp. 2117-2124, 2012 https://doi.org/10.5762/KAIS.2012.13.5.2117
  4. J.M. Park, J.S. Bang, S.W. Hong, Y.J. Song. A Study on Improvement of Emt-paramedic's Pre-hospital Paramedic Emergency Care for Cardioplegic Patients. Crisisonomy Vol.9, No.3, pp. 89-110, 2013.
  5. J.H. Park. Recognition and Request for Medical Direction by 119 Emergency Medical Technicians. Korean J Emerg Ser Vol.15, No.3, pp. 31-44, 2011.
  6. Bayley R, Weinger M, Meador S, Slovis C. Impact of Ambulance Crew onfiguration on Simulated Cardiac arrest Resuscitation. Prehosp Emerg Care Vol.11, No.3, pp. 214-217, 2008 DOI: https://doi.org/10.1080/10903120701708011
  7. Brown LH, Owens CF Jr, March JA, Archino EA. Does ambulance Crew Size Affect On-scene Time or Number of Prehospital Interventions?. Prehosp Disas Med Vol.11, No.3, pp. 214-217, 1996. DOI: https://doi.org/10.1017/s1049023x00042977
  8. Kelly AM, Currell A. Do Ambulance Crews with One Advanced Paramedic Skills Officer Have Longer Scene Times than Crews with Two?. Emerg Med J Vol.19. No.2, pp. 152-154, 2002. DOI: https://doi.org/10.1136/emj.19.2.152
  9. Statistic Korea: The statistics of major emergency patients categories. 2015.
  10. G. J. Suh, S. H. Lee, I. J. Jo, W. Y. Kwon, H. G. Song, J. E. Rhee, Y. K. Youn. Prehospital Trauma Care System in Seoul by 119 Rescue Services. J Korean Soc Emerg Med, Vol.12, No.2, pp. 160-169. 2002.
  11. H. J. Ahn. Prehospital Treatments of the Patient with Hypoglycemia by 119 Emergency Medical Technicians: Analysis of the Current Data and Survey. Korean J Emerg Med Ser, Vol.14, No.1, pp. 31-46, 2010.
  12. S. G. Roh. Prehospital for the Improved Emergency Care System of 119 Rescue. Unpublished master's thesis, Yonsei University 2005, Seoul, Korea.
  13. H. A. Bae. Medicla Direction and Unlicensed Medical Practice in Prehospital Emergency Medical System. Korean Criminological Review, Vol.14, No.1, pp. 31-46, 2009.