Purpose: This study aimed to provide baseline data for implementing advanced life-support for 119EMTs. This is done with an in-depth examination of the emergency care experiences of the 119EMTs on-site and during transportation. Methods: Interviews were conducted with twelve 119EMTs, and the data were analyzed using the phenomenological method. Results: The 34 topics had 19 sub-components and were analyzed according to seven categories: 'A work environment where you cannot focus only on emergency care on-site and during transportation', '119EMTs struggling with manpower shortage', 'Current status of education blocking the upward standardization of 119EMT', 'Implementation of professional emergency care was held back due to the limited legal scope of 119EMT', 'Medical oversight makes it difficult to implement emergency care due to low flexibility', '119EMTs who cannot choose hospital selection and find it difficult to receive help', 'An evaluation system not reflecting reality at all that only leaves high scores'. Conclusion: This study was undertaken to implement specialized emergency care for 119EMTs; not only the necessity of reviewing the expansion of the work scope of 119EMTs but also the necessity of effective 'Medical Oversight system' reorganization raised as well.
Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.
Emergency statistics for cities and provinces are currently derived using simple results of comparative numerical data, but there is a limit to the ability to analyze and compare deviations relevant to a specific city and province. This study aims to derive various correlations through statistical analysis of emergency and rescue data for Gwangju Metropolitan City and to develop an analytical model that can be applied nationwide. With the new statistical model, further detailed analysis is possible beyond simple evaluation of rescue data, through links to other institutions and analyses using keywords from Internet portal sites and social networks. Second, a system which that can analyze data that are not shared is required. Through this system, a large amount of data can be automatically analysed in real time. Third, the results should flow back for application in various policies. A real-time monitoring and management system should be created for abnormal patterns of disease. In addition, the results should be available to tailor services for individuals, communities, or specific organizations.
Purpose : This study aims to provide basic data to establish an effective emergency medical service system by analyzing health educator' understanding and use of emergency medical service system at schools. Method : 93 questionnaires from 200 elementary, middle and high school nurses in the city D were collected from May 26 to July 7, 2008 and ${\chi}^2$ analysis and frequency analysis were carried out with SPSS win PC 14.0. Results : 1. As for emergency contact points, 3(3.30%) answers 'they do not have any knowledge', 40(43.96%) said 'they have some idea' and 48(52.75%) said 'they do know about it'. Among 24 respondents who have less than five years of working experience, 2(8.33%), 16(66.67%) and 6(25.00%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. As for 9 who have 6-10 years of career, 1(12.50%), 4(50.00%) and 3(37.50%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. Among 32 respondents who have 11~20 years, there were no respondents with no knowledge on the given question, and 9(29.03%) said they have some understanding and 22(70.97%) answered they have clear understanding on the topic. From this result, it can be said that there is statistically meaningful differences among different working year groups with ${\chi}^2=16.583$ and p= .010. 2. As for 119 emergency contact in the given district, 24(29.63%), 30(37.04%) and 27 (33.33%) answered 'do not know', 'know' and 'know very well' respectively. As for the question to ask whether they know Emergency Medical Information Center 1339, 66(70.97%) answered 'Yes' and 27(29.03%) answered 'No'. When it comes to emergency contact numbers and list of hospitals, 59(63.44%) said 'they have some list', 20(21.51%) answered 'they have well established contact network' and 14(15.05%) said 'they have none'. 3. As for the use of 119 service at the time of emergency at schools, 59(63.44%), said 'Yes' and 12(12.90%) answered 'No'. Among those who said 'yes', 29(31.18%), 24(25.81%) and 5(5.38%) answered they have used the service 1-2, 3-5 and 6-10 times respectively. Conclusion : In order to ensure health educator to effectively deal with emergency situations at schools, there should be special activities to enhance health educator' understanding on 119 and Emergency Medical Information Center 1339 and at the same time, a system should be established to connect schools, 119 in a given district, hospitals and Emergency Medical Information Center 1339.
Purpose: The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS). Methods: Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis. Results: Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05). Conclusions: The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.
