• Safety and Health at Work
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• v.7 no.1
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• pp.32-37
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• 2016

Background: Previous research has shown that paramedics are exposed to risks in the form of injuries to the musculoskeletal system. In addition, there are studies showing that they are also at increased risk of cardiovascular disease, cancer, and psychiatric diseases, which can partly be explained by their constant exposure to stress. The aim of this study is to evaluate whether the use of shoulder straps decreases physical effort in the form of decreased heart rate and cortisol concentration. Methods: A stretcher with a dummy was carried by 20 participants for 400 m on two occasions, one with and one without the shoulder straps. Heart rate was monitored continuously and cortisol samples were taken at intervals of 0 minutes, 15 minutes, 30 minutes, 45 minutes, and 60 minutes. Each participant was her or his own control. Results: A significant decrease in heart rate and cortisol concentration was seen when shoulder straps were used. The median values for men (with shoulder straps) at 0 minutes was 78 bpm/21.1 nmol/L (heart rate/cortisol concentration), at 15 minutes was 85 bpm/16.9 nmol/L, and at 60 minutes was 76 bpm/15.7 nmol/L; for men without shoulder straps, these values were 78 bpm/21.9 nmol/L, 93 bpm/21.9 nmol/L, and 73 bpm/20.5 nmol/L. For women, the values were 85 bpm/23.3 nmol/L, 92 bpm/20.8 nmol/L, and 70 bpm/18.4 nmol/L and 84 bpm/32.4 nmol/L, 100 bpm/32.5 nmol/L, and 75 bpm/25.2 nmol/L, respectively. Conclusion: The use of shoulder straps decreases measurable physical stress and should therefore be implemented when heavy equipment or a stretcher needs to be carried. An easy way to ensure that staff use these or similar lifting aids is to provide them with personalized, well-adapted shoulder straps. Another better option would be to routinely sewn these straps into the staff's personal alarm jackets so they are always in place and ready to be used.

• Fire Science and Engineering
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• v.29 no.2
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• pp.44-53
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• 2015

This study is a survey research to improve the fire-fighting ambulance interior design safer and more efficient to identify the type of structure and functional problems 119 ambulance. When the paramedics and four degrees to over 755 people modify the target report and related literature on the future development of an ambulance for patient safety at the 2007 British National Patients Safety Agency (NPSA) and was used as a complementary tool. General characteristics questionnaire was composed of items for your design improvements for ambulance promote safety and efficiency. The data were collected by distributing a questionnaire e-mail or in person. The collected data were processed using the SPSS 20.0 statistical program, the general characteristics as frequency analysis, percentage, ambulance interior design improvement-related items were analyzed using the chi-square verified. As a result, this research elicited that vans converted fire ambulance cars have a problem with the narrow interior space and truck converted fire ambulance cars should be comfortable to drive in ride quality. In addition, we also found that the improvement of paramedics treatment position and the paramedic's personnel safety belt are required. Based on these results, we propose that a number of improvements are needed in the fire-fighting ambulance car.

• Journal of the Korean Society of Safety
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• v.30 no.1
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• pp.79-86
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• 2015

This research proposed a design direction for the ambulance interior storage space based on the placement and access to the equipment to facilitate an emergency medical practice taking into account the safety and efficiency by the emergency medical technician ergonomic factors. Therefore, through a field survey for the current derivation of the storage space problem 'placement', 'enable', 'management' like these three items resulting clarity, accessibility, simplicity and functionality of the four functional elements by targeting ambulances in operation in this country. First, there is a need to improve standardized of cabinet sizes fit to loaded meet emergency equipment standards. Currently, the equipment designed to use a simple storage cabinet has had problems in the usability. Second, it must be located in the continuous exposure in progress to the user's traffic line. Third, the problem was the insufficient function of the cabinet to ensure the safety of patients by paramedics from the emergency rescue equipment and due to the leaning of the ambulance driving. Besides, it was pointed out that in addition to the proposed alternatives, including the agenda, states that safety belt replacement equipment, emergency personnel and patients with the handle of a guardian for the efficient use storage space within the 119 ambulance. However, in the present study suggest that there is a state proceeds mainly limited usability in the field, having been installed.

