• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.153-168
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• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.78-96
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• 2013

The purpose of this study is to analyze the emergency health care utilization using status according to income class. The target was the 2011 data out Korea Health Panel's raw data. 2011 data composed of total 17,035 people from total 5,741 households. This study set total 1,101 adults over full-20-years old having used an emergency health care utilization as its analysis target. In order to find out the number of emergency health care utilization use according to income class and the influential factors on emergency health care utilization cost, this study conducted the multiple regression analysis. And in order to more accurately analyze the emergency health care utilization use status depending on the income class and the features of emergency health care utilization use status, this study developed Models. As the result, this study found following findings. First, as the income class was lower, the gender was male, the age was lower, and the user has spouse, the user was not a business owner or a paid worker, the user is a house owner, the emergency medical facility type was a clinic, the means of transportation was others rather than 119 ambulance, the reason visiting emergency medical facility was belonged to others rather than accidents or poisoning, then the number of emergency was increased. Second, as the user was in higher income class, received the health insurance benefits, the using medical facility was general hospital, used 119 ambulance more often, stay days in emergency was shorter, then health care utilization cost was increased. In this study investigating the data out of Korea Health Panel, it was found that while the number of emergency health care utilization use was increased in the lower income class, but the emergency health care utilization cost was increased for higher income class. It is considered that this finding was caused from the facts that lower income class was more often exposed to dangers for physical health, so the number of emergency health care utilization use was increased, but their health care utilization cost was decreased because of their economic burdens against various examinations and their difficulties to pay such costs, comparing to that of higher income class. Therefore, in order to solve unequal problem of emergency health care utilization use between lower and higher income classs, it is required to set suitable solutions like the disease prevention effort by facilitating national health check-up programs, the enhancement of public health services in quantity and quality, the emergency health care utilization securing policy at using medical facilities, the promotional, educational activities about emergency health care utilization delivery system, the enhanced accessibility of emergency health care utilizations and emergency medical facilities.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.84-87
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• 2005

Spontaneous hemothorax vary in cause and are rare for hemothorax induced osteochondroma. Sometimes hemothroax is reported due to osteochondroma induced injury of diaphragm, lung, pericardium, heart, or pleura. We report a patient with diaphragm laceration due to osteochondroma.

• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.55-78
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• 2005

The purpose of this study is to analyze the effect on satisfaction after education of cardiovascular pulmonary resuscitation(CPR) in Daejon Emergency Medical information Center in Korea. The major instruments of this study were Korean Self-Analysis Student Opinionnaire. Questionnaire contains 12 items which measure student's satisfaction or attitude factor. To take the analysis of data, the total of 308 students were investigated in Medical Information Center in Dae-jon Metropolitan City from 2004. 2. September to 2004. 16. September. The data were analyzed by the path analysis SPSS program. The result are as follows: 1. After education of CPR, there was significant satisfaction of CPR knowledge P=0.0011). 2. After education of CPR, there was significant satisfaction of CPR skill(P=0.00001).

• Journal of Radiation Protection and Research
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• v.37 no.4
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• pp.226-230
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• 2012

The gross alpha analysis of nasal smear samples for the radiation emergency and the additional follow-up steps were established. Cotton swab sticks using in local hospitals for nasal smear in Korea were used for the verification. The measurement results of standard samples spiked with certified reference source were well agreed within ${\pm}20%$ compared with reference values. The clearance ratio of smear samples conducted with wet smear condition showed higher value. To eliminate the quenching effect of liquid scintillation samples, dry of smear samples should be followed up before counting samples. Based on the measurement results, medical decision levels and internal dose assessment were established for the victims in the beginning of radiation emergency.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.2
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• pp.27-36
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• 2018

