• Title/Summary/Keyword: 救急醫學

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Survey of Point-of-Care Testing Devices for Pre-hospital EMS Equipment of Glucometer on Local Area (지역 EMS의 현장검사 혈당측정기 사용에 대한 실태조사)

  • Byeong-Hyun, Kim;Dai-Hai, Choi;Gyoung-Yim, Ha
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.220-228
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    • 2022
  • Objective: glucometer is one of POCT(point-of-care testing) devices used by EMS. Accurate measurement value is important for patient decision making. Quality control is necessary for this, but most EMS are still using glucometer without quality control it. Therefore, management status and quality control status of glucometers used by 119 paramedics waswere investigated. Methods: 6 and 8 of glucometers and blood glucose test strips were submitted from 4 safety centers in 2010 and 8 safety centers in 2012, respectively. Glucometers submitted by local safety centers were analyzed in 2010 and 2012. The control glucometer, which was well managed at A University Hospital, was assumed to be accurate for at blood glucose measurement. Glucose values of various quality control materials control solutions were measured and analyzed using linear regression and Pearson's correlation test. Error rates were obtained via error tolerance range required by the 2011 ISO(International Organization for Standardization) guideline. For statistics, Excel and MedCalC programs were used. Results: mong 14 safety centers in the region, 4 centers(28.5%) in 2010 and 8 centers(57.1%) in 2012 submitted 6 and 8 glucometers. In the first evaluation in 2010, 2 out of 6(33.3%) glucometers were untestable due to error, and 45 out of 6(66.683.3%) blood glucose test strips' validity were expired. In the second evaluation in 2012, 1 out of 8(13.5%) glucometers were untestable due to lack of battery, and 2 out of 8(25%) blood glucose test strips' validity were expired. All correlation coefficients were above 0.989 in 2010 and above 0.997 in 2012. Error rates were generally high when using expired blood glucose test strips. Conclusion: Among 119 paramedics' guideline, quantity and operation status of POCT devices are well managed, but quality control is not. Therefore, it is necessary to add management status and quality control status of POCT devices to the EMS' field work guideline.

A Study on Remote Medical Emergency System Development for Ambulance (구급차용 응급 원격의료 시스템에 관한 연구)

  • Kwon, Jang-Woo;Kim, Gyu-Dong;Hong, Jun-Eui;Lee, Dong-Hoon;Kim, Su-Jin
    • Proceedings of the Korea Information Processing Society Conference
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    • 2007.05a
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    • pp.657-660
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    • 2007
  • 구급차에서는 위급한 상황의 환자를 이송할 시에 적절한 응급조치가 필요로 하고 환자의 상태에 맞는 조치를 취하여야 한다. 그러나 모든 구급차에 의사가 상주 할 수 없음으로 CDMA 망을 이용하여 원격지의 의사가 원격의료가 가능한 시스템을 제안한다. 낮은 전송속도에서 효율적으로 중요한 의학적 정보를 전송할 수 있는 원격 응급 의료 시스템이 개발된다면 의료기관에 상주하는 의사와 데이터를 송수신하는 시간도 단축할 수 있으며, 응급상황 발생시 대처를 하지 못하거나 하는 경우를 예방할 수 있어 환자 이송 시에 상당한 효과가 있으리라 판단된다.

Awareness of Caregivers, Emergency Medical Technicians, and Emergency Medical Doctors about the Storage Media for Avulsed Teeth (완전탈구된 치아의 보관매체에 관한 보호자, 구급대원, 응급의학과 의사의 인식도)

  • Kim, Gyulim;Kim, Seunghye;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.3
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    • pp.303-311
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    • 2020
  • The aim of this study was to assess the awareness of caregivers, emergency medical technicians, and emergency medical doctors by investigating the storage media for avulsed teeth at the trauma site. This study was performed by reviewing medical records of 183 patients with the age under 17 years old, who visited Ajou University Hospital for dental trauma. Based on their medical records, storage media for avulsed permanent teeth were investigated by classifying them as dry, milk, saline, saliva and tap water. The storage media chosen by caregivers at the trauma site were classified as cases by parents and school nurse teachers. Storage media chosen by emergency medical technicians and emergency medical doctors were also investigated using the same classification criteria. The results show that both parents and school nurse teachers used milk the most as a storage medium for avulsed teeth. Dry storage was the second most chosen medium by parents, and saline by nurse teacher. As a storage media emergency medical technicians used saline the most, while emergency medical doctors used only saline when they failed to replant avulsed teeth. There is a need to improve the knowledge of caregivers, emergency medical technicians, and emergency medical doctors regarding the storage media for avulsed teeth.

