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Purpose: This study aimed to identify the differences in pre-hospital and in-hospital triage (pre-hospital triage and KTAS(Korean Triage and Acuity Scale)) of patients with abdominal pain and the characteristics of high hospitalization probability in the treatment results. Methods: We analyzed 941 people who visited the area C emergency center for 2 years from January 2017 to December 2018. The collected data were analyzed using SPSS 26. Results: Among the transfer hospitals, 84.8% (798) of patients were selected by the 119 rescue service, and the most common diagnosis was simple abdominal pain (46.5%, 438 patients). A total of 50.7% (477) of patients classified as severe pre-hospital cases changed to mild in-hospital cases. There was a difference of 5.3% (50 cases) in cases where patients classified as mild pre-hospital were changed to severe in-hospital cases. The Kappa coefficient did not match with 0.04 (p=.051). Pre-hospital overtriage was 58.2% (548 cases), and 71.2% (670) of patients were discharged from the emergency room as a result of the treatment. Conclusion: The results of this study showed that pre-hospital and in-hospital triage were not consistent. The rates of pre-hospital overtriage were quite high. Most patients with abdominal pain were classified as mild cases, and pre-hospital triage classifiers should be trained to reduce errors in selecting transfer hospitals.

Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.

Purpose: The purpose of this study was to identify the degree of resilience, traumatic events, secondary traumatic stress, and calling reported by firefighters and to identify the factors affecting the resilience of firefighters. Methods: Data were collected using structured questionnaires and 200 fire officials working in D city were enrolled as the subjects. Data were analyzed using SPSS 24.0, and the analyses included descriptive statistics, independent t-test, ANOVA, Scheffé test, Pearson correlation coefficient, and multiple linear regression. Results: The difference in resilience according to general characteristics showed significant differences in health status (F=4.33, p=.014) and job satisfaction (F=6.13, p=.003). The factors affecting resilience were identified as calling (β=.25, p<.001), and the explanatory power for resilience was 19.2%. Conclusion: It is necessary to increase calling in order to increase resilience. Therefore, we suggest that professional education and programs that consider personal characteristics are needed to strengthen the calling.

Purpose: This experimental study aimed to solve the problem of discomfort and stably fix the bandage. A new self-adhesive bandage was manufactured to reduce the inconveniences associated with the plaster bandage. We compared the associated stability between the plaster bandage and the new self-adhesive bandage. Methods: The traditional elastic bandage (traditional EB; i.e., plaster bandage) and modified elastic bandage (modified EB; i.e., new self-adhesive bandage) were applied to 30 people each. We measured the time of preparation and attachment for traditional TB and attachment for modified TB. A 4kg cattle bell was fixed to each bandage to compare their respective stability levels. Results: The speed for the traditional EB was 28.93(±9.28)sec (mean 25.56s) and 6.13(±1.81)sec for the modified EB (mean 5.95sec). The stability values were 1.49(±.77)min for the traditional EB (mean 1.31min) and 26.22(±9.04)min for modified EB (mean 1.31min). The differences in speed and stability were statistically significant. Conclusion: Compared to the traditional EB, applying the modified EB could solve the attachment inconvenience and provide stable maintenance.

Purpose: The purpose of this study was to provide basic data for developing strategic programs based on the types of perception to aid in the coping strategy of 119 emergency medical technicians who experienced have violence. Methods: The subjects were 119 emergency medical technicians working out of hospitals in Korea. Data were collected from March 10, 2019, to June 30, 2019. Q samples of 37 statements and P samples of 36 persons were taken using PC QUANL software. Results: As a result of the study, four types of coping with violence experiences were identified; these four types explained 53.79% of all variables from the examination. The types were labeled as the cooperation seeking and manual emphasis type, emotional suppression and stability seeking type, active response and business continuation type, communication empathy and recovery effort type. Conclusion: The Fire Department requires institutional measures to lower violence during field activities, and it will be necessary to develop a policy according to the type of perception of coping behaviors.

Purpose: The purpose of this study was to investigate the educational satisfaction of trainees in implementing violence prevention education by workers in the emergency room and insufficient education. Methods: The participants of the study were 65 emergency room employees in S area. Results: First, education was helpful if you actively participated in education, and if you did not actively participate in education, education was shown to be of little or no help (χ2 (p)= .000 p-value<.05). Second, formal education (53.3%) was identified as the problem of preventive education currently in place of education, and statistics show that the biggest problem with applying emergency room violence prevention education at worksites is a lack of active support (41.7%) from the police and hospitals. Third, 48.3 percent of the respondents thought that the education methods invited experts were appropriate for emergency room violence prevention education. Conclusion: The problem with the current emergency room violence prevention education is that it is necessary to establish a connection program between hospitals and police stations and give lectures by experts in violence prevention education to apply the contents of the educational curriculum in the workplace with one time and formal education.

