• Title/Summary/Keyword: Level 1 emergency medical technician

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Diagnostic performance of emergency medical technician for ST-segment elevation myocardial infarction

  • Soo Hoon Lee;Daesung Lim;Seo Young Ko
    • Journal of Medicine and Life Science
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    • v.21 no.2
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    • pp.31-39
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    • 2024
  • This study was conducted to determine whether level-1 emergency medical technicians (EMTs) can adequately recognize ST-segment elevation myocardial infarction (STEMI) in the emergency department (ED) and whether their ability to do so differs from that of emergency medicine physicians (EMP). From December 2022 to November 2023, patients aged 20 years or older visiting the ED with chief complaints suggesting acute coronary syndrome (ACS) were enrolled. As soon as the patient arrived at the ED, a level-1 EMT conducted a 12-lead electrocardiogram (ECG) to assess STEMI; an EMP subsequently assessed whether to activate the percutaneous coronary intervention team. Demographic characteristics, test results, and final diagnoses were collected from the medical records. Among the 723 patients with case report forms, 720 were included in the analysis. These were categorized as follows: 117 (16.3%) with STEMI, 159 (22.1%) with non-ST-segment elevation ACS, and 444 (61.7%) with other conditions. STEMI was correctly recognized in 100 patients (91.7%) by level-1 EMTs and in 104 patients (95.4%) by EMPs (kappa=0.646). EMTs with less than 1 year of ED work experience correctly recognized 60 out of 67 STEMI patients (89.6%), which was comparable with the EMPs who recognized 65 out of 67 STEMI patients (97.0%, kappa=0.614). EMTs with more than 1 year of ED work correctly recognized 40 out of 42 STEMI patients (95.2%), and therefore performed better than EMPs, who recognized 39 out of 42 STEMI patients (92.9%, kappa=0.727). The level-1 EMTs adequately recognized STEMI using a 12-lead ECG and were in substantial agreement with the evaluations of the EMPs.

The Legal Consideration in Emergency Medical Service System (의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로-)

  • Kang, Byung Woo
    • The Korean Journal of Emergency Medical Services
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    • v.3 no.1
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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Factors related to empowerment of paramedic students who experienced clinical practice (임상실습을 경험한 응급구조(학)과 학생의 임파워먼트 관련 요인)

  • Song, Seo-Yeong;Han, Mi-Ah
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.1
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    • pp.17-30
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    • 2016
  • Purpose: This study investigated factors related to empowerment of paramedic students. Methods: A total of 208 students in the department of emergency medical services who experienced clinical practice at 5 universities were selected by convenience sampling methods. Differences in empowerment by general and major-related characteristics were evaluated using a t-test and analysis of variance. The association between satisfaction with clinical practice and empowerment was tested using correlation coefficients. Multiple linear regression analysis was performed to investigate the factors associated with empowerment. Results: The levels of overall satisfaction with clinical practice and empowerment were 107.48 and 99.46, respectively. In simple analysis, empowerment level was associated with general characteristics, major-related characteristics, characteristics of clinical practice, and satisfaction with clinical practice. Empowerment level was significantly higher in older subjects (${\beta}=5.282$, p = .023), subjects with very good (${\beta}=8.487$, p = .002) or fair (${\beta}=4.879$, p = .010) subjective health status, and high subjective school record (${\beta}=5.837$, p = .008) in multiple linear regression analysis. Satisfaction with clinical practice was positively associated with empowerment (${\beta}=0.250$, p < .001). Conclusion: Empowerment was associated with major-related factors and satisfaction with clinical practice. Increased satisfaction with clinical practice could positively influence empowerment for paramedic students.

A Study on Empowerment and Critical Thinking of the 1st Emergency Medical Technician (1급 응급구조사의 임파워먼트와 비판적 사고성향에 관한 연구)

  • Park, Dae-Sung;Kim, Eun-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.10 no.3
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    • pp.5-20
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    • 2006
  • Purpose: This study examines the degree of empowerment recognized by the 1st paramedics and the trend of their critical thinking, analyzes correlations between empowerment and critical thinking to reveal whether there is statistically significant difference between them and then is to provide basic materials necessary for research on empowerment and critical thinking. Method: This study distributes 105 structured self-report questionnaires to the 1st emergency medical technicians working at fire fighting police boxes, general hospitals, clinics and emergency medical information centers in G Metropolitan City and J province from April 29 to May 28, 2006, collects their responses directly and analyzes results with t-test, F-test(ANOVA) and Pearson's Correlation Coefficient. Result: 1. First, average score of empowerment of subjects was 4.68 out of 6 and according to scores by area, capacity 5.98 was highest, followed by significance 5.41, self- determination 4.44 and effectiveness 3.79. 2. degree of empowerment according to general characteristics of subjects showed statistically significant differences in final education(F=2.714, p= .049), level of salary (F=3.298, p= .014) and satisfaction of current job (F=5.399, p= .001). 3. average score of critical thinking of subjects was 3.28 out of 7 and according to areas, no bias 3.95 was highest, followed by maturity 3.68, structure 3.35, inquisitiveness 3.11, pursuit of truth 3.07, critical thinking and self-confidence 3.00, analyticity 2.98. 4. degree of critical thinking by general characteristics of subjects showed statistically significant differences in age(F=2.577, p= .041), final education (F=7.877, p= .000), current workplace (F=3.513, p= .018), level of salary(F=4.628, p= .002), satisfaction with current job(F=6.879, p= .000) and intention to transfer current job(t=15.21, p=.000). 5. as a result of correlations between empowerment and critical thinking of subjects, Pearson correlation coefficients between whole empowerment and critical thinking were r= .21, p=.013. Conclusion: It is considered that the 1st paramedic managers must seek how to keep and manage empowerment and development of education and training program which can enhance critical thinking is needed. Further, emergency educators must develop educational program based on the concept of empowerment to establish early awareness of a desirable organization culture and increase understanding of empowerment in the process of education.

