• 한국응급구조학회지
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• 제16권3호
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• pp.9-18
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• 2012

Purpose : The purpose of this study was to determine the changes that occur due to the real-time monitoring of paddle pressures which has an important influence on the defibrillation success rate in defibrillation treatment known as the only treatment for cardiac arrest patients with VF. Methods : 40 people participated in the cardiac arrest simulation training and played the role of the defibrillation operator. Investigators measured the pressure of paddle while defibrillating by using instrument which was developed by the investigator. Results : Through real-time monitoring of the paddle pressures of defibrillator by indicator, the front sternum paddle showed a 77.5% success rate and the apex paddle showed a 40% success rate. While the values without monitoring the paddle pressures, the front sternum paddle showed a 51% success rate and the apex paddle showed a 20% success rate. These experiment revealed statistically significant(p <.001) low success rate. Conclusion : The method of monitoring the paddle pressures during defibrillation showed that the paddle can be precisely gripped. The success rate of paddle pressures is significantly correlated with height, weight and grip strength.

• 한국임상보건과학회지
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• 제7권1호
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• pp.1215-1223
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• 2019

Purpose: This study is to figure out not only the characteristics relating to transfer time of inter-hospital transfer patient which is transferred by a private ambulance, but also factors influencing the transfer time. Methods: In this study, an analysis of 750 patients with high severity levels among those transferred to another hospital by a private ambulance in Busan for whole year of 2017. Results: The results showed that the following factors significantly influence the total inter-hospital transfer time: Ambulance crew (${\beta}=10.525$, p=.001) and patient and carer (${\beta}=37.606$, p<.001) when setting a doctor (selecting a medical institution) as a criterion; availability of the specialized care (${\beta}=12.435$, p=.008) when setting the near distance (reason for selecting a hospital for transfer) as a criterion. The explanatory power of this analysis was R2=0.423, whereas the explanatory power of calibration was R2=0.411. Conclusions: Factors that increase the total inter-hospital transfer time were the ambulance crew, and patient and carer's selecting a medical institution, and the reason for selecting a hospital where enables to offer the specialized care services.

• 대한임상독성학회지
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• 제15권2호
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• pp.116-121
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• 2017

Purpose: The aim of this study was to compare the toxicologic profiles and outcome of poisoned patients by comparing the data obtained through telephone counselling, each provided by emergency medical information center (1339) and emergency dispatch center (119). Methods: We analyzed the telephone-based poison exposure data before and after Seoul 1339 merged to 119. We compared the Seoul 1339 call response data in 2008 with Seoul and Busan 119 call response data between 2014 and 2016. We analyzed the changes in the trend and quality of data obtained, as well as the quality of service provided by each center before and after this reallocation, by comparing the data each obtained through telephone counselling. Results: The data was collected for a total of 2260 toxin exposure related calls made to Seoul 1339 in 2009, and 1657 calls to 119 in Seoul and Busan between 2014 and 2016. Significant difference was observed for age, sex, and reason for exposure to toxic substance between the two groups. Conclusion: After the integration of 1339 with 119, 119 focused on role of field dispatch and hospital transfer, lacking the consulting on drug poisoning. Moreover, data on exposure to toxic substances at the pre-hospital stage indicate that drug information and counseling are missing or unknown. In addition, first aid or follow-up instructions are not provided. Thus, systematic approach and management are required.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.20-27
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• 2024

Purpose: Severe abdominal injuries often require immediate clinical assessment and surgical intervention to prevent life-threatening complications. In Jeju Regional Trauma Center, we have instituted a protocol for emergency department (ED) laparotomy at the trauma bay. We investigated the mortality and time taken from admission to ED laparotomy. Methods: We reviewed the data recorded in our center's trauma database between January 2020 and December 2022 and identified patients who underwent laparotomy because of abdominal trauma. Laparotomies that were performed at the trauma bay or the ED were classified as ED laparotomy, whereas those performed in the operating room (OR) were referred to as OR laparotomy. In cases that required expeditious hemostasis, ED laparotomy was performed appropriately. Results: From January 2020 to December 2022, 105 trauma patients admitted to our hospital underwent emergency laparotomy. Of these patients, six (5.7%) underwent ED laparotomy. ED laparotomy was associated with a mortality rate of 66.7% (four of six patients), which was significantly higher than that of OR laparotomy (17.1%, 18 of 99 patients, P=0.006). All the patients who received ED laparotomy also underwent damage control laparotomy. The time between admission to the first laparotomy was significantly shorter in the ED laparotomy group (28.5 minutes; interquartile range [IQR], 14-59 minutes) when compared with the OR laparotomy group (104 minutes; IQR, 88-151 minutes; P<0.001). The two patients who survived after ED laparotomy had massive mesenteric bleeding, which was successfully ligated. The other four patients, who had liver laceration, kidney rupture, spleen injury, and pancreas avulsion, succumbed to the injuries. Conclusions: Although ED laparotomy was associated with a higher mortality rate, the time between admission and ED laparotomy was markedly shorter than for OR laparotomy. Notably, major mesenteric hemorrhages were effectively controlled through ED laparotomy.

• 한국응급구조학회지
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• 제22권3호
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• pp.101-115
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• 2018

Purpose: This study aimed to provide fundamental data for the development of a human management strategy depending on the followership type in 119 EMTs. Methods: The subjects were thirty eight 119 EMTs working out of hospital in Y, D, S, G city. Data were collected from June 25 to August 10, 2017. The Q sample was selected as 40 statements in total and analyzed using the PC QUANL program. Results: As a result of the study, three followership types explained 67.59% of all the variables. Three different types were identified from the examination. The types were labeled as 'Responsible helper type', 'Quick response type', and 'Enterprising self-development type'. Conclusion: For each type, a leader and follower should develop a team management strategy for 119 EMTs to provide high-quality emergency medical services.

