Objective: Emergency medical services (EMS) personnel are at a high risk of spreading infections. Compliance with the EMS handwashing regulations is difficult due to frequent dispatches and on-site treatment. This study sought to investigate the education status and awareness about handwashing of EMS personnel, their performance of the recommended handwashing pattern, and their compliance with infection control protocols. Methods: A total of 677 paramedics were educated on handwashing methods and performance and 76 of them were surveyed on handwashing awareness and performance. The survey tool comprised a total of 15 questions, including three on general characteristics, six recognition questions, and six performance questions. The data were analyzed using the SPSS version 17.0 program. Results: Sixty-five percent of the EMS personnel were educated on handwashing methods. The higher the work experience, the higher the performance of handwashing after personal hygiene activities. Hence, there were significant differences in performance among the personnel (P<0.001). Overall, it was found that EMS personnel with a high awareness of handwashing methods, regardless of their occupation, had a good knowledge of the appropriate methods of cleaning and disinfecting ambulances and were able to treat and control infection well. The higher their awareness regarding handwashing, the higher the performance of the same (P<0.001). Conclusion It is necessary to develop annual evaluation programs, a customized education curriculum for each job, and conduct regular education for paramedics.

Objective: Peritonitis is a life-threatening, emergent surgical disease with very high mortality and morbidity. Currently, there are insufficient Korean studies using the P-POSSUM (Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and the Mannheim Peritonitis Index (MPI) as risk prediction models for nontraumatic peritonitis patients who visit the emergency room. Methods: This retrospective study was carried out on 196 cases of non-traumatic peritonitis in a single emergency center from January 2015 to December 2019. Receiver operating characteristic (ROC) curves were obtained and the area under the ROC curve (AUC) was compared using both P-POSSUM and MPI. The observed mortality and expected mortality for P-POSSUM were compared using the goodness of fit assessed using the Hosmer-Lemeshow equation. Results: Diastolic blood pressure, blood urea nitrogen, potassium, length of stay, and intensive care unit admissions were significantly different between survivors and non-survivors. The AUC was 0.812 for P-POSSUM and 0.646 for MPI. The observed-to-expected mortality ratio for P-POSSUM indicated fewer than expected deaths in all quintiles of risk and this was more pronounced, especially when the expected mortality was over 60%. Conclusion In non-traumatic peritonitis patients, P-POSSUM was more useful in predicting risk than the MPI score. However, P-POSSUM overestimated the risk in high-risk patients. Although the MPI score is only somewhat useful for predicting mortality in patients with non-traumatic peritonitis, it is useful as an adjuvant.