• 한국화재소방학회논문지
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• 제20권2호
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• pp.31-43
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• 2006

현재 우리나라 응급의료서비스(Emergency Medical Service)의 대부분을 차지하는 119구급대는 구조적인 문제에 봉착해 있다. 119 EMS가 무료로 공급되면서 그에 대한 수요가 비정상적으로 증가하여 119구급대원들의 과부하가 문제시되는 한편 정작 중요한 성과지표인 소생률(resuscitation rate)은 외국에 비해 저조한 수준을 면치 못하고 있다. 이러한 문제를 해결하기 위해서는 예산 및 인력 증원이 필요한데 현 시스템 하에서는 막대한 예산 소요, 소방공무원 표준정원제와 소방력기준과의 불일치 등에 의한 제약 때문에 이마저도 쉽지 않다. 본 연구는 이러한 문제의식 하에서 현행 EMS 시스템이 의료기관이나 민간이송업체를 포괄하는 민관파트너십 시스템으로 이행하는 방식을 간략하게 설계하고, 그 타당성을 검토하고자 한다. 우선 미국 주요도시의 EMS 성과와 관련된 기초 통계를 바탕으로 분석해 본 결과, 소방이던 의료기관이던간에 단일기관이 EMS를 전담하는 경우보다는 복수의 기관이 협력하는 경우가 소생률이 높다는 것을 확인할 수 있었다. 또한 각국의 EMS 체계와 관련된 사례를 수집한 결과 한국과는 달리 대부분의 국가나 지자체들이 민관파트너십을 통해 보다 질 높은 EMS를 제공하고 있었다. 결국 한국의 EMS도 소방 중심에서 탈피하여 의료기관, 민간업체 등과 파트너십을 구축하는 방향으로 EMS 체계를 재설계하는 것이 타당할 것이라는 결론을 얻었다.

• 한국응급구조학회지
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• 제10권2호
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• pp.53-62
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• 2006

Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

• 한국화재소방학회논문지
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• 제29권5호
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• pp.96-103
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• 2015

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008~2011년 연간 데이터(Version 1.0)을 이용해 노인의 구급 이송 서비스 이용 특성과 관련 요인을 파악하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등의 구급 이송 서비스를 이용한 노인은 전체 이용자의 46.8%를 차지하며, 응급실을 방문한 노인의 35.1%가 구급 이송 서비스를 이용했다. 둘째, 노인의 구급 이송 서비스 이용은 성별 중 남성(OR = 2.19, 95% CI = 1.51~3.17), 가구주와의 관계 중 배우자(OR = 2.19, 95% CI = 1.45~3.32), 의료 보장 형태 중 의료 급여(OR = 1.41, 95% CI = 1.10~1.82), 장애가 있는 경우(OR = 1.44, 95% CI = 1.14~1.83), 응급실 방문 이유 중 사고/중독(OR = 1.53, 95% CI = 1.20~1.97), 응급실 이용 후 조치 중 입원/전원(OR = 3.45, 95% CI = 2.80~4.25)이 통계적으로 유의한 영향 요인으로 나타났다. 따라서 고령화 시대에 노인 인구의 증가는 구급 이송 서비스의 수요 급증으로 이어질 것이며, 이에 따른 노인 맞춤형 응급의료 서비스 등의 개발이 필요하다.

