Earticle

Purpose: The purpose of the study was to investigate the effects of laryngeal mask airway (LMA) insertion from different positions, using different methods, on the quality of the insertion, for identifying a more convenient and effective insertion method. Methods: In a model ambulance, 30 paramedic students performed the LMA insertion procedure, in four different settings, combinations of the rescuer’s position (at the head end of the patient, at the side of the patient), and insertion technique (index finger insertion, thumb insertion), in a randomized order. Quality of insertion index and convenience of use were measured. Results: The quality of insertion index (tidal volume, gastric insufflation, airway pressure, airway sealing pressure, midline positions, insertion success grade, and insertion time) were not significantly different among four different settings. However LMA insertion from the anterior (head) end, using the index finger method compared to the thumb method was found to be significantly more convenient. Conclusion: We recommend using the more convenient and familiar LMA insertion method, between index finger insertion and thumb insertion, regardless of rescuer’s position.

Purpose: The purpose of the study was to investigate knowledge and attitudes of students majoring in health-related fields toward automated external defibrillator (AED) and to identify the influencing factors of knowledge and attitudes in AED use among the students. Methods: Data were collected from 346 students and analyzed using descriptive statistics, t-tests, one-way ANOVA, post hoc Scheffé test, Pearson’s correlation coefficient, and hierarchical multiple regression analysis, with SPSS Win 20.0 program. Results: Overall knowledge of AED in health-related major students, except paramedics and physical therapy was relatively low while attitudes were at moderate level. There were statistically significant differences in knowledge according to age, grade, major, cardiopulmonary resuscitation (CPR) awareness, exposure to AED and CPR education; and differences in attitude according to major, health status, health awareness, CPR awareness, exposure to AED, and CPR education. Significant factors explained 63% of knowledge on AED (F= 43.96, p<.001) and 37% of attitudes on AED (F= 15.84, p<.001). Conclusion: The study findings suggest that systemic education programs on AED should be implemented during undergraduate curriculum to improve survival rate of sudden cardiac arrest.

Purpose: The purpose of the study was to investigate the core competency of disaster management of 119 paramedics. Methods: A self-reported questionnaire was completed by 242 paramedics in C area from April 28 to May 12, 2017. The study instrument included general characteristics of the subjects (4 items), disaster experience, recognition, and preparedness (20 items), and importance and performance of disaster management core competency (24 items) by Likert 5-point scale. Data were analyzed using t-test, ANOVA, Pearson’s correlation coefficient using IBM SPSS 24.0. Results: The seriousness of personal disaster was 4.02 points and the importance of disaster-related education was 4.28 points. The importance to core competency of disaster management was 4.39 points and the ability to perform core competency was 3.58 points. The seriousness of personal disaster and the importance of disaster-related education were positively correlated (r=.600, p=.000). The importance and ability to perform core competency were positively correlated (r=.389, p=.000). Conclusion: It is necessary to strengthen core competency of disaster management in paramedics who are the first defense line of disaster.

Purpose: The purpose of this study was to validate the Moral Intelligence Checklist(MIC) of Borba (2001) modified by Kim et al. (2010) for college students majoring in health. Methods: The MIC survey was performed with 348 college students in Gongju, Chungnam. Initial MIC modified by Kim et al. (2010) consists of 7 factors (empathy, self-control, conscience, kindness, fairness, respect and tolerance) and 42 items. Data were analyzed using confirmatory factor analysis. Results: We finally analyzed with 37 items, because 5 items with estimates level below 0.5 were deleted. The Cronbach's α of 7 factors were ranged from .780 to .851. Finally, the model fit of GFI (.805), CFI(.864), RMSEA(.033) was satisfied with confirmatory factor analysis using structural equation model. Conclusion: This MIC model is suggested to be used in development of moral intelligence educational programs.