• Fire Science and Engineering
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• v.31 no.2
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• pp.119-126
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• 2017

This study examined the soundness, vibration, and size of ambulances currently used in Korea as well as the comfort and convenience of ambulancesin Korea. The target vehicles were measured and investigated using the currently used freight type, van type, and Benz ambulance. Currently, the ambulance standards in Korea have only formal production standards, and there is no regulation on safety for ambulances, space regulation for first aid, comfort, and convenience. Therefore, comparative experiments on the comfort and convenience were measured using noise and vibration measurement experiments, and research was conducted on the size and interior rearrangement of ambulances to investigate the areas that can improve the comfort and convenience. The noise measurementsshowed that the noise was large in the order of the van type, Benz type, and freight type. In the case of a speed of 40 km/h or more, the noise measurement result was 60 to 70 dB or more. In the case of vibration, the Benz type and van type ambulance were good, and the vibration of the freight type showed the worst result, highlighting the need for improvement. Lastly, it is not possible to increase the internal size of the structure of domestic ambulance. On the other hand, it is important that through ambulance relocation and the position of first aid personnel, it will be possible to use it more comfortably and conveniently.

• Journal of the Korean Society of Hazard Mitigation
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• v.9 no.3
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• pp.59-65
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• 2009

To investigate a posttraumatic stress, social support and work burden and to identify high risk group and related factors which were exerted influence on posttraumatic stress of firefighters. Data were gathered from total 264 firefighters consisting of 85 fire distinguishers & rescue workers, 96 emergency medical personnel and 83 in ambulance & fire truck drivers in C province and were analyzed 22 items by IES-R, 20 work burden items by Choi(2000), 8 social support items by Oh(2006) using SPSSWIN 14.0 program. Posttraumatic stress of general characteristics by work was showed significant difference in age, marriage status, education, position, office duration, mobilization frequency and experience of traumatic events. Posttraumatic stress were showed significant difference in 3 groups and fire distinguishers & rescue workers is the highest group. Posttraumatic stress was correlated with work burden(r=.317, p<0.01) for fire distinguishers & rescue workers, social support(r=-.331, p<0.01) and work burden(r=.522 p<0.001) for emergency medical personnel and work burden(r=.454, p<0.01) for ambulance & fire truck drivers. The high risk groups are fire distinguishers & rescue workers(60%), emergency medical personnel(55.2%)and ambulance & fire truck drivers(45.8%). Related factors are the experience seeing victim's danger for fire distinguishers & rescue workers(odds ratio=1.216, 95% confidence interval:1.068-1.383), and are work burden(odds ratio=1.100, 95% confidence interval:1.043-1.159) and office duration(odds ratio=1.010, 95% confidence interval 1.001-1.018) for emergency medical personnel, and are the experience seeing victim's danger(odds ratio=1.178, 95% confidence interval:1.010-1.373), age(odds ratio=1.129, 95%confidence interval:1.020-1.249), work burden(odds ratio=1.103, 95% confidence interval:1.034-1.177) for ambulance & fire truck drivers.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.199-210
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• 2004

Since the 119 fire department was legally permitted to serve in Emergency Medical Service(EMS)Operation of emergency patients in 1983, 119 EMS operation in general has made a big progress in serving the needs for emergency patients. Currently EMS operation is carried out by 119 EMS unit, private ambulance Co.,etc. But due to the public recognition and volunteers, 119 EMS operation carries the major share of the service. This observation is not surprising in that such a trends occured in Japan 20 years ago. This paper compared the 119 EMS operation conducted by the fire department in Korea with that of Japan in order to draw some inferences from the comparison. The results of the study compared to Japan were as follows: 1. Japan was higher 1.5 times in the number of EMS units per population(100,000), 1.1 times in the number of patient transports per unit. 2. Japan was higher 4.54 times in the number of the 119 EMS personnel per population(100,000), 30.6 times in that per square killometers, 30.6 times per 119 EMS unit, in per ambulance 2.48times. 3. Japan was higher 1.83 times in the number of ambulance per population(100,000), 1.26 times in that per square killo meters. 4. Japan was higher 1.7 times in the number of transport patients per population (100,000), but Korea was higher 2.68 times in the transport patients per EMS personal. 5. Compared to Japan, there was no emergency care related to ALS, for example, such as administering dugs orally and intravenously, interpreting elctrocardiograms, performing endotracheal tube or LMA insertion, using monitors and other complex equipments in Korea.

