• 한국화재소방학회논문지
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• 제20권4호
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• pp.77-90
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• 2006

119구급대원의 응급구급활동과 관련하여 형사법적으로 문제되는 영역은 크게 세 가지이다. 첫째는 구급 요청을 거절하는 행위이며, 둘째는 요구호자를 이송하지 않는 미이송 행위이고, 셋째는 응급처치행위이다. 이러한 일련의 구급대원의 행위들이 '응급의료에 관한 법률'이나 관련 법규의 규정에 위반되어 이루어진 경우에는 이들 법률들에 규정된 범죄행위가 성립한다. 특히 정당한 이유 없이 구급요청을 거절한 행위는 응급의료법상 응급의료거부죄가 성립하고, 적법한 절차에 의하지 아니한 응급처치는 무단 응급처치죄가 성립한다. 또한 구급요청거절과 미이송 행위 그리고 응급처치나 미응급처치 등으로 인해 요구호자가 사망하거나 상태가 악화된 경우에는 형법상 살인죄나 업무상과실치사죄 또는 중상해죄가 성립할 수 있다. 이처럼 구급대원의 경우에는 구급활동과 관련하여 형사적 책임으로부터 자유로울 수가 없다. 즉 구급대원들도 직무의 소홀과 과실로 인해 발생하는 법익침해적 결과에 대해서는 당연히 형사적 책임을 져야 한다. 그러나 긴급상황에서 불가피하게 국민의 생명과 건강을 침해한 경우에는 이들을 보호할 수 있는 법적 방안도 마련되어야 하며, 특히 열악한 근무환경에서 구급대원에게만 그 책임을 전가할 수 없는 게 현실이다. 현재 구호자보호법 제정문제가 논의되고 있는데, 이 법률에 구급대원의 형사면책부분이 합리적으로 규정되어 궁극적으로 구급대원들이 국민의 생명과 건강을 지키는 파수꾼으로서 그 역할에 충실할 수 있도록 하여야 한다.

• 한국응급구조학회지
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• 제22권3호
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• pp.67-76
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• 2018

Purpose: The purpose of this study was to evaluate the quality of chest compressions and ventilation when using an mechanical device(LUCAS) and 2-men manual cardiopulmonary resuscitation(CPR) performed on a minikin, as well as to propose a more effective CPR method during transit. Methods: Data were collected by LUCAS and manual virtual reality based ambulance simulation. Analysis was performed using SPSS software 12.0. The average and standard deviation of chest compression depth and ventilation were analyzed using descriptive statistics and t-test. Results: In the virtual reality based LUCAS and manual CPR results, LUCAS showed better chest compression and lower incomplete chest release than manual CPR. During CPR with a chest compression-ventilation ratio of 30:2 in virtual reality ventilation with bag-valve mask was able to deliver an adequate volume of breathing. Conclusion: It is suggested that rescuers on ambulance may consider using LUCAS as an alternative to high-quality chest compression during transit.

• 의료법학
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• 제24권3호
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• pp.105-124
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• 2023

현대 사회는 뜻밖의 사고와 위험 상황으로 불안정한 환경에 직면하고 있다. 예를 들어 분당 다리 붕괴사고와 이태원 압사사고 등이 그 예가 될 것이다. 이와 함께 급성심정지나 뇌졸중과 같은 중대한 응급상황이 발생하였을 때, 신속한 조치와 전문 의료 기관으로의 원활한 이송이 필요한 경우 또한 빈번하게 발생하고 있다. 이러한 위험 요소에 대응하기 위해 국가는 국민의 생명과 안전을 보호하기 위한 다양한 시스템을 구축하고 있는데, 119구급대는 응급 의료 시스템 중 핵심적인 역할을 수행한다. 중대한 외상 환자나 중증 질환 환자의 응급 상황에 즉각적으로 대응하여 손상을 최소화하고, 응급의료 기관으로 신속하게 이송하여 전문적인 치료를 제공함으로써 환자의 생명과 안전을 보호하는 것이 그 목표이다. 이와 관련된 핵심 활동이 구급활동인 것이다. 특히, 119구급시스템은 응급 환자의 병원 이송을 책임지는 핵심 기관이나, 구급대원들은 업무수행 중 구급활동 방해 사례에 여전히 직면하고 있다. 이러한 방해 사례는 경찰의 협조 노력에도 불구하고 줄어들지 않고 있고, 구급활동은 공무집행 방해죄와 유사한 특성을 지니며, 응급의료 시스템 내에서 근무하는 응급의료 종사자에 대한 폭행 및 장비 파손과 같은 사례와도 유사한 형태를 보인다. 따라서 119구급시스템을 포함한 응급 의료 활동을 수행하는 과정에서 발생하는 방해 문제에 대한 심층적인 이해와 개선 노력이 필요하다. 이러한 문제에 대한 해결책은 "소방기본법"과 "119구조·구급에 관한 법률"을 중심으로 구급활동 방해죄의 조건을 정립하고 개선하는 것이다.

