• Title/Summary/Keyword: Emergency medical dispatch

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An Analysis on the Prehospital Care of 119 Emergency Medical Service squads in Gyeonggi Area and Improvement Methods - Focusing on Prehospital Care - (경기도지역 119안전센터의 구급활동 현황과 개선방안 - 현장 응급처치 내역을 중심으로 -)

  • Choi, Keun-Myung
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.3
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    • pp.55-69
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    • 2008
  • Purpose : The purpose of this study was to analyze the prehospital care report prepared by EMS squads of 119 center in Gyeonggi area and to identify the status of prehospital care activities, problems and improvement possibilities of the emergency care. Method : Five hundred copies of prehospital care report prepared by EMS squads in thirty-eight 119 centers under 18 fire stations in Gyeonggi area from March to April in 2008 were randomly chosen for the analysis. Data abstracted according to the purpose of the study were input and the analysis of prehospital care activities were performed using SPSS-WIN(ver. 16) statistics package. Results : 1. Total 500 cases of prehospital emergency care activities were reviewed. By sex, females were 219 (43.8%) and males were 281 (56.2%). The places of reporting were home (57.8%). According to the type of emergency, 281 cases (56.2%) were caused by disease and 291 (43.8%) were from other causes such as traffic accidents or incidental injuries. 2 The average time needed for the 119 EMS squad to arrive at the scene after being reported was 7.29 minutes. The time used at the scene for the emergency care was 7.3 minutes in average and the time to arrive at the hospital was 25.4 minutes in average. 3. In patient evaluation, in 68% of the cases more than two vital signs were measured at one time and emergency patients were 31%, and non-emergency patients were 69%. 4. In one EMS activity, average 2.15 cases of emergency care were provided to a patient. The cases where two kinds of emergency care were given were 14.4%, which is the most frequent cases. When reviewing the details of the emergency cares given to the patient including multiple cares, trivial cards (taking it easy and giving comfort) were the most frequent one as 40.6% and the medical direction of the doctor was given in only one case out of 500 cases. 5. In patient evaluation and emergency care, vital signs were provided to emergency patients at significantly higher rate comparing to the non-emergency patients. The number of emergency care performance was significantly higher in emergency cases. In emergency dispatch, the cases that EMT (1st class) was on board was 86.2%. When comparing the cases when the 1st class EMT was on board and otherwise, the cases with the presence of 1st class EMT showed more vital signs were detected but there was no significant difference in the number of emergency cares provided. Conclusion : It seemed that the on-scene emergency care did not satisfy the expectations. So it is necessary to enforce the cooperation between the elements, the qualifications of the 119 EMS squads and to improve the prehospital working environment in order to provide the better medical service at any time.

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The Effect of Job Stress of 119 Paramedics on Job Satisfaction : city of ChungCheong center area

  • Kim, Jun-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.10
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    • pp.159-168
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    • 2020
  • The purpose of this study is to confirm the general characteristics of 119 paramedics who are treating early emergency patients and to confirm the relationship between job stress and job satisfaction and to examine the effect of stress on satisfaction, a questionnaire survey was conducted on 365 paramedics in four Chungcheong provinces. The reliability of the job stress tool was Cronbach α = .87. The job satisfaction tool was Cronbach α = .84. The collected data were analyzed by SPSS WIN 18.0 program. There were differences among the sub - variables of general characteristics, but the general characteristics excluding academic ability were less correlated with job stress, and job satisfaction was higher when the subjects' age, number of dispatches and field hours were smaller. Job stress was found to be low when stress was high on first aid, dispatch, transport, medical guidance, conflicts and emergencies excluding partners. To reduce job stress of 119 paramedics, it is recommended to provide institutional support and education to improve the ability to recruit new emergency personnel and to provide emergency medical care and guidance because of diversification of dispatch methods and appropriate stress management.

A Study on Lawsuit Cases and Measures of Emergency Medical Service (응급의료서비스 중 발생되는 소송사례와 대책 연구)

  • Kwon, Hay-Ran
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.77-90
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    • 2009
  • Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

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Use of Defibrillator(AED) on Prehospital Cardiac Arrests (심정지 환자 이송 시 구급대원의 자동제세동기 사용현황)