Purpose: This study measured the mental health levels of 119 paramedics, and identified the association of mental health levels with safety environments, personal protective equipment, and coronavirus risk awareness. Methods: A total of 119 out of 428 from Daegu and Gyeongbuk took part in this study. The statistical analysis methods were the t-test, ANOVA, Pearson's correlation analysis and multiple regression analysis. Results: In a multiple regression analysis, females (β=-.137, p=<.001) showed a higher relevance to negative mental health than males. The moderate satisfied (β=-.088, p=.014) and dissatisfied (β =-.147, p=.006) showed a higher relevance to negative mental health than higher satisfied. Moderate stress perception (β=-.199, p=<.001) and higher stress perception (β=-.414, p=<.001) showed a higher relevance to negative mental health than lower stress perception. Corona-virus risk awareness (β =-.050, p=.045) was related to negative mental health and safety environment (β=.136, p=<.001). Personal protective equipment (β=.147, p=<.001) were related to positive mental health. Conclusion: Conclusively, it is necessary to develop and implement high-quality intervention programs using significantly influencing variables to impact the mental health of 119 paramedics.

Purpose: This study aims to identify the present handover status and the difference in performance and importance of handover between 119 paramedics and emergency department (ED) staff to improve the quality of handover. Methods: The study involved a questionnaire survey of 171 paramedics and 108 ED staff in four regions from August 28 to September 23, 2020. Subsequently, 279 questionnaires were collected and 277 copies were used for this study. Data were analyzed by SPSS 26.0 version. Results: The results showed that most of the paramedics and the ED staff rely on memory and verbally handover, without formal education about the handover process. And there were significant differences in performance in important information of prehospital. Some of the handover items were a difference in performance and importance between the paramedics and the ED staff. Conclusion: The unified education based on required and optional items is necessary to reduce the loss of information between the paramedics and ED staff, and standardized tools need to be developed in the handover process.

Purpose: The purposes of this study were to determine the changes in the pattern of patients who were transferred to the emergency room through inter-hospital private institutions and to determine how long transport takes following the COVID-19 outbreak. Methods: This retrospective observational study analyzed the emergency medical services reports of private institutions following the COVID-19 outbreak in South Korea. The study was conducted in Busan between January 19, 2019 and January 18, 2020, and between January 19, 2020 and January 18, 2021. Results: Upon comparing the patient transport times during the “Pre-COVID-19 period” and “COVID-19 period,” a significant delay was noticed in the preparation for transfer of patients during the “COVID-19 period” (p<.05). There were significantly more patients with respiratory infections and patients who complained of general symptoms during the “COVID-19 period.” Moreover, there was a higher frequency of patients who were transferred to a ‘Level I’ emergency room during the “COVID-19 period” compared to during the “Pre-COVID-19 period” (p<.05). Conclusion: Following the COVID-19 outbreak, there is a delay in patient transport to the emergency room through private institution inter-hospital transport and an increase in the number of patients complaining of respiratory infection symptoms. Thus, emergency medical services need additional administrative and economic support to transport infected patients.

Purpose: This study aimed to evaluate the Citizen-Corps-Active-In-Disaster (CAIND) according to a new viewpoint based on changes in basic theoretical concepts and establish a development plan. Methods: A documentary survey was administered, and the study followed the technical approach method. Detailed information on CAIND was taken from scholarly monographs, specialty publications, and previous studies, including master and doctorate dissertations. Results: CAIND may be defined as legal auxiliary organizations composed of local residents who volunteer to prepare for “all kinds of disasters as well as prevention activities” and instill the ideology of “leading service organizations of safety as a form of community involvement,” “resident-friendly organizational activities based on autonomous operation,” and “performing activities which supplement their demands according to the realization of social welfare and regional conditions.” Conclusion: The newly established basic theoretical concept included the concepts of “professionalism and possibilities,” “social expandability,” “voluntary participation,” and “the realization and complementation of social welfare”

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient’s condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

Purpose: This study aimed to obtain, categorize, and analyze baseline data regarding the subjective perception of ambulances from the consumers’ perspective, which can be utilized for improving emergency medical service systems. Methods: Fifty people aged 20 to 40 years old were selected as P samples. Data from 35 statements of Q-cards and Q-sample distribution plots were gathered using Q-sort and analyzed using the PC-QUANL program for major factor analysis. Results: We found four unique characteristics which accounted for 57.57% of the total variation: “Considerate of emergency situations,” “Identifying emergency patients,” “Trusting emergency vehicles,” and “Sympathizing with emergency patients.” Conclusion: Organizations that provide emergency medical services using ambulances should plan and render patient care according to the four types of public perception of ambulances.

