Clinical Analysis of Direct Medical Oversight in a Korean Metropolitan City.
- Author:
Kyung Won LEE
1
Author Information
1. Department of Emergency Medicine, Inje University Seoul Paik Hospital, Seoul, Korea. emkwlee@gmail.com
- Publication Type:Legislation ; Original Article
- Keywords:
Emergency medical services;
Emergency medical service communication systems;
Medical direction
- MeSH:
Ambulances;
Bandages;
Blood Glucose;
Certification;
Consciousness;
Electrocardiography;
Emergencies;
Emergency Medical Service Communication Systems;
Emergency Medical Services;
Emergency Medical Technicians;
Fires;
Glucose;
Humans;
Immobilization;
Korea;
Local Government;
Masks;
Nitroglycerin;
Nurses;
Oxygen;
Patient Safety;
Physician Executives;
Ventilation;
Vital Signs;
Water;
Wounds and Injuries
- From:Journal of the Korean Society of Emergency Medicine
2017;28(4):362-373
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: In Korea, the EMS system is a municipal governmental fire-based system. Since 2012, an EMS medical director has been appointed in all fire stations by legislation. This study examined the direct medical oversight (DMO) clinically in a Korean metropolitan city. METHODS: This is a descriptive analysis of the fire-based centralized DMO in a metropolitan city. The current status of the ambulance crew of a fire station including certification, EMS experience, the number of requested DMO, and the statistics of DMO, and the DMO physicians of a fire department dispatch center, was studied. The ambulance run sheets of a fire station were reviewed to survey the assessment and intervention of ambulance-receiving DMO. RESULTS: Although it is increasing every year, the ratio of ambulance runs receiving DMO was 2.5–11.1% in a fire station. The fire station has 45 ambulance crew, half of which were level 1 emergency medical technicians and registered nurses. In a fire department dispatch center, most (70%) of the DMO physicians were emergency physicians. The ratio of prehospital assessment, including consciousness (100%), full vital sign (78.8–91.2%), oxygen saturation (86.5–100%), blood sugar test (31.3–94.4%), and ECG (16.7–48.5%), was higher than the ratio of prehospital intervention, including advanced airway (1.9–21.15), bag mask ventilation (3.0–63.2%), IV dextrose water (55.6%), nitroglycerin subligual (42.9%), cervical immobilization (57.7%), and wound dressing (53.85) in an ambulance run receiving DMO in a fire station. CONCLUSION: The ratio of patients transported by ambulance receiving DMO is still low in a metropolitan city. The DMO should be strengthened to improve the patient safety and quality of EMS in Korea.
