• Title/Summary/Keyword: 119 EMS

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Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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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.

The Effectiveness of Quality Control of 119 Emergency Medical Services on Survival Rate of Cardiac Arrest Patients (119구급서비스 품질관리가 병원 전 심정지 환자의 생존율에 미치는 영향)

  • Jung, Eun-Kyung;Yun, Hyeong-Wan
    • The Korean Journal of Health Service Management
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    • v.7 no.1
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    • pp.21-34
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    • 2013
  • Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

Local Imbalance of Emergency Medical Services(EMS): Analyses on 119 EMS Activity Reports of Busan (구급서비스의 지역 불균형: 부산시 119 구급활동일지 분석)

  • Lee, Dalbyul
    • Journal of the Korean Association of Geographic Information Studies
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    • v.23 no.3
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    • pp.161-173
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    • 2020
  • This study analyzed local imbalances in the supply and demand of emergency medical services in Busan using the 119 emergency activity reports of the Busan Fire & Disaster Headquarters. The data for EMS activity reports in 2017 was converted into Jimgyegu units. The spatial distribution of the indicators representing the local imbalance of emergency demand and supply (number of reports, number of reports relative to the population, average coefficient of variation and outlier of on-site arrival time, and number of dispatches outside the jurisdiction) was analyzed using Hotspot analysis of GIS spatial statistics analysis. As a result of the analysis, the hot spot area and the cold spot area where both supply and demand of emergency services are concentrated were clearly distinguished. This means that the supply and demand of emergency services in Busan are locally unbalanced. In particular, there was a difference in the demand and supply of emergency services in the original downtown and its surrounding areas, and in the outskirts of Busan.

An Analysis on the Prehospital Care of 119 Emergency Medical Service squads in Gyeonggi Area and Improvement Methods - Focusing on Prehospital Care - (경기도지역 119안전센터의 구급활동 현황과 개선방안 - 현장 응급처치 내역을 중심으로 -)

  • Choi, Keun-Myung
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.3
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    • pp.55-69
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    • 2008
  • Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

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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.

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;Lee, Hyo-Ju;Lim, Yong-Deok;Han, In-Deuk;Lee, Jae-Gook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.500-506
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    • 2018
  • 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.

Functional Properties of Stand-alone Microgrid EMS Application (에너지 자립섬 EMS 어플리케이션의 기능적 특성)

  • Lee, Ha-Lim;Chun, Yeong-Han;Chae, Wookyu;Park, Jungsung
    • KEPCO Journal on Electric Power and Energy
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    • v.2 no.1
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    • pp.115-119
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    • 2016
  • For many past years, research in the operation of stand-alone Microgrid, which provides electric power generated from renewable energy sources and energy storage system instead of diesel generators, has been a major issue in order to prepare the exhaustion of fossil fuel and to protect environment, in island grids. Samso Island, known as the world's first stand-alone Microgrid in Denmark, is connected to the mainland grid through AC system, which has different technical conditions with Korea's isolated power system. Korea's first stand-alone Microgrid has been built in Ga-sa island, Chun-la-nam-do, based on Energy Management System (EMS) operation, and other islands are under construction to follow the next step. These stand-alone Microgrid's has large capacity of Battery Energy Storage System (BESS) and the proportion of the renewable energy sources are large, which makes it necessary to use a Microgrid-Energy Management System (MG-EMS) to operate the grid effectively and economically. However, since the main subject of MG-EMS is different from EMS, specific characteristics and functions must be different as well. In this paper, the necessary characteristics and functions are explained for a general MG-EMS compared to a large power system EMS.

