• 한국응급구조학회지
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• 제8권1호
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• pp.117-126
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• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• 한국응급구조학회지
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• 제1권1호
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• pp.71-86
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• 1997

This study is to suggest some developmental policies by analyzing the activities of first aid party in Kwangju and Chonnam regions for two years from Jan. 1, 1991 to the end of December, 1995. First, the residents in Kwangju and Chonnam regions have the sufficient benefits of emergency medical center, but it will be desirable that general hospital should be established and managed in Kohung peninsula which forms the wide island area far away from big cities. Second, the classification of the degree of severe case in the field by rescue members should be strengthened as the means which can reduce the number of patients transferred to the emergency room and the legal method which rescue members can select the medical agency. Third, children less than 10 are most frequent emergent patients and it is due to parent's indifference and children's in sensibility to safety. So the safely education in the course of infant and elementary education should be strengthened and the method which can keep the self safety through the legal system. Fourth, to increase the rate of emergency measure by rescue members, the reasons of fail of emergency treatment are suggested, the treatment results of each rescue member are analyzed every year and it is desirable that the system which can evaluate the personal ability should be introduced. Fifth, the medical accidents occurred in the case of medical act, by rescue members must lake the legal responsibility, but such a problem can he solved with the compensation of insurance system by government. Sixth, to reduce the time required for transfer, traveling service system for the fixed period in beach should be complemented and extended more and service system at ordinary times should be examined at mountains, the area of traffic jams and large special industrial park. Seventh, since service system with one team of two members of 119 rescue party in expressway cannot be mobilized when multiple accidents occur at the same time, it is considered that service system of two teams of four members should be extended. Eighth, first-aid service in expressway is conducted with rescue and emergency treatment by the rescue party at the same time, but the professional rescue lacks and it may result in the injury of patients. Therefore the creation of rescue party in expressway is the urgent problem.

• 한국응급구조학회지
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• 제6권1호
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• pp.141-152
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• 2002

The purpose of this study is to provide the basic materials for searching the way of improvement to heighten the emergency medical welfare level by one step further. To achieve this purpose, the subjects of this study were selected 452 college students in Gwangju, using a random sampling method. The statistical analysis methods utilized for analyzing the collected data are frequency analysis, $x^2$ test. The conclusions obtained from these analyses are as following ; 1. In question about necessary optimum number of persons for rescue first aid activity, health and non-health major college students responded by 39.2%, 45.3% respectively that rescue team 15 people, first aid team 3 people is most suitable. But there was no significant difference in major department(p<0.05). 2. In question about security of the public health doctor and the emergency medical technician, all health and non-health major college students are recognizing necessity urgently, but there was no significant difference in major department(p<0.05). 3. In question about 119 rescue first aid team member applying for an examination qualification grant to the department of EMT's graduate, all health and non-health major college students were highest by 52.9%, 52.4% respectively in "necessity" item. But there was no significant difference in major department(p<0.05). 4. Because rescue first aid equipment level appears higher than 41.7% in non-health major college student's case by 54.2% in health major college student's case, health major college students are recognizing that equipment level should be supplemented more but there was no significant difference in major department(p<0.05). 5. In question about equipment supplement, all health and non-health major college students appeared highest by 64.8%, 69.3% in accident type different special equipment. But there was no significant difference in major department(p<0.05). 6. In question about rescue ambulance car size, we could know being thinking that health and non-health major college student each 61.2%, 56.5% is small and narrow that large size of the rescue ambulance amount need. But there was no significant difference in major department(p<0.05). 7. In question about patient's state is worsened, because rescue first aid equipment is inferior, health major college student responded sometimes 55.1%, many 29.5%. very many by 11.5%, while non-health major college student responded 65.8%, 23.1%, 4.0% respectively. There was significant difference in major department(p<0.05). 8. In question about emergency patient must utilize for 119 rescue ambulance car, all health and non-health major college students appeared highest by 38.8%, 41.3% in "not so" item. In question about rescue first aid team's first-aid treatment ability improves more, all health and non-health major college students appeared highest by 58.1% and 58.7% respectively in "improve" item. In question about "119 rescue ambulance car must go more rapidly than now", all health and non-health major college students are recognizing that should be quicker by 58.1%, 60.9% respectively. When called to 119 all health and non-health major college students responded highest by 55.5%, 53.3% respectively that we must receive first-aid treatment direction from a doctor. In question about "119 rescue ambulance car must be made the pay system", all health and non-health major college students responded 74%, 80% respectively in "not so" item. There was significant difference in major department(p<0.05). In conclusions, In oder to provide superior rescue first aid service to people, a public health doctor should be placed in the situation room inside the fire station so that the doctor could instruct the proper emergency treatment suitable for each situation to the rescue first aid team. Also, national education about a first-aid treatment that do to all people is necessarily necessary in emergency delivery system and this should be spread extensively through school education and broadcasting medium and education should be gone side by side, and see that will can save emergency patients' life which is more when these education consists continuously fixed period for public institution of policeman, fire officer etc. specially. And for reinforcement of patient transfer system, public organization must procure special ambulance car so that emergency patient receive first aid treatment while transfer.

• 한국응급구조학회지
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• 제9권1호
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• pp.111-119
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• 2005

Glucose is the most importantenergy source in the central nervous system. Because the central nervous system cannot synthesize or store glucose. low blood glucose even for a short period results in no functionally normal activity of the brain. In addition, continuous low blood glucosecan cause irreversible brain damage and brain death. Therefore, the current status of emergency care by first aid staffs during transfer of patients with hypoglycemia has been investigated in this study, 114 patients who have visited the hospital using 119 Emergency Medical Service from January 1, 2004 till December, 2004 and shown blood glucose of 2.8 mmol/L and less on arrival have been involved. In case of nurses, assistant nurses, first aid staffs receiving first aid training and second-class emergency medical technicians(EMTs), they provided basic life support (BLS). In case of first-class EMTs, they measured blood sugar and then they orally administered glucose to conscious patients or provided simple first aids and prompt transfer for unconscious patients. As a result of analysis, it is suggested that first aid retraining is required.

