Earticle

Purpose: This study aimed to present the learning items of indirect practice as an alternative means of ambulance riding practice. Methods: Twelve on-site professionals participated in testing the effectiveness of learning items of utility value in indirect experience practice among the recommended learning objectives of ambulance ride practice using the modified Delphi technique. To validate the learning objectives, the Delphi technique was used to check content validity, and analytic hierarchy process (AHP) analysis was used to analyze the weighting value. Results: As the learning goal of indirect experience practice replaced the ambulance riding practice, four items were derived in consideration of practicality. These items were consistent with the Delphi panel's consistency index, convergence, and agreement. The first learning item to consider was ‘Prevention of infection and risk of infection.’ Conclusion: The results of this study are meaningful in that they propose the learning items that can achieve the minimum educational goal through indirect experience practice as an alternative means of ambulance training.

Purpose: This study aimed to investigate the relationship between emergency medical service accessibility in different regions and the sudden death rate in elderly patients with ischemic heart disease using data analysis techniques and suggest improvements in regional emergency medical services. Methods: The study collected data from the NEDIS database and Statistics Korea. Data on a total of 75,867 patients aged ≥65 years were reviewed among patients with ischemic heart disease who visited emergency medical institutions in 2018. Frequency analysis, chi-square test, multiple logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0. Results: With an emergency medical resource per 100km2 , there was a concomitant reduction in the risk of death. There was a decrease in the death rate by 0.967, 0.970, 0.997, and 0.391 times with the increase in the presence of a fire department, an ambulance, a paramedic, and a regional medical center, respectively. Furthermore, a decrement in the death rate was witnessed 0.844, 0.825, and 0.975 times with the initiation of a local emergency medical center, a local emergency medical institution, and an angiography device, respectively(p <.001). Conclusion: To improve the accessibility of emergency medical services, the population and geometric area of the region should be considered essential factors when deploying emergency medical resources.

Purpose: Emergency medical technicians (EMTs) have so far been trained as professionals under the same conditions, with no change in the 1995 Act. We aimed to find ways for them to secure expertise in accordance with social needs by strengthening the quality of the EMT education. Methods: This is a descriptive study comparing the operation status of the national emergency medical examination conducted by the Korea Health Personnel Licensing Examination Institute, and the national examinations of EMT paramedic and EMT basic. The scope of the national examinations for EMT was compared by subject and area. Results: The national written exam for EMT paramedic consists of five areas. EMT basic does not include basic medicine in three related subjects, 11 areas, and 18 detail areas. Paramedic care does not include advanced pediatric life support. In addition, nine areas and 20 detail areas are not included. Conclusion: The study suggests the need for institutional supplementation so that those who have completed EMT basic and the subjects prescribed by the ordinance of the Ministry of Health and Welfare at universities, etc., in the Higher Education Act can take the EMT paramedic national exam.

Purpose: This study aimed to develop 360° virtual reality videos and common videos for cardiac arrest recognition. Methods: A sequential mixed methods study was conducted, using qualitative interviews (with a total of seven experts) and a quantitative survey. Results: First, the cardiac arrest situation should be developed within 2-3 minutes after witnessing the patient collapse, for each of the four cardiac arrest videos about apnea, gasping, seizure, gasping, and seizure. Second, the education program should be designed so that the education on cardiac arrest recognition can proceed before CPR practice begins. Conclusion: 360° virtual reality videos and common videos for cardiac arrest recognition can play an important role in the education of the general public about cardiac arrest experience.

Purpose: This study aimed to examine the development and improvement direction of university education according to job type and investigate the types of knowledge required for employment after graduation for departments of emergency medical technology in preparation for the era of the fourth industrial revolution in a converged society. Methods: From June 3 to June 10, 2019, data were collected through structured questionnaires from 90 paramedics working in firefighting, hospitals, different industries, and emergency patient transportation. Data were analyzed using the software SPSS version 18.0. Results: For employment after graduation in departments of emergency medical technology, character and sincerity education should be strengthened. To prepare for the fourth industrial revolution, educational innovations such as improving the field practice system and devising a convergence curriculum are needed. Preparation for the fourth industrial revolution should be accomplished through the development of convergence subjects such as forensic science, information and communications technology, and safety engineering. Ninety percent of the study respondents indicated their need for convergence subjects. Conclusion: The demands of future society should be responded to flexibly by holding and conducting convergence subjects. Furthermore, preparations should be made in anticipation of a shortage of 120,000 college freshmen for the 2024-2025 school year by increasing the competitiveness of departments of emergency medical technology.