• 한국응급구조학회지
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• 제11권3호
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• pp.191-204
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• 2007

This study analyzes use and operation of silver ambulance with 110 patients who had used silver ambulance in Gwangju and Jeonnam regions from June of 2006 to June of 2007 and 53 paramedics who are involved directly in ambulance operation and the results of this analysis are as follows. 1. Users' health conditions, 69.1% of users answered as bad and 67.3% suffered from chronic diseases over 3 months and it was found that they used silver ambulance due to their bad health conditions. 2. Cronbach's alpha was 0.630 and family function index was generally reliable and solution was high as 1.60, but total points were low as 7.11 and it was considered that they had family troubles. 3. On the question of ambulance use, 44.5% answered they used it because it is free, 53.6% used it for appointed medical examination and treatment and 18.1% used it for emergency. 4. Degrees of satisfaction with ambulance and paramedics were 95.4% and 76.4% respectively and 80.0% of ambulance users answered ambulance arrived quickly within 15 min. 5. Correlation($x^2 $) between family or relative's residence and frequency of visits was 86.367 and its significance probability was 0.00 and it was found that it was significant in the level of 0.1%, but correlation($x^2 $) between visitors other than family or relatives and frequency of visits was 14.768 and its significance probability was 0.25 and it was found that it was not significant in the level of 5%. 6. Correlation($x^2 $) between transfer operation speed and mobilization time was found that it was not significant in the level of 5%. Correlation($x^2 $) between their own health condition purpose of ambulance use was 13.802 an 5.696 and its significance probability was 0.93 and it was found that it was not significant in the level of 1%, and it was considered because paramedics carried patients with safe operation.

• 한국응급구조학회지
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• 제21권2호
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• pp.51-61
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• 2017

Purpose: This study measured return of spontaneous circulation (ROSC) in relation to dispatch distance in patients with out-of-hospital cardiac arrest. Methods: Of 2,347 out-of-hospital cardiac arrest patients transported by emergency medical technicians in J Province between January 1 and December 31, 2015, those under age 18, those with reserved resuscitation, and those with traumatic cardiac arrest, leaving 855 patients in the study sample. ROSC was compared between those with dispatch distance ${\leq}4km$ (short dispatch distance, 465 patients) and those with dispatch distance >4 km (long dispatch distance, 390 patients). Results: The mean was 2.17 km in the short dispatch group and 9.87 km in the long dispatch group (p=.000). Mean distance from was 6.49 km and 13.39 km in the two groups, respectively (p=.000). ROSC differed significantly between the short and long dispatch distance groups (7.1% for short dispatch distance, 3.6% for long dispatch distance, p=.025). The length of time from to cardiopulmonary resuscitation also differed significantly between the short and long dispatch distance groups (8.77 minutes and 14.63 minutes, respectively, p=.000). Conclusion: ROSC was lower in areas of long dispatch distance compared to those of short dispatch distance. We expect this was most likely due to differences in response time by age and dispatch distance to the scene of cardiac arrest. However, no significant differences were found between the groups in the factors affecting ROSC.

• 한국응급구조학회지
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• 제6권1호
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• pp.55-64
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• 2002

This analysis is accomplished by using 331 rescue and medical evacuation cases performed by KangWonDo Fire Service Department Aviation(KFSA-119 Heicopters) between Jan. 1998 and Oct. 2002. By analysing injury causes, annual differences, sexual, scenic(locaional) distribution and wounded part distribution, this study tried to figure out the general tendency of the helicopter-transported patients in Korea. The results are as follows; 1. The whole population of the patients rescued and transported by helicopters is increasing by the annual rate of 150%~200%. 2. For the locational (scenic) distribution of the patients, 57% (190 cases) of the target population were injured on their mountain-climbing or tracking. 3. 12% (41 cases) of the target population were the Inter-Hospital transport cases. 4. 6% (16 cases) were the expired cases. 5. for the wounded part distribution, 46% (106 cases) were muscular skeletal injuries. 6. The aircraft and personnel of the KFSA were rescue-oriented, so for the EMS operations especially inter-hospital transport missions, different medical equipments and personnels are needed.

• 한국응급구조학회지
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• 제26권3호
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.

