• 한국응급구조학회지
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• 제13권3호
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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.

• 보건행정학회지
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• 제34권1호
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• pp.17-25
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• 2024

연구배경: 본 연구의 목적은 17개 광역시·도 내 응급의료병상 적정 분배수준과 분배수준에 따른 경제적 편익을 추정하기 위함이다. 방법: 각 지역별 응급의료병상의 적정 분배수준을 추정하기 위하여 통계청에서 발표한 '2014-2021년 사망원인통계자료', '지역·인구·성별·연령에 관한 지역통계' 그리고 '장래인구추계'를 활용하였으며, 추가적으로 건강보험심사평가원에서 발표한 '시군구별 응급실 병상 수' 자료도 활용하였다. 또한 응급의료시설 증가로 인해 감소된 예방 가능한 응급사망자들의 경제적 편익을 추정하기 위해 한국개발연구원과 한국교통연구원의 지침을 참고하여 응급사망에 따른 임금 손실비용을 계산하고 적용하였다. 결과: 응급의료병상의 적정 분배량은 경기, 서울, 경남, 경북, 부산 순으로 높았고 대전, 제주, 세종은 상대적으로 낮은 수준을 보였다. 또한 응급의료시설 증가로 인한 경제적 편익은 경기, 서울, 경북, 경남, 부산에서 가장 높은 것으로 분석되었다. 한편, 17개 광역시·도별 인구표준화를 통해 계산한 경제적 편익은 경북, 충남, 전남, 경남 그리고 부산 순으로 높은 것으로 분석되었다. 결론: 본 연구결과는 향후 지역별 적정 응급의료시설 분배를 위한 기초자료로 활용될 수 있으며, 지역 간 응급의료시설 공급의 불균형을 해소하기 위한 정책에 기여할 수 있다. 또한 지역 특성을 감안하여 응급의료시설의 분배수준을 조정하는 것은 궁극적으로 국가 재정의 효율성을 증가시키고 경제적 편익을 얻을 수 있을 것으로 판단한다.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.

• Journal of information and communication convergence engineering
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• 제20권3호
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• pp.204-211
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• 2022

This study evaluated the completeness of patient care report (PCR). A retrospective quality analysis was conducted using raw data of 122,140 EMS activity reports prepared by paramedics in Gyeonggi-do from April 1 to May 31, 2021. In all, 67,830 cases of normal transfers were statistically analyzed using IBM SPSS Statistics version 22, and statistical significance was set at p<0.5. The 119EMT_2 certificate was omitted in 50,037 (73.8%) cases, followed by time-related items in 1,227 (1.8%) cases. In the primary assessment of vital signs, systolic blood pressure was omitted and erroneous in 1,218 (1.9%) and 1,129 (1.8%) cases, respectively. In the secondary assessment, the completeness of all vital sign items was approximately 70%. Advanced emergency care and online medical control (OLMC) reporting showed discrepancies in all items. As the severity of the patient's condition increased, the errors in the Patient care report (PCR) also increased, at a significant level (p= .00). Paramedics must be aware of the importance of completing the activity report.

• 한국화재소방학회논문지
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• 제32권4호
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• pp.122-130
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• 2018

최근 도시화 및 인구의 밀집화는 전 세계적인 기후변화의 영향과 더불어 재난의 대형화 및 복합화를 유발하고 있다. 그러나 국내의 경우, 재난발생에 대하여 예방, 구조, 복구에 중점을 두고 있으며, 재난 시 생명유지에 절대적으로 필요한 재난의료는 외면되고 있는 실정이다. 따라서, 본 연구에서는 침수피해가 빈번하며, 지하주택이 밀집되어 피해가능성이 크다고 판단되는 서울시를 대상으로, 침수이력지역의 지하주택을 응급환자 발생지로 가정하고 이송거리 및 이송시간을 분석하였다. 본 연구는 응급의료시설과 재난발생지로의 접근성과, 구급대로부터 재난발생지로의 접근성을 함께 고려하여 응급의료서비스 개선의 기초자료로써 의의가 있다고 판단된다.

• 성인간호학회지
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• 제12권4호
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• pp.641-653
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• 2000

A quantitative descriptive survey was conducted to assess the needs of elderly people in relation to accessibility of medical care. Identifying their functional status was done and accessibility of medical care was ascertained. Using a convenient sampling method, 856 elderly aged 65 and over in Taejon-city participated. A multi-dimensional questionnaire containing sections on health status, Activities of Daily Living(ADLs) and accessibility of medical care in terms of use, time, distance, transport, cost and feeling at ease was developed by the researchers of this study to collect data. Data were collected between October and December, 1999. In general, the result of the self-reports from this study found that approximately 40% of participants had difficulties with their health status and ADLs while about 45% of the population did not access medical care. The majority of respondents stated that they had no difficulties with time distance and transport to access medical care. About two-thirds of the respondents felt that they had many or some difficulties with expenses and strategies for emergency to access medical care. Even though these findings need to be generalized, several recommendations for appropriate medical care delivery for the elderly still can be outlined from the study findings. Recommendations suggested are: To identify impediments to access medical care in emergency in elderly people and to remove those factors preventively are required. Responsible governmental involvement for solving problems of the medical care cost and additional costs in relation to separation of dispensary from medical practice for the elderly is required. More constructive and practical uses of public health community centers are recommended.

