• 한국산학기술학회논문지
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• 제14권4호
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• pp.1709-1717
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• 2013

본 연구는 119 구급대의 1급 응급구조사에 의한 심장 마비 환자에 대한 전문기도유지술 실시횟수의 관련 요인을 파악하였다. 광주소방 본부의 1급 응급구조사 95명을 대상으로 구조화된 설문지를 이용하여 일반적 특성, 직업관련 특성, 자기효능감, 전문기도유지술을 시행하는데 저해요인을 조사하였고, 2010년 1월 1일부터 2011년 6월 30일까지 전문기도유지술 실시한 자료는 광주 소방본부에서 제공받았다. 본 연구의 결과로, 전문기도유지술 관련 특성과 실시횟수와 상관관계를 분석한 결과, 필요를 느낀 횟수(r=0.397, p<0.01)와 자기효능감(r=0.419, p<0.01)이 상관관계를 보였고, 저해요인과 실시횟수와 상관관계를 분석한 결과 자신감(r=-0.036, p<0.01)과 경험문제(r=-0.405, p<0.01)가 상관관계가 있었다. 결론적으로, 전문기도유지술의 필요성을 제대로 인식하도록 하고, 자기효능감을 향상시킬 수 있도록 현장위주의 교육 프로그램과 인적자원관리에 대한 대책 마련이 필요할 것이다.

• International Journal of Advanced Culture Technology
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• 제10권2호
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• pp.140-147
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• 2022

This study analyzes research trends by systematically examining research about domestic emergency medical services' clinical practice, and it is aimed to present the basic data needs in development plan in clinical practice education in the future. The thesis was searched through the electronic data research (Science Direct, PubMed, Medline, and 55 academic DB interworking) from the library of Konyang University from 2010 to 2021. The main keywords were "Emergency Medical Technician(EMT) Student" and "Clinical Practice," and 6 pieces of researches were selected, finally. As the result of analyzing the qualitative level of selected research, all the 6 pieces of research subjects(100.0%) were pertinent to level IV(survey research) which is low-qualitative level. As the principal subjects, "Clinical practice experience" got the highest frequency as 6(100%), "Satisfaction of clinical practice" was 3(50%), "Self-efficient, Major satisfaction" and "Stress, Depression, Coping" showed 2 (33.3%), and "Change after clinical practice", "Clinical practice improvement plan" was 1(16.7%) each. From this time on, it is confirmed that the quantitative and qualitative growth in domestic emergency medical clinical practice is necessary. This is expected to contribute to establishing a practical and systematic development plan of clinical practice education.

• 한국화재소방학회논문지
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• 제26권5호
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• pp.54-60
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• 2012

이 연구는 소방 119구급대에서 근무하는 1급 응급구조사의 병원임상수련 실태를 조사한 연구이다. 조사대상은 소방에 근무하는 1급 응급구조사 42명으로 하였으며, 2012년 5월 11일부터 2012년 5월 12일까지 구조화된 무기명 자기기입식 설문지를 이용한 설문조사에 의하였다. 연구결과 1급 응급구조사의 업무범위를 한 번 이상 직접 경험한 경우는 56.5 %였고, 이들 중 기관내삽관 66.9 %, 후두마스크 8.4 %, 정맥로확보 76.6 %, 니트로글리세린 설하투여 61.2 %, 기관지확장제 흡입 50.0 %, 수액투여 73.8 %, 인공호흡기 사용 57.6 %, 포도당 주입 57.6 %를 경험하였으며, 1급 응급구조사 업무범위를 16개 의료기관별로 살펴본 결과 58.0 %가 한 번 이상 직접 경험하였다. 향후 1급 응급구조사의 교육 요구도에 대한 지속적 연구가 필요하며, 병원임상수련의 문제점 분석, 임상실습지침서의 보완과 실무중심의 교육프로그램 운영 및 관리에 대한 규정과 지속적인 평가가 필요하다.

• 한국화재소방학회논문지
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• 제30권3호
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• pp.124-132
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• 2016

직접의료지도란, 현장에서 환자에게 응급처치를 수행하거나 이송하는 구급대원이 의사에게 전문적인 지도와 자문을 제공받는 행위를 말한다. 본 연구는 직접의료지도의 이용 실태를 파악하고 관련요인을 조사하고자 실시되었다. 광주광역시에 근무하고 있는 119 구급대원 153명을 연구대상으로 하였고, 자기기입식 설문조사를 이용하여 자료를 수집하였다. 통계분석은 SAS version 9.3을 이용하였다. 연구대상자 중 약 82%가 최근 한 달 이내 직접의료지도 경험이 있었고, 다중로지스틱 회귀분석 결과 기혼자인 경우(OR = 3.87, 95% CI = 1.22~12.27), 1급 응급구조사인 경우(OR = 2.87, 95% CI = 1.02~8.09), 심혈관계 응급환자를 처치한 경우(OR = 9.19, 95% CI = 1.87~45.08)에 직접의료지도 이용에 대한 교차비가 유의하게 높았다. 따라서 향후 직접의료지도 내용과 제도 개선 시 119 구급대원의 특성과 처치하는 환자의 질병상태를 고려한다면 직접의료지도 활성화에 도움이 될 것이다.

