• Health Policy and Management
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• v.28 no.4
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• pp.411-422
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• 2018

Background: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. Methods: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ${\geq}15years$. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). Results: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. Conclusion: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.

• Journal of Digital Convergence
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• v.18 no.11
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• pp.293-301
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• 2020

The study was conducted to investigate and identify safety awareness and traffic accident relation. Data collection used raw data from the 6th year(2014) to the 7th year(2017) of the National Health and Nutrition Survey. Subjects of the study were conducted on 421 people with experience in traffic accidents and the analyzed using the SPSS/WIN 23.0 program. Data analysis determined safety awareness and traffic accident using frequency and ratio, Chi-Square, and logistics return analysis. The more Basic Living Allowance, the more do not Seat belts in the front seat of the car, the more Professional are related to traffic accidents. It is expected that this will contribute to making basic data for future studies related to reduction of traffic accident patients.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.113-123
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• 2019

Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.

• Journal of Medicine and Life Science
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• v.18 no.1
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• pp.20-23
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• 2021

Methemoglobin is generated by the oxidation of ferrous iron to ferric iron within a hemoglobin molecule. Methemoglobin is unable to bind and transport oxygen, resulting in methemoglobinemia, which can lead to fatal tissue hypoxia. The most common cause of methemoglobinemia is poisoning by oxidizing agents such as dapsone, benzocaine, and primaquine. However, methemoglobinemia can also be caused by normal dietary sources. We present two cases of methemoglobinemia that developed after a normal diet in two male patients. In this case report, the patients suddenly developed dyspnea and cyanosis after eating the same meal. They had no history of suspected poisoning, such as the use of drugs, exposure to chemicals, or gas inhalation. Their symptoms did not improve even after a high dose of oxygen was administered; further, an abnormal 'oxygen saturation gap' was observed. Because of CO-oximetry, the methemoglobin levels of the patients were 50.0% and 46.6%, respectively. We administered methylene blue (1 mg/kg), and the patients recovered completely without any complications. Emergency physicians should, therefore, be aware that methemoglobinemia can also be caused by normal dietary sources. In addition, if the source and route of contamination are unclear, an epidemiological investigation should be conducted.

• Journal of Radiation Protection and Research
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• v.39 no.1
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• pp.46-53
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• 2014

For the case of radiation emergency, it is required to assess internal contamination of the public, including children as well as adults. The objective of the present study was to assess counting efficiency of a whole body counter by human body size and standing position of the measurement person. In this study, the FASTSCAN whole body counter used at National Radiation Emergency Medical Center of Korean Institute of Radiological and Medical Science was simulated by a radiation transport computer code. The simulation results of the counting efficiencies agreed well with measurements within the 2% of discrepancy for 4-year child and 5% for adults. The standing positions of the people were adjusted by body size to find the consistent trend of the counting efficiencies by human body size. Body size scaling factors of the whole body counter were derived to consider human body size and improve the measurement accuracy. The counting efficiency assessment methodology in this study can be successively used to improve the measurement accuracy when using a whole body counter for the case of radiation emergency.

• Fire Science and Engineering
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• v.28 no.4
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• pp.81-88
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• 2014

This study identified the complaint ratio of musculoskeletal symptom by 119 EMTs and investigated the work risk extent through ergonomics evaluation about the patient transport works, which cause work-related musculoskeletal disorders (WMSDs) to 119 EMTs. For this, the complaint ratio of musculoskeletal symptom utilized questionnaire tool based on KOSHA Code H-30-2008 and the risk extent about the patient transport work evaluated by using ergonomics evaluation tools such as OWAS, RULA and REBA. According to the study result, 60.9% of 119 EMTs experienced musculoskeletal symptom. Among them, the symptom on back was the most common (36.1%). The work, which mostly causes WMSDs, has been found as patient transport work (48.4%). Among the patient transport motion, loading/unloading of ambulance cot to/from ambulance and the lifting of patient by stretcher were OWAS risk-level 3 and RULA/REBA risk-level 3 to 4. Among the patient transport environment, carrying patient on stairway using emergency mini-stretcher, moving patient in vehicle using spine board and piggy-back carrying or cradle carrying patient on stairway or slope way were OWAS, RULA, REBA risk level 3 to 4. It is suggested that immediate improvement in work postures for these works should contribute to prevention against WMSDs to 119 EMTs.

• Neonatal Medicine
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• v.18 no.1
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• pp.137-142
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• 2011

Purpose: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. Methods: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. Results: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. Conclusion: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.

• 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.

• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.209-233
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• 2018

The purpose of this study was to ascertain whether or not to recover the spontaneous circulation of patients with cardiac arrest before arrival in the emergency room for 5 years (2012 to 2016), and try to investigate the factors affecting this. In this research, we used the "raw material for acute cardiac arrest survey" conducted in "Disease management headquarters" from 2012 to 2016 for the whole country of our country as the main material. In this study, 136,212 cardiac arrest patients were analyzed in the study data of the cardiac arrest in the country during the 5 years from 2012 to 2016. We performed a Chi-square analysis to analyze the recovery of spontaneous circulation before arrival in the emergency room according to general characteristics, social·demographic characteristics, and developmental characteristics. and We performed a Binary logistic regression analysis to determine the factors affecting the recovery of spontaneous circulation. The analysis results of this study show that whether CPR sustained transport before endoplasmic reticulum arrival, whether to witness an acute cardiac arrest before arrival in the emergency room, the type of general cardiopulmonary resuscitation, the location of acute cardiac arrest, the acute heart Causes of stoppage cause factor of whether spontaneous circulation recovery recovers before arrival of the endoplasmic reticulum(P<0.001, P<0.01). Therefore, it is necessary to strengthen systematic government health policy implementation and dissemination and health education focusing on factors that affect recovery of spontaneous circulation of cardiac arrest patients.

• Fire Science and Engineering
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• v.32 no.3
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• pp.116-122
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• 2018

In Chemical, Biological, Radiological and Nuclear (CBRN) disaster, integrated and optimized equipment package including stretcher, isolation unit, patient monitoring and treatment equipment is essential to achieve proper treatment and prevent secondary contamination. The purpose of this study was to evaluate the efficiency and ease of use of integrated CBRN disaster equipment package for disaster medical response. This study was a randomized crossover study using a manikin simulation for emergency medical technitian (EMT). All participants used the existing devices and prototype of integrated CBRN disaster equipment package alternately. Efficiency was measured by time from vital sign change to detection or treatment application. Ease was use was measured by questionnaires for each patient monitor, stretcher care and isolation unit. 12 EMTs were enrolled. hypoxia-detection time of integrated equipment group was significantly shorter than existing equipment group (4.9 s (3.8-3.9) vs 3.5 s (2.5-3.9), p < 0.05). There was decreasing tendency of ECG change detection and facial mask oxygen supply but no statistical significance was observed. Overall satisfaction of patient monitoring device in integrated equipment group was significantly higher than existing devices (4(3.5-5) vs 3(3-3), p < 0.05). The use of integrated CBRN disaster equipment package shortened the hypoxia detection time and improved usability of vital sign monitor compared to existing devices.