• 한국화재소방학회논문지
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• 제24권2호
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• pp.154-161
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• 2010

각종 질병, 사고 및 재해로 인한 응급환자에게 현장응급처치를 시행하고 의료기관 이송업무를 수행하는 119구급대원이 정당한 직무수행과정에서 폭행피해를 당하는 일이 발생하고 있다. 병원 전 단계에서의 구급대원이나 응급의료센터에서 의료진을 폭행하는 가해자의 특징은 음주상태인 연령 30~40대의 남성이라는 점, 환자본인과 가족이나 동료와 같은 보호자에 의한 경우가 많고, 주로 야간시간에 발생하고 있다. 응급의료센터에서는 청원경찰 등의 안전요원을 24시간 배치하고, 관할 경찰지구대와 직통 연락망을 설치하는 등 응급실 난동 및 폭행과 같은 비상사태에 대비하고 있다. 하지만, 소방은 녹음기를 지급하고, 구급차에 녹화장치를 설치한 것 이외에는 별다른 대처방안조차 마련되어 있지 않다. 본 연구에서는 119구급대의 폭행피해실태 및 사례를 기초로 공무집행방해죄에 대한 법리와 별도 처벌조항의 신설 필요여부 등에 대하여 살펴보고, 119구급대의 폭행피해 예방 및 대응방안에 대하여 논하고자 한다.

• 대한임상독성학회지
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• 제8권2호
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• pp.69-78
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• 2010

Purpose: The living standards vary between the urban and rural areas in Korea. This study aims to compare the characteristics of acute poisoning victims in urban and rural areas. Methods: A retrospective study was conducted over a period of 2 years from 2008 to 2009. The study group included adults over 19 year old with acute poisoning and who were later were admitted to the local emergency medical center located in Daegu, Korea. The exclusion criteria were 1) the victims of adverse effects of therapeutic doses of drugs, 2) the victims with chronic exposure and 3) the victims who were missing data in their emergency medical records. We divided the victims into the adult group (19-64 years old) and the old group (over 65 years old). Results: There were 569 acute poisoning victims during the study period, and they constituted 1.11% of the total ED visits (51,199). Four hundred seventy six patients were enrolled in this study. Out of the 359 acute poisoning victims, 252 victims were from urban areas and 107 victims were from rural areas. They showed statistical differences for gender, ED access, transport, toxins and the time to the ED. In the old group, 61 victims out of 117 were from urban areas and the remaining 56 victims were from rural areas. They showed statistical differences for gender, ED access, toxins and transport. Conclusion: Through the clinical comparison between the acute poisoning victims of urban and rural areas, we exposed the clinical differences between the urban and rural areas, and we concluded that prevention and education for acute poisoning should be generated differently between the two groups.

• 한국응급구조학회지
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• 제24권2호
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• pp.39-50
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• 2020

Purpose: This study aimed to compare the effect of chest compression and the resulting ventilation volume in walking cardiopulmonary resuscitation (CPR), straddling CPR, and mechanical CPR while moving manikins to main stretchers. Methods: We compared the chest compressions in terms of compression depth, number of incomplete releases, complete release depth, compression rate, duration between peak time of previous compression and peak time of current compression, and respiration. We analyzed the compression comparatively with the ventilation volume in three different types of CPR. Results: The chest compression depth was significantly improved during straddling CPR as compared to walking CPR, during which women were unable to achieve sufficient chest compression depth. A constant chest compression depth was maintained during mechanical CPR. Conclusion: High-quality chest compressions were difficult to achieve in moving spaces. Further, walking CPR may be helpful in men, but straddling or applying automatic chest compressions in women would result in more effective CPR. Our findings demonstrate the limitations and trends in administering CPR in men and women, which may be useful in devising better education and training methods in the future.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2021년도 추계학술대회
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• pp.167-169
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• 2021

충청남도 도서지역에 주민들이 정기적으로 이용할 수 있는 공공의료시설은 보건진료소 14개, 건강생활지원센터 1개, 병원선 1척이 전부이며, 이러한 시설과 장비로는 중증외상, 뇌혈관·심혈관 질환 등의 응급환자 발생 시 효과적으로 대응할 수 없다. 가장 신속한 응급환자 이송 수단은 단국대학교병원(천안시 소재)에 배치된 닥터헬기를 이용하는 것이다. 그러나 배치된 닥터헬기는 1대 뿐이고, 야간에는 운항을 할 수 없으며, 충청남도 전 지역을 담당하므로 다수 환자 발생 시에는 신속한 이송에 한계가 있다. 따라서 4차 산업의 한 분야인 도심 항공 모빌리티(UAM) 산업과 도서지역 응급환자 이송체계의 문제점을 보완하는 '충남형 닥터UAM 개발'의 필요성을 검토하고자 한다.