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A Study on Job Stress, Fatigue and Job Satisfaction of 119 Emergency Medical Technician (119구급대원의 업무스트레스와 피로 및 직무만족도에 관한 연구)

  • Park, Dae-Sung
    • The Korean Journal of Emergency Medical Services
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    • v.8 no.1
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    • pp.71-86
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    • 2004
  • This study selected emergency medical technicians at 24 fire police boxes in Jeonnam in order to examine the relationship between job stress, fatigue and job satisfaction of 119 emergency medical technicians. Data were collected from Apr. 10 to May 9, 2004, questionnaires were mailed and returned by mail. Total 109 questionnaires were distributed and 89 questionnaires were collected and 80 except 9 omitting answers and showing inappropriate answers were used for final analysis. The results of this study are as follows. A. The total mean of areas composing job stress in the degree of job stress of 119 emergency medical technicians was over the average as 2.54 (SD .44) of 4 full marks. According to the degree of job stress by each area, the highest area of job stress was crisis situation (2.98), followed by role conflict as professional job (2.58), social factors (2.57), involvement in organization (2.55). To the contrary, the areas of the lowest job stress were professional knowledge and technique (2.35), psychological burden of medical limitation (2.38), conflicts in personal relationship and services (2.45) and improper treatment (2.53). B. The degree of fatigue of 119 emergency medical technicians by areas was over mean as 2.09(SD .49) of 4 full scores and physical fatigue was highest (2.18), followed by mental fatigue (2.11) and neurosensory fatigue (1.99). C. The degree of job satisfaction of 119 emergency medical technicians was 2.71 of 5 full scores and working condition area (3.70) showed the highest job satisfaction, followed by requirement of organization (2.85) and the lowest job satisfaction area was job itself (2.18), followed by desire for job (2.49). D. According to differences in demographical characteristics of 119 emergency medical technicians, there was no variable of statistical difference at job stress and job satisfaction in significance level .05, but fatigue showed statistical difference at final education (F=2.393, p=.046). E. According to differences related to job characteristics of 119 emergency medical technicians, job stress showed statistical differences at motif of current services (F=4.935, p=.003), fatigue showed those at health conditions (F=2.732, p=.008), job satisfaction at overtime (F=3.038, p.034) and the greatest reason of having job (F=3.217, p=.017), F. As a result of analyzing correlations between job stress. fatigue and job satisfaction of the subject, job stress showed positive correlations (r=.411, p=.000) with fatigue and negative correlation (r=-.267, p=.008) with job satisfaction. Fatigue showed negative correlation (r=-.287, p=.005) with job satisfaction. Therefore, the hypothesis of this study. "There will be relationship between degree of stress, fatigue and job satisfaction of subjects." was supported.

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Influencing factors of prevention practices against infection exposure among emergency medical technicians in emergency rooms (응급실 응급구조사의 감염노출 예방행위 수행정도에 영향을 미치는 요인)

  • Sim, Kyung-Yul;Kim, Jee-Hee;Lee, Hyo-Cheol;Kim, Chul-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.1
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    • pp.21-34
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    • 2018
  • Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in emergency rooms. Methods: A self-reported questionnaire was filled out by 100 EMTs in emergency rooms from June 1 to August 31, 2017. The questionnaire consisted of items concerning the defensive environment for the prevention of infection exposure, perception of preventive behavior, and degree of performance of preventive actions against infection based on a five-point Likert scale. Data were analyzed by descriptive statistics, ${\chi}^2$ test, ANOVA, Pearson's correlation coefficients, and linear regression. Results: The defensive environment for the prevention of infection exposure was 4.12. The perception of preventive action was 4.71, and the degree of performance of preventive actions against infection was 4.54. There was a significant relationship between the degree of performance of preventive actions against infectious exposures and the degree of perception of preventive behavior(r=.506, p=.01) and prevention of infectious exposure(r=.506, p=.01). The protective environment(B=.360, t=3.236, p=.002) and perceived level (B=.904, t=4.662, p=.000) were influenced by the degree of prevention of infection exposure. Conclusion: It is important to manage the protection environment for infection exposure prevention and to enhance the awareness of infection prevention actions against infection exposure among the EMTs in emergency rooms.

