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Purpose: Emergency medical service (EMS) personnel are at high risk of spreading infection. In this study, we used the PRECEDE model to identify the knowledge, status, and barriers to infection control among Korean paramedics to provide basic infection control data. Methods: A total of 164 respondents were analyzed for the study. A questionnaire was administered and collected through an online self-response platform. Descriptive analysis, t-test, ANOVA, multiple regression, and logistic regression analyses were performed to determine infection control practices and associated factors using SAS 9.4. To identify the pathways and direct, indirect, total effects based on the PRECEDE model, we used AMOS 26.0. Results: Highly rated self-efficacy (OR 8.82, 95% CI: 3.23-24.09), awareness (OR 6.05, 95% CI: 2.06–17.72), and enabling factors (OR 3.23, 95% CI: 1.18–8.78) led to superior infection control. As a result of the structural model analysis, the highly rated enabling factors and awareness led to superior practice patterns. Conclusion: Practice is related to self-efficacy, awareness, and enabling factors; however, further research is needed to develop strategies for infection control. In particular, institutional arrangements are needed to improve the enabling factors. Improving infection control performance may lead to better infection control and enhanced protection of EMS personnel and patients against infection risks.

Purpose: We analyzed the characteristics and differences in patients’ medical benefits and health insurance based on disease severity classification. Methods: We examined 29,139 patients who visited the emergency medical center of K Hospital from January 1,2016 to December 31, 2016. Survey items included the Korean Triage and Acuity Scale (KTAS) classification of emergency and non-emergency situations ratio and type of insurance. Results: According to KTAS classification, 76.2% of patients exhibited an emergency condition and 23.8% exhibited a non-emergency condition. Emergency patients exhibited more trauma than non-emergency patients. According to the type of insurance coverage, the duration of stay in the emergency room was longer for patients with medical care than for patients with health insurance. Additionally, 119 ambulances use was significantly higher among patients with medical care. Conclusion: Policy discussions should address alternative ways to replace the 119 ambulances used by patients in this study. Additionally, health care administrators should identify alternative care agencies as potential alternatives to emergency room visits.

Purpose: The purpose of this study was to provide basic data for improving the response capacity of 119 EMS systems by analyzing the effects of particulate matter on cardio-cerebrovascular and respiratory symptoms in the pre-hospital stage. Methods: We examined 46,389 patients who transferred to the hospital with complaints of cardiopulmonary arrest and cardio-cerebrovascular and respiratory symptoms by 119 ambulances in Incheon from 2016 to 2018. Results: The probability of 119 emergency dispatch for patients with cardiopulmonary arrest increased 2.8-4.0% from the day of symptom onset until two days before hospital presentation as particulate matter 10μm or less in diameter(PM10) increased by 10μg/m3 (OR=1.028; 95% CI=1.014–1.041, p=0.000, lag 0), (OR=1.040; 95% CI=1.024–1.056, p=0.000, lag 1), (OR=1.032; 95% CI=1.016–1.049, p=0.000, lag 2). Meanwhile, emergency dispatch increased 3.6-6.1% for PM2.5 in creased by 10μg/m3 (OR=1.046; 95% CI=1.024–1.068, p=0.000, lag 0), (OR=1.061; 95% CI=1.035– 1.088, p=.000, lag 1), and (OR=1.036; 95% CI=1.010–1.063, p=0.006, lag 2). Conclusion: Emergency medical technicians (EMTs) who respond to 119 calls should rapidly and accurately evaluate patients and provide professional emergency care by identifying the characteristics of the vulnerable groups relative to particulate matter size. To prevent the occurrence and exacerbation of symptoms caused by particulate matter, EMTs should be prepared and equipped with a response system for high particulate matter in the EMS system.

Purpose: The purpose of this study was to test the effect of simulation-based learning on knowledge, confidence, and critical thinking of paramedical students enrolled in the Korean Advanced Life Support (KALS) program. This study used a one group, pre-post test design. Methods: The subjects of this study were 79 paramedical students in D city. Data were collected before and after the simulation-based training using a structured questionnaire. The data were analyzed using SPSS version 22.0. Results: After the simulation-based KALS education, knowledge (t=-6.88, p<.001) and confidence (t=-10.12, p<.001) increased among paramedical students. There was a positive correlation between confidence and critical thinking disposition (r=0.37, p=.001). Conclusion: A practical module for simulation-based education that can improve knowledge, confidence, and critical thinking disposition related to professional resuscitation is needed for use with paramedical students. Additionally, follow-up studies should be conducted to verify the educational effects of such a program.