• Journal of Korean Public Health Nursing
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• v.9 no.1
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.137-145
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• 2014

Purpose: The emergency medical service (EMS) system in Japan is similar to that in Korea. This study reviewed the development of paramedics who are major personnel in the respective EMS system of their country. Methods: We searched law for paramedics and publications in J-stage, MEDLINE and the webpage of Japan's Fire and Disaster Management Agency. Results: Paramedic training had started in Japan in 1991, and most paramedics were employed in fire departments. In Japan, ambulances belonging to fire department are staffed by a three-person unit, including at least one paramedic. Medical control advisory boards were established in all Japanese prefectures in 2003 with the purpose of upgrading the activities of ambulance personnel, including paramedics. The scope of paramedics' work has been widened owing to the continued efforts of medical control advisory boards. This allows them to perform invasive procedures including tracheal intubation, intravenous line placement, and epinephrine administration under medical control of a physician. Conclusion: As paramedics' responsibilities expand, further development of the paramedic role and an effective medical control advisory board system are imperative both Korea and Japan.

• The Korean Journal of Emergency Medical Services
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• v.7 no.1
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• pp.55-64
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• 2003

The purposes of this study which was conducted by applying three projection formulae to the data from admission quota for paramedic of the Ministry of Education & Human Resources Development the number of ambulances the number of emergency medical centers of the Ministry of Health & Welfare and rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board were to find out demand and supply of paramedic from 2002 to 2045 and to expand scope of practice of paramedic in Korea. The conclusions from this study were summarized as follows; (1) The simple formulae derived from the projection formula of the Economic Planning Board were applied under the present Emergency Medical Services Act including qualifying over 3-years experienced EMT-Basic for paramedic examinee, stationing paramedic or EMT-Basic or physician or nurse per ambulance, stationing paramedic or EMT-Basic per emergency medical center and under the amended Emergency Medical Services Act including qualifying only paramedic graduate for paramedic examinee, stationing 4.5 paramedics per ambulance, stationing 10 to 2 paramedics per emergency medical center. (2) It was estimated that on the American basis of 5.6 EMTs per 10,000 in 1996, the number of paramedics under the present act will reach the basis before 2020, the number of paramedics under the amended act will reach the basis about 2040. (3) It was estimated that on the basis of 22,000 paramedics demanded from the number of ambulances, the number of emergency medical centers in 2001, the number of paramedics under the present act will reach the basis before 2015, the number of paramedics under the amended act will reach the basis about 2030. (4) There was relationship between requirements for emergency medical centers scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic including EMD, instructor, teacher of safety. (5) This study which includes only expanded scope of practice of paramedic and projection for paramedic in the act needs complementary studies such as decision-making process in health manpower policy and so on.

• The Korean Journal of Emergency Medical Services
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• v.26 no.3
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• pp.121-135
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• 2022

Purpose: The purpose of this study was to develop a training protocol to standardize the management of mass casualties as part of the disaster response, and to verify the effectiveness of the training protocol. Methods: The study was conducted as a quasi-experimental study with a non-equivalent control group and pretest-posttest design. The protocol was divided into 5 parts, the first for the advance party, the second for the rescue team, the third for the paramedic team, the fourth for the ambulance team, and the fifth for the 119 EMS team. This study was conducted on November 15, 2021 and consisted of 21 subjects in the final experimental group and 23 subjects in the control group. In this study, the prior homogeneity test was analyzed using the χ²-test, intragroup comparisons were analyzed using the paired t-test, and intragroup comparisons were analyzed using the independent t-test. Results: The protocol was developed in five parts: advance party, rescue team, paramedics team, ambulance team, and 119 EMS team. In verifying the effectiveness of the protocol, it was found that there were significant differences in self-efficacy (t=-0.941, p=0.001) and self confidence within the group (t=-0.025, p=0.001) after the implementation of the mass casualty incident response training program. However, there was no significant difference between the experimental and control groups. Conclusion: Based on the findings of this study, it is believed that disaster response personnel can experience lower levels of anxiety and tension in disaster situations if they receive practical and realistic education and training. In the future, it is necessary to enhance protocol based practical education that can improve the knowledge and skills of each team and individual.