• 한국응급구조학회지
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• 제26권3호
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• pp.137-148
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• 2022

Purpose: This study aims to provide essential data for developing educational methods and content, tailored for the prehospital field situation, by analyzing the effects of education regarding the management of cardiac arrest. Methods: This study is a primitive experimental study of 55 new firefighters in C Fire Service Academy. Data were collected from the training which was imparted using the CPR virtual reality simulation program (CBS 2.0) in accordance with COVID-19 quarantine rules and social distancing. Data were analyzed utilizing SPSS version 25.0. Results: After VR simulation training, knowledge about performing CPR (14.85) and self-efficacy (4.12) were significantly high (p<.001). Learning immersion was also high (3.99±0.59), but learning satisfaction was even higher (4.34±0.62). Depending on the recruitment field, firefighters showed higher learning immersion (4.04±0.58 vs 3.68±0.63) and self-efficacy (4.16±0.55 vs 3.91±0.84) than 119 EMTs' but, there was no significant difference between them. In contrast, The quality of performance of CPR by EMT's was significantly higher than that of firefighters (p=.025). Depending on previous simulation experience, there was no significant difference among dependent variables. Conclusion: Virtual reality simulation shows positive results in learning immersion, learning satisfaction, self-efficacy, and performance of CPR. Therefore, we propose that virtual reality simulation training can be a new educational paradigm.

• 한국컴퓨터정보학회논문지
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• 제16권12호
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• pp.265-271
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• 2011

고품질의 맞춤형 서비스는 사회가 고령화, 초핵가족화, 재난 취약 계층의 증가로 인하여 급격히 늘어나게 되었다. 급성 질환, 심뇌혈관 질환, 자살 등 예방 가능한 사망률이 선진국에 비해 높으므로 빠르고 전문적인 구조 및 구급 서비스가 요구된다. 본 논문에서는 응급 환자가 발생하여 병원에 도착하기 전에 환자의 정보를 이용하여 응급처치가 가능하도록 한다. 그리고 응급 의료 기관에서는 환자 진료 준비를 사전에 갖출 수 있도록 하여 응급 환자 진료의 효율성을 높였다. 사회적 인지도가 높은 119번호를 이용하여 다양한 복합 응급 신고를 접수하고 있고, 유관기관과 통합적 대응 체계를 구축하는 효율적 응급의료서비스 선진화 전략을 제시하고자 한다.

• 한국응급구조학회지
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• 제1권1호
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• pp.71-86
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• 1997

This study is to suggest some developmental policies by analyzing the activities of first aid party in Kwangju and Chonnam regions for two years from Jan. 1, 1991 to the end of December, 1995. First, the residents in Kwangju and Chonnam regions have the sufficient benefits of emergency medical center, but it will be desirable that general hospital should be established and managed in Kohung peninsula which forms the wide island area far away from big cities. Second, the classification of the degree of severe case in the field by rescue members should be strengthened as the means which can reduce the number of patients transferred to the emergency room and the legal method which rescue members can select the medical agency. Third, children less than 10 are most frequent emergent patients and it is due to parent's indifference and children's in sensibility to safety. So the safely education in the course of infant and elementary education should be strengthened and the method which can keep the self safety through the legal system. Fourth, to increase the rate of emergency measure by rescue members, the reasons of fail of emergency treatment are suggested, the treatment results of each rescue member are analyzed every year and it is desirable that the system which can evaluate the personal ability should be introduced. Fifth, the medical accidents occurred in the case of medical act, by rescue members must lake the legal responsibility, but such a problem can he solved with the compensation of insurance system by government. Sixth, to reduce the time required for transfer, traveling service system for the fixed period in beach should be complemented and extended more and service system at ordinary times should be examined at mountains, the area of traffic jams and large special industrial park. Seventh, since service system with one team of two members of 119 rescue party in expressway cannot be mobilized when multiple accidents occur at the same time, it is considered that service system of two teams of four members should be extended. Eighth, first-aid service in expressway is conducted with rescue and emergency treatment by the rescue party at the same time, but the professional rescue lacks and it may result in the injury of patients. Therefore the creation of rescue party in expressway is the urgent problem.