The experience of violence and turnover intention of female 119 emergency medical technicians (여성 119구급대원의 폭력 경험과 이직 의사)

  • Kim, Hee-Jung;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.2
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    • pp.65-76
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    • 2013
  • Purpose : The purpose of this study was to provide an appropriated direction for fire service organizational management by analyzing the violence experiences and turnover intention of female 119 emergency medical technicians (119 EMT) in Korea. Methods : The questionaries were obtained from 415 female 119 EMT in Korea from April 27 to March 8 in 2009. The collected data were analyzed with SPSS WIN 19.0 program. Results : Female 119 EMTs experienced 94.9%-verbal insults, 57.1%-violence aggression, 62.89%- potential violence, 32.5%-physical assault. About 76.4% of the subjects experienced to feel shame about the verbal insults. They had a stress level (mean 5.47 out of 10) and about 41.2% was more than seven points. About 39.3% of the subjects responded turnover intention. Conclusion : We proposed the preventive program against violence as well as critical incident stress debriefing. These results are expected to be useful in making human resource management plans to lower turnover intention.

Factors Influencing on Safety knowledge of Scuba divers (스쿠버다이버의 안전지식에 미치는 영향요인)

  • Kang, Kyung-Soon;Uhm, Dong-Choon;Baek, Hong-Suck
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.10
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    • pp.4403-4410
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    • 2011
  • The purpose of this study was to investigate on the safety knowledge level, and to identify the factors that affect the safety knowledge according to general characteristics of scuba divers. This research design was a descriptive study. Data of 179 scuba divers were collected from October 17, 2010 to June 17, 2011. Data were analyzed by SPSS PASW statistics 18.0 program. The mean score of safety knowledge related to diving was 2.07(${\pm}0.54$)(score range was 1~4). The highest score was safety knowledge to cope with the cold($2.42{\pm}0.64$점). The lowest score was safety knowledge for hyperexpansion of lungs. In the results of multivariate regression analysis after variable selection, Adjusted $R^2$ value was 0.567. The model fit was 56.7%. The factors that affect the safety knowledge were age(${\leqq}29$ years), equipment(all purchase, some lease), motivation(job), participation period(${\leqq}11$ months) and frequency(once a month)(p<.05, p<.001). It is necessary to develop and conduct the educational program for scuba divers safety at country level.

The Factors Influencing Employment Stress of the Department of Emergency Medical Service Students (응급구조학과 학생의 취업스트레스에 미치는 영향요인)

  • Kim, Duk-Won;Ju, Ho-Hyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.589-596
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    • 2017
  • The purpose of this study was to investigate factors affecting employment stress among Emergency Department students and reduce stress of employment. A questionnaire survey was administered to 276 students who experienced clinical practice among 4 emergency college students in Jeollabuk-do and Jeollanam-do at 4-year and 3-year colleges from September 10 to 15, 2017. Statistical analysis was performed using the SPSS 18.0 program and analyzed by t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. In the results, there were significantly negative correlations between clinical training stress and major satisfaction (r=-0.192, p=0.001), significantly positive correlations between career stress and clinical training stress (r=0.222, p<0.001), and significantly negative correlations between career stress and major satisfaction (r=-0.245, p<0.001). In the multi-regression analysis, the following was discovered: higher clinical training stress (${\beta}=0.157$, p=0.005), lower major satisfaction (${\beta}=-0.211$, p<0.001), and higher career stress. Junior students (${\beta}=0.237$, p<0.001) and senior students (${\beta}=0.288$, p<0.001) had the highest career stress. Subjects with medium-level financial status had high career stress (${\beta}=0.173$, p=0.012). Therefore, this study suggests that colleges should reduce clinical training stress among emergency medical technology students, and more job support centers should be opened and job management programs developed.

Literature review on the job competency of paramedics and paramedic students in Korea (국내 응급구조사 및 응급구조학과 학생의 직무역량 관련 연구에 대한 문헌고찰)

  • Min-Ju Kang;Keun-Young Kim;Hye-Jin Seo;Seung-Tae Han
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.2
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    • pp.41-50
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    • 2023
  • Purpose: This study aimed to identify research trends related to the job competency of paramedics and paramedic students in Korea. It also presents further research directions. Methods: Papers from three databases (RISS, KISS, and DBpia) were reviewed. The keywords were 'paramedi* and competency,' 'paramedi* and job competency,' 'paramedi* and student and competency,' and 'paramedi* and student and job competency.' No limit was imposed on the research period. Four researchers conducted the inclusion and exclusion processes. Differences in opinion were resolved through sufficient discussion. Results: Twelve studies were selected for review, of which 11 were descriptive survey research studies and 1 was quasi-experimental. Eight studies aimed to determine the current level of competency, and three aimed to identify competency. The remaining study was designed for the development of and application in competency-related programs. The subject of most studies was competency during disasters. Conclusion: Based on these results, future research on paramedic job competency should include a wider variety of methods and subjects.