Earticle

연구 목적: 본 연구는 우수한 1급 응급구조사 인력 양성 및 배출을 위해 응급구조사의 역량을 도출하여 교육제도 를 재정립하고 국가시험 및 자격제도를 개선하기 위한 정책 제안을 하고자 하였다. 연구 방법: 본 연구는 전문가 회의 및 설문지를 이용하였다. 설문 자료는 교육 전문가(응급구조학과 대학교수)와 현장 전문가(소방 119구급대원 및 병원에 근무하는 1급 응급구조사) 총 277명으로부터 수집되었으며, 자료수집 기 간은 2016년 9월 7일부터 9월 20일까지였다. 수집된 자료는 SPSS 22.0을 이용하여 분석하였다. 연구 결과: 1급 응급구조사 교육과정 강화를 위해 표준교육과정안으로 총 27과목 94학점을 제안하였고 1급 응급구 조사의 핵심역량 9가지를 도출하였다. 국가 자격시험은 필기시험 과목을 통합하는 방안과, 실기시험에 시나리오형 의 문제를 추가하고, 실기를 절차대로 수행하는 단순실기시험에 낙제기준(critical criteria)를 적용하며, 실기시험 은 통과/실패만 결정하는 것을 제안하였다. 또한 1급 응급구조사의 보건의료적 업무특성을 반영하여 자격은 면허 로 바꾸는 것을 제안하였다. 결 론: 본 연구 결과를 토대로 표준교육과정 운영으로 핵심역량을 갖추고 배출된 인력들이 신뢰성 있는 국가시 험제도를 통해 자격을 취득하고 1급 응급구조사로서 전문성을 강화할 수 있는 자격관리제도가 선순환을 이룰 때 우리나라 응급의료서비스의 질적 수준이 향상될 것이다.

Purpose: With the purpose of educating and producing outstanding paramedics by enhancing their competencies, this study aimed to make policy suggestions to re-establish the education system and improve the national examination and the certification scheme. Methods: This study used focus group interviews and questionnaires to collect data. Totally, there were 277 subjects, including experts from the education and field. Data were collected from September 9 to 20, 2016, and analyzed using SPSS 22.0. Results: To strengthen the curriculum of paramedics, this study suggested 27 courses with 94 credits as the standardized curriculum and derived 9 core competencies of paramedics. For the national examination, this study suggested consolidating written test subjects, adding scenario questions to practical tests, and applying critical criteria to simple practical tests that performs a procedure, grading these tests on a pass/fail basis. In addition, this study suggested converting certification into license, reflecting paramedics’ healthcare job characteristics. Conclusion: The quality of emergency medical services in Korea will improve when those with core competencies that originated from the standardized curriculum based on the results of this study acquire their certification through the national test scheme, and the certification management system creates a virtuous cycle to further enhance paramedics’ professionalism.

Purpose: The purpose of this study was to investigate the influencing factors of prevention practices against infection exposure among emergency medical technicians (EMTs) in emergency rooms. Methods: A self-reported questionnaire was filled out by 100 EMTs in emergency rooms from June 1 to August 31, 2017. The questionnaire consisted of items concerning the defensive environment for the prevention of infection exposure, perception of preventive behavior, and degree of performance of preventive actions against infection based on a five-point Likert scale. Data were analyzed by descriptive statistics, χ² test, ANOVA, Pearson's correlation coefficients, and linear regression. Results: The defensive environment for the prevention of infection exposure was 4.12. The perception of preventive action was 4.71, and the degree of performance of preventive actions against infection was 4.54. There was a significant relationship between the degree of performance of preventive actions against infectious exposures and the degree of perception of preventive behavior(r=.506, p=.01) and prevention of infectious exposure(r=.506, p=.01). The protective environment(B=.360, t=3.236, p=.002) and perceived level (B=.904, t=4.662, p=.000) were influenced by the degree of prevention of infection exposure. Conclusion: It is important to manage the protection environment for infection exposure prevention and to enhance the awareness of infection prevention actions against infection exposure among the EMTs in emergency rooms.

