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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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