• 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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• 제17권1호
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• pp.41-50
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• 2013

Purpose : This study intended to improve the quality of prehospital emergency care for patients with dyspnea by figuring out the current situations and problems based on run-sheets of 119 emergency medical technicians (EMTs). Methods : A total of 336 dyspnea patients were transferred to G university hospital by 119 ambulances from January 1, 2011 to December 31, 2011. Results : The data were analyzed by SPSS 19.0. Patients over 60 years old accounted for 57.2% and 48.4% had the history of heart disease. Among the heart disease patients, 31.7% complained of dyspnea and chest pain. The vital sign measurement performance by 119 EMTs increased compared to previous study. The number of prehospital treatment by 119 EMTs significantly increased depending on the mental state of the patients. Conclusion : 119 EMTs should remind the heart disease and other past history of the patients when they perform the dyspnea patient care.

• 한국화재소방학회논문지
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• 제25권1호
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• pp.27-33
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• 2011

최근 우리나라는 인구 저출산과 의료기술의 발달, 식생활의 향상 등으로 인구의 고령화가 빠르게 진행되고 있다. 인구의 고령화는 노인에 대한 복지정책 경제적 문제 일자리 창출 등 여러 가지 정책적인 문제들을 야기 시킨다. 소방행정에서는 노인들을 위하여 실버구급차의 운행 등 노인의 특성에 맞추어 서비스를 제공하고 있다. 근래에는 IT 기술의 접목으로 먼저 알아서 찾아가는 서비스를 제공하기도 한다. 소방행정에서 노인들에게 제공하는 서비스를 분석하고 이에 대한 개선 방안을 모색하고자 하는데 본 연구의 목적이 있다.

• 보건행정학회지
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• 제24권4호
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• pp.357-366
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• 2014

Background: The objective of this study was to evaluate the efficiency of an emergency ambulance system and to investigate socio-economic and clinical characteristics associated with emergency ambulance service. Methods: Based on 2011 Korea health panel, unmet need and inappropriate use of emergency ambulance service were measured by Gibson in 1977. Furthermore, the factors associated with unmet need and inappropriate use of emergency ambulance service were identified by Fisher's exact tests and multiple logistic regression models. Results: Unmet need, defined as the proportion of emergency patients who clinically need ambulance transportation but do not receive it, was found to be 59.8%. Inappropriate use, defined as the proportion of emergency patient receiving ambulance care who did not clinically need it, was found to be 37.2%. There were statistically significant differences between appropriate and inappropriate groups in overall variables of socio-economic and clinical characteristics. Specifically, gender, age, relationship to household, and reasons of visiting emergency department (accident/disease) were statistically significant factors associated with appropriate use of emergency ambulance service. Conclusion: Unmet ambulance need is a useful measure for patients needs assessment, and inappropriate ambulance use is a valid criteria in judging the efficiency of emergency ambulance system. To improve and understand emergency ambulance system, unmet need and inappropriate use of emergency ambulance service should be more concerned.

• 한국직업건강간호학회지
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• 제26권4호
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• pp.227-235
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• 2017

Purpose: This descriptive correlational study investigated the effects of violent experience and resilience on burnout in emergency medical technicians (EMTs). Methods: The participants were 160 EMTs working in fire stations (safety center and local center) located in U, B, and D city. The collected data were analyzed by descriptive statistics, independent t-test, ANOVA, $Scheff{\acute{e}}$ test post-hoc analysis, Pearson correlation coefficients, and multiple regression analysis using IBM SPSS Statistics 20.0. Results: The number of EMTs getting into ambulances was significantly associated with violent experience, resilience, and burnout. Position of EMTs was significantly associated with both resilience and burnout. In the multiple regression analysis, the subscales of durability and optimism in resilience were significantly associated with burnout after controlling for confounding variables. Conclusion: This study indicated that improving durability and optimism in resilience was important to cope with experience of violence and to prevent burnout in EMTs.

