• Safety and Health at Work
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• 제7권1호
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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.

• 한국화재소방학회논문지
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• 제29권2호
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• pp.44-53
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• 2015

본 연구는 119구급차 유형별 구조와 기능상의 문제점을 파악하여 구급차 내부 디자인을 보다 안전하고 효율적으로 개선하기 위한 조사연구이다. 4개 시 도의 구급대원 755명을 대상으로 2007년 영국 National Patients Safety Agency (NPSA)에서 개발한 환자 안전을 위한 미래 구급차에 관한 보고서와 이와 관련된 문헌고찰을 통해 수정 보완한 도구를 이용하였다. 설문지는 일반적 특성, 소방 구급차 내 안전성과 효율성 증진을 위한 디자인 개선을 위한 항목으로 구성되었다. 자료는 설문지를 전자우편 또는 직접 배포하여 수집하였으며, 수집된 자료는 SPSS 20.0 프로그램을 사용하여 통계처리하였다. 또한, 일반적 특성은 빈도분석, 백분율로, 구급차 내부 디자인 개선관련 항목은 카이제곱검증을 이용하여 분석하였다. 연구결과, 승합차 개조 소방구급차에서는 내부공간이 좁은 문제와 화물차 개조 구급차에서는 승차감의 개선이 이루어져야 함을 도출하였다. 또한, 구급요원의 안전벨트와 구급요원의 처치 위치의 개선이 필요함을 알 수 있었다. 향후, 이와같은 결과를 토대로 소방 구급자동차의 많은 개선이 필요함을 제시한다.

• 한국안전학회지
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• 제30권1호
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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.

• 한국화재소방학회논문지
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• 제31권2호
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• pp.119-126
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• 2017

본 연구에서는 국내에서 사용되고 있는 구급차의 안락성과 편의성의 조사를 위하여 소음과 진동 및 사이즈의 타당성 등에 관하여 파악하였으며, 대상차량으로는 현재 사용되고 있는 화물형, 승합형 및 벤츠 구급차등을 이용하여 측정 및 조사하였다. 현재 국내의 구급차 제작기준을 살펴보면, 응급환자를 이송하고 구급차 내에서 응급처치를 시행해야 하는 특수목적을 가진 구급차에 대해 별도의 규정 없이 일반자동차와 동일한 기준을 적용하고 구급차량에 대한 안전도, 응급처치에 대한 공간규정, 안락성 및 편의성 등에 관한 규정이 없는 실정이다. 따라서 구급차 환자실의 소음과 진동 측정 실험을 통하여 안락성과 편의성에 대한 비교 실험을 측정하였고, 구급차 환자실의 사이즈 및 내부의 재배치에 대하여 연구하여 안락성과 편의성에 개선이 될 수 있는 부분에 대하여 조사하였다. 소음 측정 결과 승합형, 벤츠타입 및 화물형 타입의 구급차 순으로 소음이 큰 것으로 측정이 되었고, 40 km/h 이상의 속도에서는 60~70 dB 이상의 소음측정 결과를 보여주었다. 진동의 경우는 승합형과 벤츠타입의 구급차량이 양호하고 역시 화물형 타입이 진동 또한 가장 안 좋은 결과를 보여주었으며, 이에 대한 개선사항이 필요하다고 측정되었다. 마지막으로 국내의 구급차량 환자실의 내부를 살펴보면, 구조적으로 내부의 크기를 늘릴 수는 없는 구조이나, 침상의 재배치와 응급처치요원의 위치, 환자보호용 장의자의 배치 및 수납장 등의 재배치를 통하여 편의성을 개선시키는 것이 구급차의 사용을 보다 안락하고 편의성 있게 사용할 수 있을 것이라는 결과를 얻을 수 있었다.

• 한국방재학회 논문집
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• 제9권3호
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• pp.59-65
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• 2009

본 연구에서는 소방공무원의 직무형태별 외상 후 스트레스와 사회적지지 및 업무부담감을 알아보고 직무별 고위험군을 확인 하고 외상 후 스트레스에 영향을 주는 변수들을 알아보고자 하였다. 자료는 C도에 근무하는 소방대원 중 구급 96명, 구조 및 화재진압 85명, 기관 83명인 총 264 명이 수집되었다. SPSS WIN 14.0 program을 이용하여 총 22문항으로 구성된 외상 후 스트레스 검사 도구 (IES-R), 20문항으로 최은숙(2000)이 수정하여 개발한 업무 부담감 측정도구와 오진환(2006)의 연구에서 수정보완 한 사회적지지도구로 분석하였다. 직무별 일반적 특성에 따른 외상 후 스트레스증상의 결과는 나이, 결혼, 학력, 직급, 재직기간이 세 직무집단 간에서 유의한 차이를 보였다. 직무별 외상 후 스트레스는 구조 및 화재 진압에서 가장 높았으며 세집단 간에 유의한 차이를 보였다. 직무별 세 변수와의 상관관계에서 구조 직무군에서 업무부담감(r=.317, p<0.01)이 많을수록 외상 후 스트레스는 높았고, 구급 직무군에서는 사회적 지지(r=-.331, p<0.01)가 낮을수록, 업무부담감(r=.522 p<0.001)이 많을 수록 외상 후 스트레스가 높았고, 기관 직무군에서는 업무부담감(r=.454, p<0.01)이 많을수록 외상 후 스트레스가 높게 나타났다. 고위험군에 속한 군은 구조 및 화재 진압 군에서는 51명(60%) 구급은 53명(55.2%), 기관은 38명(45.8%)으로 전체 264명 중 142명(54%)이었고 직무별 외상 후 스트레스 고위험군에 영향 주는 변수로는 구조 및 화재 진압군은 요구조자 위험을 경험시 느끼는 충격이었으며(odds ratio=1.216, 95% 신뢰구간: 1.068-1.383) 구급직무군은 업무부담감과(odds ratio=1.100, 95% 신뢰구간: 1.043-1.159) 재직기간(odds ratio= 1.010, 95% 신뢰구간 1.001-1.018)으로 나타났고 기관 직무군에서는 요구조자의 위험을 경험시 느끼는 충격(odds ratio=1.178, 95% 신뢰구간: 1.010-1.373), 나이(odds ratio=1.129, 95% 신뢰구간: 1.020-1.249), 업무부담감(odds ratio= 1.103, 95% 신뢰구간: 1.034-1.177)이었다.

• 한국응급구조학회지
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• 제8권1호
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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.

• 한국보건간호학회지
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• 제9권1호
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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.

• 한국응급구조학회지
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• 제18권2호
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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.

• 한국응급구조학회지
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• 제7권1호
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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.

• 한국응급구조학회지
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• 제26권3호
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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.