Degree of Satisfaction with Indirect Medical Oversight Programs to 119 Rescue Services

PURPOSE: The purpose of this study was to identify the degree of satisfaction with indirect medical oversight programs and its determinants. METHODS: Gumi 119 rescuers participated in indirect medical oversight programs, including Emergency Medical Services (EMS) record review, weekly visiting education, and monthly EMS conference from March 2012 to February 2013. Data were collected using a mail survey with a self-administered questionnaire. The degree of satisfaction with the programs was categorized according to two groups (1=satisfied, 2=unsatisfied). Then the Mann-Whitney U test and Fisher's exact test were performed in order to find statistically significant factors influencing satisfaction. RESULTS: Cronbach alpha of questionnaires was 0.869. Among the 59 questionnaires, 55(93.2%) were returned. No differences in sex, age, career, EMS record review, monthly conference, linkage with direct medical direction, and improvement of confidence in ER medical team were observed between the two groups. Qualification, weekly visiting program, and improvement in reliability to hospital showed statistical significance (p=0.017, 0.040 and 0.001, respectively). CONCLUSION: The level of qualification of 119 rescuers and weekly visiting education at the fire department by doctors has had a significant influence on satisfaction with indirect medical oversight.

Degree of Satisfaction with Indirect Medical Oversight Programs to 119 Rescue Services

PURPOSE: The purpose of this study was to identify the degree of satisfaction with indirect medical oversight programs and its determinants. METHODS: Gumi 119 rescuers participated in indirect medical oversight programs, including Emergency Medical Services (EMS) record review, weekly visiting education, and monthly EMS conference from March 2012 to February 2013. Data were collected using a mail survey with a self-administered questionnaire. The degree of satisfaction with the programs was categorized according to two groups (1=satisfied, 2=unsatisfied). Then the Mann-Whitney U test and Fisher's exact test were performed in order to find statistically significant factors influencing satisfaction. RESULTS: Cronbach alpha of questionnaires was 0.869. Among the 59 questionnaires, 55(93.2%) were returned. No differences in sex, age, career, EMS record review, monthly conference, linkage with direct medical direction, and improvement of confidence in ER medical team were observed between the two groups. Qualification, weekly visiting program, and improvement in reliability to hospital showed statistical significance (p=0.017, 0.040 and 0.001, respectively). CONCLUSION: The level of qualification of 119 rescuers and weekly visiting education at the fire department by doctors has had a significant influence on satisfaction with indirect medical oversight.

Effectiveness of Indirect Medical Oversight on the Quality of Prehospital Emergency Care by Emergency Medical Technicians

PURPOSE: This study examined the effect of indirect medical oversight on the quality of prehospital emergency care by emergency medical technicians. METHODS: Indirect medical oversight was applied for a year and 119 rescue run sheets were retrospectively analyzed before and after the program to study the effect of an indirect medical oversight program in one city. The general characteristics of patients who visited hospitals before and after the program were analyzed, along with patient evaluation records, personal data, outbreak patterns, transfer information, direct medical oversight, and emergency medical services (EMS) mobilization reports. In addition, by comparing medical records and the 119 rescue run sheets, changes in the accuracy of 119 rescue run reports, the adequacy of patient classification, and the adequacy of medical direction were analyzed. After gathering these data, statistical analysis was performed and the level of significance was defined as p<0.05. RESULTS: After executing the indirect medical oversight, there was significant improvement in the accuracy of 119 rescue run sheets (p<0.001) and in the consistency of severity classification in 119 rescue run sheets compared with medical records (p=0.016). The adequacy of direct medical oversight request also showed improvement after the indirect medical oversight took effect (p<0.001). However, there was no statistical significance in prehospital procedures. CONCLUSION: Indirect medical oversight significantly improved the quality of emergency medical service by emergency medical technicians. However, the further application and improvement of indirect medical oversight programs are required for the development of prehospital emergency medical care.

Analysis of the Impact on Community Health after Accidental Leak of Hydrofluoric Acid

PURPOSE: The purpose of this study is to verify the influence of a massive hydrofluoric acid spill on community health through patients who claimed to have been exposed. METHODS: We analyzed 2459 patients who visited our emergency department with the claim of exposure to hydrofluoric acid, and retrospective analyses were performed. We analyzed changes in numbers of visitors per day from the day of the accidental hydrofluoric acid spill, symptoms presented by the 1924 patients, and general characteristics. Comparisons of symptoms and hematologic characteristics were made between the initially set evacuation zone(1.3 km radius parameters from the spill) and the outer zone. RESULTS: A total of 2,459 patients who claimed exposure visited our ED from 27 September 2012 to 23 October 2012, and there was a significant increase in the number of visiting patients from day 8 of the hydrofluoric acid spill. The most common complaints were a sore throat, 729(37.9%) and no specific symptom with health concern, 547(28.4%). Statistically significant findings were pulmonary symptoms (p=0.001), nasal symptoms (p=0.001), diarrhea (p=0.023), and skin symptoms (p=0.007). In hematologic study, a statistically significant difference was observed in white blood cell count (p=0.018), creatine phosphokinase (p<0.001), erythrocyte sediment rate (p=0.013), and phosphorus (p<0.001). CONCLUSION: A significant increase in the number of patients was observed one week after the accidental spill of hydrofluoric acid. The most frequent symptoms were sore throat, headache, cough, and sputum. Statistically significant increase in creatine phosphokinase level and decrease in phosphorus level were noted in patients within the evacuation zone.