Objectives: This study aimed to combine the satisfaction survey results and suggestion for continuing education of the emergency medical technicians through a systematic review of continuing education of the emergency medical technicians. Methods: This review focused on previous studies published until 2020 that were associated with the continuing education of emergency medical technicians. We followed the guidelines set for each phase of the study and selected the 26 studies that met the selection criteria for the analysis. Results: The level of satisfaction with continuing education for emergency medical technicians was low. The most frequently suggested method for continuing education was patient case presentation. The answers to the desired training subjects of the continuing education program varied. Finally, studies on continuing education have not been published continuously. Conclusion: To enhance the satisfaction and competence of continuing education, we need to provide various programs that reflect the needs of emergency medical technicians attending maintenance training. In addition, various methods should be considered to improve the attendance rate for continuing education, and further investigations and research should be actively conducted on continuing education in the future.

Purpose: This study aimed to examine the degree of job satisfaction of emergency medical technicians and its influencing factors through systematic review of prior studies. Methods: Databases were searched including national assembly library, national digital science library, korea education research information service and korean studies information service system to conduct systematic literature review. Results: The included studies were published from 2004 to 2017. After applying the inclusion and exclusion criteria to the retrieved 92 studies, a total of 11 studies were included for the final analysis. The questionnaire developed by Slavitt, Stamps, Piedmont and Haase was the most common tool used from the included studies. In the study using 5 point Likert type scale, the average job satisfaction level of emergency medical technicians was 3.18. It was 2.86 based on 4 point scale. Conclusion: According to the study results, the satisfaction level of emergency medical technicians is around the medium level. Effective strategy should be developed to improve job satisfaction based on the findings of the influencing factors to emergency medical technicians’ job satisfaction.

Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients’ and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

Purpose: The purpose of the study is to check up the status of 119 emergency control centers usage. Therefore, the status of use of 119 emergency control centers and the incidence of pre-hospital cardiac arrest patients were investigated. Methods: The emergency activity daily reports and first aid diaries of 119 emergency control centers from January to December 2018 were reviewed. For more accurate status analysis, Among the first aid guidance received in the emergency rescue standard system, the cardiopulmonary resuscitation guide log was reviewed. Results: In 2018, the total usage of the 119 emergency control centers was 1,358,356 calls, hospital guidance werethe most commom (n=629,676, 46.4%), followed by first aid (n=428,027, 31.5%), disease consultation (n=170,238, 12.5%), medical oversight (n=111,188, 8.2%), and interhospital transfer (n=5,052, 0.4%). Regarding the user number per 1,000 persons, Jeju was the greatest at 48.0, whereas Changwon was the lowest at 13.0. A total number of dispatcher-assisted cardiopulmonary resuscitation was 12.181. The time from report to chest compression were 156.2±80.8 seconds for those with previous cardiopulmonary resuscitation training and 168.0±79.3 seconds for those without such training (p<.05). Conclusion: The ratio of first aid instructions, including dispatcher-assisted cardiopulmonary resuscitation, among total usage of the 119 emergency control centers increased. Therefore, additional efforts are required to improve the quality and expertise of information provided through the 119 emergency control centers.

Cardiogenic syncope occurs due to arrhythmia (bradycardia and tachycardia) or decreased cardiac output, and if proper treatment is not provided, it can lead to acute sudden death. A detailed medical history and physical examinations are required to determine the cause of syncope, and clinical approaches, including 12-lead ECG, are important. The 12-lead ECG does not have a chest lead in the posterior wall of the left ventricle; therefore, ECG of the isolated posterior wall myocardial infarction caused by left circumflex artery occlusion is not observed with ST elevation. Therefore, the significantly higher appearance of ST depression and R waves than S waves from V1 to V3 of the chest lead must be interpreted meaningfully. Isolated posterior wall myocardial infarction is small in the area of myocardial necrosis, and tension is increased in the necrotic area due to the contraction of the normal myocardial muscle, which can cause ventricular wall rupture. Therefore, it is necessary to additionally check Beck’s triad, such as jugular venous distension and decreased heart sound, in patients with low blood pressure with an isolated posterior wall myocardial infarction on 12-lead ECG in patients with syncope.

A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.