Earticle

Purpose: This study aimed to determine the core competencies for 119 emergency medical technicians (EMTs) and to provide evidence for the development and utilization of 119 EMTs, education and training programs. Methods: Data were collected with a questionnaire that consisted of items on the general characteristics of the subjects (8 items) and importance and satisfaction levels for 10 competencies, including 34 items on subfactors. The Borich Needs Assessment Model was used in designing the questionnaire. A locus for focus model was used to derive the top priority competencies for the improvement of core competency in the profession. Data were analyzed with by SPSS ver.21 (IBM, Armonk, NY, USA). Results: The core competencies for 119 EMTs were derived from technical competency, information competency, communication competency, problem-solving competency, self-development competency and interpersonal competency. In addition, among the sub-factors of these competencies, 16 abilities (including leadership), ability to apply technical knowledge, technical comprehension, conflict management ability, ability to create documents, problem handling ability, ability to think, technical selection ability, and computer literacy were included in the priority category. Conclusion: This study derived and presented the core competencies for 119 EMTs to enable them to meet the modern day requirements of their roles, which may contribute to enhancing their professionalism.

Purpose: This study aimed to investigate disaster preparedness competence and disaster response competence of paramedics working in emergency medical centers operating a disaster medical assistance teams. Methods: Data of 174 emergency medical technician(EMT)-paramedics were collected from July 15 to August 14, 2018 at regional and local emergency medical centers that operate disaster medical assistant team. Analysis of the data was carried out with IBM SPSS statistics 24.0 software (IBM, Armonk, NY, USA). Results: The mean disaster preparedness competence score was 3.57±0.63 (out of five). Participants’ disaster preparedness competence significantly differed according to type of emergency medical center (p<.000), disaster education experience (p<.000), and education frequency (p=.001). The mean disaster response competence score was 4.09±0.57 (out of five). Participants’ disaster response competence significantly differed according to disaster education experience (p<.000) and medical assistance experience (p=.045). Conclusion: Emergency medical technician-paramedics without disaster training should first be provided with this training. Further, it is important for EMT-paramedics to know their disaster preparedness and response capacities and strengthen their shortcomings. It is also important to develop education and training programs that properly equip EMT-paramedics with practical competencies.

Purpose: This study aimed to identify the effects of post-traumatic stress disorder intervention programs on firefighters through a meta-analysis. Methods: Seven studies were selected for meta-analysis. The overall average effect size, effect sizes for each intervention variables, and publication bias were analyzed using Comprehensive Meta-Analysis(CMA) version 2.0 (Biostat, Englewood, NJ, USA). Results: Post-traumatic stress disorder intervention programs were found to have a very low, not statistically significant effect (effect size=-.171, confidence interval=-0.361~0.019, Z=-1.768, p>.05). However, these programs was less than 50 (effect size=-.622). Conclusion: The results of this study suggest that further research on the effects of post-traumatic stress disorder intervention among firefighters is needed in order to develop more effective programs.

Purpose: The purpose of this study was to assess 119 emergency medical technicians' perception of child abuse, attitudes towards mandatory reporting, and perceptions of mandatory reporting system, and to promote early reporting. Methods: The questionnaire was filled out by one hundred ninety 119 EMTs with paramedic or nurse licenses. The questionnaire consisted of 53 items with responses based on a five-point scale. Data were collected from July 10 to July 31, 2018, and were analyzed using IBM SPSS version 24.0 software. Results: The average score for 119 EMT’s perception of child abuse was 3.76. The average score for positive attitude towards mandatory reporting was 3.63, and the average score for negative attitude towards mandatory reporting was 2.63. The average score for perceptions of the mandatory reporting system was 3.50. There was a significant positive correlation between perception of child abuse and positive attitude towards mandatory reporting (r=.244, p=.001), between perception of child abuse and perceptions of the mandatory reporting system (r=.209, p=.004), and between positive attitude towards mandatory reporting and perceptions of mandatory reporting system (r=.336, p=.000). Conclusion: Systemic educational programs for 119 EMTs on perception of child abuse and reporting are needed. It is very important to establish institutional strategies such as the use of checklist for suspicion of child abuse, procedural simplicity after reporting, and protection of reporter information.

