PURPOSE: The purpose of this study is to examine the work experiences of nurses working as 119 paramedics and to provide basic information to develop administrative and institutional support system for the nurses. METHOD: The data were collected from December, 2007 to July, 2008 and analyzed using the phenomenological method provided by Munhall and Boyd. Participants of this study were 7 nurses currently working as 119 paramedics and who were willing to fully express their experiences. The grand mal question used in this study was "How is your work experience as an 119 paramedic?" RESULT: Narratives of the participants were analyzed and divided into 3 categories such as 'recognizing', 'withdrawal', and 'confrontation'. CONCLUSION: The results showed even if the participants think of their tasks fulfilling and be proud, they have some difficulties due to restrictions of tasks and work environment. Based on the findings, we suggest developing educational programs to improve their task abilities, establishing safety policy and compensatory reward system according to their accomplishments, and providing counseling opportunities for their traumatic experiences with difficult emotion.
Allied Health Personnel ; Counseling ; Humans ; Reward

OBJECTIVE: This study aimed to evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management in ground intubation for pre-hospital trauma patients. METHODS: A prospective randomized crossover study was conducted with 18 paramedics to examine intubation performance of two blind intubation techniques through a supraglottic airway devices (IGI and laryngeal mask airway Fastrach), compared with use of a Macintosh laryngoscope (MCL). Each intubation was conducted at two levels of patient positions (ground- and stretcher-level). Primary outcomes were the intubation time and the success rate for intubation. RESULTS: The intubation time (sec) of each intubation technique was not significantly different between the two positions. In both patient positions, the intubation time of IGI was shortest among the three intubation techniques (17.9±5.2 at the ground-level and 16.9±3.8 at the stretcher-level). In the analysis of cumulative success rate and intubation time, IGI was the fastest to reach 100% success among the three intubation techniques regardless of patient position (all P < 0.017). The success of intubation was only affected by the intubation technique, and IGI achieved more success than MCL (odds ratio, 3.6; 95% confidence interval, 1.1 to 11.6; P=0.03). CONCLUSION: The patient position did not affect intubation performance. Additionally, the intubation time with blind intubation through supraglottic airway devices, especially with IGI, was significantly shorter than that with MCL.
Airway Management ; Allied Health Personnel ; Cross-Over Studies ; Emergency Medical Technicians ; Humans ; Intubation* ; Laryngeal Masks ; Laryngoscopes ; Prospective Studies ; Simulation Training

OBJECTIVE: Various educational programs have been implemented to achieve skill, willingness and self-confidence in performing cardiopulmonary resuscitation (CPR). Paramedic students usually participate in clinical practice in emergency department as one of their educational courses. We investigated the effects of hospital based clinical practice and participation in real cardiac arrest situation on paramedic students' CPR performance and recognition. METHODS: Eighty-one paramedic students from 10 different universities who received hospital based clinical practice for 3 or 4 weeks in a regional emergency medical center from December 2016 to August 2017 were enrolled in our study. Subjects were asked, using a questionnaire, about their confidence and willingness to perform CPR before and after clinical practice. We also objectively measured two minute-CPR performance using the Laerdal skill reporter before and after clinical practice. During clinical practice, students participated in real CPR situations and took several theoretical examinations; however, additional CPR practical training was not included. RESULTS: This study included 48.1% male volunteers and 70.4% respondents who had Basic Life Support provider certification. The average number of real CPR situations participated in was 8.35 times. Scores in confidence of CPR increased significantly (3.80 vs. 4.36, P < 0.001) after clinical practice; however, scores in willingness to conduct CPR were high in both groups (4.46 vs. 4.48, P=0.787). Average chest compression depth also increased significantly (51.3 mm vs. 55.5 mm, P < 0.001) after clinical practice, but average compression rate showed no difference (111 vs. 111, P=0.694). Correct hand positioning and chest recoil also showed no difference between groups. CONCLUSION: Hospital based clinical practice of paramedic students could provide extra confidence in student's ability to perform CPR and lead to adequate chest compression depth.
Allied Health Personnel* ; Cardiopulmonary Resuscitation* ; Certification ; Education ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Emergency Service, Hospital ; Hand ; Heart Arrest ; Humans ; Male ; Surveys and Questionnaires ; Thorax ; Volunteers

