• Title/Summary/Keyword: Hospital emergency services

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Grid-based geospatial analysis of areas vulnerable to prehospital transportation of emergency patients in Jeju (제주 지역 중증 응급 질환의 병원 전 이송 취약 지역에 대한 격자 기반 지리 공간 분석)

  • Hansol Hong;Woo Jeong Kim;Myung Sang Ko;Sung Wook Song;Yoon Ji Kim;Kyeong Won Kang
    • Journal of Medicine and Life Science
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    • v.19 no.3
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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.

A feasibility study of audio-video communication application using mobile telecommunication in inter-hospital transfer situations (병원 간 전원 상황에서 이동통신망을 이용한 음성화상정보통신 애플리케이션의 유용성에 관한 연구)

  • Jeong, Joo;Kim, Tae-Han;Kang, Saee-Byel
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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    • pp.125-134
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    • 2019
  • Purpose: The aim of this study was to evaluate the usefulness of video communication with medical staff located at a remote location, through a communication application connected to a long term evolution (LTE) mobile communication network in a moving ambulance. Methods: In this study, we recruited patients who were transferred by mobile intensive care unit ambulance from one hospital to another. In the moving ambulance, the information of the patient was transferred to a physician using the application in real time. Recorded video files were evaluated by emergency physicians with experience in video direct medical control. Results: A total of 18 patients were evaluated, and the average score was 5.9 out of a possible 9. It was expected that applying the use of the technology to actual clinical sites would enable the sites to provide assistance. Conclusion: In this study, we confirmed the possibility of benefiting from the clinical field when using the video-audio communication application which is connected to the remote location in real time through the current LTE mobile communication network in the ambulance.

Factors influencing the image about emergency medical technology jobs in paramedic students (응급구조(학)과 학생의 응급구조사 직업이미지에 미치는 영향 요인)

  • Hwang, Seong-Hak;Uhm, Dong-Choon
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.3
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    • pp.63-75
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    • 2014
  • Purpose: The purpose of this study was to investigate the image about emergency medical technology (EMT) jobs and to identify factors influencing the image of EMT jobs among students of this department. Methods: A self-reported questionnaire was administered to 532 paramedic students in the cities of D, G, and J between May 28 and June 19, 2013. Data were analyzed by using the SPSS version 21.0 program. Results: The image about EMT jobs was positively related to self-esteem. However, the image about EMT jobs was negatively related to grade and hospital practice experience. In the multiple regression analysis, the adjusted $R^2$ value was .220 (p < .001). Conclusion: The importance of enhancing the self-esteem of paramedic students should be emphasized. Further research on the image about EMT jobs in the hospital practice setting is needed.

Status analysis of patients on islands and seas of Jeollanam-do (전라남도 섬과 해상에서 발생한 환자의 현황분석)

  • Choi, Young-Ju;Yun, Jong-Geun
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.87-96
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    • 2022
  • Purpose: By analyzing the health status of emergency patients on islands in the Jeollanam-do province, this study aims to provide basic data for proposed future medical emergency services on the islands. This information includes monthly and hourly statistics on patients' characteristics, patient frequency, an analysis of first aid procedures, response times, and time spent at hospitals. Methods: The study analyzed the monthly and hourly frequency of emergency patients, first aid status and procedures, general patient characteristics, accident types, patient cognitive status and agility, marine police response times, and frequency and percentile of hospital dispatch times. Results: 1Q and #q show the highest patient turnover rate in one year. 50.5% of daily patients are admitted between 4 PM and 12 PM. The hospital dispatch time is within a one- to two-hour window for 54.0% of all patients. Conclusion: The emergency medical service system for the Jeollanam-do province islands and seas is available to all Korean residents, citizens, and visitors. It is necessary to implement an emergency medical system for the relevant organizations.

