응급의료 신고번호 체계 통합 후 이용실태 분석 연구
Analysis of Use Status After Integration of Emergency Medical Service Call System
- 주제(키워드) 119 Emergency Control Center , Cardiac Arrest(CA) , Emergency Medical Service System (EMSS) , Cardiopulmonary Resuscitation (CPR) , Emergency Medical Dispatcher (EMD)
- 발행기관 아주대학교
- 지도교수 최상천
- 발행년도 2019
- 학위수여년월 2019. 2
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000028722
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Analysis of Use Status After Integration of Emergency Medical Service Call System Emergency medical response system at the pre-hospital phase in Korea was originally divided into the 119 ambulance service under the Korean National Fire Agency and the 1339 Emergency Medical Information Center under the Ministry of Health and Welfare. However, with the amendment of the Act on the 119 Rescue and Emergency Medical Service by the National Assembly of the Republic of Korea in 2012, the 1339 Emergency Medical Information Center was closed. Instead, the 119 service has become a comprehensive center for medical emergencies (reporting an incident, dispatching the ambulance, hospital guidance, first aid guidance, and transferring the patient to an appropriate medical center) in an attempt to provide a “one-stop” service for patients. In addition, a 119 Emergency Control Center has been established and operates at the Korea National Fire Agency and its headquarters in different cities and provinces. This study assessed pre-hospital phase emergency telephone call usage before and after the consolidation of emergency telephone numbers, analyzed the usage status by region and reasons for consultation after the stabilization of the Emergency Rescue Standard System (ERSS) operated by the 119 Emergency Control Center, and investigated the registered content of newly introduced cardiopulmonary resuscitation (CPR) and first aid protocols after the consolidation of emergency telephone numbers. In this study, 19,439 cases – including cases of usage of the 119 Emergency Control Center and CPR and first aid cases registered in the Emergency Rescue Standard System (ERSS) – between January and December 2016 have been used for the analysis. The following are the key outcomes of this study: 1. Since the consolidation of 119 and 1339 in June 2012, the overall operational performance of the 119 Emergency Control Centers has decreased by 27.8% compared to 2011, prior to the consolidation. Examining the reasons for consultation found that although the performance for first aid guidance has increased by 91.0%, consultations for disease management and hospital guidance have decreased by 42.5% and 46.5%, respectively. 2. By client type, the usage by the general population, the highest usage rate, has decreased by 28.8%. Although the usage of the 119 emergency team has increased by 66.0%, usages by medical institutions, transporters, and related organizations have all decreased by 65.2%, 87.9%, and 77.2%, respectively. 3. By location, the city of Seoul showed the greatest frequency of usage with 305,942 cases. The usage per 1,000 people was greatest in the city of Daejeon (57.2 per 1,000 people) and lowest in the city of Changwon (11.5 per 1,000 people). 4. The mean age of patients with cardiac arrest who received CPR was 68.3 ± 18.7 years, and the majority of patients were in their 80s. Males exhibited more frequent cardiac arrest (11,710 patients, 60.2%) than females (7,729 patients, 39.8%). The main causes of cardiac arrest for different age groups were as follows: no breathing and suspected cardiac arrest without external cause for patients aged 70–80s; choking for those aged 40–50s; and suspected cardiac arrest from external damage (i.e., traffic accident or fall) for those aged 50–70s. CPR performers were mostly family members or cohabitants (73.4%), followed by friends or acquaintances (9.1%) and facility participators (5.9%). 5. The time period between emergency telephone call (reporting of incident) and dispatcher-assisted CPR (DA-CPR) was 182.3 ± 89.8 seconds. Subjects who had CPR training showed a shorter time period (173 ± 88.6 seconds) than those who did not have training (184.0 ± 88.2 seconds). The outcomes of this study demonstrated that although the usage status of consolidated 119 Emergency Control Centers has decreased in terms of overall operational performance compared to the previous system, the rate of first aid training (including CPR) via telephone has steadily increased since the consolidation of pre-hospital phase emergency medical service system. Therefore, studies or measures to provide more efficient and professional treatment instructions and improved quality of information are needed in the future. Enhancing the capability of the 119 Emergency Control Center will undoubtedly contribute to establishing an effective pre-hospital phase emergency medical service system.
more목차
Ⅰ. Introduction 1
A. Study background and purpose 1
1. Study background 1
2. Study purpose 6
3. Definition of terms 6
B. Scope of the study & Materials and Methods 7
1. Scope of the study 7
2. Subjects of the study 7
3. Statistical analysis 10
Ⅱ. Theoretical background of the emergency medical service system 11
A. The concept of an emergency medical service system 11
1. Significance of the emergency medical service system 11
2. Management of the emergency medical service system 12
B. Need for the emergency medical service system 13
1. Need for the emergency medical service system 13
2. Composition of the emergency medical service system 15
C. Importance of cardiopulmonary resuscitation training 29
1. Concept of CPR 30
2. Definition of cardiac arrest (CA) 30
3. CPR guidelines 31
4. Status of rescue and emergency medical care training 32
5. Status of the occurrence of cardiac arrest 35
E. Foreign emergency medical service system 35
1. The emergency medical service system in the U.S. 35
2. The emergency medical service system in the U.K. 38
3. The emergency medical service system in France 40
4. The emergency medical service system in Germany 43
5. The emergency medical service system in Japan 46
Ⅲ. Results 50
A. The status of emergency telephone call usage before and after the consolidation of emergency telephone numbers 50
1. Usage based on the reasons for consultation 50
2. Usage by type of client 51
B. Status of the usage of the 119 Emergency Control Center before and after consolidation of emergency phone numbers 53
1. Usage by region 53
2. Usage by day of the week and time of day 55
3. Usage per 1,000 people by region 58
C. Status of the usage of CPR and first aid 60
1. General characteristics of the patients 60
2. Usage of emergency telephone calls by CA patients by month and day 61
3. Usage of emergency telephone calls by CA patients by time of day 63
4. Relationship between CA patient and CPR provider 65
5. Association between the cause of cardiac arrest and age 66
6. The time period between reporting the incident and chest compression 68
Ⅳ. Discussion 70
Ⅴ. Conclusion 78
References 80
국문요약 85