Effect of a Triage Education Program on Accuracy of Triage -Focused on 119 Emergency Medical Service Team- (중증도 분류 교육 프로그램이 중증도 분류 정확성에 미치는 효과 -119구급대원을 중심으로-)

  • KIM, YOUNG SEOK
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.6
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    • pp.1-7
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    • 2022
  • The study was conducted to determine the effectiveness of the triage training program utilizing pre-and post-training experiments designed for 119 emergency medical services teams. Objectives: This study evaluated the effectiveness of triage training programs on the accuracy of triage performed by 119 emergency medical services team staff who participated in the triage training program. Behavior: Participants in this study included 119 of the 166 EMS staff. In this program, a modified START triage consisting of a 20-minute theoretical presentation was presented to the participants. Data were analyzed using SPSS 21.0. Results: A significant increase in triage accuracy for 119 EMS teams(p<.001). And undertriage showed a significant decrease(p<.001). In addition, overtriage showed a decrease but was not statistically significant. Conclusions: The results obtained from this study showed that the triage training program was effective in improving the accuracy of the triage of multiple injury patients or disaster victims when presented to the 119 emergency medical services team. Therefore, these results suggest that it would be helpful to add triage training to the fire department's formal training program.

Evaluation of musculoskeletal disorders risk of 119 emergency medical technicians during emergency medical services procedures in firefighter combat challenge (119 구급대원의 근골격계 질환 위험성 평가 - 소방기술경연대회 구급종목을 대상으로 -)

  • Son, Jeong-Won;Park, Jae-Bum
    • The Korean Journal of Emergency Medical Services
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    • v.21 no.3
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    • pp.59-71
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    • 2017
  • Purpose: The purpose of the study was to evaluate the ergonomic risk factors of 119 emergency medical technicians (EMT) with musculoskeletal disorders, performing emergency medical services (EMS) procedures in a firefighter combat challenge. Methods: The evaluated EMT procedures were cardiopulmonary resuscitation (CPR) & intubation, trauma patient assessment, and intravenous (IV) injection. Measurement of working posture was done during training. Results: In CPR & intubation, OWAS-score was 2 (mean 1.9, maximum 4), requiring correction action, while REBA-score was 11 (mean 7.28, maximum 11), requiring immediate improvement. In trauma patient assessment & IV injection, OWAS-score was 4 (mean 2.9, maximum 4), requiring immediate correction action, while the REBA score was 7 (mean 7.5, maximum 11), requiring improvement. Conclusion: Both OWAS score and REBA-score showed improvement of posture and high-risk of musculoskeletal disorders. Occupational health management in EMS procedures during combat challenge and effective injury prevention program in fire stations are warranted.

Regeneration of Plants from EMS-treated Immature Embryo Cultures in Soybean [Glycine max(L.) Merr.]

  • Van, Kyu-Jung;Jang, Hyun-Ju;Jang, Young-Eun;Lee, Suk-Ha
    • Journal of Crop Science and Biotechnology
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    • v.11 no.2
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    • pp.119-126
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    • 2008
  • Since somatic embryogenesis combined with ethylmethane sulfonate(EMS) treatments is the most efficient technique for mutagenesis, the embryogenic capacity of four soybean cultivars was evaluated at different EMS concentrations, treatment times, and preculture durations. Two to 4 mm long immature cotyledons were placed in induction medium after EMS treatment, and the numbers of somatic embryos formed per explant were counted four weeks after culture initiation. We observed genotypic differences in the efficiency of somatic embryogenesis from immature embryos among four cultivars treated with different concentrations of EMS for six hours. Cultivars, Sinpaldalkong 2 and Jack, displayed highly efficient somatic embryogenesis regardless of EMS concentration, whereas very low efficiency or no survival was observed in Jinju 1 and Iksannamulkong cultivars. Preculture duration did not influence the efficiency of somatic embryogenesis. Because Sinpaldalkong 2 exhibited the best somatic embryogenesis, much higher concentrations of EMS were used to test somatic embryo formation under different periods of time in this cultivar. Three and six hour treatments with both 1 and 2 mM EMS yielded higher embryo formation than longer periods of time. Increasing the time with embryos in 2 mM EMS caused a reduction in somatic embryogenesis in Sinpaldalkong 2, but many chlorophyll-deficient soybean variants were identified in the $M_1R_0$ and $M_2R_1$ generations. In addition to Jack, Sinpaldalkong 2 is a good genotype for plant regeneration from EMS-treated immature embryo cultures.

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