  • Koh, Bong-Yeun;Choi, Yong-Chul;Lee, Jae-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.2
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    • pp.53-62
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    • 2006
  • Purpose: There has been an increase in the number of prehospital cardiac arrests due to the increasing number of cardiovascular diseases and the increase in the average age of the population. We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrests. Methods: This studied 159 victims with prehospital cardiac arrests(VF or VT rhythm) by EMT's Reports from January to August, 2005. Results: 108 of 159 victims(67.9%) were shocked by AED. Eighty of 159 victims(50.9%) were recorded with AED shock in prehospital cardiac arrests. A number of shocks is averaged 2.19; 46.2% of one-shock and 86.1% of 1-3 shock. EMS first-tier response interval from time of dispatch to scene arrival was 5.88 minutes, from scene arrival to scene start was 7.36 minutes, from scene start to hospital admission was 9.91 minutes and from scene arrival to AED shock was 6.84 minutes. EMT provided advanced care to prehospital cardiac arrests: 97.5% in CPR, 10.1% in advanced airway management, 67.9% in AED shock. Conclusion: With the increase in cardiovascular disease and old age, the number of prehospital cardiac arrests has risen gradually. However, there were lack of CPR by bystander, defibrillation and advanced cardiac life support(ACLS) in prehospital stage. To improve the adequacy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

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Analysis of Predicted Instructions about Shockable Cardiac Arrest Patients by Dispatcher at 119 Emergency Situation Management Center (제세동이 가능한 심정지 환자를 119구급상황관리센터 상황요원이 예측한 지령 분석)

  • Jeong, Eun-Kyung;Jeong, Ji-Yeon
    • Fire Science and Engineering
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    • v.27 no.6
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    • pp.122-128
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    • 2013
  • This study analyzed the emergency activity daily reports and emergency instruction sheets of the research subjects and proceeded with the shockable cardiac arrest cases transported to 119 emergency units for two years before the hospital from January 1, 2010 through December 31, 2011. The most frequently predicted instruction by the dispatchers at the 119 Emergency Situation Control Center was 74 cases of fainting (33.3%). Among varied types of predicted instructions, 112 cases (50.5%) like fainting, chest pain, general prostration and others were not able to be predicted while predictable instructions involved with cardiac arrest such as consciousness disorders, difficult breathing, cardiac attacks and convulsion were 110 cases (49.5%). In such cases, success rates of cardiopulmonary resuscitation (CPR) trials by eyewitnesses at predictable instructions involved with cardiac arrests were significantly higher. As mentioned, situation agents must categorize types of cardiac arrests accurately by posing questions over assessments regarding patients' consciousness and respiration in detail. The patients categorized by such methods must guide eyewitnesses to be able to do CPR. Moreover, not only emergency medical technicians who receive predictable instructions involved with cardiac arrests given by dispatchers (49.5%) but also filed emergency medical technicians who are not able to reach a precise conclusion to non-cardiac arrests on unpredictable instructions on cardiac arrests (50.5%) must prepare for situations related to cardiac arrests before being dispatched to the field.

A survey on job stress, ego-resilience and incident impact on firefighters (소방공무원의 직무스트레스, 자아탄력성 및 사건충격 정도 실태 조사)

  • Cha, Jin-Gyung;Choi, Uk-Jin;Bang, Sung-Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.49-60
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    • 2019
  • Purpose: This study was conducted to analyze job stress, ego-resilience, and results of the impact of event scale in order to verify the actual job stress of firefighters and provide baseline data for developing resolution programs. Methods: Data were collected via e-mail from 270 firefighters working at 119 safety centers and firehouses in the regions of Gyeonggi, Chungcheong, Busan, and Gyeongsang-do between the $1^{st}$ and $30^{th}$ of July, 2017. Results: Regarding gender differences in job stress, women ($2.16{\pm}0.65$) showed statistically significant job stress compared to men ($1.93{\pm}0.57$). As for the results of the incident impact of event scale statistically significant differences were observed (p=.001), and ego-resilience in men ($4.15{\pm}0.54$) was significantly higher than that in women ($3.79{\pm}0.75$) (p=.006). Depending on the work period, there were statistically significant differences (p=.000) in job stress, ego-resilience (p=.002), and impact of event scale (p=.000). Conclusion: Since job stress, ego-resilience, and results of the impact of event scale were closely related to dispatch frequency and work period of the firefighters, detailed and continuous stress management programs that consider these factors need to be developed.

A Study on the Public-Private Partnership in the Emergency Medical System in Korea (한국응급의료서비스 민관파트너십 도입의 타당성에 관한 연구)

  • Kim, Kook-Rae;Kim, Tae-Yun
    • Fire Science and Engineering
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    • v.20 no.2 s.62
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    • pp.31-43
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    • 2006
  • In Korea, the Emergency Medical Service, EMS is provided by Fire Services with 119 EMS and all the public uses the service for free. Although it appears very successful and is respected nationally, structural problem EMS exist and are worsening. First of all, the "free riding effect" becomes increasingly problematic. Some argue that 30% of the demands is not urgent or emergent. The total number of demands is increasing even without the free riding effect. The Current EMS system itself cannot meet the increasing EMS demand. The medical aspect is so poor that the EMS cannot dispatch a medical specialist to the scene. The cardiac arrest resuscitation rate is only $1.24{\sim}9.9%$, compared to 40% in Boston, MA, USA. But due to the regulations and limitations of the Fire Service organization, it is difficult to secure enough EMS resources. To work out these problems, it needs a structural innovation. To secure enough resources and achieve higher medical performance we should invite the medical sector and the private sector into EMS arena by contracting partnerships with Fire Services and charging a reasonable EMS fee. We found through statistical test that any partnership system is more effective than fire-alone system and most countries around the world have partnership system rather than fire-alone system.

