• 성인간호학회지
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• 제29권1호
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• pp.12-21
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• 2017

Purpose: The purpose of this secondary data analysis study was to compare what factors influenced individual's satisfaction with emergency medical services (EMS). Methods: Data were obtained from the Korea Health Panel Survey 2013 with 20,641 participants. A total sample of emergency room (ER) users (n=1,709) aged 20 and over were selected and divided into two age groups, one for 1,046 adults and the other for 663 elderly. Participants' responses were analyzed using descriptive statistics, ${\chi}^2$ test and logistic regression. Results: Among adults and elderly who were transferred to other hospitals instead of being admitted or returned to their homes reported less satisfaction (${\chi}^2=10.18$, p=.006). Further, the adults who perceived their arrival to the ER as not delayed (${\chi}^2=3.74$, p=.049) or visited the ER for treatment for illness (${\chi}^2=5.32$, p=.021) reported more satisfaction than those who perceived their ER service being delayed or visited the ER for accident or poisoning. The elderly who visited ER by non-ambulance reported higher satisfaction than those who arrived by ambulance (${\chi}^2=14.15$, p<.001). Conclusion: In both adults and the elderly, satisfaction of EMS can be increased by avoiding transferring patients to other hospital. For adults to be satisfied with EMS, efficient and rapid EMS might be needed to avoid delay in ER arrival, especially for adults with accidents or poisoning.

• 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.

• 의료법학
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• 제13권1호
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• pp.249-293
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• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• 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.

• 한국정보시스템학회지:정보시스템연구
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• 제19권3호
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• pp.263-278
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• 2010

Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.

• 한국응급구조학회지
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• 제17권1호
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• pp.63-78
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• 2013

Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.

• 한국응급구조학회지
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• 제17권1호
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• pp.21-39
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• 2013

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

• 한국응급구조학회지
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• 제21권3호
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• pp.7-16
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• 2017

Purpose: The purpose of the study was to investigate the effects of laryngeal mask airway (LMA) insertion from different positions, using different methods, on the quality of the insertion, for identifying a more convenient and effective insertion method. Methods: In a model ambulance, 30 paramedic students performed the LMA insertion procedure, in four different settings, combinations of the rescuer's position (at the head end of the patient, at the side of the patient), and insertion technique (index finger insertion, thumb insertion), in a randomized order. Quality of insertion index and convenience of use were measured. Results: The quality of insertion index (tidal volume, gastric insufflation, airway pressure, airway sealing pressure, midline positions, insertion success grade, and insertion time) were not significantly different among four different settings. However LMA insertion from the anterior (head) end, using the index finger method compared to the thumb method was found to be significantly more convenient. Conclusion: We recommend using the more convenient and familiar LMA insertion method, between index finger insertion and thumb insertion, regardless of rescuer's position.

• 한국응급구조학회지
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• 제18권2호
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• pp.137-145
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• 2014

Purpose: The emergency medical service (EMS) system in Japan is similar to that in Korea. This study reviewed the development of paramedics who are major personnel in the respective EMS system of their country. Methods: We searched law for paramedics and publications in J-stage, MEDLINE and the webpage of Japan's Fire and Disaster Management Agency. Results: Paramedic training had started in Japan in 1991, and most paramedics were employed in fire departments. In Japan, ambulances belonging to fire department are staffed by a three-person unit, including at least one paramedic. Medical control advisory boards were established in all Japanese prefectures in 2003 with the purpose of upgrading the activities of ambulance personnel, including paramedics. The scope of paramedics' work has been widened owing to the continued efforts of medical control advisory boards. This allows them to perform invasive procedures including tracheal intubation, intravenous line placement, and epinephrine administration under medical control of a physician. Conclusion: As paramedics' responsibilities expand, further development of the paramedic role and an effective medical control advisory board system are imperative both Korea and Japan.

• 한국응급구조학회지
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• 제26권1호
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• pp.129-138
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• 2022

Purpose: To analyze the frequency of emergency room visits according to socioeconomic factors of emergency room visitors. Methods: In this study, frequency analysis, percentage analysis, and x² test were performed using the SPSS 23.0 program based on the 2018 data from the Korea Health Panel. Results: Among 1,648 participants included in this study, 1,279 visited the emergency room only once in the past year, while 369 visited the emergency room more than once. The relationship between frequency of emergency room visits and socioeconomic factors was analyzed using x² test, and no statistically significant relationship was noted between emergency room visits and education, economic activity, insurance type, and individual quartile income. However, a significant relationship was noted between emergency room visits and being handicap and living in households with quintile income. Conclusion: The study determined the relationship between frequency of emergency room visits and socioeconomic factors. A follow-up study analyzing socioeconomic factors of outpatient departments, 119 ambulance transport services, and frequency of emergency room visits among chronically ill patients is needed to provide basic data for establishing health policies among different socioeconomic strata.