A Study on Civil and Criminal Liabilities of 119 Rescue and Its Legal Protection (공무원인 119구급대원의 직무수행과 관련하여 발생할 수 있는 민$\cdot$형사상 책임과 그에 따른 법적 보호를 위한 대책에 관한 연구)

  • Bae Hyun-A;Yun Soon-Young;Jung Koo-Young;Lee Kyung-Whan;Kim Chan-Woong
    • Fire Science and Engineering
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    • v.19 no.2 s.58
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    • pp.45-62
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    • 2005
  • This thesis has defined the legal status of 119 rescue who plays a major role in the Korean prehospital emergency medical system and reviewed the various issues that may occur depending on work related legal liabilities. As a result, the purpose of this study was to represent the countermeasures for legal protection of 119 rescue required for the quality improvement of prehospital emergency medical system and as well as the countermeasures for risk management prepared for its related lawsuits. The legal liabilities of 119 rescue officers can be divided largely into public law liabilities and civil and criminal liabilities. In order to decrease the incidences of legal problems and provide the legal protection to rescue officers, the liability of supervising physician should be emphasized when the emergency medical practice is performed by a rescue officer under their supervision by consolidating medical control and the rescue officer should have legal liability on his emergency medical practice. itself Also, the emergency medical service guideline for 119 rescue officers should be prepared and their works should be performed according to such a guideline and procedures. In addition, the accurate legal documentation on emergency medical system from on-site to ER and related mobilization should be framed and preserved. Moreover, it is required to enact a new law such as the Good Samaritan Act or the Rescue Officers Protection Act.

通过 ≪护产厅日记≫ 对朝鲜王室关于分娩的 医学处置以及医学哲学的考察 (『호산청일기(護産廳日記)』를 통해 본 조선왕실출산(朝鮮王室出産)의 의학적처치(醫學的處置)와 의철학(醫哲學)에 대한 고찰(考察))

  • Ryu, Jeong-A
    • The Journal of Korean Medical History
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    • v.27 no.1
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    • pp.9-13
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    • 2014
  • 연구목적 : 조선(朝鮮) 왕실자녀(王室子女)의 출산과정을 일지(日誌) 형식으로 기록한 "호산청일기(護産廳日記)"는 후기 조선(朝鮮)의 임산(臨産)과 분만, 산후 및 신생아 증상에 대한 의학적 처치 및 산실배설(産室排設)과 출산의례를 고찰할 수 있는 가치 있는 의학사료(醫學史料)이다. 연구방법 : 1. "호산청일기(護産廳日記)"에 기록된 세 번의 출산에 대해 출산 전후 산부(産婦)와 신생아의 실제 상황과 증상, 의관(醫官)의 판단과 치법(治法), 처방(處方)내용, 치료경과 등 의학적 처지의 내용을 살펴봄으로써 당시 산과의학(産科醫學)의 경향성, 발달정도 등을 가늠해보았다. 2. "호산청일기(護産廳日記)"에 기록된 세 번의 출산에 대해 조선왕실(朝鮮王室)의 출산형식 및 관련의례에 드러난 당시 의학의 출산에 대한 의철학(醫哲學)이 어떠하였는지 고찰하였다. 결과 및 결론 : 산전(産前) 의관(醫官)의 정기문진으로 산모와 의사 간 관계형성 및 산부(産婦)의 안정을 도모하였으며, 의녀(醫女)의 진찰소견을 의관(醫官)이 판단하여 처방하였다. 임산(臨産)에 불수산(佛手散)과 인삼차(人蔘茶), 산후어혈증(産後瘀血症)에 가미궁귀탕(加味芎歸湯)을 빈용(頻用)하였으며, 화반곽탕(和飯藿湯)의 식치(食治)가 주요 산후조리법이었다. 신생아의 구급(救急)에 특히 우황(牛黃)을 빈용(頻用)하고 증상에 따라 유모(乳母)가 복약(服藥)하기도 하였으나, 조산(早産)된 신생아의 청색증(靑色症)(cyanosis)으로 보이는 증후(症候)와 사망례(死亡例)가 보인다. 산실배설(産室排設) 및 현초(懸草), 권초제(捲草祭) 등 관련의례에는 출산을 '하늘과 직접 소통하는 하나의 의례(儀禮)'로 생각하여 외부 환경의 방해 없이 산부(産婦)와 신생아의 천계(天癸)가 잘 작동하도록 배려한 의철학(醫哲學)이 드러나 있다.