• 한국응급구조학회지
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• 제18권1호
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• pp.107-116
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• 2014

Purpose : The purpose of this study is to demonstrate the effectiveness of using a digital sensor device during CPR by analyzing the results from that chest compressions with a digital sensor device are applied to cardiac arrest patients. Methods : This study analyzed the results from the experiment that 42 people were selected randomly among Korean 119 rescuers, and they divided into the experimental group using a digital sensor device and the control group only using their hands, then they had been observed to conduct chest-compressions to mannequins for 10 minutes. Results : The results were found that compression depth in both the control and experimental group was gradually decreased over time, but the experimental group not only kept the depth but also maintained the speed of chest-compressions close to 100 times a minute. In addition, due to the use of the digital sensor device, the insufficient recoil ratio of chest-compressions was significantly reduced. Conclusion : The results show that conducting chest-compressions with a digital sensor device keeps the compression-death, maintains the speed of chest-compression properly and makes the insufficient relaxation ratio of chest-compressions reduce significantly.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5893-5900
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• 2012

심정지 또는 중증 외상 환자의 신속한 기도유지는 매우 중요하다. 본 연구의 목적은 후두튜브(LTS)와 후두마스크(PLMA)의 삽관 속도, 성공률, 교육 전 후 자신감 변화를 비교하여 병원 전 단계의 주축을 담당하고 있는 119구급대의 전문기도관리 능력을 향상 시키는데 있다. 연구 대상자는 119구급대원 중 1급 응급구조사 60명(LTS군 30명, PLMA군 30명)이며 마네킹을 대상으로 5분간 3회 실습 후 삽관 소요시간과 성공 여부, 자신감 변화를 측정하였다. 연구결과 LTS와 PLMA를 이용한 삽관 시간은 유의한 차이를 보였고(p=.000), 성공률은 유의한 차이가 없으며, 실험 후 자신감은 유의하게 상승하였다(p=.000). 결론적으로 경추가 고정되고 혀 부종이 있는 외상환자에게 신속한 삽관이 필요한 경우 LTS 사용이 효과적이며 교육을 통하여 전문기도관리 능력을 향상시킬 수 있을 것으로 사료된다.

• 한국응급구조학회지
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• 제15권3호
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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.

• 한국응급구조학회지
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• 제13권1호
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• pp.35-48
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• 2009

Purpose: Firefighters were subjected to be exposed to 24-hour shiftwork and high level of job stress, but there is little study of fire fighters about between Job Stress and Psychological stress in Korea. This study was performed to evaluate job stress of fire fighters grouped by different job types and analyze the health effect of job stress by using a PWI-SF(Psycho-social Well-being Index, Short Form). Methods : This study was to measure the degree of job stress and socio-psychological stress of firefighters working at 119 safety center and analyze the relationship between job stress and mental health, through self-administered questionnaire survey on 918 fire fighters working at fire department located in Korea, during October in 2008. Question items of the questionnaire consist of general characteristics, job stress, and socio-psychological stress. Job Stress Measurement Scale for Koreans was used to measure job stress, while PWI-SF used for socio-psychological stress. Collected data was analyzed through frequency analysis, ${\chi}^2$ test, one-way ANOVA, correlation analysis, multi-regression analysis using a statistic program, SPSS/10.0 Ver for Windows, and statistical significance level was 0.05. Result : Accordingly, this paper is written for the purpose of scrutinizing the reason of 119 rescuers' job stress and Socio-Psychological stress. This thesis tries to analyze a problem and provide contents through many variables concerned and theoretical investigation with the actual research of questionnaire. The results of the study are summarized as follows : Fire fighters feel relatively high stressful in their performance. Job stress, organizational commitment and burnout did not have been influence upon by individual cases such as economic condition, regular exercise etc. Finally, as a result of step by step regression analysis, the variable that can explain Socio-Psychological stress the best was negative emotion scale(NE). Conclusions : It is necessary to conduct repeated studies in the future, since the study implied that there was a contrary relationship between job stress and socio-psychological stress. In order to reduce job stress and maintain better mental health, it is more important than anything else to help firefighters have willingness and efforts to sustain a healthy life, so the development of various programs and education to raise their awareness should be implemented.

• Journal of the Korean Data and Information Science Society
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• 제27권2호
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• pp.409-417
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• 2016

본 연구는 시간 (3분, 4분)에 따른 구령방법이 심폐소생술의 피로도와 정확도에 미치는 영향을 자료로 제시하기 위하여 실험집단과 대조집단의 실험 전 신체적 특성의 동질성을 독립표본 t 검정을 실시하여 동질한 집단으로 나타났다. 집단 별 젖산의 차이를 반복측정 분산분석을 실시한 결과, 시간 (F=7.835, p <.01)과 집단 (F=8.695, p <.01)의 주효과 및 시간과 집단의 상호작용효과 (F=12.582, p <.001) 등에서 모두 통계적으로 유의하게 나타났다. 즉 집단과 시간 (3분, 4분)에 따른 주효과 검정을 Bonferroni방법을 이용하여 실시한 결과에서 실험집단의 젖산 양이 대조집단에 비해 더 많다는 것을 알 수 있었고 (p <.01), 젖산이 실험 전과 3분 후는 차이가 나타나지 않았지만, 실험 전과 4분 후 (p<.05), 3분 후와 4분 후 (p<.05)는 각각 차이를 나타냈다. 다음으로 측정 시간에 따른 정확도를 비교하기 위하여 대응표본 t 검정을 실시한 결과에서 3분 후의 정확도가 4분 후의 정확도에 비해서 더 높게 나타났다 (t=4.584, p <.001). 따라서 응급상황에서 119가 도착하기 전까지 심폐소생술 시 처치자는 심폐소생술을 3분 전에 타인과 교대로 실시해야 한다.