PURPOSE: The resuscitation room is the hub of intensive care and focused management within the emergency department (ED). For patients with life-threatening conditions, immediate triage and proper treatment using the resuscitation room is important. This study was conducted to assess the epidemiology of patients using the resuscitation room in an emergency department. METHODS:This was a retrospective observational study. Eligible subjects were enrolled through the National Emergency Department Information System from July 2007 to September 2008. All subjects came through a single regional emergency center that logs more than 45,000 patients annually. Pediatric patients less than 15 years of age and those who were dead on arrival at the ED were excluded. The Emergency Severity Index (ESI) version IV was used as a triage tool, and characteristics and ESI levels of patients using or not using resuscitation rooms were compared. RESULTS: The total number of eligible subjects was 40,926 and the male-female ratio was 1:0.92. The numbers of patients using the resuscitation room was 1,050 (2.99%). Patients using the resuscitation room were older than the patients not using the resuscitation room, were more likely to have used an ambulance to visit the ED, and had a higher mortality rate and a higher admission rate. A majority of staff members had the authority to put patients in the resuscitation room. Among them were professors 18.19%, emergency residents 11.43%, certified emergency nurses 40.57%, emergency nurses 19.43%, emergency medical technicians 2.86%, and paramedics 6.19%. Critical care was done in the resuscitation room for cardiopulmonary resuscitation 11.66%, intubation 26.33%, ventilation 1.71%, defibrillation 5.73%, and other 54.57%. The most frequent ESI levels of patients using the resuscitation room was 1 (57.89%); an ESI score of 3 (72.01%) was the most frequent value for patients not using the resuscitation room. CONCLUSION: Patient using the resuscitation room were older, more likely to have used an ambulance, and had a higher mortality rate, admission rate and ESI level.
Allied Health Personnel ; Ambulances ; Cardiopulmonary Resuscitation ; Critical Care ; Emergencies ; Emergency Medical Technicians ; Humans ; Information Systems ; Critical Care ; Intubation ; Porphyrins ; Resuscitation ; Retrospective Studies ; Severity of Illness Index ; Triage ; Ventilation

Aid post orderlies in one district of the Southern Highlands Province were trained to give immunizations to children as part of the Expanded Programme on Immunization. The performance of the aid post orderlies (APOs) as immunizers is compared with that of the traditional maternal and child health (MCH) team. Also the results of the combined efforts of the APOs and MCH sisters in this pilot district are compared with those in a control district. The joint APO-MCH effort was more successful than the traditional approach in reaching national immunization targets.
Allied Health Personnel ; Human ; Immunization Schedule ; Infant ; Papua New Guinea

Brain tumor registry is an essential element of brain tumor control strategy, providing epidemiological, management, and outcome data for patients with brain tumor. To establish a well documented and sustainable assessment of brain tumor data in Korea, the Korean Brain Tumor Study Group prepared Korean Brain Tumor Registry, which is a collaborative study involving all of the neurosurgical training hospitals in Korea. The participating hospitals will collect epidemiololgical data for the malignant, benign, uncertain and unspecified tumors of the brain. The 10th Revision of the ICD and the morphlolgy rubrics of the second edition of the ICD-O will be used to meet the international standards of tumor registry. The annual study will provide clinical information that will be disseminated to physicians, allied health personnel, administrators, health care planner, and public and private agencies. The final goal of this study is to establish the population-based national brain tumor registry.
Administrative Personnel ; Allied Health Personnel ; Brain Neoplasms* ; Brain* ; Delivery of Health Care ; Epidemiology ; Humans ; Korea ; Neurosurgery

Gachon Medical School developed an "Experience-based Sharing Program" as a component of its "Patients, Doctors and Society" course. The program was designed to familiarize preclinical students with the various roles which patients and hospital personnel take on in the hospital setting by directly experiencing these roles and performing the same daily routines that these personnel perform. The unit was organized as a 6-day program for 2nd and 3rd year students during the winter recess. Distinguishing features of the course are that it encouraged (1) the active participation of students in the daily hospital activities which various hospital personnel perform other than providing direct medical care within the hospital setting, (2) non-faculty hospital personnel to function as educational facilitators, (3) the development of medical students interpersonal skills with various groups of hospital staff and patients, and (4) students to engage in self-evaluation by requiring them to report on their experience. We conclude that the program is useful and essential in motivating students to understand the roles of their future coworkers in medical practice, in developing students interpersonal skills with the goal that they will be better doctors, and in encouraging paramedical personnel to be facilitators in educating medical students.
Allied Health Personnel ; Diagnostic Self Evaluation ; Humans ; Learning* ; Personnel, Hospital* ; Schools, Medical ; Students, Medical*

BACKGROUND: Recently, patients' demands for emergency medicine are increasing, and most of prehospital medical care, including basic life support, cardiopulmonary resuscitation and triage, are provided by paramedics or emergency medical technicians. Evaluation of the adequacy of prehospital management and triage has become important for improving the quality and the effectiveness of the emergency medical system. METHODS: The 202 patients who were transferred by ambulance with paramedics, nurses, or emergency medical technicians to the Emergency Department in Gil Medical Center from July 1, 1999, to September 31, 1999, were enrolled. This study was conducted prospectively by using the emergency physician's log and newly devised protocols recorded by paramedics or nurses. RESULTS: 1) Male to female ratio was 1:0.8, and the peak age of the patients were the 4th(18.8%) and 6th decade(15.3%). 2) Of the 202 patients, 84 patients were transferred for trauma and 118 for medical problems. The mean transfer time was 6+/-1.73 minutes. 3) The validities of prehospital triage and decisions using the trauma severity measure and the disease severity measure, were 33.3% in trauma patients and 57.6% in medical patients. 4) The results for the adequacy rate in prehospital management analyzed by using the rate of necessity of treatment, performance of treatment, and adequate treatment were as follows: oxygen supply, 38.1/41.6/93.8; wound dressing, 19.3/71.8/92.9; immobilization of the cervical spine, 15.8/56.3/92.9; application of a spinal board, 12.9/42.3/72.7; application of a splint, 9.9/50.0/60.0; manual maintenance of an airway, 9.9/55.0/63.6; and CPR, 4.5/66.7/0.5) Kind of ALS(Advanced Life Support) were not conducted(peripheral IV, EKG, intubation medical administration, defibrillation, pacing). The rates of necessity of treatment were as follows: peripheral IV, 40.6%; ECG monitoring, 23.3%; endotracheal intubation, 8.9%; medical administration, 8.9%; defibrillation, 3.5%; and pacing, 1.5%. CONCLUSION: The adequacy of prehospital triage and decisions using trauma and disease severity measures was relatively low. To improve the adequacy of BLS(Basic Life Support) and to increase the performance of ALS(Advanced Life Support), we must create challenges to develop new protocols and to supplement new equipment.
Allied Health Personnel ; Ambulances ; Bandages ; Cardiopulmonary Resuscitation ; Electrocardiography ; Emergencies ; Emergency Medical Technicians ; Emergency Medicine ; Emergency Service, Hospital ; Female ; Humans ; Immobilization ; Intubation ; Intubation, Intratracheal ; Male ; Oxygen ; Prospective Studies ; Spine ; Splints ; Triage* ; Wounds and Injuries