• 한국응급구조학회지
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• 제22권2호
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• pp.51-65
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• 2018

Purpose: The purpose of this study was to investigate experiences of violence with patients or family members by paramedics working at emergency rooms. Methods: A questionnaire was administered from June 1 to 31, 2017 to 225 paramedics working at 27 emergency medical centers. The collected data were analyzed with SPSS statistics ver 24.0 program. Results: Within the past year, 208(92.9%) of 224 participants experienced violence among whom 202(90.2%) experienced verbal abuse, 193(86.2%) experienced physical threat, 89(39.7%) experienced physical violence, and 52(23.2%) experienced sexual violence. The level of violence response depending on the overlapping experience of violence type showed significant difference from emotional response (p= .001), social response (p= .001), physical response (p= .004), and overall violence response (p= .001). Conclusion: In conclusion, paramedics are frequently exposed to violence in the emergency rooms, of which they mostly experience verbal abuse. In addition, because the reporting system in the event of violence and the coping process are not well-informed, paramedics are unable to sufficiently utilize the reporting system and programs established within the institution. Therefore, the support of the legal system is needed to create a safe working environment for the medical staff who work in the emergency medical centers.

• 한국응급구조학회지
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• 제16권3호
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• pp.45-62
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• 2012

Purpose : This study was carried out from September 2011 to September 2012 to indicate improvement and performance schemes and planning strategies by way of scenario based practical examination to inspire adaptable capacity to EMS field for Emergency Medical Technician. Methods : In order to improve the examination, a survey was conducted to EMT-Paramedics (Level 1), EMT-Basics (Level 2), and other expert groups. The researchers visited the National Registry of Emergency Medical Technician (NREMT) headquarter and the psychomotor examination site in Ohio in April, 2011. The 21 EMT professors took part in a workshop experiencing the US psychomotor examinations provided by two NREMT examination experts in October, 2011. Results : The results showed that the general plan of new National Practical Examination for EMTs should consist of integrated emergency care examination based on clinical performance and simple skill examination based on objective structured skill protocol Conclusion : The National Practice Examination consists of two sessions and the examinees select the test number randomly in each session. The future examination should include the critical criteria and this criteria should be the decisive factor for the pass or fail.

• 농촌의학ㆍ지역보건
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• 제35권3호
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• pp.301-313
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• 2010

2009년 3월 1일~4월 31일까지 광주광역시와 전라남도에 근무하는 119 응급구조요원 288명을 대상으로 병원 전 단계 에서 119 응급구조요원이 약물중독환자에게 실시하는 병원 전 응급처치의 지식과 수행 태도에 대한 서술적 조사 연구이다. 약물중독의 지식정도 평점은 10점 만점에 7.04점, 약물중독환자의 응급처치 수행 태도는 평점 4점 만점에 2.96점으로 응급처치 지식은 높으나 수행태도는 낮은 경향이었다. 또한 약물중독 환자에게 틀리게 응급 처치한 경우가 34.6%로서 환자의 생명에 직결되는 문제를 야기할 수도 있다. 수행 태도의 4개 하위 영역별로 살펴보면, 환자 상태파악 영역 3.52점$\pm$0.59, 환자처치 영역 2.95점$\pm$0.57, 환자예후 파악 영역 2.78점$\pm$0.75, 의료지도 업무수행 영역 1.67점$\pm$1.05의 순으로 의료지도 업무 수행영역이 가장 낮은 점은 시사하는 바가 크다. 즉 병원 전 단계의 의료지도가 중요하므로 향후 응급실의 응급의학 전문의 중 1인이 응급구조사로 부터 환자상태를 보고 받으면 투약과 처치를 지도하는 병원-응급구조대 연계체계의 구축이 바람 직하다. 약물중독환자에 대한 지식은 연령, 성별, 지역별 근무지에 따라 차이가 있었다. 응급처치 수행 태도는 성별, 지역별 근무지, 교대 근무 형태, 학력, 올바른 응급처치, 연수 여부 별로 차이가 있었다. 대상자인 119 응급구조요원의 약물중독 보수교육률과 연수률이 낮았고 약물중독에 관한 전문교육요구는 높았다. 이상의 연구결과를 통해 병원 전 단계 약물중독환자에 대한 응급구조사의 지식은 높지만, 수행 태도에서 환자 상태파악은 잘 하고 있었으나, 환자예후 파악과 의료지도 업무는 정확하게 수행하지 못하고 있었다. 본 연구는 향후 응급구조사와 119 응급구조요원에 대한 반복적인 술기 중심 응급처치 연수를 통한 응급구조사의 질 향상과 병원 전 단계 약물중독 환자 지침서 개발에 유용한 자료가 될 것으로 본다.