• 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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• 제19권1호
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• pp.19-33
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• 2015

Purpose: The purpose of this study was to improve the quality of prehospital care provided to infants and toddlers (preschoolers) based on questionnaire findings. Methods: A total of 1,634 running sheets from 119 centers of D city from patients older than 1 month and less than 7 years of age from January 1, 2013 to December 31, 2013 were reviewed for 119 emergency medical technicians (EMTs) activity analysis. And a self-reported questionnaire about knowledge and competency in prehospital care of preschoolers was completed by 159 EMTs at fire stations in D city. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: Of 1,634 patients, 58.6% were call to 119 due to disease, 33.8% due to injuries and 7.5% due to traffic accident. Knowledge and confidence in treating preschoolers was significantly higher among paramedic EMTs than basic EMTs. The 119 EMTs surveyed indicated that training for preschooler prehospital care was most needed. Conclusion: In order to provide high quality prehospital care for preschoolers transported to emergency rooms, it is necessary to equip ambulances with the proper equipment. In addition, EMTs should be provided educational opportunities and clinical training.

• 한국응급구조학회지
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• 제24권2호
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• pp.111-121
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• 2020

Purpose: The purpose of this study was to compare visual blood loss estimation and subjective emergency according to clothing color. Methods: This is a quasi-experimental study which involved the use of mock bleeding patients wearing different colors tops. Results: Differences in visual estimates according to clothing color were significant in both paramedic students (F=6.69, p=.002) and the general department students (F=20.92, p=.000). When looking specifically at the accuracy of visual estimates, the paramedic students group tended to underestimate (50% white, 62.5% black, 32.5% yellow) the actual blood volume in all experimental conditions. On the other hand, the general department group tended to overestimation (45% white, 40% black, 67.5% yellow). The subjective emergency was also found to differ between paramedic students (F=13.58, p=.000) and general department students (F=9.67, p=.000). Conclusion: Paramedics treating bleeding patients at pre-hospital stages need to pay attention to blood loss estimations depending on clothing color, a factor not to be neglected or underestimated.

• 대한의생명과학회지
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• 제24권3호
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• pp.270-274
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• 2018

Chlorine dioxide ($ClO_2$) gas is a neutral chlorine compound. $ClO_2$ gas was proven to effectively decontaminate different environments, such as hospital rooms, ambulances, biosafety level 3 laboratories, and cafeterias. In this study, to evaluate the effects of $ClO_2$ gas, bacteria of clinical importance were applied. Staphylococci, Streptococci and Bacillus strains were applied and Klebsiella, and others e.g., Escherichia coli, Shigella, Salmonella, Serratia were also done for the inhibitory analysis. Bacteria plates were applied with a hygiene stick, namely, "FarmeTok (Medistick/Puristic)" to produce $ClO_2$. $ClO_2$-releasing hygiene stick showed the very strong inhibition of bacterial growth but had different inhibitions to the bacteria above 96.7% except for MRSA of 90% inhibition. It is difficult to explain why the MRSA were not inhibited less than others at this point. It can be only suggested that more releasing $ClO_2$ should be essential to kill or inhibit the MRSA. B. subtilis, S. agalactiae, S. pyogenes, E. coli O157:H7, S. typhi (S. enterica serotype typhi) and S. marcesence were inhibited over 99%. This study will provide fundamental data to research growth inhibition by $ClO_2$ gas with bacteria of clinical importance value.

• 한국응급구조학회지
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• 제12권3호
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• pp.129-135
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• 2008

Purpose : This study was to analyze the demand for emergency ambulance service and to characterize the factors associated with the demand. Method : The basis for the model was from the actual demand for public emergency ambulance and socioeconomic and geographic characteristics. Multiple regression analyses were done for the related characteristics of public ambulance service. Result : The model explained total demand with a high degree of accuracy : the coefficient of determination($R^2=0.96$). For the regression, the set of variables indicative of low socioeconomic status were all significant. It showed the inappropriate use of public ambulance system. Public ambulance demand increased in higher housing density, low income, male unemployment and female labor force. Conclusion : The demand for public ambulances appeared to be highly predictable, using a simple linear model employing socioeconomic variables, quality of service variables, and land use variables. Low-income families tended, to use the public ambulance system more often than higher income. Area having elderly people or children also made many calls. Estimated demand calls were stable and had a tendency to be similar incident types.