• 제목/요약/키워드: Emergency Medical Services (EMS)

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일반인의 심폐소생술 교육 희망에 대한 영향 요인 분석 (Which Laypersons Want Cardiopulmonary Resuscitation Education?)

  • 강경희
    • 한국응급구조학회지
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    • 제10권1호
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    • pp.5-12
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    • 2006
  • Purpose: Few data exist regarding the cardiopulmonary resuscitation(CPR) education in relationship to characteristics of socio-economic status and health-medical conditions in Korea. The purpose of this study is to describe and analyze the characteristics of which laypersons want the CPR education. Methods: Based on a health survey of Incheon Metropolitan City adults(n=5,114), tests of the differences between the group that wants the CPR (n=1318) and the group that doesn't (n=3576), and a logistic regression analysis of two groups was performed on socio-economic status-gender, age, marital stats, education level, numbers of family members, and monthly household income-and health-medical conditions-diseases, accident experience, EMS(emergency medical system) experience, and health status. Results: Even the participation rate of the CPR education in Korea is only 4.3%, which is extremely lower than other developed countries, there are statistically significant differences between the group that wants the CPR and the group that doesn't on gender(p=0.005), age(p=0.000), education level(p=0.000), numbers of family members(p=0.000), monthly income(p=0.000). diseases(p=0.000). health status(p=0.042). Furthermore, age(OR: 1.025, p=0.000), education level(OR : 0.721, p=0.000), numbers of family members(OR: 0.809, p=0.000), and health status(OR: 1.077, p=0.000) are statistically significant factors on the wish for the CPR education. Conclusion: Accident and EMS experiences are not so much influential factors on that laypersons want the CPR education in Korea. Therefore, certain subgroups of laypersons such as high-risk patients and family members need targeted outreach programs in CPR education.

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효율적인 응급의료 정보전달매체로서의 119구급활동일지 분석 (An Analysis of the 119 EMS System using the Standardized Record on the Efficient Emergency Medical Information Delivery Media)

  • 노상균
    • 한국화재소방학회논문지
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    • 제24권1호
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    • pp.64-71
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    • 2010
  • 이 연구를 위해 2009년 1월1일부터 2009년 2월 8일 까지 일개 종합병원에 119구급대로 내원한 모든 환자의 구급활동일지 255부를 조사하였다. 구급활동일지의 전체 기재율 62.1%, 가장 높은 항목은 환자 인수자에 대한 기록으로 100.0%, 가장 낮은 항목은 의사지도에 관한 항목으로 0.4%로 나타나 기대치에 미치지 못한 것으로 조사되었다. 효율적인 응급의료 정보전달매체로서의 119구급활동일지의 기재율을 높이기 위해서는 전문 인력의 확충과 의료진의 적극적인 관심 및 피드백, 구급활동일지의 항목 배열의 규칙성, 기록의 중요성에 대한 지속적인 교육이 필요할 것으로 사료된다.

119구급서비스 품질관리가 병원 전 심정지 환자의 생존율에 미치는 영향 (The Effectiveness of Quality Control of 119 Emergency Medical Services on Survival Rate of Cardiac Arrest Patients)

  • 정은경;윤형완
    • 보건의료산업학회지
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    • 제7권1호
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    • pp.21-34
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    • 2013
  • Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

COVID-19 기간 119구급차를 통해 일개 응급의료센터에 내원한 환자 중증도의 변화 (Change in the severity of patients visiting emergency medical centers through the 119 ambulance during the COVID-19 pandemic)

  • 김용준;이경열
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.145-156
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    • 2021
  • Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

Evaluating the Performance of the Emergency Medical Services Index

  • Eun, Sang Jun;Lee, Jin-Seok;Kim, Yoon;Jung, Koo Young;Park, Sue Kyung;Lee, Jin Yong
    • 보건행정학회지
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    • 제23권2호
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    • pp.176-187
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    • 2013
  • Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

119 구급대의 구급장비 감염 관리와 실태조사 (Infection management for emergency rescue equipment)

  • 박소미;이효주;최장희;김종호
    • 한국응급구조학회지
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    • 제21권1호
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    • pp.87-98
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    • 2017
  • Purpose: This study investigated the use of infection management and the frequency of emergency equipment sterilization by emergency rescue crews to provide basic guidelines and suggestions for infection control. Methods: A self-reported questionnaire was completed by 160 emergency medical technician rescue crews in J area from May 7 to May 22 in 2015. The questionnaire consisted of 95 items, including the general characteristics of the subjects (8 items), the use of emergency equipment (33 items), the frequency of facility sterilization (33 items), infection control (12 items), vaccination (4 items), and the use of personal protective equipment (5 items). Results: In all, 97.3% of respondents were aware of the "Guidelines of Infection management for Rescue Operators' and 90.9% received training on infection control. A total of 72.7% and 47.3% of rescue centers were equipped with disinfection facilities and laundry rooms, respectively. The average frequency of sterilization was $3.17{\pm}0.75$, which significantly differed for teams with more clinical experience (p=.050) and teams with three members (p=.030). The average score for individual protective equipment supplies was $1.95{\pm}0.66$. Conclusion: For proper infection management of emergency equipment, our results suggest that the number of crew members should be increased for each ambulance, protective equipment and rescue products should be supplied, and the number of facilities for sterilization and laundry at rescue centers should be doubled.

외상환자의 병원 전 및 병원단계 중증도 평가의 일치도 (Measure of Agreement between Prehospital EMS Personnel and Hospital Staffs using Guidelines for Field Triage of Injured Patients)

  • 김대곤;홍기정;노현;홍원표;김유진;신상도;박주옥
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.126-132
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    • 2014
  • Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

Bag-Valve-Mask의 사용방법에 따른 일회호흡량과 평균기도압의 변화 연구 (Differentiation of tidal volume & mean airway pressure with different Bag-Valve-Mask compression depth and compression rate)

  • 조승묵;정형근
    • 한국응급구조학회지
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    • 제16권2호
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    • pp.67-74
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    • 2012
  • Purpose : The purpose of this study is to get basal user guidelines of safer bag-valve-mask application on patient with normal pulmonary patho-physiologic condition. Methods : This study was accomplished by pre-qualified 25 EMS junior grade students. Participants were instructed randomly compress bag to one-third, half and total and also with differesnt compression speed. Resultant tidal volumes and mean airway pressures obtained in RespiTrainer were analysed in relation to the each compression depth and rate. Results : Demographic difference does not affect tidal volume with any compression depth and rate change. Increasing compression depth is correlated with tidal volume increasement at any compression rate and also with mean airway pressure. If the compression depth is same, compression rate change did not affect significantly the resultant tidal volume or mean airway pressure. Conclusion : Hand size, Experience, BMI dose not affect tidal volume. Compress the 1600 ml bag half to total amount is safe way to offer sufficient tidal volume without risky high airway pressure delivery to patient airway who with normal lung patho-physiologic condition.

강원도 지역에서의 소방헬기에 의한 이송환자 분석 (An Analysis of Patients distribution Rescued or Tansported by Fire Service Department Helicopter at the KangWonDo Region, KOREA)

  • 이경희
    • 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.

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