• Journal of Trauma and Injury
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• v.30 no.4
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• pp.120-125
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• 2017

Purpose: The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS). Methods: Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis. Results: Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05). Conclusions: The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.223-234
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• 2021

Purpose: The purpose of the study is to check up the status of 119 emergency control centers usage. Therefore, the status of use of 119 emergency control centers and the incidence of pre-hospital cardiac arrest patients were investigated. Methods: The emergency activity daily reports and first aid diaries of 119 emergency control centers from January to December 2018 were reviewed. For more accurate status analysis, Among the first aid guidance received in the emergency rescue standard system, the cardiopulmonary resuscitation guide log was reviewed. Results: In 2018, the total usage of the 119 emergency control centers was 1,358,356 calls, hospital guidance werethe most commom (n=629,676, 46.4%), followed by first aid (n=428,027, 31.5%), disease consultation (n=170,238, 12.5%), medical oversight (n=111,188, 8.2%), and interhospital transfer (n=5,052, 0.4%). Regarding the user number per 1,000 persons, Jeju was the greatest at 48.0, whereas Changwon was the lowest at 13.0. A total number of dispatcher-assisted cardiopulmonary resuscitation was 12.181. The time from report to chest compression were 156.2±80.8 seconds for those with previous cardiopulmonary resuscitation training and 168.0±79.3 seconds for those without such training (p<.05). Conclusion: The ratio of first aid instructions, including dispatcher-assisted cardiopulmonary resuscitation, among total usage of the 119 emergency control centers increased. Therefore, additional efforts are required to improve the quality and expertise of information provided through the 119 emergency control centers.

• Journal of the Korean Burn Society
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• v.23 no.2
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• pp.42-53
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• 2020

Purpose: It is important to consider both clinical factors and epidemiological factors in treating burn patients in emergency rooms. However, many emergency medical staffs happen to miss their chances of treating burns based on these considerations. This study is designed to find a better treatment for burn patients in emergency rooms along this approach. Methods: This study was conducted based on the data of the burn patients visiting the emergency room of a single general hospital from January 2015 to December 2019. The epidemiological and clinical factors were extracted out of the data, then the relationship between the prognosis and these factors were analyzed. Results: Most of burn accidents occurred at home, and were caused by hot water, soup, drinks, oil, etc. Especially, flame burns showed high hospitalization rate, surgical rate and mortality. In addition, their prognosis was poor when the affected area included facial, limb and perineal areas etc., or any inhalation burn co-existed. Also, the hospitalization rate and period increased when the treatment time was delayed or the pre-treatment was taken. There was a strong relationship between prognosis and the period of follow-up when patients were admitted during the period. Conclusion: It is difficult for medical staffs to evaluate prognosis of burns in emergency rooms due to progressive damages. Precise treatment and disposition are essential for patients' good prognosis. Therefore, medical staffs should establish treatment plans by identifying the patient's epidemiological and clinical factors, rather than giving prescriptions based on fragmentary and superficial symptoms.

• Journal of Korea Society of Industrial Information Systems
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• v.18 no.3
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• pp.47-56
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• 2013

With the development of the morden medical science technology, the life of the men is keeping by medical technology. But if a proper treatment could not be provided to the patient in pre-hospital phase and the patient could not be transferred to the necessary hospital timely, it can not prevent the serious damage to the patient. In this paper, when an emergency was generated, the emergency medical technician can give the most suitable first aid to the patient by our proposed efficient emergency medical information system using heuristic knowledge.

• Korean Circulation Journal
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• v.53 no.9
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.141-145
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• 2020

The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.

• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.243-249
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• 2021

A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.7-16
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• 2021

Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

• Journal of Korean Neurosurgical Society
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• v.37 no.6
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• pp.453-455
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• 2005

Two young women were brought to the Emergency room with generalized tonic and clonic seizures. Seizure developed seven and ten days after delivery respectively without the clinical signs of pre-eclampsia throughout the pregnancies. Magnetic resonance(MR) image of the brain showed characteristically symmetrical abnormal signals in the parietal and occipital regions. After several days of medical treatment, they were discharged without neurologic sequelae and follow-up MR images taken three months after discharge showed complete disappearance of the previous abnormal signals.

• Journal of Korean Academy of Nursing
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• v.33 no.8
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• pp.1153-1160
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• 2003

Purpose. 1) To identify the time taken from symptom onset to the arrival at the hospital (pre-hospital delay time) and time taken from the arrival at the hospital to the initiation of the major treatment (in-hospital delay time) 2) to examine whether rapid treatment results in lower mortality. 3) to examine whether the pre- and in-hospital delay time can independently predict in-hospital mortality. Methods. A retrospective study with 586 consecutive AMI patients was conducted. Results. Pre-hospital delay time was 5.25 (SD=10.36), and in-hospital delay time was 1.10 (SD=1.00) hours for the thrombolytic therapy and 50.24 (SD=121.18) hours for the percutaneous transluminal coronary angio-plasty (PTCA). In-hospital mortality was the highest when the patients were treated between 4 to 48 hours after symptom onset using PTCA (p=.02), and when treated between 30 minutes and one hour after hospital arrival using thrombolytics (p=.01). Using a hierarchical logistic regression model, the pre- and in-hospital delay times did not predict the in-hospital mortality. Conclusion. Pre- and in-hospital delay times need to be decreased to meet the desirable therapeutic time window. Thrombolytics should be given within 30 minutes after arrival at the hospital, and PTCA should be initiated within 4 hours after symptom onset to minimize in-hospital mortality of AMI patients.