Purpose: In the case of mass disaster, the establishment of temporary medical facilities for the first aid and treatment is required for the stable accommodation of patients caused by the disaster. However, the criteria for decision making related to the deployment of field emergency medical facilities are not specified. So, The purpose of this study is to draw considerable factors needed for the deployment of field emergency medical facilities and to make proposal for site selection process of field emergency medical facilities on the basis of the factor. Methods: This study performs text mining of disaster-related laws, guidelines and documents to derive key factors affecting site selection, also proposes a decision making process and conducts virtual deployment to validate the process. Results: The key factors for the site selection derived as the size of the damage, the size of the DMAT inputs, the location of available place, and distance to the disaster base hospital. As a result of virtual deployment following proposed decision making process, It is confirmed that the site of field emergency medical facilities is changed depending on the type of disaster, even if the scope of the disaster damage was the same. Implications: The deployment of field emergency medical facilities requires a separate criteria for each type of disaster, not uniform, as a future research a quantitative approach of the criteria needs to be performed.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.71-86
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• 2004

This study selected emergency medical technicians at 24 fire police boxes in Jeonnam in order to examine the relationship between job stress, fatigue and job satisfaction of 119 emergency medical technicians. Data were collected from Apr. 10 to May 9, 2004, questionnaires were mailed and returned by mail. Total 109 questionnaires were distributed and 89 questionnaires were collected and 80 except 9 omitting answers and showing inappropriate answers were used for final analysis. The results of this study are as follows. A. The total mean of areas composing job stress in the degree of job stress of 119 emergency medical technicians was over the average as 2.54 (SD .44) of 4 full marks. According to the degree of job stress by each area, the highest area of job stress was crisis situation (2.98), followed by role conflict as professional job (2.58), social factors (2.57), involvement in organization (2.55). To the contrary, the areas of the lowest job stress were professional knowledge and technique (2.35), psychological burden of medical limitation (2.38), conflicts in personal relationship and services (2.45) and improper treatment (2.53). B. The degree of fatigue of 119 emergency medical technicians by areas was over mean as 2.09(SD .49) of 4 full scores and physical fatigue was highest (2.18), followed by mental fatigue (2.11) and neurosensory fatigue (1.99). C. The degree of job satisfaction of 119 emergency medical technicians was 2.71 of 5 full scores and working condition area (3.70) showed the highest job satisfaction, followed by requirement of organization (2.85) and the lowest job satisfaction area was job itself (2.18), followed by desire for job (2.49). D. According to differences in demographical characteristics of 119 emergency medical technicians, there was no variable of statistical difference at job stress and job satisfaction in significance level .05, but fatigue showed statistical difference at final education (F=2.393, p=.046). E. According to differences related to job characteristics of 119 emergency medical technicians, job stress showed statistical differences at motif of current services (F=4.935, p=.003), fatigue showed those at health conditions (F=2.732, p=.008), job satisfaction at overtime (F=3.038, p.034) and the greatest reason of having job (F=3.217, p=.017), F. As a result of analyzing correlations between job stress. fatigue and job satisfaction of the subject, job stress showed positive correlations (r=.411, p=.000) with fatigue and negative correlation (r=-.267, p=.008) with job satisfaction. Fatigue showed negative correlation (r=-.287, p=.005) with job satisfaction. Therefore, the hypothesis of this study. "There will be relationship between degree of stress, fatigue and job satisfaction of subjects." was supported.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.190-197
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• 2013

Purpose: Trauma is one of the major cause of death in Korea. This study focused on the survival rate and the neurologic outcome for patients with traumatic cardiac arrest (CA) at one emergency center. Methods: We retrospectively reviewed the medical records of patients with traumatic CA who were seen at a regional emergency medical center from January 2010 to December 2011. From among major trauma patients at that medical center, adults older than 18 years of age who had CA were included in this study. CA included out-of-hospital CA with arrival at the Emergency Department (ED) within three hours and in-hospital CA. We checked the survival rate and the neurologic outcome. Results: A total of 61 patients were analyzed: 32 patients had return of spontaneous circulation (ROSC), 6 patients survived to discharge (survival rate: 9.84%), and 4 were still alive 90 days after discharge. The Cerebral performance category (CPC) scores at 6 months after discharge showed 1 good and 5 poor in neurologic outcomes. Factors such as initial rhythm of CA, part with major injury, Revised Trauma Score (RTS) and pH, were significant for ROSC, survival, and neurologic outcome in patients with traumatic CA. Conclusion: In this study, patients who had traumatic CA showed a 9.84% survival rate and a 1.64% good neurologic outcome. The results are poorer than those for CA caused by disease. Multi-center, prospective studies are needed.