Change in Acceptance Rate of Emergency Transfer According to Personnel who Receive the Emergency Transfer Request

PURPOSE: To allocate emergency patients to appropriate hospitals, the 1339 emergency medical information center should contact personnel in individual hospitals for information about the availability of medical resources, with the contacted individuals deciding to accept or to reject the transfer request. The acceptance ratio would influence the time spent finding appropriate hospitals, and would affect the quality of emergency care. The acceptance or rejection ratio of emergency transfer request was analyzed with regard to the personnel receiving the transfer requests. METHODS: The study involved intern doctors in their emergency medicine (EM) rotation or nurses in 2007, EM doctors in 2008~2010, and doctors from the specialty departments in 2010 in one study hospital who made decisions whether to accept patients asked to be received by emergency information center. The data registered in computerized database in the emergency information center were analyzed. RESULTS: The total number of phone calls asking for emergency transfers to the study hospital from March 1 to August 31 in 2007, 2009, and 2010 was 798, 1,100, and 1,334, respectively. Accepted cases were 375(47%) in 2007, 708(64.4%) in 2009 and 801(60.0%) in 2010. CONCLUSION: The hospital staffs or members of department (e.g. Emergency department) who can take charge of the data related to pre-hospital patients should decide whether to accept the patients asked to be received into hospital or not.

Effects of Additional Instructor's Intervention on CPR Performance Immediately after DVD-based or Instructor-led Instruction

PURPOSE: Effective training in CPR is important for medical personnel and the public and a variety of educational methods have been used. We compared the results of the two most common CPR teaching methods, video-based and Instructorled teaching, with particular emphasis on the effects of supervised practice by an instructor. METHODS: Sixty college students who had never been taught CPR were divided into 2 groups of 30. One group was given a 30-minute lecture using slides and the other watched the 30-minute CPR Anytime DVD. Afterwards, all participants were tested on the Mini Anne manikin. All students were re-tested after 30 minutes of practice under the supervision of an instructor. RESULTS: The only statistically significant difference between the two groups was an increased accuracy in breath delivery in the DVD group before the instructor supervised practice. There were no statistically significant differences between the 2 groups after the instructor supervised practice. CONCLUSION: Self practice via DVD was relatively more effective than the theory lecture. However, the effect of the education significantly increased with instructor's participation and the difference between teaching methods was insignificant.

Comparison of Quality in Chest Compressions at Scene, in a Moving Ambulance by Student Nurses, the 119 Member Group, and an Automatic CPR Machine

PURPOSE: In an emergency, the quality of CPR prior to hospital arrival is a very important component for the survival of victims. We want to know differences in chest compression quality performed by groups that have variant experiences of CPR, and automatic CPR machine on the floor, or in an ambulance moving at 40 km/hr, or at 80 km/hr. METHODS: We analysed the chest compression quality of each group, and that performed on the floor, in an ambulance moving as 40 km/hr, and at 80 km/hr. We measured the following factors: mean compression depth; mean compression rate; exact performance percentile; and the compression error through too deep, too weak, wrong compression location, and no full recoil. RESULTS: In the student-nurse group, the quality of chest compression performed on the floor was better than that performed in a moving ambulance. In 119 member group, chest compression performed in an ambulance moving as 40 km/hr was better than that performed in an ambulance moving at 80 km/hr. The use of an automatic CPR machine, there were no differences in chest compression quality in all circumstances. In comparing each group, compression quality of the 119 member group and the automatic CPR machine group was better than that of the student nurses. CONCLUSION: In the group with real CPR experience, there were no differences between chest compression performed on the floor and that performed moving at 40 km/hr. Chest compression performed moving as 40 km/hr is better than that performed moving at 80km/hr. In the group without CPR experience, chest compression performed on the floor is better than that performed in a moving ambulance.