• Title/Summary/Keyword: Emergency medical transport

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The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments

  • Jung, Hyemin;Do, Young Kyung;Kim, Yoon;Ro, Junsoo
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.309-316
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    • 2014
  • Objectives: This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits. Methods: We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions. Results: The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes. Conclusions: A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.

Implementation of the Smart Emergency Medical System (스마트 응급의료 시스템 구현)

  • Park, Hong-Jin
    • Journal of Advanced Navigation Technology
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    • v.15 no.4
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    • pp.646-654
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    • 2011
  • Recently, the task in which the number of people of the emergency medical technician whom it boards the ambulance is unreasonably insufficient and in which the fire fighter one person gets in the ambulance and which transfers the patient comes into question often. When the emergency patient is generated, it has to transfer to the special hospital in which above anything else, the measure which is quick and exact is needed and where there is the medical device which is suitable for particularly, the patient. This paper implementations the emergency medical system by the smart phone. The implemented system monitors the heart beat of the patient the monitoring among the patient transport with the real-time type. It can grasp the medical history information of the patient, and etc. in the past. And the system provides the emergency hospital which the patient requires and the pre-hospital phase provides the environment in which the disposition which is quick and efficient is possible to the emergency patient.

Multiple casualty disaster scene response management: a survey of 119 paramedics (119구급대원의 다수사상자 발생 재난 현장의 대응 역량에 관한 연구)

  • Lee, Hyo-Cheol;Kim, Jee Hee;Shin, Yo-Han;Kook, Jong-Won
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.73-85
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    • 2022
  • Purpose: The purpose of this study is to understand currently active Korean paramedics' disaster response abilities, including immediate response, severity classification, patient treatment, and patient transfer, in a disaster situation with multiple casualties. Methods: A structured questionnaire consisting of a total of 25 questions was used, including 5 questions on the subject's general characteristics and 20 questions on disaster-related emergency response abilities. Results: Among the disaster response abilities of the participants, the patient transport ability scores were high and the cooperative support ability scores were low. In terms of general characteristics, there was a significant difference in age, and it was high in the 40s, and there was a significant positive correlation between each competency. Conclusion: These results suggest that there is an urgent need to develop a systematic and specialized educational system with components inside and outside fire departments related to multiple casualty disasters to improve overall abilities.

A Study of Russian Patients' Satisfaction on Medical Tourism in Korea with Air Ambulance Service (해외 의료관광객의 Air Ambulance를 이용한 의료관광서비스 만족도에 관한 연구 : 러시아 이용객을 중심으로)

  • Kim, Pyung-Soo;Kim, Kee-Woong;Park, Sung-Sik
    • Journal of the Korean Society for Aviation and Aeronautics
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    • v.22 no.4
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    • pp.99-109
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    • 2014
  • Airline and medical industry in Korea have rapidly grown since 21st century. However, air ambulance service using an aircraft has not as popular as in Japan, Europe or United States. Central government has decided to start emergency helicopter service since 2011 to transport emergency patients transported in the past by fire fighter helicopter. Unfortunately, 32 OECD countries out of 33 have operated emergency aircraft system except Korea. There are more than 25 emergency helicopters in Japan, which can operate within five minutes. Such system could save a lot of social direct or in-direct cost by saving valuable lives of Japan citizens. This paper has tried to research the perception of overseas Russian medical tourists on using Air ambulance for their medical tourism to Korea. Researching air ambulance, this paper expects to find ways to enhance both medical tourism industry and airline, business jet industry. According to research results, it was proven that tangibility of medical tourism service has a positive effect on the human factor of air ambulance. The human factor has also a significant impact on the passenger comfortableness of air ambulance. Such comfortableness increases the overall satisfaction of medical tourism.

Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims? (응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가?)

  • Lee, Kyung Won
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.19-25
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    • 2007
  • Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools (예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석)

  • Kim, Yong-Joon;Sim, Kyoung-Yul;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.7-18
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    • 2022
  • Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

Influencing factors of the severity of occupational fall injury (직업손상과 관련된 추락환자의 중증도에 영향을 미치는 요인)

  • Ju, Jeong-Mi;Tak, Yang-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.113-125
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    • 2016
  • Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

Interhospital Transport System for Critically Ill Patients: Mobile Extracorporeal Membrane Oxygenation without a Ventilator

  • Yeo, Hye Ju;Cho, Woo Hyun;Park, Jong Myung;Kim, Dohyung
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.8-13
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    • 2017
  • Background: Extracorporeal membrane oxygenation (ECMO) has been successfully used as a method for the interhospital transportation of critically ill patients. In South Korea, a well-established ECMO interhospital transport system is lacking due to limited resources. We developed a simplified ECMO transport system without mechanical ventilation for use by public emergency medical services. Methods: Eighteen patients utilized our ECMO transport system from December 2011 to September 2015. We retrospectively analyzed the indications for ECMO, the patient status during transport, and the patient outcomes. Results: All transport was conducted on the ground by ambulance. The distances covered ranged from 26 to 408 km (mean, $65.9{\pm}88.1km$) and the average transport time was $56.1{\pm}57.3minutes$ (range, 30 to 280 minutes). All patients were transported without adverse events. After transport, 4 patients (22.2%) underwent lung transplantation because of interstitial lung disease. Eight patients who had severe acute respiratory distress syndrome showed recovery of heart and lung function after ECMO therapy. A total of 13 patients (70.6%) were successfully taken off ECMO, and 11 patients (61.1%) survived. Conclusion: Our ECMO transport system without mechanical ventilation can be considered a safe and useful method for interhospital transport and could be a good alternative option for ECMO transport in Korean hospitals with limited resources.

Chemical accident response competencies and educational needs of 119 EMTs (119 구급대원의 화학사고 대응역량 및 교육요구도)

  • Myeong-Hui Park;Seung-Eun Han
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.1
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    • pp.7-19
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    • 2024
  • Purpose: This study aimed to evaluate and assess the response capabilities and educational needs of 119 emergency medical technicians (EMTs) in chemical accidents. Methods: A self-reported questionnaire was completed by 167 119 EMTs between December 1st and December 31, 2023. The questionnaire comprised 8 questions on general characteristics, 2 on chemical accidents experienced by the participants, 29 on response capabilities, and 15 on educational needs. Data analysis was performed using t-tests, analysis of variance, Duncan's test for post-hoc analysis, and Pearson's correlation coefficient, using SPSS 27.0. Results: The participants scored 2.69 points on response capacity to chemical accidents. The EMT-Paramedics scored high in 'patient triage,' 'patient treatment,' 'patient transport,' and 'collaborative support' (F=3.924, p=.010; F=5.843, p=.001; F=3.698, p=.013; F=5.272, p=.002), followed by educational experience (t=-4.962, p<.001; t=-2.685, p=.008; t=-3.455, p=.001; t=-3.593, p<.001; t=-3.034, p=.003). The participants scored 4.19 points on educational needs, with high scores for 'patients treatment and transport' (4.280.93). The scores for 'patient triage competency', and 'patient triage' (r=.169, p=.024) correlated positively. Furthermore, the scores for 'patient treatment competency' and all sub-factors of educational needs (r=.185, p=.013; r=.215, p=.004; r=.199, p=.008; r=.190, p=.011; r=.197, p=.008) correlated positively. Conclusion: To strengthen the response capabilities of 119 EMTs, it is imperative to develop an educational program that focuses on first-aid responses.