• Health Policy and Management
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• v.2 no.2
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• pp.152-178
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• 1992

This study focuses on making recommendations for the improvement of poor emergency medical services or EMS in Korea. Problems of the current EMS system is widely reviewed. As an alternative of the current system, a franchises system is introduced to EMS. A feasibility study of the new system is carried out as follows. 1) The current EMS system shows such problem as; - Inadequacy of emergency medical fee schedule, - Shortage of emergency medical resources, - Concentration of emergency medical facilities in metropolitan area, - Unestablishment of training program for emergency personnel, - Inappropriateness of patients' behvaviro pattern in emergency care system. 2) Recommendations for the improvement of EMS are as follows: - Well organized communication and transportation system needs to be established by utilizing all the availabl EMS is to be devised for the provision of appropriate emergency care. - A franchises system can be widly adopted so that private organizations are willing to establish a free standing emergency center. - Emergency care fee schedule of the franchises system needs to be appropriate for the system to provide high standard medical services.

• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.153-168
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• 2002

Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

• Journal of the Korean Society of Industry Convergence
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• v.27 no.4_2
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• pp.815-824
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• 2024

The purpose of this study was to examine the scope of work of femergency medical technician who can directly affect the resuscitation of emergency patients at the pre-hospital stage. As a result of the main study, the overall level of the subjects' work scope expansion averaged 3.34points(out of 5points), and among the items, 'The scope of work of emergency medical personnel should be expanded by revising the Act on emergency medical cars' was the highest. As for the difference in the expansion of the scope of work of paramedics by position, 'The current telemedicine guidance system is inconvenient to use' was the highest for emergency medical technicians, and there was a statistically significant difference(p<.01). Based on this study, it is believed that repeated studies are needed to establish and generalize the scope of work of paramedics.

• 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.19 no.2
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• pp.51-69
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• 2015

Purpose: This study aimed to identify the effects of job insecurity and job engagement on turnover intention of paramedics who work in emergency medical institutions. Methods: From October 14 to 28, 2014, data were collected by structured questionnaires from 171 paramedics who were working in emergency medical institutions. The data were analyzed by using SPSS/WIN 21.0. Results: Of the 171 subjects, 57.3% were temporary employees, of whom 87.5% were working in regional emergency medical centers. The mean scores were 3.19 for job insecurity, 4.58 for job engagement, and 3.28 for turnover intention. The correlation between the variables showed that the higher the job insecurity of the participants, the higher their turnover intention (r = .397, p <.001). Moreover, the higher their job engagement, the lower their turnover intention (r = -.354, p <.001). The variable that most significantly affected turnover intention was job insecurity. The coefficient of determination ($R^2$) of job insecurity and job engagement was 24.3%. Conclusion: A law should be enacted to involve paramedics as required personnel for emergency medical institutions in order to enhance the quality of emergency medical services and provide prompt and professional emergency medical services to emergency patients.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.5-14
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• 2011

Purpose: The aim of this study is to identify the legal concept of a license and a qualification for health care personnel. We analyze the appropriateness of the qualification for the first-class paramedics and the sufficiency of 3-year job experience in substitution for college level academic major. Method: We reviewed Laws on Healthcare which stipulate academic and career qualifications for healthcare personnel for whom college-level academic training and job experience to get a license. Results: There is no legal consideration which permits major and educational background substituted by job experience. Only third-class hygienist who graduated from a high school or the equivalent with 3 year job experience can apply for first-class hygienist' national license examination without educational requirements. However, it is nothing to compare with first-class paramedics because the work of hygienist is not directly related to patients care and there is no need of doctor's supervision for hygienist' job. Paramedics have a major role in saving emergency patients in making prompt decision, applying appropriate emergency treatment, securing intravenous route, managing intubation, applying defibrillator, and etc. Conclusion: Ministry of Health & Welfare should grant license to paramedics and annul replacement of academic major background. In addition, it is imperative to broaden the scope of paramedics' job so that they can guarantee patient's life saving in emergency situation with quality major curriculum of college level.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.31-44
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• 2011

Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

• Korean Security Journal
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• no.3
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• pp.336-384
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• 2000

The current function of 119EMS(Emergency Medical Service) is simply to transport patients to hospitals due to the lack of medical personnel and medical equipments. In order to mark the current 119EMS system, that is to say, more many medical technician and paramedics, medical equipments supplementation, korean EMS communication system simplification and the re-arrangement of the existing fire organization, and so on. Also so various problems involving 119EMS should be solved political and financial support and the change in people's attitude toward the public fire service.

• The Korean Journal of Emergency Medical Services
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• v.12 no.1
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• pp.5-15
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• 2008

Purpose : Centering on users(patients) who are offered the patient transport service by the emergency medical service system in our country, the use and satisfaction are analyzed with the transport service in 119 Emergency Medical Service System and Private transport agent. Results : 1. As for personnel in ambulance cars, 119 emergency staff showed a higher boarding rate of the first-class emergency medical technicians than private transportation centers : 48.4% and 17.7%, respectively. 2. Private transportation centers showed higher user satisfaction with transportation service than 119 emergency staff, which was not statistically significant. 3. As for the case that needs to receive the transport service in the future, the ratio with the will to use 119 Emergency Medical Service System(70.9%) was indicated to be much higher than the ratio of the private transport agent(29.1%). Suggestions : First, Centers transporting first-aid patients should essentially secure a sufficient number of first-class emergency medical technicians as professional emergency medical staff to reinforce qualitative improvement in emergency medical service. Second, It is necessary to establish a systematic monitoring system and develop educational programs in order to enhance satisfaction with the use of 119 emergency staff. Third, the government or the local government needs to positively support and guide the private transport agent, which is in charge of the public medical service.

• The Journal of Korean Academic Society of Nursing Education
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• v.2
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• pp.32-55
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• 1996

It was enacted 'Emergency Medical Act' in January, 1994 beginning the emergency medical service system from 1982, and while it was established the emergency medical department in junior college providing the detailed agenda about emergency medical technician and the regulation relative to the application of a law on the emergency medical act in 1995, the fire school and the National Medical Center are enforced the curriculum. It is very important subject faced for the construction of emergency medical system to produce a number of emergency medical technicians to be sufficient to the role of emergency aid. In this study it is analysed the training curriculum for the emergency medical technician and presented the improvement plans. 1. Though it needs the qualification level of first and second class in the selection process, the more important thing needs the detailed qualification level by term of one's service and the skills of business accomplishment. 2. In the examination management, (1) written examination is composed of the questions to understand how much faithfully they carry out the practical business as the emergency medical technicians, (2) it is added practical examination as the item to appraise the situation disposal ability. 3. It is necessary to prescribe the activity in the medical institution and ambulance arrangement through the development of 'Business Treatment Guide'. 4. For the regional balanced disposition of emergency medical personnel it is selected balanceably the educational institution by eight medical service areas, and considering the characteristics of region it is necessary to manage, in the practical business training course, another special course such as the mountains medical aid and sea medical aid. 5. In the period of education the first class needs the practical business training period of a certain period after passing examination, and the second class needs the extension of the period. 6. As the problems to improve in the curriculum [1] in the first class course (1) intensification of practical educaiton (2) reinforcement of curriculum (3) the development of standardized curriculum etc., [2] in the second class course (1) varieties of curriculum (2) intensification of basic first aid treatment education.