Earticle

Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms—which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively—appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

Purpose: This study aimed to identify research topics in the emergency medical technician (EMT) field and examine research trends. Methods: In this study, 261 research papers published between January 2000 and May 2022 were collected, and EMT research topics and trends were analyzed using topic modeling techniques. This study used a text mining technique and was conducted using data collection flow, keyword preprocessing, and analysis. Keyword preprocessing and data analysis were done with the RStudio Version 4.0.0 program. Results: Keywords were derived through topic modeling analysis, and eight topics were ultimately identified: patient treatment, various roles, the performance of duties, cardiopulmonary resuscitation, triage systems, job stress, disaster management, and education programs. Conclusion: Based on the research results, it is believed that a study on the development and application of education programs that can successfully increase the emergency care capabilities of EMTs is needed.

Purpose: This study aims to analyze the effects of flipped learning on paramedic students’ self-directed learning and academic self-efficacy. Methods: A one-group pretest, posttest design was utilized for the 32 paramedic students who participated. The data were analyzed by employing paired t-test and Pearson correlation coefficient along with the SPSS 23.0 program. Results: The scores of self-directed learning and academic self-efficacy significantly increased after flipped learning classes (t = -3.90, p<.05; t = -5.92, p<.05, respectively). Conclusion: Flipped learning is an effective intervention for improving self-directed learning and academic self-efficacy in paramedic education. In the long run, the application of flipped learning will play a role in improving the paramedic students’ educational environment and strengthening the overall abilities of students.

Purpose: This study aimed to survey coronavirus disease (COVID-19) related knowledge, preventive possibility, and preventive behaviors levels among college students and identify the correlation between these variables. Methods: An online survey was conducted among college students from October 25 to November 5, 2021. The data were analyzed by an independent t-test and Pearson’s correlations. Results: A total of 344 college students participated. The correct answer rate for COVID-19 knowledge level was high, infection and preventive possibility levels were moderate, and the anxiety level was high. Infection possibility had a positive correlation with anxiety and preventive behaviors had a positive correlation with preventive possibility. Conclusion: The findings regarding COVID-19 perception can be used to develop appropriate health policies for infectious disease prevention behaviors in educational fields.

Purpose: This experimental study compared the chest compression quality, muscle activity, and subjective fatigue of paramedic students who did or did not wear a mask. Methods: The subjects of this study were 13 paramedic students at college D located in B city. Frequency percentages, mean standard deviations, and paired sample t-tests were conducted using the SPSS/WIN 23.0 program. Results: This study revealed that chest compression depths (t=-2.151, p=.053) and compression rates (t=-2.714, p=.019) were higher in mask-wearers, while muscle activity and subjective fatigue (t=2.382, p=.035) of the erector spinae (t=7.082, p=.001), rectus abdominis (t=4.776, p=.001), and pectoralis major muscles (t=3.193, p=.008) were lower in mask-wearers. Conclusion: The results of this study can be used as a basis to increase the resuscitation rates of cardiac arrest patients and provision of high-quality chest compressors to rescuers when infectious diseases recur in the future.

Purpose: The purpose of this study is to understand currently active Korean paramedics’ disaster response abilities, including immediate response, severity classification, patient treatment, and patient transfer, in a disaster situation with multiple casualties. Methods: A structured questionnaire consisting of a total of 25 questions was used, including 5 questions on the subject's general characteristics and 20 questions on disaster-related emergency response abilities. Results: Among the disaster response abilities of the participants, the patient transport ability scores were high and the cooperative support ability scores were low. In terms of general characteristics, there was a significant difference in age, and it was high in the 40s, and there was a significant positive correlation between each competency. Conclusion: These results suggest that there is an urgent need to develop a systematic and specialized educational system with components inside and outside fire departments related to multiple casualty disasters to improve overall abilities.

Purpose: By analyzing the health status of emergency patients on islands in the Jeollanam-do province, this study aims to provide basic data for proposed future medical emergency services on the islands. This information includes monthly and hourly statistics on patients’ characteristics, patient frequency, an analysis of first aid procedures, response times, and time spent at hospitals. Methods: The study analyzed the monthly and hourly frequency of emergency patients, first aid status and procedures, general patient characteristics, accident types, patient cognitive status and agility, marine police response times, and frequency and percentile of hospital dispatch times. Results: 1Q and #q show the highest patient turnover rate in one year. 50.5% of daily patients are admitted between 4 PM and 12 PM. The hospital dispatch time is within a one- to two-hour window for 54.0% of all patients. Conclusion: The emergency medical service system for the Jeollanam-do province islands and seas is available to all Korean residents, citizens, and visitors. It is necessary to implement an emergency medical system for the relevant organizations.

연구 목적: 병원 밖 심정지(OHCA)에서 자동제세동기(AED)의 사용은 환자의 생존율을 향상시킨다. 싱 가포르는 절도를 막고자 공공 AED를 ‘브레이크 글래스’ 기전의 잠금 박스로 보호하고 있는데 지역사회 대응자들은 AED를 회수하기 위해 유리를 깨면서 부상을 당하곤 했다. 최초로 시도한 본 연구는 성공적 인 AED 회수에 영향을 미치는 요인들을 밝히고 만연한 부상을 문서화하고자 하였다. 연구 방법: 설문지를 작성, 배포하였다. 참가자는 지난 12개월 동안 OHCA에 대처한 자들이다. 비교 검정은 피셔-프리만-할턴 정확 검정 또는 피어슨 카이제곱 검정을 사용하여 5% 유의 수준에서 시행되었고, 로짓링크함 수를 사용하여 다중로지스틱회귀분석을 시행하였다. 연구 결과: 88명의 참가자가 적격했다. 성공적인 AED의 회수는 직업, 연령, 성별 및 시간 영향을 받지 않았다. myResponder 앱의 활성화로 OHCA에 대응했던 참가자들은 성공적으로 AED를 회수할 가능성이 높았다. (AOR 11.111, 95% CI: 2.141-58.824) 결 론: 모바일 myResponder 앱을 활용할 경우 AED회수 성공률이 훨씬 높았다. AED의 성공적 회수는 시간 뿐만 아니라 이용자의 성별, 연령, 직업과 무관했다. 싱가포르에서 지역사회 대응자들은 부상 위험에도 불구하고 심정지에 대응할 적극적 자세가 되어 있다.

Purpose: Automated External Defibrillator (AED) usage in out-of-hospital cardiac arrests (OHCAs) improves the survival of patients. In Singapore, public AEDs are protected by locked boxes with a ‘break glass’ mechanism to deter theft. Community responders have sustained injuries while breaking glass to retrieve AEDs. This unprecedented study aimed to elucidate the factors influencing successful retrieval of an AED and to document the prevalence of injuries. Methods: A survey was created and distributed. Participants were required to have responded to an OHCA in the past 12 months. Comparison tests were performed with the Fischer-Freeman-Halton Exact test or Pearson chi square test at 5% significance levels, and with multiple logistic regression with a logit link function. Results: Eighty-eight participants were eligible. The success of retrieving an AED was found not to be impacted by occupation, age, gender or time. Participants who responded to an OHCA because of activation by the myResponder App were more likely to retrieve an AED successfully. (AOR 11.111, 95% CI: 2.141-58.824) Conclusion: Use of the myResponder mobile application is associated with the greater success of retrieving an AED. Successful retrieval of an AED is not impacted by time, gender, age, or the occupation of the responder. Community responders in Singapore remain motivated to respond to Cardiac Arrests despite risk of injury.