• Journal of Medicine and Life Science
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• 제19권3호
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• pp.109-115
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• 2022

During emergencies, the time from symptom onset to definitive treatment determines the final outcome. Therefore, the emergency medical service (EMS) system in Korea, aims to transfer patients requiring emergency care to appropriate medical facilities within 30 minutes. This is in an attempt to improve the chances of survival and reduce sequelae. We attempted to locate areas vulnerable to prehospital transportation and identify hot spots with high demand for emergency medical helicopters in Jeju, by using a grid-based geospatial analysis. This retrospective cross-sectional observational study employed EMS data of 119 ambulance run sheets spanning from January 1, 2010 to September 30, 2018 in Jeju. The location data of emergency patients was superimposed on the spatial analysis frame using the geographic information system (GIS). Subsequently, the locations of long-distance transfer and delayed transfers to the hospital were analyzed, to identify hot spots where the demand for helicopter emergency services would be high. Of the total analysis targets, 42.2% (20,288 people) took more than 30 minutes from reporting to 119 dispatchers to hospital transfer. As the transfer time interval increased, the patient occurrence time increased in the city of Jeju, increased in Seogwipo, and the ratio of patients/guardians to select a transfer hospital rose with significant differences. This study identified the characteristics related to time delays in prehospital transfer of emergency patients in Jeju, and the areas vulnerable to prehospital emergency care were derived and visualized through spatial analysis using the GIS.

• 한국응급구조학회지
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• 제27권2호
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• pp.51-63
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• 2023

Purpose: The study aimed to analyze the occurrence and transfer status of emergency patients at Incheon International Airport in Korea. Methods: This study design included 810 patients for eight years, from July 1, 2014 to June 31, 2022. The collected data were analyzed with SPSS statistics version 25.0. Results: For the demographics, 531 (65.6%) were males, 151 (19.5%) were in the highest age group (in their 50s), and 289 (35.9%) were foreigners. The most common place of occurrence was in protected areas in the passenger terminal, with 341 (42.1%) of cases occurring here. The time of arrival at the site (z=-3.444, p=.001), stay duration at the site (z=-8.145, p=. 001), and transfer time (z=-3.623, p=.000) were all significantly longer. Conclusion: It is necessary to consider a rapid emergency transportation plan, such as developing a system that simplifies immigration procedures when emergency patients move from protected areas to general areas. Moreover, in order to quickly respond to foreign emergency patients, detailed characteristics will need to be identified. Lastly, considering the long transfer time, an instructing doctor should accompany an ambulance and actively perform advanced resuscitation.

• 식품보건융합연구
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• 제8권6호
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• pp.11-17
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• 2022

Emergency transport is directly related to the life of the patient, and rapid transport to the hospital is crucial. However, external environmental factors such as traffic or weather, interfere with hospital transport. In this study, we investigated the external environment affecting hospital transport time. We examined the transfer time and patient treatment time of emergency patients in an area of northern Gyeonggi-do from 2018 to 2020. Diagnosis after arrival at the hospital was used, and on-site treatment time was measured from paramedic arrival time at the scene to departure. Furthermore, we examined whether there was a correlation between the time paramedics left the scene and hospital arrival time through the reason for the delay as recorded in the emergency log. Traffic jams had the greatest impact on patient transport, while transport delays occurred due to heavy rain, but not snow. Among injured patients, electrical accidents were the most problematic in terms of on-site treatment time. This was because a lot of first aid is needed in electrical accidents. It must be necessary to mobilize two ambulances in an emergency through the expansion of infrastructure, prepare a plan for rapid transport in heavy rain, and implement strong laws against transport obstruction.

• 한국응급구조학회지
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• 제5권1호
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• pp.177-198
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• 2001

The purpose of this research which was conducted by surveying the transfer consultation records from 360 medical institutions such as general hospitals, hospitals, clinics to the Emergency Medical Center at E University Hospital for six months(Jan. 1, 2000 - Jun. 30, 2000) are to standardize & complete transfer consultation record of hospitals at the 1st & 2nd referral level and to give patients transferred emergency medical center medical information services on a better quality. The conclusions and suggestions from this study were summarized as follows; (1) Examing the distribution of the referral medical consultation(transfer) sheet type, surgery part local clinic sheet types were 34.4%, medical part local clinic sheet types were 26.7%, undifferentiated local clinic sheet types were 23.9% and hospital level sheet types were 15.0%. (2) The items of the transfer consultation records had been standardized more than 75% in the order of patient's name, date, doctor's name, diagnosis, patient's status, impressions. (3) That the degree of recording completion on these items is in the order of patient's name, date, diagnosis, impressions was revealed. (4) Because the standardization and the degree of recording completion are very low in the patient's gender, age, address, electronic recording system was needed for more perfect input of initial patient informations. (5) This standardizing & complete recording on examination and medication will prevent re-examination and abuse of medication for patients transferred emergency medical center. (6) EMT Transfer System should be fixed in all medical institute for the standardizing & complete recording on care period and departure time will give many emergency patients the proper treatments at the proper time. (7) It was revealed that developing new standardized transfer consultation record & using electronic recording system are needed. (8) The complete recording & Fast Track System were needed for higher rate of bed operation at emergency medical center and more hospital profit.

• 한국응급구조학회지
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• 제8권1호
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• 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.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.25-30
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• 2011

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.6-15
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• 2010

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

• 대한응급의학회지
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• 제29권5호
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• pp.415-422
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• 2018

Objective: This study compared the prognosis of patients who visited the trauma center directly (direct visit group) with those transferred from the non-trauma center (transferred group). Methods: The patients, who were 18 or older with Injury Severity Score of 15 or more in the trauma center at Busan, were studied from October 2015 to October 2016. To compare the treatment time between the direct visit and transferred group, first treatment time, final treatment time, and time to visit the trauma center were examined. To compare the prognosis, this study compared the 48-hour, 7-day, and in-hospital mortality rate as well as the duration of intensive care unit (ICU) and total hospital stay. To analyze the factors affecting the outcome of transferred group, the physician's level and procedures that had been performed at the non-trauma center were examined. Results: The mortality was similar in the direct visit and transferred group (48-hour 7.6% vs. 4.6%, P=0.111; 7-day 11.1% vs. 7.2%, P=0.89; and in-hospital 14.6% vs. 11.3%, P=0.214). The length of ICU and total hospital stay were similar in the two groups. The mortality was higher in the patients in the transferred group when using intubation, transfusion, and pressure intensifier. The intubated patients showed higher mortality according to logistic regression. Conclusion: The mortality, length of ICU, and hospital stay were similar but the time to visit the trauma center and the final treatment time were longer in transferred group. Stabilizing the patient at the near non-trauma center may be more helpful for some patients.

• 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.