• The Korean Journal of Pain
• /
• v.32 no.2
• /
• pp.97-104
• /
• 2019

Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

• Journal of Medicine and Life Science
• /
• v.19 no.3
• /
• pp.109-115
• /
• 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.

• The Korean Journal of Emergency Medical Services
• /
• v.9 no.2
• /
• pp.101-110
• /
• 2005

In Korea, EMS Fund Operation seems to move the opposite direction to right way. The most initial EMS fund was consumed loan for some emergency patients without any particular results. Since 2002, the use of EMS fund also has shown a tendency to shift one side. By the results, it was 44.3% to support emergency medical centers, so called hospital EMS system and 28.4% to purchase ambulances and helicopters, and 1.6% to operate Central Medical Center, prehospital base in the EMS fund consumed in 2004. It was never supported for the environmental improvement and development of universities, colleges, and private EMS units having the primary responsibilities. The initial EMS fund using should be used for prehospital base, e.g., prehospital staffs, communications, and facilities and balanced development between public and private EMS units than any other fund using.

• Fire Science and Engineering
• /
• v.24 no.2
• /
• pp.185-193
• /
• 2010

This study aimed to develop a prehospital protocol on CPR to patients with nontraumatic cardiac arrest for emergency medical technicians. For the purpose, we prepared a protocol based on preliminary items and demonstrated its validity to confirm a final protocol from March 1, 2007- August 30. 2008. The practical CPR protocol on cardiac arrest victims can be used as means to support quick and exact decision-making on CPR, which will contribute to enhancement of emergency medical services.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.4
• /
• pp.1540-1546
• /
• 2010

In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.13 no.5
• /
• pp.2117-2124
• /
• 2012

This is the study of actual condition and improvement on emergency medical treatment by 119 emergency medical service personnel. The subjects in this study were 299 emergency medical service personnel. Data were collected from May 1 to August 31 of 2010, and analyzed by SPSS 12.0 program. The major area of study of them were study of emergency medical services 41.5%, study of nursing 10.0%, fire fighting related studies 15.4%, health related studies 1.0%, and others 32.1%. The certificate of them were 1st class emergency medical technician(EMT) 38.1%, 2nd class EMT 33.8%, nurse 9.4%, first aid education 14.0%, and others 4.7%. Frequency of Prehospital emergency care, oxygen supply(274), splint apply(229), spinal immobilization(229), external bleeding control(223), medication(7), intravenous(4). Professionally trained EMT makes possible to secure high quality emergency medical treatment in the prehospital phase. Therefore, it is essential for the quality improvement of prehospital emergency care that well trained EMT ride on the ambulance together and take the responsibility for the treatment and transferring of emergency patients. In order to improve the proficiency of 119 emergency medical services personnel, it is also necessary to provide continuous job training programs for the prehospital emergency medical treatment.

• Journal of Korean Academy of Nursing
• /
• v.46 no.6
• /
• pp.804-812
• /
• 2016

Purpose: This research was done to identify the hospital arrival rate and factors related to prehospital delay in arriving at an emergency medical center within the golden time after symptom onset in patients with acute myocardial infarction (AMI). Methods: Data used in the research was from the National Emergency Department Information System of the National Emergency Medical Center which reported that in 2014, 9,611 patients went to emergency medical centers for acute myocardial infarction. Prehospital time is the time from onset to arrival at an emergency medical center and is analyzed by subdividing arrival and delay based on golden time of 2 hour. Results: After onset of acute myocardial infarction, arrival rate to emergency medical centers within the golden time was 44.0%(4,233), and factors related to prehospital delay were gender, age, region of residence, symptoms, path to hospital visit, and method of transportation. Conclusion: Results of this study show that in 2014 more than half of AMI patients arrive at emergency medical centers after the golden time for proper treatment of AMI. In order to reduce prehospital delay, new policy that reflects factors influencing prehospital delay should be developed. Especially, public campaigns and education to provide information on AMI initial symptoms and to enhance utilizing EMS to get to the emergency medical center directly should be implemented for patients and/or caregivers.

• The Korean Journal of Emergency Medical Services
• /
• v.6 no.1
• /
• pp.27-37
• /
• 2002

The health and medical service attracts more public attention as the economy of Korea is rapidly growing up and the standard of living is elevated. Especially, the interest and demand on the prehospital emergency medical service that consists of the important part of primary medical service that is directly related to the life of patients are gradually increased. However, as compared with other advanced countries such as America in this area, Korea actually fell behind in the utilization of IT (Information Technology) to maximize the efficiency of emergency service system as well as has a problem in the general service system. This study suggested the necessity to introduce EMD (Emergency Medical Dispatch) system that takes a great role as the core part in the prehospital emergency medical service that is not systemized in Korea yet. In addition, this study proposed the implementation model of EMD ASP system using ASP (Application Service Provider) in EMD system to flexibly deal with the change of IT and efficient implementation and integration of information system as well as to significantly reduce cost through wire/wireless high speed Internet network that is politically promoted in Korea on the basis of EMD. The system analysis and design was executed by HIPO (Hierarchy Plus Input Process Output) analysis that was the conceptual design technology for EMD information system modeling based on ASP and DFD (Data Flow Diagram). This study proposed DB table configuration and data schema to implement the application of web browser interface in EMD system through ERD(ER-Diagram) of EMD ASP system. Finally, this study described how to implement and utilize EMD information system. This study aims to facilitate the qualitative development of emergency medical service in the future as suggesting the concrete models for the implementation of high value-added prehospital emergency medical information system as applying ASP concept to EMD system of prehospital emergency medical service area.

• The Korean Journal of Emergency Medical Services
• /
• v.25 no.3
• /
• pp.17-35
• /
• 2021

Purpose: This study aimed to investigate basic data on preceptor's core competencies required for junior 119 paramedics to improve the quality of emergency care in the prehospital field. Methods: From February 23 to March 10, 2021, data were collected through structured mobile questionnaires from 163 paramedics working in Sejong, Daejeon, and Chung Nam fire stations. The data were analyzed using SPSS version 25.0. Results: The average score of core competencies for junior 119 paramedics accounted for the importance of core competency (3.92 points), level of competence (3.43 points), educational needs (3.65 points). Among them, the importance of a role model accounted for 4.02 points, the highest among the sub-areas. Additionally, there was a significant correlation (r=.686), which was the highest, between the importance and educational needs of core competency; therefore, higher the importance of core competency, higher are the educational needs. Conclusion: Preceptor's core competencies concern three domains: role model, socialization facilitation, and instructional design. It would be more effective for those with higher professionalism and professional self-development needs to be trained as a prehospital preceptor.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.172-179
• /
• 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.