• 한국지리정보학회지
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• 제10권1호
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• pp.113-123
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• 2007

본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

• 한국응급구조학회지
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• 제22권3호
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• pp.55-66
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• 2018

Purpose: This study was conducted to investigate the disaster response competencies of 119 emergency medical technicians (EMTs). Methods: The subjects of this study were 226 119 EMT's at the fire station located in G province. The questionnaire consisted of 5 sub-factors and 29 items for measuring disaster response competencies and the collected data were analyzed using SPSS program. Results: Disaster response competency comprising immediate response, patient triage, patient treatment, patient transport, and collaboration support were 3.48, 3.64, 3.52, 3.64, and 3.16, respectively. Advanced EMTs scored significantly higher in patient triage (p<.001), treatment (p<.001), and transport (p=.022) competency than basic EMTs. Conclusion: In order to improve disaster response competency, it is necessary not only to enhance individual ability but also to continue disaster management training with related organizations.

• 한국응급구조학회지
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• 제10권1호
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• pp.13-21
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• 2006

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.

• 농촌의학ㆍ지역보건
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• 제30권3호
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• pp.255-262
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• 2005

도서 지역이라는 울릉도의 특성상 응급 환자의 이송 수단으로 헬리콥터는 필수적이다. 울릉도 지역의 인구 분포의 변화가 고령화가 심화됨에 따라 헬리콥터의 이송 빈도는 더욱 증가될 것으로 예상된다. 그러나, 응급 환자 이송용 헬리콥터가 없어 이송 시간동안의 응급처치 등에 장애가 있으므로, 동해안에 환자 이송의 역할을 가진 헬리콥터의 배치가 필요하다고 생각된다. 아울러 최근 감소세에 들어섰던 울릉군 지역의 인구가 증가하고 있고, 독도 열풍에 따른 관광객의 증가가 현저하므로 그에 따른 울릉군의 적절한 보건 정책이 필요하다고 생각된다

• 한국응급구조학회지
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• 제20권1호
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• pp.71-82
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• 2016

Purpose: This research aimed to provide baseline data for undergraduate safety education by evaluating paramedic student risk perception and safety practice behavior regarding transport and disaster-related accidents. Methods: A total of 367 paramedic students at three different universities were surveyed using questionnaires. Risk perception questions about hazard, feeling of dread, and uncontrollable factors regarding seven items in transport and disasters were asked on a 7-point scale. Safety practice behavior consisted of 14 transport-related questions and 12 disaster-related questions in 4-point scale. All data were analyzed using SPSS Window 21.0. Results: Of 367 surveyed, 54.8% (201) were females, and 28.9% (106) were freshmen. In risk perception, 'drunk driving' in transport was the highest on average obtaining 6.49 points for hazard and 5.12 points for the feeling of dread. In disasters, 'war' recorded the highest average with 6.61 points for hazard and 5.71 points for the feeling of dread. In safety practice behavior regarding transport and disasters, a higher awareness of the need for safety education correlated with a significantly higher the rate of safety practice behavior (p <.001 respectively). Conclusion: The results indicate that undergraduates have inadequate perception of risk in emergencies. Safety education programs are needed to raise awareness of risks and to increase the safety practice rate.

• Journal of Trauma and Injury
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• 제19권2호
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• pp.159-163
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• 2006

Purpose: The number of patients transported by the Helicopter Emergency Medical Service (HEMS) has increased recently. In our review of the Korean HEMS, there was no established helicopter utilization criteria or triage tool on the scene, so many patients with minor injuries were transported to tertiary care centers. The aim of this study is to evaluate the percentage of patients with minor injuries and to propose a more appropriate triage tool for predicting the need for transport to a tertiary care center. Methods: The subjects of this study were 59 trauma patients transported to Asan Medical Center (AMC) from the scene by Seoul HEMS from January 2004 to December 2005. The Triage score (TS), Injury Severity Score (ISS), and modified Canadian Triage and Acuity Scale (mCTAS) were calculated as severity scales. Patients with minor injuries were defined as those with TS=9, ISS${\leq}15$, and mCTAS${\geq}3$. We evaluated the association of TS, ISS, and mCTAS with the appropriateness of transport. Results: Many of the patients transported to tertiary medical centers were classified as having a minor injury: TS=9 group 35 cases (72.9%), ISS${\leq}15$ group 30 cases (62.5%) and mCTAS${\geq}3$ group 27 cases (56.2%). However, 56.2% (27/59) of the patients were appropriately transported according to need for admission or an operation. The more severely injured patients classified by TS, ISS, and mCTAS were more appropriately transported to a tertiary center (p<0.05). Conclusion: Many patients with minor injuries were transported to a tertiary center from the scene directly. The TS can be easily calculated by an emergency medical technician at the scene. Thus, we propose the TS as a useful triage tool for determining the necessity of transport to a tertiary center by helicopter.

• 한국응급구조학회지
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• 제27권3호
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• pp.47-58
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• 2023

Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

• 한국응급구조학회지
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• 제9권2호
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• pp.29-38
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• 2005

The purpose of this study was to provide the basic data for improvement of Emergency Medical Service System in Kwangju. The EMSS can be defined as the complete chain of human and physical resources that provides patient care in cases of sudden illness and injury. To provide effective emergency care through the EMSS in a region, the issue of training especially as it relates to EMT in EMSS delivery is more important than emergency medical equipment and facilities for pre-hospital emergency care. The transport of emergency medical patients carried out almost by 119 Emergency Medical Services. But out of all the employees at 119 EMS only 19.0% have graduated with a major in Emergency Medical Technology. It would seem prudent then that the graduates of EMT programs should gradually replace employees working at 119 EMS that do not have an EMT degree to ensure the best possible pre-hospital care for emergency medical patients. Therefore it can be expected that in the future there should an enormous demand for qualified EMT professionals to meet the growing needs for a superior level of emergency medical care for civilian.

• 한국화재소방학회논문지
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• 제29권5호
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• pp.96-103
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• 2015

본 연구에서는 한국보건사회연구원과 국민건강보험공단의 한국의료패널 2008~2011년 연간 데이터(Version 1.0)을 이용해 노인의 구급 이송 서비스 이용 특성과 관련 요인을 파악하였다. 분석 결과를 요약하면, 첫째, 119 구급차, 민간 구급차 등의 구급 이송 서비스를 이용한 노인은 전체 이용자의 46.8%를 차지하며, 응급실을 방문한 노인의 35.1%가 구급 이송 서비스를 이용했다. 둘째, 노인의 구급 이송 서비스 이용은 성별 중 남성(OR = 2.19, 95% CI = 1.51~3.17), 가구주와의 관계 중 배우자(OR = 2.19, 95% CI = 1.45~3.32), 의료 보장 형태 중 의료 급여(OR = 1.41, 95% CI = 1.10~1.82), 장애가 있는 경우(OR = 1.44, 95% CI = 1.14~1.83), 응급실 방문 이유 중 사고/중독(OR = 1.53, 95% CI = 1.20~1.97), 응급실 이용 후 조치 중 입원/전원(OR = 3.45, 95% CI = 2.80~4.25)이 통계적으로 유의한 영향 요인으로 나타났다. 따라서 고령화 시대에 노인 인구의 증가는 구급 이송 서비스의 수요 급증으로 이어질 것이며, 이에 따른 노인 맞춤형 응급의료 서비스 등의 개발이 필요하다.

• 한국응급구조학회지
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• 제11권1호
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• pp.53-64
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• 2007

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.