Nurses are medical personnels under the Medical Service Act and perform medical practice such as medical assistance at medical institutions. The nurse, a medical personnel, provides emergency medical service to emergency patients in the pre-hospital emergency medical system as a 119 rescuer based on the Act on 119 Rescue and Emergency Medical Services. The scope of practice of nurses is comprehensively defined in the Medical Service Act and specified through precedents. In contrast, The scope of work of emergency medical technician is listed in detail. It is understood that nurses in the pre-hospital emergency medical service system have a wider scope of practice than emergency medical technician. In particular, the scope of practice of nurses as emergency medical personnel in the pre-hospital emergency medical system should be interpreted differently within the medical institution, considering the urgency of the patient, being transferred to the emergency medical institution, and the specificity of medical direction through tele-communication.
As a part of improving early response system for senior emergency patients in rural areas in preparation for accelerated transition of Korea into aged society, this study seeks to make effective use of town broadcasting equipments and improve conventional educational ways for the first aid for senior people to boost up availability of private rescue personnel, so that it can contribute to improving capacity to early response to potential occurrence of emergency situations. In addition, this study focuses on profiling current activities of 119 geriatric Emergency Medical Services available in Korea, and also exploring possible ways to improve emergency services for senior safety which can play useful roles of social safeguard in imminent aged society as well as efficient ways to build up infrastructure for senior safety on the basis of opening up senior safety center.
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.
Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.
Purpose : This study analyzes prehospital care report of emergency service at prehospital stage, examines characteristics of activities of 119 paramedics and its users and aims to provide help for improving emergency system in future. Methods : Data collected were 119 prehospital care report and hospital records with 7,160 patients to emergency room by 119 ambulance from Jan. 1 to Dec. 31, 2006 and percentage and frequency of the data were obtained. Results : 1) Use of emergency room by 119 ambulance was increased in summer and autumn such as August(9.1%), September(11.2%) and October(13.5%) and it was more frequently used on Monday(17.3%), Saturday(17.2%) and Friday(16.1%) by telephone(98.6%). 2) Using emergency room was most in over sixties(51.8%), men(64.2%), community residents (78.3%), by report of family(50.3%) and at '09:01~12:00'(16.5%). 3) Symptoms of emergency room users included headache, chest pain, stomachache, lumbago and others as 40.6% and places where patients were found were at home(60.1%) due to chronic internal diseases at 49.2%. 4) Most of non-emergency patients(80.2%) arriving at hospital had normal pupil condition (88.4%) and clear consciousness(71.2%) and most of them left hospital after having first-aid treatment. 5) Physiological symptom tests evaluated by paramedics at prehospital stage included blood pressure(56.6%), pulse(22.9%), breathing(13.0%) and temperature(9.2%), and there was no SPo2 case. 6) Classification of severity by paramedics showed difference as emergency patients(18.0%) by paramedics and those(24.9%) by hospital. 7) First-aid treatments by paramedics at prehospital stage were promoting comfort(28.9%), hemostasis(7.7%), fixing cervical vertebrae(4.0%) and ensuring vein route(3.1%). 8) Selectors of medical agency were patients or guardians(86.2%) and emergency medical technicians(73.6%). Conclusion : To sum up the above research, it was found that percentage of using 119 ambulance by non-emergency patients was higher and paramedics performed basic first-aid treatment rather than professional first-aid treatment due to several conditions such as legal problems, range of allowance, etc. Therefore, it is considered that method to reduce frequency of ambulance by non-emergency patients and approaches to alleviate limitations of allowance of paramdeics to make them perform effective first-aid treatment at prehospital stage should be sought in the dimension of individual, organization and government.