Comparing the "pre-COVID-19 period" and the "COVID-19 early-stage period" for emergency medical services (COVID-19 발현 초기 119 구급대를 경유해 응급실로 내원하는 환자들의 이송 시간과 호소하는 증상의 변화 : 부산지역 일개 응급의료센터로 이송된 환자의 구급활동일지를 중심으로)

  • Kang, Ji-Hun;Ji, Jae-Gu;Jang, Yun-Deok;Lee, Si-Won;Kim, Seong-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.161-169
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    • 2020
  • Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

Necessity of Education for Emergency Medical Technicians to Improve Awareness of Early Symptoms of Stroke and Assessment of Stroke Patients (응급구급대원에서 뇌졸중 조기증상 인지 및 환자평가 향상을 위한 교육 필요성)

  • Lee, Jeong-Mi;Lee, Jang-Yeol;Park, Seong-Bin;Lee, Young-Hoon;Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.130-141
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    • 2013
  • Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

The Educational Need of Forensic Medicine for Emergency Medical Technicians in 119 Rescue Service (119구급대 응급구조사에 대한 법의학교육의 필요성)

  • Kim, Byung-Yong;Lee, Sang-Han
    • Journal of forensic and investigative science
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    • v.2 no.2
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    • pp.50-66
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    • 2007
  • An Emergency Medical Technician (EMT) is a well-trained emergency responder to provide emergency medical services to the critically ill and injured patient. In various situations, EMT may destroy potential physical evidences associated with the crime scene or determination of real cause of death. This study was aimed to evaluate the educational need of forensic medicine in Korean EMT. Questionnaires were administered to 592 EMTs during March 2007. The response rate was 60.3%(357 EMTs). In questionnaires there were 13 questions regarding the general characteristics, 16 questions about roles of EMTs related with forensic circumstances, 9 questions about the education related to forensic medicine. Questionnaires rated on a 4-point Likert scale or 5-point Likert scale. Most of 119 rescue EMTs had experienced with situations related to crime or unexpected sudden death. EMTs had arrived to the scenes earlier than police and complained of some difficulties related with deficit of forensic knowledge. EMTs wanted to receive continuous educations about forensic medicine. In order to reduce dissatisfaction with EMTs roles and to improve crime scene preservations, Emergency Medical Services policies should provide regular educational curriculum by forensic pathologists and promote legal responsibilities for 119 rescue EMTs.

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Indications and Estimations of the Needs for Direct Medical Control in the Patients Transported by 119 Rescuers (119 구급대에 의해 이송된 환자들 중 직접적 의료지도가 필요한 범위와 그에 따른 수요 추정)

  • Park, Jae-Young;Jung, Koo-Young;Bae, Hyun-A
    • Fire Science and Engineering
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    • v.20 no.3 s.63
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    • pp.42-47
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    • 2006
  • Direct medical control by medical doctors is an essential part of emergency medical services system (EMSS). However, the indications are not specifically defined, even in 119 system with their own medical control team. The Seoul Metropolitan Fire and Disaster Management Department has operated internal medical consultation services on its own since January 2004. Based on the experiences from these services, we reviewed the cases of the direct medical consultation and establish the indications for direct medical control. And we presumed the demand of direct medical control with the established indications. The crews of 119 in Seoul made 793 calls to Medical Control Team during November 2004. We reviewed all of the calls according to the level of consciousness (AVPU), the kinds of emergency care done by crews during transport (10 categories), and the mechanisms of injuries (9 categories). The need for direct medical control was judged by authors with reviewing the records reported by the crews and control teams. Among 23 items, 14 items assigned as the indications, which were abnormal level of consciousness (VPU), 6 kinds of emergency care, and 5 mechanisms of injures. The sum of the three of them, 7,782 cases (45.9%), was in need of direct medical control. In conclusion, about half of the patients transported by 119 crews in Seoul require direct medical control. The need for the direct medical control in Seoul was estimated as many as 260 calls per day. To fulfill the need for direct medical control and to provide a effective medical control, the direct medical control should be accomplished through the communications between the crews and the medical staffs in the local hospitals.

The effects of out of hospital ACLS simulation training on the paramedic's duty ability (구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향)

  • Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.99-106
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    • 2019
  • The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.