Survey on the needs and satisfaction of special emergency medical service providers for education program in Gangwon province

Objective@#To expand the scope of the work performed by emergency medical service (EMS) providers, a 3-day education training course was implemented at the national level to organize and operate a special EMS unit consisting of level-1 EMS providers and nurses. We conducted an evaluation of the curriculum for EMS providers that completed the education course. @*Methods@#From June 2019 to July 2020, a survey was conducted to evaluate the curriculum of 270 EMS providers that completed the training course in Gangwon province. We analyzed differences between educational needs, satisfaction with educational contents, and job performance confidence with respect to age, sex, certification, and career. @*Results@#We analyzed the contents of 143 questionnaires received from the EMS providers. Satisfaction with the “instructor” was highest at 4.52 points, and satisfaction with the “education” provided was lowest at 3.89 points. Those aged over 40 had the highest satisfaction scores for “education”, and a significant inverse relationship was found between age and satisfaction (P=0.020). In the overall curriculum, educational need was highest among those with a career duration of ≥ 3 years and those in their 30s. Regarding educational contents, the need for advanced cardiovascular resuscitation was greatest and the need for emergency delivery was lowest, but this difference was not significant. @*Conclusion@#When designing a curriculum for EMS providers in the future, segregation into similar groups is required to reflect their educational needs.

Outcome of cardiopulmonary resuscitation for prehospital traumaticcardiac arrest: focused on Gangwon province

Objective@#This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospitaltraumatic cardiac arrests (TCA). @*Methods@#The charts of patients with pre-hospital TCA who visited the various emergency department (ED) in Gangwondofrom January 2013 to December 2017 were reviewed retrospectively. @*Results@#TCA patients comprised 0.3% of patients transferred by 119. A total of 367 patients were enrolled in the study.Traffic accidents were the leading cause of the arrest. The initial field and ED rhythm were mostly asystole (field, 79.6%;ED, 82.3%). It took 11.24±9.95 minutes from the call to the field. From the field to ED, it took 22.87±15.37 minutes. Thetotal CPR time before ED arrival was 21.62±15.29 minutes. The causes of TCA were brain injury (35.7%), hypovolemicshock (29.2%), and severe lung injury (16.3%). Seventy TCA patients experienced at least one return of spontaneous circulation(ROSC). Twenty-six patients (7.14%) were admitted to the ward, and their average injury severity score was38.96. Eight patients expired before 12 hours after transient ROSC. Four more patients expired before 24 hours. Fourpatients were discharged alive among patients who lived for more than 24 hours. @*Conclusion@#In this study, 1.5% of patients were discharged alive. The possibility of ROSC was higher as the time to ED,and the cardiopulmonary resuscitation time of 119 was shorter. Pulseless electrical activity rather than asystole tends topromote ROSC. The survival rate increased when ROSC occurred before arriving at the ED.

Psychometric Properties of a Measure Assessing Attitudes and Norms as Determinants of Intention to Use Oral Contraceptives

PURPOSE: Asian immigrant and Asian American women are less likely to use oral contraceptives (OCs) and tend to rely on low-efficacy methods of contraception. This contraceptive pattern remains poorly understood, in part, because no theory-driven measurement exists to assess psychosocial determinants essential in explaining behaviors related to OC use in this population. The current study aimed to evaluate the psychometric properties of a measure of attitudes and subjective norms toward OC use among Korean American women as a first step to determine whether the measure can be used in this population and, potentially, in other Asian ethnic groups. METHODS: The sample consisted of 329 Korean immigrant women living in New York City. The theory of reasoned action guided the development of the measure assessing attitudes and norms. Psychometric evaluation included item analysis, internal consistency estimates of reliability, and construct validity (i.e., factorial, discriminant, and predictive). RESULTS: All item-total correlations were above the recommendation of .30. The Cronbach's alpha for the attitudes and subjective norms measure was .88 and .86, respectively. Exploratory factor analyses revealed four interpretable factors, and confirmatory factor analyses confirmed that the factor structures derived from the exploratory factor analyses fit the data well. Discriminant and predictive validity of the measure were also established. CONCLUSIONS: The study provides support for the validity and reliability of the measure and its use for determining the degree to which Korean immigrant women intend to use OCs.

Prevention of Venous Thromboembolism in Hip Surgery Patients / 대한고관절학회지

The risk for venous thromboembolism (VTE) in total hip arthroplasty and hip fracture surgery is much higher than that of any other surgery. There is a general agreement that prevention of VTE in hip surgery patients is necessary due to concerns regarding symptomatic deep vein thrombosis or fatal pulmonary embolism. Optimal strategies for prevention of VTE include pharmacologic and mechanical approaches; however, the ideal prophylactic regimen has not been identified. Selection of a prophylactic regimen should be balanced between efficacy and safety. This article discusses the different prophylactic options available today for prevention of VTE in hip surgery patients.

Analysis of the Influence of Diagnosis Related Variables on the Accuracy of Initial Diagnosis in Patients with Acute Abdominal Pain Seen at the Emergency Center

BACKGROUND: Abdominal pain is a common complaint seen at emergency centers. Various diseases can cause abdomin al pain making it difficult to make a correct diagnosis. In the elderly, however, the consequences of an incorrect or delayed diagnosis can be more critical. We investigated the accuracy of initial diagnoses in the emergency center and analyzed the associations among medical factors including age. METHODS: We compared the ICD 10 codes of initial diagnoses to the codes of final diagnoses, defined the 'degree of agreement' using a 5 point scale, and classified patients into 'high degree of agreement' or 'low degree of agreement' groups. According to the severity of illness, we classified patients as 'admission' or 'out patient follow up'. According to their illness, we classified them as 'surgical' or 'medical'. According to age, we classified them as 'elderly' or 'adult'. Finally, we analyzed the statistical significance of each association. RESULTS: Overall, admitted patients and surgical diagnoses had higher degrees of agreement. 'Elderly' patients had no significant difference in 'degree of agreement' from 'adult' patients. CONCLUSION: Among patients presenting with acute abdominal pain to the emergency center, the degree of agreement between initial diagnosis and final diagnosis is dependent on the diagnostic characteristics of the disease, and not on the age of the patients. Further studies on the diagnostic accuracy of individual diseases are needed. Additional diagnosis associated variables, for example comorbidity and prognosis, needs to be studied regarding relationship to diagnostic accuracy.