• 한국응급구조학회지
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• 제23권3호
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• pp.135-143
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• 2019

Purpose: The purpose of this study was to determine the effect of a violent experience and job stress on burnout and to investigate the factors that affect burnout in female 119 emergency medical technicians. Methods: Data from 189 female EMTs were collected using a structured questionnaire. The data were analyzed using SPSS 23.0. The analyses included descriptive statistics, independent t-tests, analysis of variance, Scheffe test, Pearson's correlation coefficient, and multiple linear regression. Results: Burnout was positively correlated with a violent experience in female 119 EMTs. Violent experience (β=.39, p<.001) were a significant predictor of burnout in 15.2% of female 119 EMTs. Conclusion: A violent experience is identified as a significant factor affecting burnout in female 119 EMTs. Therefore, it is necessary to impart education to female 119 EMTs on effectively coping with violence.

• 기본간호학회지
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• 제18권3호
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• pp.411-420
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• 2011

Purpose: The aim of this study was to exam differences in awareness and ethical attitudes associated with Do-Not- Resuscitate (DNR) among emergency department's team. Method: The participants in this study were 402 emergency department's team working in the 41 hospitals. The data was collected by using "awareness measuring tool" by Kang (2003) and "ethical attitudes measuring tool" by Ko (2004) from May 1 to September 15, 2009. Collected data were analyzed by descriptive statistics, t-test, Pearson correlation coefficient using SPSS WIN 14.0 program. Results: 74.4% of subjects was responded that they had never been educated about DNR, but 73.9% of subjects was responded that they had experienced DNR in the emergency room. The majority of subjects responded that the patients and their families should make a decision about the DNR. There was a difference in an appropriate time for explanation of DNR among emergency department's team. There was a difference in ethical attitudes associated with Do-Not- Resuscitate among emergency department's team. Conclusion: For a professional and systematic approach to the problem, DNR guideline sufficient to elicit a social consensus is needed.

• 한국산학기술학회논문지
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• 제14권12호
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• pp.6461-6468
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• 2013

본 연구는 병원 전 응급의료 현장을 담당하고 있는 119 구급대원의 근골격계 질환에 대해 조사하기 위해 2012년 7월 2일부터 7월 31일까지 전북지역의 119 구급대원 216명을 대상으로 설문조사한 결과이다. 조사결과 대상자의 57.9%가 근골격계 질환과 관련한 자각증상을 호소하였으며 신체부위별로는 허리와 엉덩이 부분에 통증이 있다는 응답이 47.2%로 가장 많았다. 또한 이러한 통증의 원인이 구급업무와 관련이 있는 것으로 조사되었다. 또한, 일반적 특성에 따른 근골격계 증상에서 성별(t=16.579, p=.000), 연령(t=102.344, p=.000), 학력(t=5.363, p=.027), 음주(t=6.999, p=.030), 흡연(t=6.266, p=.009)에 따른 유의한 차이가 있었으며 직업적 특성에서는 경력(t=67.684, p=.000), 구급차량 탑승인원(t=7.717, p=.004), 자격 및 면허(t=25.480, p=.000), 직급(t=74.615, p=.000)에서 유의한 차이가 있는 것으로 나타났다.

• 한국임상약학회지
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• 제28권1호
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• pp.51-56
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• 2018

Objective: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. Methods: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. Results: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p<0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (${\pm}0.8$). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. Conclusion: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.

• 한국응급구조학회지
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• 제12권3호
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• pp.27-41
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• 2008

Purpose : The purpose of this study was to supply basic data for the impact on the accuracy of basic CPR according to position and foot-board height of basic CPR provider. Methods : Study design was within - group design. Subjects were 25 EMT-P Students in K city. Interventions was basic CPR performed on a resuscitation manikin placed on a hospital bed, kneeling on the bed adjacent to the manikin. Data was analyzed using descriptive statistics and Friedman test. Results : In case of the basic CPR performed on a resuscitation manikin placed on a hospital bed, ventilation accuracy was the highest in less than 160 cm height, foot-board height : $34.2{\pm}1.48cm$, 91.4% and in 161-165 cm height, foot-board height : $26.0{\pm}2.14cm$, 88.4% and in 171-175 cm height, foot-board height : $23.0{\pm}1.41cm$, 91.3% and in the above 176 cm, kneeling on the bed, 95%. Chest compression accuracy was the highest in less than 160 cm height, foot-board height : $30.2{\pm}1.48cm$, 95.6% and in 161-165 cm height, kneeling on the bed, 97.6% and in 171-175 cm height, kneeling on the bed, 98.5% and in the above 176 cm, kneeling on the bed, 98.7% and foot-board height : $20.5{\pm}1.91cm$, 98.7%. Chest compression error was due to too weak : 2.0-35.4 times. There were ststistically significant differences in 191-195 cm group according to chest compression mean depths($x^2=10.824$, p = .013) and chest compression error (p = .040). Conclusion : In contrast to current guidelines, the position and foot-board height of basic CPR provider are very important to the accuracy of the basic CPR. Furthermore, we recommend that a using real time audiovisual feedaback system significantly improve the quality of chest compression and ventilation during resuscitation.