Purpose: The purpose of this study was to investigate both the occurrence status of emergency vehicles traffic accidents and contents of the experiences of emergency medical technicians (EMTs) in fire station. Methods: A self-reported questionnaire was completed by 451 EMTs in fire stations in 6 cities provinces from February 9, 2017 to February 27, 2017. Results: Of 451 EMTs, 207 (45.9%) had traffic accidents experience. Regarding environment-related features, results indicated hour (12∼18 hours), place (national highway), traffic flow (smooth), weather (clear), season (winter), and day (Friday). Regarding correlation analysis of differences in the number of ambulance traffic accidents pursuant to general features of accident-experienced drivers as a human factor, there were no significant differences in recruitment, driving careers of regular cars, driving careers of fire engines, and class but there were significant differences in fire-fighting careers. Accident experience in the group with careers over 6 years and less than 10 years higher than in the other groups. Conclusion: Efforts to expand fire engine driving education programs for the prevention of traffic accidents involving 119 emergency vehicles are required.

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was 81.72±30.86%, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was 18.97±32.44%, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

Purpose: The purpose of the study was to analyze the effects of ethical decision making factors on vocational ethics and job satisfaction of firefighters and to provide basic data to promote appropriate vocational ethics and improve job satisfaction. Methods: A self-reported questionnaire was filled out by firefighters in D metropolitan area from May 7 to 15, 2017. A total of 410 data were analyzed using SPSS 24.0 program. Results: Among influential factors of ethical decision making, "ethical environment of organization"(β =.266), "coworkers' influence" (β=.216), and "managers' ethical competence" (β=.148), ‘compensation and punishment’(β=.097) had a positive effect on vocational ethics, while "coworkers' influence" (β=.281), "ethical environment of organization" (β=.274), and "managers' ethical competence" (β=.143) had a positive effect on job satisfaction. Vocational ethics was found to have a significantly positive effect on job satisfaction (B=.657, t=8.802, p=.000). Conclusion: It is necessary to promote vocational ethics for improvement of firefighters' job satisfaction, and appropriate ethics education should be provided. It is important to actively manage the factors affecting ethical decision making.

Purpose: The purpose of this study was to compare the tidal volumes and airway pressures of 3 masksealing methods (one hand C-E, two hands C-E, and one hand O-E) for ventilation treatment. Methods: The study subjects were 45 paramedic students. Tidal volume was measured for the three sealing methods by setting a ventilator, connecting it to the masks for 2 minutes, and using Respi-trainer software. Results: Regarding general characteristics, the group of men, in upper grades, and with practical training experience and experience and experience in the implementation of bag-valve-mask ventilation provided higher tidal volumes. Regarding physical characteristics, larger hands and greater grip strength correlated with higher tidal volume. Two hands C-E generated the highest tidal volume of 483.78±34.14mL, one hand O-E generated 449.59±51.09mL and one hand C-E generated 394.31±68.95mL. Conclusion: Means of tidal volumes were statistically significantly different based on mask sealing methods (p<.001). Two hand C-E was performed by the two-persons task and was suggested as the most effective method. For the one-person task, one hand O-E was the more effective method compared to the previous one hand C-E.

Purpose: The purpose of this study was to provide basic data for the development of personal protective equipment (PPE) for emergency medical technicians (EMTs) during chemical, biological, radiological, nuclear, and explosive situations. Methods: Body measurements were obtained for adults aged from 20 to 59 years from the data in the 6th Size Korea national sizing survey. These data were compared to the sizes of protective clothing currently available in the market. In-depth interviews with active paramedics with experiences of wearing PPE were conducted. Results: Most of the imported protective clothing turned out to be unfit for Korean adults. This showed the urgent need for developing appropriately sized protective clothing for Korean emergency technicians. In total, 55.0% of the respondents indicated that the current protective clothing is unsafe, and 71.0% requested the clothing to have level C protective performance. Regarding the design, many people wanted hooded all-in-one type of clothing. Conclusion: Considering these requirements, most of the wearers wanted their protective clothing to be fundamentally protective of their body, be available in various sizes with adjustable parts, and easy to wear and take off. They also wanted the clothing to be secure in clear sight, while not revealing any parts of their body and not interfringe with their ability to communicate with others.