Comparison of triage and treatment results of abdominal pain patients of pre-hospital and in-hospital conditions (병원전과 병원내의 복통환자 중증도 분류 및 진료결과 비교)

  • Kim, Dong-Hyeon;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.7-22
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    • 2021
  • Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

Prehospital care of patients with dyspnea by 119 emergency medical technician (주호소가 호흡곤란인 환자에 대한 119구급대원의 병원전 응급처치 현황)

  • Yun, Seong-Woo;Choi, Bo-Ram;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.1
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    • pp.41-50
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    • 2013
  • Purpose : This study intended to improve the quality of prehospital emergency care for patients with dyspnea by figuring out the current situations and problems based on run-sheets of 119 emergency medical technicians (EMTs). Methods : A total of 336 dyspnea patients were transferred to G university hospital by 119 ambulances from January 1, 2011 to December 31, 2011. Results : The data were analyzed by SPSS 19.0. Patients over 60 years old accounted for 57.2% and 48.4% had the history of heart disease. Among the heart disease patients, 31.7% complained of dyspnea and chest pain. The vital sign measurement performance by 119 EMTs increased compared to previous study. The number of prehospital treatment by 119 EMTs significantly increased depending on the mental state of the patients. Conclusion : 119 EMTs should remind the heart disease and other past history of the patients when they perform the dyspnea patient care.

A study on Medical servicer satisfaction of Emergency Department patient (응급실 내원자의 의료서비스 만족에 관한 연구)

  • Kwon, Seon Suk;Yoo, In Soo;Jung, Ha Sook
    • The Korean Journal of Emergency Medical Services
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    • v.1 no.1
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    • pp.42-53
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    • 1997
  • To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

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Prehospital care status and improvement plan of 119 emergency medical technician to anaphylaxis patients (119구급대원의 아나필락시스 환자에 대한 병원 전 응급처치 현황 및 개선 방안)

  • Choi, Jang-Hui;Jo, You-Hwan;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.1
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    • pp.57-70
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    • 2016
  • Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.

Public perception of ambulances (일반인의 구급차 이미지에 대한 인식 유형)

  • Kim, Jun-Hyeong;Mun, Jun-Young;Cho, Eun-Sook;Woo, Il-Woong;Sim, Kyong-Yul
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.1
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    • pp.159-175
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    • 2021
  • Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers' perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: "Considerate of emergency situations," "Identifying emergency patients," "Trusting emergency vehicles," and "Sympathizing with emergency patients." Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

Job analysis of paramedic on the developing a curriculum method (데이컴 기법에 의한 1급 응급구조사 직무분석)

  • Yoou, Soon-Kyu;Kwon, Hay-Rran;Park, Hee-Jin;Shin, Sang-Do;Choi, Eun-Sook;Uhm, Tai-Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.115-137
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    • 2013
  • Purpose: The purpose of this study was to investigate the extended job of paramedic after the 1st job description in 2000 by the National Health Personnel Licensing Examination Board. Methods: This study was carried out from May 2012 to July 2013 on the Developing A Curriculum (DACUM) method to analysts 330 responses among 400 questionnaires (response rate 82.5%) after analysing 30 pilot questionnaires. In order to enhance validity and reliability of this job description, 2 job analysts in universities and 10 EMT-Paramedics in hospitals and fire stations were recruited. Results: There were differences between 166 (year 2000) and 240 (2012) in task element. There were higher answering at triaging patient(2.64 frequency, 4.15 importance), calling for help(2.68 frequency, 4.07 importance) in disaster emergency care. There were higher answering at measuring vital sign (3.95 frequency, 4.22 importance), measuring ECG(3.84 frequency, 4.14 importance), wound care(3.48 frequency, 3.86 importance), bleeding control & wound care(3.46 frequency, 3.86 importance), applying $O_2$(3.40 frequency, 3.94 importance) in physician assistant. Conclusion: Scope of extended practice as a physician assistant in hospital setting recommended us to replace the present curriculum and national exam with new curriculum and national written & skill test.