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider’s essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

Purpose: This study was conducted to determine effective chest compression methods that could be used when performing cardiopulmonary resuscitation in rocking boats. Methods: Tests were conducted for four minutes using manual and mechanical chest compressions on two mannequins, placed in boats, and moving at a speed of 35km/hours on calm sea surfaces with wave heights of 0.5m and wind speeds of 2-3m/s (testing for two minutes, followed by rest, then a second round of testing for two minutes). To compare the quality of the chest compressions, data were analyzed using mannequins (Resusci Anne Q-CPR, Laerdal, Norway) and then statistically processed. Results: When chest compressions were administered in the moving rescue boat, an accuracy analysis showed that the pressure speed of the hand and mechanical techniques were normal, h owever, the pressure depth accuracies were 49.04% for manual techniques and 0% for mechanical techniques. The relaxation accuracies during compressions were 2.07% for manual techniques and 95.4% for mechanical techniques. Conclusion: When administering chest compressions in rocking rescue boats, mechanical rather than manual techniques should be preferentially considered.

Purpose: The purpose of this study was to analyze the English abstract key words found within the Korea Society of Emergency Medical Services journal using text mining techniques to determine the adherence of these terms with Medical Subject Headings (MeSH) and identify key word trends. Methods: We analyzed 212 papers that were published from 2012 to 2019. R software, web scraping, and frequency analysis of key words were conducted using R's basic and text mining packages. Additionally, the Word Clouds package was used for visualization. Results: The average number of key words used per study was 3.9. Word cloud visualization revealed that CPR was most prominent in the first half and emergency medical technician was most frequently used during the second half. There were a total of 542 (64.9%) words that exactly matched the MeSH listed words. A total of 293 (35%) key words did not match MeSH listed words. Conclusion: Researchers should obey submission rules. Further, journals should update their respective submission rules. MeSH key words that are frequently cited should be suggested for use.

Purpose: The purpose of this study was to investigate the ethical values of paramedics and their awareness and practice of medical information protection protocols. Methods: A survey was conducted involving 300 university students majoring in a four-year paramedical education program at two universities in Daejeon and Chungnam. Ultimately 220 surverys were subjected to analysis. Results: There was a significant difference in students' perception of medical information protection according to the need for education on medical information protection protocol (p=0.022); however, there were no significant differences in the practice of these protocols. The idealism tendency was positively correlated with the awareness of medical information protection (r=.332, p=.000) and the practice of medical information protection (r=.309, p=.001). A tendency toward relativism was significantly associated with the awareness of medical information protection (r=.138, p=.040) and not significantly related to the practice of medical information protection protocols. The tendency toward idealism tended to have a significant positive effect on the awareness of medical information protection protocols (β=.318, t=4.777, p=.000) and the degree of practice (B=.369, t=3.456, p=.001). Conclusion: Appropriate educational programs for medical information protection are needed. These programs should adhere to the characteristics of the department by linking with the training institution.

Purpose: This descriptive study investigated the relationship between death awareness and life ethics awareness, according to life stress, among students in the department of paramedics. Methods: General characteristics were identified using means and frequency, and the differences between the two military models were analyzed using the χ2-test and t-test by dividing them into lower and higher groups based on the mean life stress score (99.76 points). Results: Those with high life stress had higher death awareness than those with low life stress at 114.11 points. In contrast, those with low life ethics experienced more severe life stress with a score of 145.61 points (t=-2.609, p=.010)(t=-2.953, p=.003). The death recognition attitude and bioethics according to the degree of living stress-showed a significant correlation between the low and high groups (r=.188, p=.043) (r=.201, p=.042). Conclusion: Paramedic students require education on how to cope with life stress. However, access to education is limited to people living in modern times. As a potential solution to this problem, observing videos on the Internet is recommended. Moreover, we suggest accessing Internet and smart phone applications for advertising/educational purposes.