• 한국응급구조학회지
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• 제18권3호
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• pp.19-35
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• 2014

Purpose: This study aimed to improve the quality of prehospital emergency care for elderly patients by determining current prehospital care status based on run sheets and level of knowledge, and prehospital care confidence toward the elderly through questionnaires answered by 119 emergency medical technicians (EMTs). Methods: This study was conducted with 4,946 elderly patients who were transferred to the hospital by 119 ambulances in D city from March 1, 2013 to February 28, 2014. This study was a descriptive study of 119 run sheets. The questionnaire was completed by 160 EMTs working in D city. All data were analyzed by using SPSS 21.0. Results: 74.2% was due to disease among the 4,946 elderly patients who were transferred by 119 ambulances, and a rest was due to injury. The mean knowledge score of the 119 EMTs regarding elderly patients was low. Their confidence on prehospital care of the elderly patients statistically significantly differed according to career at hospital and education. Conclusion: Theoretical knowledge, education on prehospital care of the elderly, and repeated technical prehospital care education and training accompanied by feedback assessment by 119 EMTs are needed.

• 한국응급구조학회지
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• 제19권1호
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• pp.19-33
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• 2015

Purpose: The purpose of this study was to improve the quality of prehospital care provided to infants and toddlers (preschoolers) based on questionnaire findings. Methods: A total of 1,634 running sheets from 119 centers of D city from patients older than 1 month and less than 7 years of age from January 1, 2013 to December 31, 2013 were reviewed for 119 emergency medical technicians (EMTs) activity analysis. And a self-reported questionnaire about knowledge and competency in prehospital care of preschoolers was completed by 159 EMTs at fire stations in D city. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0. Results: Of 1,634 patients, 58.6% were call to 119 due to disease, 33.8% due to injuries and 7.5% due to traffic accident. Knowledge and confidence in treating preschoolers was significantly higher among paramedic EMTs than basic EMTs. The 119 EMTs surveyed indicated that training for preschooler prehospital care was most needed. Conclusion: In order to provide high quality prehospital care for preschoolers transported to emergency rooms, it is necessary to equip ambulances with the proper equipment. In addition, EMTs should be provided educational opportunities and clinical training.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.180-187
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• 2010

Purpose: The "golden hour" concept in trauma is pervasive despite little evidence to support it. This study addressed the association between prehospital time and in-hospital mortality in seriously injured abdominal trauma victims. Methods: A retrospective study was conducted over a three-year period from 2006 to 2008. We analyzed trauma victims with abdominal injuries who underwent an emergency laparotomy in a local emergency center located in a city with a population of 2,500,000. According to the 'golden hour' oncept, we separated the trauma victims into two groups (Gourp 1: prehospital time ${\leq}$ 1 hour, Group 2: prehospital time > 1hour) and investigated several factors, such as time, process, and outcome. Results: During the period from January 2006 to December 2008 139 trauma victims underwent an emergency laparotomy, and 89 of them were enrolled in this study. Between the two groups, emergency department (ED) access, transportation, and injury mechanism showed statistically meaningful differences, but no statistically meaningful differences were observed in various measures of the outcome, such as length of hospital stay, length of Intensive Care Unit stay, and mortality. In a univariate logistic regression study, age (odds ratio [OR]: 1.101; 95% confidence interval [CI]: 1.026 to 1.182), Revised Trauma Score (RTS) (OR: 0.444; 95% CI 0.278 to 0.710), hemoglobin (OR: 0.749; 95% CI: 0.585 to 0.960), and creatinine (OR: 24.584; 95% CI: 2.019 to 299.364) were significant prognostic factors, but prehospital time was not. In a multivariate logistic regression study, age and RTS were significant associated with mortality. Conclusion: In this study, we found no association between prehospital time and mortality among abdominal trauma patient who underwent an emergency laparotomy. We suggest that in our current out-of-hospital and emergency care system, until arrival at the hospital time may be less crucial for trauma victims than once thought.