Recent advances in information and telecommunication technology make u-health strategies possible in Emergency Medical Services (EMS) system. The u-Health can offer advanced life support, medical oversight to the emergency medical technician, quality improvement in EMS, and hazard management. The aim of this study is to provide comprehensive review, and to discuss the role and problems of the u-Health used in EMS system. The efficient operation of EMS system is contingent upon the quality management of both the working systems and underlying communication infrastructures of u-health. The u-Health services for EMS requires assessment skill, IT technology and organization of all systems. The u-Health raises the level of a medical control and treatment to a much higher degree in pre-hospital setting and also tends to decrease mortality. By utilizing u-Health system, the patient's data collected from ambulances transfer simultaneously to a central emergency medical information center (EMIC) and hospitals. Medical director delivers medical oversight to the paramedics in the ambulance, and also transmits the information to a doctor at ER before arriving to the hospital. The transmitted data contains the patient's information, vital signs (blood pressure, pulse rate, respiration rate, and temperature), ECG, pulse oxymetry, a moving picture and information at the point of care administration. For a successful integration of u-Health to EMS system, information technologies, assessment technologies, telecommunications, and legal remedy are needed. Especially, advance in assessment technologies offer the possibility of small size, but also of intelligent, active devices that are wireless and non-invasive or minimally-invasive. u-Health will benefit the patients by advanced life support in pre-hospital and emergency department settings. It will help decrease the cost associated with the hospital, mortality, and morbidity.
Allied Health Personnel ; Ambulances ; Blood Pressure ; Electrocardiography ; Emergencies ; Emergency Medical Services ; Emergency Medical Technicians ; Humans ; Information Centers ; Information Systems ; Physician Executives ; Quality Improvement ; Respiratory Rate ; Safety Management ; Telecommunications ; Telemedicine ; Vital Signs

PURPOSE: This study compared the outcomes of AutoPulseTM compression with manual compression provided by 119 paramedics in out-of-hospital cardiac arrest patients. METHODS: Between March and December 2016, a total of 221 out-of-hospital cardiac arrest patients were included for analysis. The patients included were categorized as the AutoPulseTM compression group and manual compression group. Patient's age, sex, pre-hospital intubation, bystander cardiopulmonary resuscitation (CPR), initial cardiac rhythm, time from arrest to CPR and CPR duration were reviewed retrospectively. The initial pH, lactate level, white blood cell (WBC) count, delta neutrophil index (DNI), and targeted temperature management status were collected. As clinical outcomes, the return of spontaneous circulation (ROSC), hospital and intensive care unit (ICU) length of stay, survival rate, and cerebral performance category (CPC) scale at discharge were analyzed. RESULTS: The initial rhythm and CPR duration were similar in the two groups. On the other hand, the pre-hospital intubation rate and pre-hospital CPR duration were significantly higher in the AutoPulseTM group than the manual group (32.9% vs. 12.7%, p < 0.001; 15.2 vs. 11.9 minutes, p=0.002). The ROSC rate, hospital and ICU length of stay, CPC scale and survival rate at discharge as the clinical outcome were similar in the AutoPulseTM group and manual group. The pH was lower and the lactate level was significantly higher in the AutoPulseTM group than the manual group (6.91 vs. 6.96, p=0.007; 12.8 vs. 11.4 mmol/L, p=0.031), but the WBC and DNI were similar in the two groups. CONCLUSION: The use of AutoPulseTM provided by 119 paramedics in out-of-hospital cardiac arrest patients is not associated with better clinical outcomes.
Allied Health Personnel ; Cardiopulmonary Resuscitation ; Emergency Medical Technicians ; Hand ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Intensive Care Units ; Intubation ; Lactic Acid ; Length of Stay ; Leukocytes ; Neutrophils ; Out-of-Hospital Cardiac Arrest* ; Retrospective Studies ; Survival Rate