Earticle

Purpose : The purpose of this study was to investigate the variation of elapsed time in the cardiopulmonary resuscitation (CPR) quality and the fatigue in continuous CPR by single rescuer. This study will provide basic data about the time for the alternation of the CPR providers. Methods : The volunteer students having healthcare provider certification were recruited from the department of emergency medical service. The students performed 30:2 CPR for 20 minutes, and the data were recorded and analyzed. Metrics were based on the 2010 American Heart Association (AHA) Guidelines, and the CPR continued without any feedback. Results : Among the indicators of CPR, the accuracy and the depth of chest compressions decreased after about 5.3 minutes, and the rate increased approximately after 6.8 minutes. Changes in clinical indicators appeared, and fatigue increased after about 3 minutes. According to the increase in fatigue level, the changes in the CPR indicators and clinical indicators showed up, and these results proved to be statistically significant. However, there were no associations among the time, fatigue, and gender. Conclusion : Even though the times of changes in the indicators appeared differently, the times of changes in fatigue and CPR quality were able to be confirmed.

Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients’ clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmo‐nary complaints practiced by paramedics showed statistically significant improvement in recent years (p< .001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.

Purpose : This study intended to improve the quality of prehospital emergency care for patients with dyspnea by figuring out the current situations and problems based on run-sheets of 119 emergency medical technicians (EMTs). Methods : A total of 336 dyspnea patients were transferred to G university hospital by 119 ambulances from January 1, 2011 to December 31, 2011. Results : The data were analyzed by SPSS 19.0. Patients over 60 years old accounted for 57.2% and 48.4% had the history of heart disease. Among the heart disease patients, 31.7% complained of dyspnea and chest pain. The vital sign measurement performance by 119 EMTs increased compared to previous study. The number of prehospital treatment by 119 EMTs significantly increased depending on the mental state of the patients. Conclusion : 119 EMTs should remind the heart disease and other past history of the patients when they perform the dyspnea patient care.

Purpose : The purpose of this study was to verify the effects of academic self-efficacy on self-directed learning attitude of emergency medical students. Methods : A total of 209 emergency medical technology students filled out the questionnaire after receiving the informed consents. The questionnaire consisted of demographical characteristics, academic self-efficacy and self-directed learning attitude. Results : Academic self-efficacy and self-directed learning attitude of the subjects were above mean average. Higher correlations existed between academic self-efficacy and self-directed learning attitude of the subjects, and the significant positive correlations were found between sub-factors of the academic self-efficacy and self-directed learning attitude. The academic self-efficacy of the subjects had the significant influence on the self-directed learning, and self-efficacy. The self-confidence among sub-factors in the academic self-efficacy had a significant influence on self-directed learning attitude and sub-factors. Conclusion : The results of the study subjects of academic self-efficacy had a significant influence on the attitude of self-directed learning, In particular, self-efficacy and confidence of the academic self-efficacy sub- factors showed a significant impact on the sub-factors, attitudes and self-directed learning. This study will provide the basic data for the implementation of the educational programs. This will be effective in managing the knowledge, information, self-directed learning attitude and academic self-efficacy.

Purpose : This study aimed to improve quality of prehospital emergency care for the insect bite patients by figuring out its current situations and problems. Methods : This study was conducted to 219 insect bite patients who were transferred to the hospital by 119 ambulance in D-City from July 1, 2009 to June 30, 2011. This study was a descriptive study by 119 run sheets. A total of 171 emergency medical technicians(EMTs) working in D-city and C-province completed the questionnaire. All of data were analyzed by SPSS 18.0. Results : Among the 219 patients, bee sting accounted for 62.6% and wasp sting accounted for 20.1%. Some patients complained of dizziness, headache, dyspnea, and disturbance of consciousness. The 119 EMTs initially treated the patients with oxygen supply to 57 patients (31.1%). Knowledge toward insect bite was statistically significant (p=.000) between advanced EMTs and basic EMTs. The obstacle to the prehospital care, many EMTs answered that the obstacle was due to the lack of 119 EMTs. Conclusion : It is necessary to differentiate the patients' symptoms and provide the better prehospital emergency care to verify the exact symptoms and signs.