• 한국응급구조학회지
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• 제24권2호
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• pp.133-153
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• 2020

Purpose: This study aimed to identify the status of emergency care of pregnant women transported by paramedics, to analyze the knowledge of paramedics related to pregnant women and their self-confidence in emergency care, and to provide foundational data to improve the quality of emergency care for pregnant women. Methods: We received a total of 1,798 rescue logs from 119 paramedics, who had transported pregnant women, in I city from January 1, 2016 to December 31, 2018. For survey analysis, we used the 164 questionnaires received from these paramedics from June 15 to August 14, 2019. Results: The analysis of the rescue logs revealed that 85.5% (1,537 individuals) either had disease symptoms or were pregnant, whereas only 14.5% (261 individuals) had traffic accidents or accident-related injuries. The mean knowledge of the paramedics related to pregnant women was 23.73 (±2.98) points, and the mean self-confidence in emergency care was 3.19 (±0.74) points. Knowledge of the paramedics about pregnant women and their self-confidence in emergency care of these women had a statistically significant positive correlation (r=.306, p=.000). Conclusion: Paramedics should be provided theoretical and practical training through various programs about the emergency care of pregnant women.

• 한국응급구조학회지
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• 제15권2호
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• pp.43-54
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• 2011

Purpose: The purpose of this study was to explore EMT-paramedic students' experience of simulation education and analyze the confidence before and after education, learning attitude and course evaluation. Method: Research survey was conducted on 38 EMT-paramedic students during November, 2011 and EMT-paramedic students' experience of simulation education was analyzed after applying head, spinal, and chest injury scenario. The confidence before and after education, learning attitude and course evaluation in gender were analyzed by Mann-Whitny U test and the difference of confidence before and after education was analyzed by Wilcoxon signed rank test and learning attitude & course evaluation were analyzed by evaluating frequency, percentage, mean, standard deviation by using SPSS WIN 17.0 program. Results: 1. Students experienced various advantages such as increasing interest and self-reflection on learning, critical thinking ability, and EMT-paramedic-role experience and recognition of importance of teamwork. Students also pointed out disadvantages such as gap between real situation and simulation, limit of time and equipments, and burden of demonstration. 2. The confidence between before and after education, learning attitude and course evaluation in gender were not significant different statistically. 3. Confidence mean score elevated from 5.53(before education) to 5.87(after education), but the difference in their confidence did not show significant difference statistically. 4. Total mean score in learning attitude after simulation education was 3.70 out of 5.00, which is considerably very high. 5. Total mean score in course evaluation was 3.89 with score of 3.83 in evaluation in learning environment and 3.99 in evaluation of debriefing. Conclusion: The finding of this study demonstrate that the simulation education can provide a safe and repetitive practice environment, improve problem-solving ability and critical thinking, and increase the confidence in prehospital emergency care; therefore, simulation may be the new effective EMT-paramedic education strategy.

• 한국응급구조학회지
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• 제15권2호
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• pp.55-66
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• 2011

Purpose: The purpose of this study was to develop a scenario and evaluate the performance of paramedic students in head trauma simulation education. Method: This study selected a refined head trauma scenario that was developed by graduate students during class from september to November, 2010. Evaluation on implementation of head trauma simulation was conducted on seventeen paramedic students divided into four groups during November, 2010. Results: 1. The head trauma scenario was developed according to the patient assessment for approximately 10 minutes. It contained scene size-up, initial assessment and intervention, rapid trauma assessment and intervention, and decision of transfer. 2. The average time turned out to be 9 min and 36 sec after simulation learning. Total mean score in simulation performance was 2.20, the highest score was 2.44 in initial assessment and intervention, and the lowest score was 1.5 in decision of transfer. 3. Confidence mean was high with the score of 1.0. Conclusion: The finding of this study demonstrate that the simulation education can improve problem-solving ability and critical thinking, and increase the confidence in prehospital emergency care; therefore, simulation may be the new effective paramedic education strategy and simulation learning is needed for further development of various scenarios.