Purpose: The study aimed to analyze the current status of traffic accident victims who were transported by 119 ambulances within the administrative district of Chungnam province and provide essential data for accident prevention. Methods: The pre-hospital care records of patients who called the 119 emergency service in 2019 were obtained from the Chungnam Fire Department. Data pertaining to 13,663 traffic accident victims who were transported to hospitals were analyzed. Results: Patients in those aged ≥60 years accounted for 49.8% of the total cases. In patients aged ≥ 80 years(n=2,154), motor cycle accidents were highest as 28.3%. In addition, cultivator (n=135) and buggy car (n=79) accident victims were the highest in aged ≥80 years as 66.7% and 67.1%, respectively. Traffic accident victims-population ratio in Chungnam was 0.65%, wherein 2.03% included population aged ≥80 years. Conclusion: It was clear that accidents varied across administrative districts depending on the age group of population distribution. Thus, safety measures for preventing motorcycle, cultivator, and buggy car accidents are necessary for areas with many older people aged ≥80 years.

Purpose: This study sought to analyze perceptions and attitudes regarding patient personal information protection according to the general characteristics of paramedic students and their clinical practice experience. Methods: A total of 215 paramedic students from G university in I metropolitan city and D university in G do were surveyed. Frequency analysis, percentage analysis, and one-way distribution analysis were conducted using the software SPSS version 23.0. Results: First, recognition regarding the operation of laws and systems related to medical law and personal information protection was high among students who had no clinical practice experience, and there were no differences with regard to students’ general characteristics. Second, the level of recognition regarding patient personal information protection and exposure did not differ depending on students’ general characteristics and clinical practice experience. Conclusion: Based on the results of this study, students’ recognition and attitude should be improved by carrying out continuous education on patient personal information protection. Furthermore, more specialized and systematic training related to patient personal information protection should be conducted to nurture appropriately trained paramedic students.

Purpose: This study aimed to identify the current status of school safety education and the differences in knowledge and practice of middle school students. Methods: A structured questionnaire was distributed to 418 middle school students in J province. The questionnaires consisted of 35 questions on the status of school safety education as well as the four school safety education domains of first aid, disaster safety, traffic safety, and daily life. Data were analyzed using frequency analysis, cross-tabulation analysis, a t-test, analysis of variance, and Pearson’s correlations. Results: Awareness regarding the top seven standards for school safety and interest in school safety education were both relatively low. Among all the different kinds of safety accidents, those related to school violence(33.8%) and life safety(24.9%) were experienced the most in school. A more pleasant school life and better peer relationships led to interest in school safety(p=.000)(p=.000), awareness regarding the top seven standards for school safety(p=.022)(p=.009), adoption of coping measures(p=.000)(p=.000), and practice(p=.000)(p=.000) in case of safety accidents(p=.000)(p=.000). Conclusion: To increase awareness regarding the seven standards for school safety education and raise interest in safety education, it is necessary to cultivate experts and actively utilize them and to prepare systematic and continuous school safety education programs.

Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

Purpose: The study was a qualitative study to examine the synchronous and asynchronous distanced learning experience of online paramedic students during the COVID-19 pandemic. Methods: The subjects included 10 students enrolled in the department of emergency medical service at J City C University. Written consent was provided by the subjects prior to the study, and focus group interviews were then conducted with sufficient explanation. The interviews were recorded and were directly transcribed immediately after the interview. Research results were then derived through content analysis. Results: A total of 4 domains and 9 categories were derived from the experiences of paramedic students on distanced learning. The 4 domains included “distanced lectures type,” “student’s adaptation and non-adaptation,” “change of evaluation,” and “learning anxiety.” Conclusion: Contents of each domain derived from this study are expected to be used as basic data for the design of the distanced learning in the future.

Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.