병원 임상 수련에 의한 119 구급대원의 병원전 평가 및 처치의 질 향상 효과에 관한 시범 연구 = A Pilot Study on the Effect of Hospital-based Emergency Medical Technician Training

다국어 초록 (Multilingual Abstract)

Purpose: This study was conducted to evaluate the short
term effect of hospital-based clinical training for emergency
medical technicians (EMTs) on improving the quality of prehospital
assessment and intervention.
Methods: Three EMTs-level 1 were assigned to a regional
emergency medical center and trained as to a designed
program with three months. Three EMTs alternatively ran to
the scene during later two months. In order to compare the
completeness and the appropriateness of prehospital
assessment and intervention between trained and nontrained
EMTs, we collected pre-hospital records and divided
the subjects into a study group who were managed by
trained EMTs and a control group who were managed by
non-trained EMTs-level 1 (level-1 control) or EMT-level 2
(level-2 control). The completeness and the appropriateness
were evaluated by three expert panel groups, each
consisting of three emergency physicians, on the basis of
the guidelines and professional opinion. In assessing intergroup
agreement, weighted kappa values for inter-panel
agreement were all above 0.4 except on one factor
(k=0.28)
Results: No significant difference existed in demographic
findings between the study group (N=129) and the control
(N=469). The study group showed significantly higher completeness
(78.9%) than the level-1 (14.9%, p<0.001) or
level-2 control group (9.8%, p<0.001) in their assessment of
vital signs. The study group also scored significantly better
for appropriateness than did the two control groups, both in
evaluation of chief complaints and in prehospital management
(p<0.001).
Conclusion: The quality of pre-hospital assessment and
intervention could be significantly improved through hospital-
based EMT training, especially in the assessment of vital
signs, appropriate evaluation of chief complaints, and prehospital
intervention.

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