This study aims to examine the relative importance of various tasks of EMT and to examine knowledge level and problems associated with AED. It is based on the survey of paramedics and 119 rescures. The results for this study were as follows ; Among the tasks of EMT, 'foreignbody removal from mouth' were rated as the most important, followed by '$O_2$ supply', 'CPR', 'Intubation for CPR', '$O_2$ supply' were rates as the most necessary, followed by 'foreignbody removal from mouth', 'external bleeding control'. In terms of the knowledge level about AED, survey respondents are most knowledgeable about 'role of other rescures during the preparation for AED' and 'treatment after 3 AEDS. The most important reason that the uses of AED is delayed is 'unclear boundary of treatment directed by medical control'. The results of the study suggest that we need guideline for EMT's tasks, efficient communication system between 119 and emergency health are center for prompt AED, and training and education program for AED.
Purpose: This study aims to identify the present handover status and the difference in performance and importance of handover between 119 paramedics and emergency department (ED) staff to improve the quality of handover. Methods: The study involved a questionnaire survey of 171 paramedics and 108 ED staff in four regions from August 28 to September 23, 2020. Subsequently, 279 questionnaires were collected and 277 copies were used for this study. Data were analyzed by SPSS 26.0 version. Results: The results showed that most of the paramedics and the ED staff rely on memory and verbally handover, without formal education about the handover process. And there were significant differences in performance in important information of prehospital. Some of the handover items were a difference in performance and importance between the paramedics and the ED staff. Conclusion: The unified education based on required and optional items is necessary to reduce the loss of information between the paramedics and ED staff, and standardized tools need to be developed in the handover process.
Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.
Purpose: The aim of this study was to provide basic data to aid in the effective adoption of the preceptor system for new paramedics by assessing the preceptor role awareness among senior 119 paramedics in the field. Methods: A questionnaire was administered to 182 senior paramedics who each had more than 3 years field experience. The questionnaire measuring preceptor role awareness was composed of 64 items with responses based on a 5 point Likert scale. Data were collected from July 31, 2018 to August 29, 2018, and were analyzed with IBM SPSS version 24.0. Results: The average score for preceptor role awareness was 3.87 (supervisor = 3.95, resource person = 3.88, role model = 3.85, and instruction designer = 3.81). There were significant differences in preceptor role awareness among the participants based on competence (p =.002) and clinical skill (p =.000). Also, there were high positive correlations between preceptor role awareness and its subdivision (p <.01). Conclusion: For effective operation of the preceptor system in the future, the preceptors' role as designers of instruction and role models should be enhanced, Also, future preceptors are very important in the improvement of competence and clinical skill in the preceptor system. Therefore, it is necessary to provide training that enables new preceptors to effectively adopt and operate the preceptor system.
Purpose: By identifying the actual profile of emergency medical personnel's pre-admission infection control practices, this study intended to provide a basic reference material for the improvement and reorientation of pre-admission infection control measures, and thereby help establish an effective plan for pre-admission infection control activities. Methods: Total 119 EMT's working for Jeollabuk-do Provincial Fire Defense HQ were asked to join a structured questionnaire survey from June to August 2006. Results: 1. It was found that 56.1% respondents answered no guideline available on the prevention of infection. Out of our rescue brigade members who knew about relevant guideline available, 34.2% respondents answered that their department conducted quality control program for the guideline. 2. For protective outfit in emergency practice, it was found that most respondents put on gloves or nothing at all(38%), which was followed by sterile gloves(29.2%), disposable mask(26.9%), gown(4.3%) and protective goggle(1.6%). And it was noted that all respondents(100%) washed out any clothing contaminated with somatic secretion on their own. 3. For a question about any experience in emergency activities exposed to infectious diseases, it was found that most of all respondents(77.9%) answered 'No', which was followed by 'Don't Know'(18.6%) and Yes(3.9 %). 4. For a question about any experience in inquiring of patients about infectious diseases, it was found that most respondents(49.4%) answered 'Yes' and 'Sometimes'(9.1%). It was noted that 20.2% respondents had extra medical examination in medical institution in terms of whether they were exposed to infectious diseases, apart from regular medical examination. Conclusions: In order to protect 119 EMT's from infectious diseases, it will be necessary to acquire emergency medical staffs specializing in infection control and organize corresponding personnel training units to keep providing reorientation and evaluation. In addition, it will be also necessary to supply them with a full set personal protection apparatuses and other equipments required for disinfection and sterilization.
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