• 한국화재소방학회논문지
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• 제19권4호
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• pp.47-56
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• 2005

비응급상황에 대한 제한적인 구급요청의 거절 및 환자 등의 이송거부로 인한 법적 분쟁으로부터 당해 구급대원을 보호하고 이에 대한 절차를 엄격히 하여 응급환자를 보호하기 위하여 $\ulcorner$구조대 및 구급대 편성$\cdot$운영에 관한 규칙$\lrcorner$이 개정되었다. 이에 대하여 본 논문은 구급대원의 이송거절 거부에 따라 발생할 수 있는 법적 책임으로 응급의료거부죄의 구성요건 해당성을 고찰하고 부작위에 의한 형사책임 및 환자에게 발생한 손해에 대한 국가배상책임의 발생가능성에 대하여 연구하였다. 구급대원을 법적 책임으로부터 보호하기 위해 개정된 규칙의 준수에 있어서 유의해야 할 점과 외국의 판례들을 고려하여 법원의 태도를 살펴보았다. 결론적으로는 구급대원의 법적인 보호를 위해 지도의사의 의료지도 확보 및 적법한 절차를 따라 문서화된 서식을 충실히 기록함으로써 구급대원의 의무에 대한 충실한 이행 및 환자의 동의를 확보하여 이송거절 및 거부에 대한 정당성을 확보하는 것이 중요함을 강조하였다.

• 한국응급구조학회지
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• 제25권1호
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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.

• 한국지리정보학회지
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• 제10권1호
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• pp.113-123
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• 2007

본 연구는 응급의료서비스를 제공하는 주요 시설인 소방파출소와 응급의료기관의 공간적 입지의 적절성 분석과 함께 응급처치를 위한 출동체계 및 후송체계와 관련된 119응급의료 활동권역의 진단을 연구 목적으로 한다. 이를 위해 부산시 119 구급관련 자료를 GIS상에서 분석 가능하도록 우선 환자 발생위치를 지번데이터와 주소를 기반으로 매칭시킴으로써 개별 개체로 입력하였으며 환자로의 출동 및 병원으로의 후송에 따른 시간을 초단위로 구축하였다. 또한 119 파출소의 위치 및 관할 구역, 응급의료기관 등을 입력하여 시간적 권역은 물론 공간적 권역의 분석을 실시하였다. 구축된 부산지역 16개 구군과 226개 읍면동별 GIS데이터를 활용한 분석결과 부산시 응급의료서비스의 5분이내 비율이 약 41%에 그쳤으며 각 구별로는 5분 초과 10분 이내의 비율이 가장 높음을 알 수 있었다. 또한 병원이용패턴에 있어서도 매우 비효율적인 활동이 이루어지고 있음을 알 수 있었다. 이와 같이 소방파출소와 응급의료기관의 출동시간대별, 후송시간대별 시공간적 분포에 대한 진단결과와 함께 이상적인 출동 및 후송 패턴을 제시하여 이를 비교함으로써 응급의료서비스 체계를 구성하는 공공시설들의 효율적 자원 활용방안을 제시하고자 하였다.

• 한국응급구조학회지
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• 제25권1호
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• pp.7-22
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• 2021

Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

• 한국응급구조학회지
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• 제11권3호
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• pp.119-128
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• 2007

It is happening a lot that the pediatric patients who are offering help in emergency room with background 119 rescuer require emergency care compared to adults. Our study was conducted to have a clear grasp of the status quo of pediatric patients who are offering help in emergency room with 119 rescuer. METHOD & OBJECT pediatric patients under 8 age who were offering help was conducted as objects by 119 cases from January, 2006 to January 2007, with 119 rescuer at C university hospital in Gwangju metropolitan city, which were 87 cases for a boy(73.1%), 32 cases for a girl. Based on emergency diary of emergency members and the medical treatment record of emergency room in C university hospital, a disease and a type of an external wound were analyzed according to ages of these patients, a time zone and season. RESULT In terms of an age, 25 cases(21.0%) have less than 1 age extremelymuch, in case of emergency, 61 cases(51.3%), which were more than non-emergency, in terms of happened places of patients, there were households up to 78 cases(65.5%) extremely much. In terms of happened time, 13:00 to 18:00 have highest data up to 48 cases(40.3%). According to season, there were no big differences in 4 seasons(spring : 30.3%, summer : 24.4%, fall : 29.4%, winter : 16.0%). In case of being offered help at emergency room due to diseases, 1-2 ages have highest estimate with 55.7%, in terms of a time zone, 19:00-24:00 have highest with 33.7%, in terms of season, summer(6, 7, 8) have highest with 32.8%. in case of traffic accident, 7-8 age have highest with 47.1%, according to a time zone, 13:00 to 18:00 have highest with 88.2%, according to season, fall have highest with 64.7%. In case of an external wound, 3-4 age have highest with 38.2%, according to a time zone, 13:00-18:00 have highest with 41.2%, according to season, spring have highest with 38.2%. CONCLUSION It shows that in case of pediatric patients who were offering help at emergency room with 119 rescuer, a pediatric under 1 age was due to a disease, in case of an external wound, there were 3-4 age, in case of traffic accident, 7-8 age have highest, a case for emergency have highest.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.