Purpose: The purpose of the study was to evaluate the ergonomic risk factors of 119 emergency medical technicians (EMT) with musculoskeletal disorders, performing emergency medical services (EMS) procedures in a firefighter combat challenge. Methods: The evaluated EMT procedures were cardiopulmonary resuscitation (CPR) & intubation, trauma patient assessment, and intravenous (IV) injection. Measurement of working posture was done during training. Results: In CPR & intubation, OWAS-score was 2 (mean 1.9, maximum 4), requiring correction action, while REBA-score was 11 (mean 7.28, maximum 11), requiring immediate improvement. In trauma patient assessment & IV injection, OWAS-score was 4 (mean 2.9, maximum 4), requiring immediate correction action, while the REBA score was 7 (mean 7.5, maximum 11), requiring improvement. Conclusion: Both OWAS score and REBA-score showed improvement of posture and high- risk of musculoskeletal disorders. Occupational health management in EMS procedures during combat challenge and effective injury prevention program in fire stations are warranted.

Purpose: The purpose of this study was to investigate the installation, management, and usability of automated external defibrillators (AED) installed in the apartments with over 500 households in Chungnam. Methods: The survey included 52 apartments with over 500 households having AED in Chungnam from July 1 to August 20, 2017. The information of AED was taken from the Chungnam Provincial Office. Results: The access and use of AED was closely affected by AED installation location, locking devices, lack of publicity, and AED use education for the residents. Conclusion: Efficient education on the use and management of AED for residents of the apartments is necessary.

Purpose: The purpose of the study was to investigate the effects of ego-resiliency and self- efficacy on paramedic students in J province. Methods: A self-reported questionnaire was completed by 465 paramedic students from the J area recruited from September 25 to October 10, 2017. The questionnaire included general characteristics, ego-resiliency, self-efficacy, and satisfaction with their choice of the major subject. Data were analyzed using t-test, ANOVA, Pearson’s correlations, and a multiple regression analysis. Results: As ego-resiliency and self-efficacy increased, satisfaction with their majoring subject also increased. Senior students had higher satisfaction than freshmen in relation to general characteristics. Students having ‘interest in their major’ owing to personal motivation of choice of major, had higher satisfaction than those having ‘suggestion from other’. It is necessary to find a way to increase satisfaction of major and to inspire ego-resiliency and self-efficacy. Conclusion: Future studies should investigate ways to increase major satisfaction toward paramedics and to enhance their ego-resiliency and self-efficacy.

Purpose: The purpose of the study was to investigate and compare the usual source of healthcare and frequent visits to emergency departments. Methods: The study subjects were 7,252 individuals with chronic diseases who filled out the questionnaire of the 2013 Korea Health Panel Survey. Data were analyzed using chi-square test and logistic regression. Results: Compared to having a public health center or clinic as a usual source of healthcare, it is 1.341 times more likely for a chronic disease patient to visit an emergency department if the hospital is her/his usual source of healthcare, while it is 1.656 times more likely for the patient to visit a general/tertiary hospital. Conclusion: It is important to investigate visits at the emergency department requiring primary care for diseases.

Purpose: The purpose of the study was to investigate the mediating effects of self-efficacy on the relationship between job stress and turnover intention of paramedics in hospitals. Methods: A self-reported questionnaire was completed by 209 paramedics in hospitals from September 4 to 24, 2015. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and multiple regression analysis using Baron & Kenny’s 3 step procedure. Indirect effect was confirmed with Sobel test using SPSS/Win 22.0 program. Results: There were negative relationships between job stress, self-efficacy, and turnover intention (r=-.509, p<.001). There was a negative relationship between job stress and self efficacy (r=-.821, p<.001). The self-efficacy and turnover intention showed a positive relationship (r=.636, p<.001) with job stress and turnover intention. Concerning the mediated effect of self efficacy on job stress and turnover intention, the influence of job stress at step 2 on turnover intention was significant (B=1.207, p<.001), while job stress at step 3 had significant influence on turnover intention (B=.474, p<.001). The mediated effect of self-efficacy on job stress and turnover intention showed significant partially mediated effect of self-efficacy (z=7.100, p<.001). Conclusion: Improvement of self-efficacy and job stress was effective at decreasing turnover intention in paramedics in hospitals.