• 대한응급의학회지
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• 제29권6호
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• pp.687-698
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• 2018

Objective: This study examined the characteristics of suicidal attempters, including pre-hospital patients and those who visited the emergency department. Methods: Suicidal attempters who had been reported to the 119 call center were selected between July 2015 and June 2016. Sex, age, place, methods of suicidal attempt, season, time, and suicide success rate were reviewed in the fire center records. Results: A total 961 suicide attempters were enrolled. Among them, 53.6% were males who had an approximately 2.6 times higher mortality than that of females (9.2%). The most preferred place to commit suicide was the home in both sexes (68.0% in male, 82.8% in female) and the most preferred methods was drug intoxication, particularly pesticide. The method with the highest mortality was hanging and the lowest was self-harm. The season of the highest mortality was spring. The success of suicide and the time variation were similar. Most of the un-transferred patients also selected fatal suicide attempts compared to transfer patients. Conclusion: Unlike previous studies, this study includes information on un-transferred patients. Overall, the probability of death was highest as more than 50 years men chose hanging as a method, which had an influence on the un-transferred patients group.

• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.477-480
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• 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

• 한국응급구조학회지
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• 제25권2호
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• pp.39-53
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• 2021

Purpose: Emergency medical technicians (EMTs) have so far been trained as professionals under the same conditions, with no change in the 1995 Act. We aimed to find ways for them to secure expertise in accordance with social needs by strengthening the quality of the EMT education. Methods: This is a descriptive study comparing the operation status of the national emergency medical examination conducted by the Korea Health Personnel Licensing Examination Institute, and the national examinations of EMT paramedic and EMT basic. The scope of the national examinations for EMT was compared by subject and area. Results: The national written exam for EMT paramedic consists of five areas. EMT basic does not include basic medicine in three related subjects, 11 areas, and 18 detail areas. Paramedic care does not include advanced pediatric life support. In addition, nine areas and 20 detail areas are not included. Conclusion: The study suggests the need for institutional supplementation so that those who have completed EMT basic and the subjects prescribed by the ordinance of the Ministry of Health and Welfare at universities, etc., in the Higher Education Act can take the EMT paramedic national exam.

• 한국응급구조학회지
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• 제22권3호
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• pp.77-90
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• 2018

Purpose: This study aimed to assess and improve the work scope of emergency medical technicians (EMT)-paramedics in emergency medical centers. Methods: Data were collected from February 1 to 14, 2018. The questionnaire comprised a total of 56 questions: eight general questions, six questions about the recognition of EMT-paramedics in emergency medical centers, and 42 questions about their work. Data were analyzed via frequency and correlation analysis using SPSS version 18.0. Results: Regarding the work of EMTs in emergency medical centers, positive opinions were found in 23 items, negative opinions in 4 items, and both positive and negative opinions in 9 items. Regarding the questions about the necessity, work importance, professionalism, and the need for an increase4 in EMR-paramedics, depending on respondents' career, there was no statistically significant difference between the group of beginners and the group comprising beginners and that of experienced workers (p>.200). Conclusion: The expert survey revealed that the work performance of EMT-paramedics in regional emergency medical centers was trusted and showed positive results of improvement and expansion.

• 한국응급구조학회지
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• 제15권2호
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.172-179
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• 2023

Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

• 한국응급구조학회지
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• 제6권1호
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• pp.15-26
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• 2002

As a result of analyzing problems in field practice and its effects, the following conclusions can be obtained. Man students were more satisfied with their choice of this department than woman students and woman students recognized the importance of hospital practice although they felt the need of fire fighting station practice and man students felt the necessity of hospital practice, but they answered the fire fighting station practice was important. Departments of field practice are emergency and nurse departments in hospitals and emergency aid section in fire fighting stations. And it is found that field practice was performed well in relation to major subject. Areas of practice included emergency room, operation room and extensive cure unit and the experience of ambulance was more in fire fighting station than in hospital. Clinical guidance of professor was preferred to once a week and the students answered they felt satisfaction with practice through conference. Answer that field practice was helpful in understanding class was very high as 96.8% and its connection with employment was low as 12.8%. It is found that a proper timing of field practice was winter vacation for hospital practice after completing the second semester of the first year and summer vacation for fire fighting station practice after the first semester of the second year. The most difficult department in field practice was nurse department in hospital because 'respondents were practice students' and administrative department in fire fighting stations because 'they lacked recognition of paramedic'. In making practice diary, 'describing measure results' was difficult most and the respondents wanted to keep the diary in their custody.

• 한국응급구조학회지
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• 제28권2호
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• pp.33-46
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• 2024

Purpose: This study aimed to assess the appointment status of medical directors and the state of direct medical oversight in private ambulance services, including an analysis of the characteristics of the direct medical oversight requested by private ambulance services. Methods: This study investigated the appointment status of medical directors and direct medical oversight in private ambulance services based on official information disclosed by the National Emergency Medical Center and 17 local governments, along with 8,119 'Dispatch and Treatment Records' collected by a university hospital from 2020 to 2022. Results: Among 129 private ambulance services, 96.12% (124 agencies) had only one medical director, and 43.8% of the medical directors were Emergency Physicians. Over the past three years, the national average direct medical oversight request rate for private ambulance services was 34.68%. In 11.14% of the cases, records stated that EMS providers communicated with the medical director but did not receive direct medical oversight. Conversely, in 36.98% of cases, records incorrectly indicated that EMS providers did not communicate with the medical director but were noted as having received direct medical oversight (p<.05). Most private ambulance services request the direct medical oversight of a single director. Conclusion: This study highlights issues, such as the suitability of the medical director's specialty and inaccuracies in private EMS providers' methods for documenting Dispatch and Treatment Records.

• 한국보건간호학회지
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• 제10권1호
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• pp.106-117
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• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• 한국응급구조학회지
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• 제17권3호
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• pp.53-60
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• 2013

Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.