Records of 255 patients was analyzed statistically according to the contents of the record form. T patients' records were collected through the visit of emergency department in one hospital by the 119 Emergency Medical Services system from January 1 to February 8, 2009. In conclusion, the total entry was the investigation of 119 ambulance run report in 62.1% of subjects. The highest record of receiving hospital item was 100.0% and the lowest record of medical control item was 0.4% of subjects. Increasing the entry of 119 ambulance run report in efficient emergency medical information delivery media needed to suggest that increasing the number of specialists on the staff, medical staffs have an active interest and feedback, rule to item arrangement of prehospital ambulance run report, continuous education in the importance of record.
During the past decade or so in Korea, 119 relief squad members were supposed to respord first urgent or emergency cases. The primary purpose of this study was to assess what levels of knowledge and techniques in prehospital care the 119 relief squad members showed. Data regarding the knowledge and technique levels were collected from both the 119 relief squad members (n=63) and the emergency room nurses(n=46). The Results indicated that the 119 relief squad when compared to emergency nurses, showed higher scores for knowledge and techniques in some areas of prehospital care but not in other areas, However, no differences in knowledge and technique were found when the ANOVAs were calculated with two covariates : duration of their career in emergency medical services and frequency of their exposure to lectures on emergency medical technology. In addition, many respondents in the 119 relief squad group rated themselves poorly in knowledge and techniques of prehospital care, The findings imply that qualitatively better curricula should be given to the 119 relief squad members before they are allowed to play an important role in the emergency medical service system. These findings are also discussed in the context of improving the emergency medical service system.
Purpose: Ths study aims to examine characteristics of patients using emergency room after execution of five-day workweek system by government and provide basic materials for operation of efficient emergency room. Methods: Data were collected tbrough medical records of patients visiting emergency room from July of 2004 to October of 2006 and they were analyzed with SPSSlPC 10.0. Conclusion : 1. The number of patients visiting emergency room was average 16.7 persons a day in 2004, 17.5 in 2005 and 18.6 in 2006 and it was found that it was increasing every year since the execution of five-day workweek system 2. Gender distribution of subjects using emergency room was higher in male than in female every year. 3. Means of transport to emergency room were mostly private car and others(public transport or on foot), but use of ambulance was increasing. 4. Residential areas of subjects were mostly 'Myeon area' in 2004~2005, but it was changed to residents at 'Eup area' in 2006. 5. Distribution of patients by medical departments was highest in internal medicine and surgery in 2004~2006 and rate of visiting pediatrics was increasing every year. 6. Time to stay at emergency room was most at 'below 30 min'. in 2004~2006, but cases of stay for 'more than 2 hours' were increasing every year. 7. On presence or absence of trauma in patients visiting emergency room, rate of visit to emergency room with 'no trauma' was higher and this result was increasing every year. 8. As a result of classifying severity of patients visiting emergency room, use rate of emergency room by 'non-emergency' patients was over 90% in 2004~2006 and such a phenomenon was deepened in 2006 compared to that in 2004. 9. Measures after emergency care of patients were most in case of 'discharge' in 2004~2006, but cases of admission to hospital after emergency care were increased every year. 10. According to use of emergency room by a day of the week, use on Sunday was most frequent in 2004~2006, but use on Friday the day before holiday was increasing. 11. According to distribution by age, use by those between '40~49' was most in 2004~2005, but use by those 'below 10' was most in 2006. 12. According to time to visit emergency room, using emergency room at "15:31~23:30 was most in 2004~2006, cases of visiting emergency room at day working hour were decreased every year and those at evening and night working hours were increased. Conclusion: In sum, it was found that characteristics of patients visiting emergency room and their actual status were changed after the execution of five-day workweek system and efforts to rearrange emergency medical system are required.
Purpose: This study aimed to compare and analyze statistical data on 119 ambulance runs and ambulance crew, which are the components of the emergency medical services system in Korea and Japan. Methods: Data from National Fire Agencies of both Korea and Japan were collected and statistically compared. Results: With regard to the ratio of 119 ambulance runs, Korea's ratio has been gradually and continuously growing beyond that of Japan (Korea 4708.11, Japan 4706.47) since 2014. The ratio of firefighting ambulances in Korea was 2.59 ($2.59{\pm}0.10$), and was 4.76 ($4.76{\pm}0.12$) in Japan. The ratio of 119 ambulance crews in Korea was 15.55 ($15.55{\pm}2.03$), and was 47.24 ($47.24{\pm}1.06$) in Japan. Among the ambulance crews, the ratio of paramedics was 33.81 ($33.81{\pm}5.85$) in Korea and was 38.86($38.86{\pm}4.10$) in Japan. Conclusion: The ratio of 119 ambulance runs in Korea has already exceeded that of Japan, but the numbers of 119 ambulance crews and paramedics qualified for special emergency treatment are still insufficient. Therefore, supply and demand policy that promotes the development of the firefighting ambulance service system is necessary.
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.
Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.
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.
Purpose: The aim of this study was conducted to assess the proficiency of both direct laryngoscopy and video laryngoscopy and the usefulness of each laryngoscope, thereby provide basic data for further education using video laryngoscopy. Methods: Forty one paramedic subjects participated in this study. Usability was measured with the System usability scale. The Macintosh direct laryngoscope and $C-MAC^{(R)}$ video laryngoscope were two instruments evaluated in the study. Results: Training with video laryngoscopy showed significantly better results within the categories of dental injury (p=.004), esophageal intubation (p=.001), and proper depth placement of intubation tubes (p=.019). The results of the System usability scale questionnaire and the degrees of visibility based on the Cormack & Lehane classification were also found to be better achieved with the video laryngoscopy (p=.000). Conclusion: This study suggests enhancing education with video laryngoscopy, which could reduce the risk of complications and duration of intubation while increasing the success rate among students and emergency medical technicians with little experience, rather than the existing method of only using direct laryngoscope, which requires considerable experience and skills.
Eun, Sang Jun;Lee, Jin-Seok;Kim, Yoon;Jung, Koo Young;Park, Sue Kyung;Lee, Jin Yong
Health Policy and Management
/
v.23
no.2
/
pp.176-187
/
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.
Glucose is the most importantenergy source in the central nervous system. Because the central nervous system cannot synthesize or store glucose. low blood glucose even for a short period results in no functionally normal activity of the brain. In addition, continuous low blood glucosecan cause irreversible brain damage and brain death. Therefore, the current status of emergency care by first aid staffs during transfer of patients with hypoglycemia has been investigated in this study, 114 patients who have visited the hospital using 119 Emergency Medical Service from January 1, 2004 till December, 2004 and shown blood glucose of 2.8 mmol/L and less on arrival have been involved. In case of nurses, assistant nurses, first aid staffs receiving first aid training and second-class emergency medical technicians(EMTs), they provided basic life support (BLS). In case of first-class EMTs, they measured blood sugar and then they orally administered glucose to conscious patients or provided simple first aids and prompt transfer for unconscious patients. As a result of analysis, it is suggested that first aid retraining is required.
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