Analysis of characteristics of out-of-hospital cardiac arrest patients by region in Chungcheong buk-do (충청북도 내 지역별 병원 전 심장정지 환자의 특성에 대한 분석)

  • Seong Bin Im;Hyeon Mo Yang;Young Jae Kim
    • Smart Media Journal
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    • v.13 no.5
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    • pp.33-44
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    • 2024
  • Chungbuk has various regional characteristics in terms of population composition by region, industrial facilities, and distribution of emergency medical institutions. However, there are no studies yet that have analyzed regional characteristic factors related to the occurrence characteristics of cardiac arrest patients. Therefore, this study provided basic data to establish a response system for OHCA patients suitable for the characteristics of the Chungcheongbuk-do region by analyzing the characteristics of OHCA patients and the transfer status of 119 paramedics in Chungcheongbuk-do. This study is a retrospective study that analyzed 1,188 cardiac arrest patients transferred by ambulance based on raw data from the survey on acute cardiac arrest in Chungbuk (2020). There are a total of 11 emergency medical institutions in Chungbuk-do, which are concentrated in city-level areas, so the transfer time of patients to hospitals in county-level areas was delayed. In the county-level area, the frequency of dispatch of special paramedics was relatively small, and the frequency of administration of cardiac arrest drugs to help resuscitate cardiac arrest patients was also low. In conclusion, efforts should be made to improve accessibility of emergency medical services (deployment of emergency vehicles in marginal areas, proper placement of emergency medical institutions, etc.), to promote prevention of traumatic cardiac arrest patients, and to expand the scope of work to strengthen the first aid expertise of paramedics.

The Regional Characteristics of 119 Ambulance Dispatch, the Distance and Response Time to the Scene (119 구급서비스 지역별 출동특성 및 출동거리와 현장도착시간과의 관계)

  • Lee, Kyoung-youl;Moon, Jun-dong;Choi, Eun-sook
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.482-492
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    • 2016
  • Purpose This study is to investigate regional characteristics of 119 ambulance dispatch and the relationship between the distance and response time to the scene. Methods This study was retrospectively conducted 119 running sheets with 1,321 patients who had been transferred to the hospital by 119 ambulance during ambulance attendant training. The training was performed at two, five and three fire station in Seoul, Daejeon and Chungnam respectively, from June 24, 2013 to July 19, 2014. Results Almost the emergency medical services provided were no more than basic first aid in all regions. The patients transferred by 119 ambulance in Seoul were more than other region. The time of call to scene and scene to hospital were the slowest in Chungnam. The major reason of call 119 was due to disease in Seoul and Daejeon, however due to injury in Chungnam. Conclusion Our study suggests that learning from ambulance attendant training course could diverse from region to region. It is, therefore, needed that standardization of ambulance attendant training course, appropriate logistics and resource allocation for providing universal quality of emergency medical services.

Duty-related incidental stress and the coping method in new firefighters (신임 소방대원의 직무관련 출동 스트레스와 대처)

  • Baek, Mi-Lye
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.53-62
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    • 2014
  • Purpose: This study aimed to investigate duty-related incidental stress, coping method, and stress factors in 133 new firefighters. Methods: A self-reported questionnaire was administrated to 133 new firefighters between April and May 2010. It consisted of 33 and 62 items concerning duty-related incident stress and coping methods, respectively. Data were analyzed by using the t-test, analysis of variance, Pearson correlation coefficient analysis, and multiple regression analysis. Results: New firefighters experienced the most stress when inappropriately dispatched. Duty-related incidental stress correlated with active (r = .420, p < .001) and passive coping (r = .450, p < .001). Also active coping statistically correlated with passive coping (r = .890, p < .001). Influencing factors of duty-related incidental stress were passive coping (t = 2.12, p < .05), experience of having a co-worker in a dangerous situation (t = 3.30, p < .001), having less than 6 months of work experience (t = 2.30, p < .05), and experience of having oneself in a dangerous situation (t = 2.05, p < .05). Conclusion: New firefighters need to be provided with training on active coping to prevent posttraumatic stress disorders and, social support immediately after an inappropriate and stressful dispatch.