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J Korean Soc Emerg Med > Volume 26(5); 2015 > Article
Journal of The Korean Society of Emergency Medicine 2015;26(5): 437-442.
구급지도의사 간의 구급대원 구급 활동에 대한 평가 일치도
박길동1, 김선휴1, 이원철2, 김민호3
1울산대학교 의과대학 울산대학교병원 응급의학과
2울산중앙병원 응급의학과
3울산대학교병원 생의과학연구소
Agreement of Medical Directors for Indirect Medical Oversight on Prehospital Care
Kil Dong Park1, Sun Hyu Kim1, Won Chul Lee2, Min Ho Kim3
1Department of Emergency Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
2Department of Emergency Medicine, Ulsan Joongang Hospital, Ulsan, Korea
3Biomedical Research Center, Ulsan University Hospital, Ulsan, Republic of Korea
Correspondence  Sun Hyu Kim ,Tel: 052) 250-8405, Fax: 052) 250-8071, Email: stachy1@paran.com,
Received: May 9, 2015; Revised: May 12, 2015   Accepted: July 31, 2015.  Published online: October 30, 2015.
ABSTRACT
Purpose:
The medical director is a core factor in maintaining high quality emergency medical services. This study was conducted to evaluate the agreement of medical oversight for prehospital emergency care between medical directors.
Method:
Two medical directors assessed the same 119 rescue run sheets with 28 cases of cardiac arrest, 12 cases of withhold or interruption of cardiopulmonary resuscitation (CPR), and 22 cases of severe trauma. The assessment for prehospital evaluation of patients, treatment and medical direction was compared between the two medical directors,
Results:
The use of an automated external defibrillator in cardiac arrest that was assessed as appropriate was 17/28, 22/28, respectively. In assessing for withhold or interruption of CPR, one medical director assessed as all appropriate for checking for pulse, respiration, and mental status regardless of recording on a 119 rescue runsheet, but the other medical director as inappropriate if there are no records on the runsheet. The assessment for airway treatment, aid for circulation, appropriateness of treatment for trauma, and appropriateness of medical direction in severe trauma differed between the two medical directors.
Conclusion:
Some differences were found in assessing the prehospital care between medical directors. A quality program for improving agreement between medical directors is necessary and the protocol for prehospital care should be modified according to the local situation.
Key words: Emergency medical services, Prehospital emergency care, Quality control
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