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J Korean Soc Emerg Med > Volume 28(3); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(3): 240-247.
119 구급대를 통해 이송한 병원 도착 전 응급 분만의 현황과 분석
정시영1, 서주현1, 차명일1, 정구영2*
1명지병원 응급의학과
2이화여자대학교 의학전문대학원 응급의학교실
Status and Analysis of the Accidental Out-of-Hospital Deliveries Transferred by Emergency Medical Service Providers
Si Young Jung1, Joohyun Suh1, Myeong Il Cha1, Koo Young Jung2*
1Department of Emergency Medicine, Myongji Hospital, Goyang, Korea
2Department of Emergency Medicine, Ewha Womans University School of Medicine, Seoul, Korea
Correspondence  Koo Young Jung ,Tel: 02-2650-5296, Fax: 02-2650-5296, Email: kyjung@ewha.ac.kr,
Received: January 18, 2017; Revised: January 31, 2017   Accepted: April 25, 2017.  Published online: June 30, 2017.
ABSTRACT
Purpose:
Accidental out-of-hospital deliveries are generally associated with high rates of perinatal morbidity and mortality. To determine the status of accidental out-of-hospital deliveries transferred by emergency medical services (EMS), we analyzed the records of EMS runsheets in two South Korean provinces, Gyeonggi and Gangwon.
Method:
The EMS runsheets of patients who were more than 20 weeks pregnant and had delivery-related symptoms between January 2012 and December 2013 in Gyeonggi and Gangwon province were reviewed retrospectively. We analyzed the characteristics of accidental out-of-hospital deliveries by comparing these with those non out-of-hospital deliveries.
Results:
There were 1,426 urgent dispatches during the study period. In 137 (9.6%) out-of-hospital deliveries, which took place prior to arriving at the hospital, and 48 of these were attended by EMS providers. The accidental out-of-hospital deliveries were more frequent during night time and more common among multiparous and younger age women; however, these observation was without any significance with respect to premature birth. The rate of the accidental out-of-hospital deliveries was not significantly different between rural and urban areas. Twenty cases of complication, including 10 arrests of neonates and EMS providers managed them by the following intervention: reduction of nuchal cord, umbilical cord clamping and cut, warming-up of and stimulating the neonates warms, using oropharyngeal suction, O2 supplication, and neonatal cardiopulmonary resuscitation.
Conclusion:
As the rate of accidental out-of-hospital deliveries in patients who were transferred by EMS is higher than the rate of out-of-hospital deliveries in general, EMS providers should be fully trained. Moreover, there is the need for more completive records and continuous education.
Key words: Emergency medical services, Delivery, obstetric, Neonate, Obstetric labor complications
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