• 한국응급구조학회지
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• 제20권3호
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• pp.37-47
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• 2016

Purpose: The purpose of the study was to establish an education curriculum subject program design for the department of emergency medical technology based on National Competency Standards (NCS) key competencies. Methods: A self-reported questionnaire was completed by 180 level 1 emergency medical technicians in K area from June 15 to 20, 2016. Except for 14 incomplete questionnaires, 141 data were analyzed. The study instrument included general characteristics of the subjects (7 items) and importance and satisfaction levels for 10 key competencies including 34 items of subfactors by a Likert 5-point scale using Borich Needs Assessment Model. A locus for focus model (LF model) was used to derive the top priority key competencies for the education curriculum. Data were analyzed by SPSS v. 20.0. Results: The order of education needs of the program included interpersonal competency (1.442), communication competency (1.384), problem solving competency (1.185) and professional ethics competency (1.149). In the LF model, the required jey competencies included interpersonal competency, communication competency, professional ethics competency, and problem solving competency. Conclusion: The study results coincided with standard education curriculum guidelines. Our resluts can provide a valid reference for the department of emergency medical technology.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.89-98
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• 2013

Purpose: The assessment of trauma patients in the prehospital setting is difficult, but appropriate field triage is critical to the prognosis of trauma patients. We sought to evaluate the triage given by the emergency medical technicians (EMTs) using the trauma score to patients injured in motor vehicle collisions (MVCs). Methods: From June 2012 to July 2012, questionnaires were distributed to EMTs, who had transported injured patients to the study hospital. Scene records, photos of the damaged vehicle, and ambulance run sheets were used to provide physiologic, physical, and mechanistic information about the MVC. To evaluate the appropriateness of the injury assessment by EMTs, we compared their impressions with the hospital's final diagnosis within a 3 level triage system comprising both the maximum abbreviated injury scale (MAIS) and the injury severity score (ISS). Kappa (k) was calculated to evaluate the agreement between the triage by EMTs and the triage based on hospital's final diagnosis. Results: A total of 91 patients were analyzed by 31 EMTs. The percentage of males was 57.1%, the mean age was 44.5, and the mean MAIS and ISS were 2.7 and 16.6 respectively. While EMTs correctly diagnosed patient injuries to the extremities in 35.7%, and to the neck in 32.1%, pelvic injuries were missed in 80.0%. The agreement between the triage by the EMTs and the triage based on the hospital's final diagnosis was 62.6%(k=0.366) by the MAIS and 50.5%(k=0.234) by the ISS. The kappa value was higher in EMT-I than in EMT-II. Conclusion: In MVC, the assessment of injured patients by EMT-I was more appropriate, and the 3-level triage method based on the MAIS could contribute to a more accurate triage. Prospective studies to search for appropriate methods of field triage are required for programming practical education for EMTs.

• 한국응급구조학회지
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• 제20권3호
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• pp.7-19
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• 2016

Purpose: The purpose of the study was to investigate the correlation between injury and injury severity score (ISS) in geriatric traffic accident patients transported by 119 emergency medical technicians (EMTs). Methods: The subjects were 240 traffic accident patients over 65 years old transported by 119 rescue services emergency departments in Busan from January 1, 2014 to August 31, 2015. Results: ISS increased in motorcycle traffic accidents (p=.026), truck injuries (p=.005), and head and neck injury (p<.001). Vital signs were evaluated by 119 rescue EMT. ISS increased in cases of unresponsive unconsciousness (p<.001), hypotension (p=.001), and bradycardia (p<.001). The need for bleeding control and dressing by the EMTs increased ISS significantly (p=.022). Conclusion: In the initial evaluation of geriatric traffic patients, ISS can increase in motor cycle accidents and truck injuries. Due to high ISS, patients with head and neck injury, chest injury, hypotension, or tachycardia should be transferred to advanced level hospitals.