During emergencies, the time from symptom onset to definitive treatment determines the final outcome. Therefore, the emergency medical service (EMS) system in Korea, aims to transfer patients requiring emergency care to appropriate medical facilities within 30 minutes. This is in an attempt to improve the chances of survival and reduce sequelae. We attempted to locate areas vulnerable to prehospital transportation and identify hot spots with high demand for emergency medical helicopters in Jeju, by using a grid-based geospatial analysis. This retrospective cross-sectional observational study employed EMS data of 119 ambulance run sheets spanning from January 1, 2010 to September 30, 2018 in Jeju. The location data of emergency patients was superimposed on the spatial analysis frame using the geographic information system (GIS). Subsequently, the locations of long-distance transfer and delayed transfers to the hospital were analyzed, to identify hot spots where the demand for helicopter emergency services would be high. Of the total analysis targets, 42.2% (20,288 people) took more than 30 minutes from reporting to 119 dispatchers to hospital transfer. As the transfer time interval increased, the patient occurrence time increased in the city of Jeju, increased in Seogwipo, and the ratio of patients/guardians to select a transfer hospital rose with significant differences. This study identified the characteristics related to time delays in prehospital transfer of emergency patients in Jeju, and the areas vulnerable to prehospital emergency care were derived and visualized through spatial analysis using the GIS.
Purpose: As emergency medical service fund is further expanded due to amendment of the law on emergency medical services in 2008, Korean government has prepared to intervene in a comprehensive manner to strengthen a trauma treatment system. As a result, it announced a master plan to establish a serious trauma treatment center in 16 areas across the nation. Therefore, this study has attempted to investigate the current status of the serious trauma treatment centers and suggest the goal and improvement plan of future serious trauma treatment centers. Methods: As of 2011, Korea operates 23 emergency cerebrovascular service centers, 23 emergency heart disease centers and 35 severe trauma treatment centers across the country. 12 emergency medical service centers have been chosen among the serious trauma treatment centers. Then, top six (6) centers chosen at Emergency Medical Institute Assessment 2011 by Ministry of Health and Welfare have been selected, and floor layout and spatial allocation by usage have been reviewed and analyzed. Results: Consequently, this study has investigated the spatial components, circulation layout and spatial allocation of a serious trauma treatment. For construction planning in consideration of the fundamental objectives and goal of emergency medical services, it is essential to allot spaces and select exact spatial components. It appears that it is necessary to design spaces for emergency medical services and come up with construction planning through appropriate spatial allocation.
This study aims to examine the relative importance of various tasks of EMT and to examine knowledge level and problems associated with AED. It is based on the survey of paramedics and 119 rescures. The results for this study were as follows ; Among the tasks of EMT, 'foreignbody removal from mouth' were rated as the most important, followed by '$O_2$ supply', 'CPR', 'Intubation for CPR', '$O_2$ supply' were rates as the most necessary, followed by 'foreignbody removal from mouth', 'external bleeding control'. In terms of the knowledge level about AED, survey respondents are most knowledgeable about 'role of other rescures during the preparation for AED' and 'treatment after 3 AEDS. The most important reason that the uses of AED is delayed is 'unclear boundary of treatment directed by medical control'. The results of the study suggest that we need guideline for EMT's tasks, efficient communication system between 119 and emergency health are center for prompt AED, and training and education program for AED.
Purpose: This study aims to examine characteristics and actual conditions of patients using emergency room at farming and fishing villages, solve overcrowding of emergency room at the tertiary hospital and activate local emergency clinics. Methods: It examines department of diagnosis and treatment, vehicles used, sex, age, residential area, visit hour, length of stay, presence or absence of trauma, measures after first aid and degree of severity based on medical records of 6,740 patients using emergency room at farming and fishing villages from Jan. 1 to Dec. 31, 2005. Conclusion : 1. Sex distribution of patients of emergency room was male 54.9% and female 45.1% and age distribution between over 40 and below 50 was most as 15.9%. 2. Transport means to emergency room were 91.4 of private car and others (public transport and going on foot), 7.5 of 119, 129 and police car and 1.0% of ambulance. 3. According to distribution of residential areas of emergency patients, 38.9% were Eup area, 42.1% Myeon area, 11.4% distant area and 7.5% adjacent area. 4. According to distribution of emergency patients by department of diagnosis and treatment, internal medicine was most as 35.8% and 55% of patients visited emergency room from 3:31 p.m. to 11:30 p.m.. 5. According to total hours of diagnosis and treatment of subjects, 51.2% were within 30min. and cases of non-trauma disease were 68.2%. 6. According to degree of emergency of emergency patients, non-emergency cases were 65.3%, urgent cases 27.7% and emergency cases 7.0% and 74.2% of patients returned home after first aid and 20.6% of them hospitalized. In conclusion, characteristics and diversification of patients should be examined and efforts by government and local medical institutions which must organize emergency system and facility and personnel levels suitable to regional conditions are needed in order to prevent overcrowding of emergency center of the tertiary hospital and activate local emergency center.
The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.
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