Purpose: This study aimed to introduce active learning methods, including flipped, case-based, and team-based learning in an electrocardiography (ECG) course and to investigate outcomes and satisfaction with these methods. Methods: To identify the learning effect of active learning, pre-and post-academic self-efficacy was compared between the experimental and control groups. In the experimental group, pre-and post-knowledge and clinical performance regarding ECG were also assessed. In addition, class satisfaction was investigated after application of active learning methods in the experimental group. Data were collected from 84 paramedic students and analyzed using SPSS 22.0 (IBM, Armonk, NY, USA). Results: The experimental group showed significant improvement in post-academic self-efficacy and knowledge. The experimental group also showed high clinical performance (9.83 out of 10 in ECG checking ability and 9.63 out of 10 in ECG reading ability). The mean satisfaction score was 4.23 out of 5 (responses based on a Likert scale) in the experimental group. Conclusion: Active learning in an ECG course was found to be highly effective and satisfactory. Furthermore, paramedic students can enhance their accountability and judgement with team-based learning through free engagement in discussion.

Purpose: It is crucial that 119 emergency medical technician (EMT) have adequate knowledge regarding forensic science. This study aimed to assess the forensic knowledge of EMTs in the Republic of Korea. Methods: This study was conducted on EMTs of five fire stations in D metropolitan city between August 6 and August 13, 2018. A questionnaire consisting of items on crime-related incident recognition (i.e., mechanical asphyxiation, trauma, sex crimes, and child abuse), forensic evidence management (i.e., evidence collection, preservation, and recording) was administered to the participants. Finally, 119 questionnaires were analyzed. Results: The ratio of correct answers for crime-related incidents recognition was 55.82%, which was lower than that for forensic evidence management(84.5%). In particular, the scores for the type of neck compression(16.5%) and wound assessment(44.0%) were low. The percentage of correct answers for forensic evidence management was 78.4% for evidence collection, 84.4% for evidence preservation, and 90.6% for evidence recording. Previous forensic education experience was not a significant variable. Conclusion: Specific and practical forensic science education on perception of crime-related incident, including asphyxia and wound identification, and forensic evidence collection is needed.

Purpose: This study aimed to compare and analyze statistical data on 119 ambulance runs and ambulance crew, which are the components of the emergency medical services system in Korea and Japan. Methods: Data from National Fire Agencies of both Korea and Japan were collected and statistically compared. Results: With regard to the ratio of 119 ambulance runs, Korea's ratio has been gradually and continuously growing beyond that of Japan (Korea 4708.11, Japan 4706.47) since 2014. The ratio of firefighting ambulances in Korea was 2.59 (2.59±0.10), and was 4.76 (4.76±0.12) in Japan. The ratio of 119 ambulance crews in Korea was 15.55 (15.55±2.03), and was 47.24 (47.24±1.06) in Japan. Among the ambulance crews, the ratio of paramedics was 33.81 (33.81±5.85) in Korea and was 38.86(38.86±4.10) in Japan. Conclusion: The ratio of 119 ambulance runs in Korea has already exceeded that of Japan, but the numbers of 119 ambulance crews and paramedics qualified for special emergency treatment are still insufficient. Therefore, supply and demand policy that promotes the development of the firefighting ambulance service system is necessary.

Purpose: This study aimed to identify the position for the most accurate head-up cardiopulmonary resuscitation (CPR) by comparing saddle position CPR (SPCPR) and traditional CPR (TCPR). Methods: Sixty certified persons who completed a basic life support provider course between May 1 and June 21, 2019 were enrolled in the study. The participants were asked to perform 2 minutes of CPR, and the depth of chest compression, rate, position, full release, and hands off time were assessed. Accuracy was evaluated based on data collected from a smart phone application connected to the manikin via bluetooth and analyzed using frequency, percentage, t-test, analysis of variance and χ². Results: The accuracy of chest compression was statistically significantly higher for SPCPR, 63.03%[±8.75] for SPCPR and 55.50%[±10.17] for TCPR [t=3.074, p=.003]. The depth of chest compression was statistically significantly greater for SPCPR, 4.51cm[±0.45] for SPCPR and 4.16cm[±0.61] for TCPR [t=2.503, p=.015]. The rate of chest compression was statistically significantly higher for TCPR, 105/min[±10.79] for SPCPR and 111/min[±11.57] for TCPR [t=-2.008, p=.049]. Accuracy of position of chest compression was statistically significantly higher for SPCPR, 96.10%[±13.73] for SPCPR and 79.93%[±30.34] for TCPR [t=2.659, p=.011]. Accuracy of full release was higher with SPCPR, with 86.30%[±30.53] for SPCPR and 71.10%[±36.05] for TCPR, but the difference was not statistically significant [t=1.762, p=.083]. Conclusion: Saddle position CPR was found to be more accurate than TCPR in the performance of manual head-up CPR.

Purpose: This study aimed to propose an effective one-rescuer infant cardiopulmonary resuscitation (CPR) chest compression technique by comparing the differences in efficacy, convenience, and pain levels between the two thumb-encircling and two finger techniques. Methods: Subjects were randomized to perform either two-thumb-encircling or two-finger technique for 8 minutes each on infant CPR manikins. After the chest compression, a survey was administered to the subjects to measure convenience and pain levels according to compression method. Results: Total compression depth over 8 minutes was significantly deeper for the two-thumencircling technique (43.5±4.8mm) compared with the two-finger technique (32.6±5.4mm) (p<0.001). In terms of compression depth measured at 1-minute intervals, compression depth with the two-finger technique decreased from 38.3±4.23mm to 29.0±6.79mm, whereas compression depth with the two-thumb-encircling technique did not show a significant change (from 43.7±4.12mm to 43.4±5mm). The results of the survey indicated that, the majority of subjects found the two-thumb-encircling technique to be the most comfortable technique for compression depth (n=29, 64.4%). The majority of subjects (n=31, 68.9%) answered that the two-finger technique resulted in the most pain. Conclusion: Comparison of efficacy of the two-thumb-encircling and two-finger-techniques in the performance of one-rescuer infant CPR revealed that the two-thumb-encircling technique was more effective in maintaining chest compression depth.

Purpose: This study aimed to assess college students’ knowledge, attitude, and health behavior regarding cancer based on 10 national cancer prevention recommendations and to examine the relation between these variables. Methods: The participants were 189 college students in J city. Data were collected with a questionnaire consisting of items on cancer-related knowledge, attitude toward cancer, and implementation of 10 national recommendations on cancer. The data were analyzed using independent two-sample t-test, one-way analysis of variance, Scheffé multiple comparison test, Pearson’s correlation coefficients, and multiple regression(stepwise) analysis with SPSS/WIN 21.0 program (IBM, Armonk, NY, USA). Results: The mean scores for knowledge, attitude, and health behavior were 23.83 points (out of a possible 32), 33.10 points (out of possible 50), respectively. Attitude was positively correlated with health behavior and accounted for 37.7% of cancer prevention health behavior. Conclusion: The findings of this study suggest that the related factors should be considered in the development and implementation of systemic education programs that can encourage and promote cancer prevention health behavior among college students.

Purpose: To discuss the records and legal standards of emergency medical technician training institutions in Korea and abroad, to identify the problems, and to provide the basic resources for improving the EMT-basic training institutions. Methods: We received advice through an advisory meeting of experts (professors of department of emergency medical technicians) and interested parties (Korean Association of Emergency Medical Technicians, officials of emergency medical technician training institutions) and referred to various reports published by governments, official institutions, and other trustworthy organizations. Also, we communicated with the related experts abroad (3 countries) on the phone or by email for surveys. Results: Compared to the abroad, it is necessary to categorize the standards and procedures of designating the emergency medical technician training institutions in Korea and improve the management of training institutions to train competent emergency medical technicians. Conclusion: It is necessary to designate and manage continuously the emergency medical technician-basic training programs for the systematic primary healthcare service.