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J Korean Soc Emerg Med > Volume 31(4); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(4): 401-419.
구급대원 현장응급처치 숙련도에 대한 구급대원과 지도의사의 인식 비교
임대성1 , 김성춘1 , 박송이2 , 유지호3 , 배병관4 , 김선휴5 , 최병호5 , 양태원6, 김정은6, 강지훈6, 김민희7, 김이민7, 조영학8, 정봉규8, 박재기9, 차준재9
1창원경상대학교병원 응급의학과
2동아대학교병원 응급의학과
3양산부산대학교병원 응급의학과
4부산대학교병원 응급의학과
5울산대학교병원 응급의학과
6부산광역시 소방재난본부
7울산광역시 소방본부
8창원 소방본부
9경상남도 소방본부
A survey on the perception of emergency medical services (EMS) providers and medical directors toward EMS provider’s field skill proficiency
Daesung Lim1 , Seong Chun Kim1 , Song Yi Park2 , Ji Ho Rhu3 , Byung Kwan Bae4 , Sun Hyu Kim5 , Byung Ho Choi5 , Tae Won Yang6, Jeong Eun Kim6, Ji Hoon Kang6, Min Hui Kim7, I Min Kim7, Yeong Hak Jo8, Bong Kyu Jeong8, Jae Ki Park9, Jun Jae Cha9
1Department of Emergency Medicine, Gyeongsang National University College of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Korea
2Department of Emergency Medicine, Dong-A University College of Medicine and Dong-A University Hospital, Busan, Korea
3Department of Emergency Medicine, Pusan National University College of Medicine and Pusan National University Yangsan Hospital, Busan, Korea
4Department of Emergency Medicine, Pusan National University College of Medicine and Pusan National University Hospital, Busan, Korea
5Department of Emergency Medicine, University of Ulsan College of Medicine and Ulsan University Hospital, Ulsan, Korea
6Busan Metropolitan City Fire and Disaster Headquarters, Busan, Korea
7Ulsan Fire Department, Ulsan, Korea
8Changwon Fire Department, Changwon, Korea
9Gyeongsangnam-do Fire Department, Changwon, Korea
Correspondence  Seong Chun Kim ,Tel: 055-214-2188, Fax: 055-214-2189, Email: gsimem@naver.com,
Received: October 16, 2019; Revised: December 16, 2019   Accepted: March 5, 2020.  Published online: August 31, 2020.
This study aimed to investigate the perception of emergency medical service (EMS) providers and medical directors toward the field skill proficiency of EMS providers. We further examined differences in perception according to the certification and hospital career of individuals.
This survey was conducted enrolling all active EMS providers in Busan, Ulsan, and Gyeongnam, as well as emergency physicians who participated in direct medical direction. Pre-developed questionnaires were sent as text messages to individual EMS providers and emergency physicians using an internet-based survey tool (Google Forms). Questionnaires were composed of 25 items in 7 categories: “airway management”, “ventilatory support”, “circulatory support”, “field assessment and management of trauma patients”, “field assessment and management of patients with chest pain”, “field assessment and management of patients with neurologic symptoms”, and “other items”. The response was based on a five-point Likert scale, where 0 score indicated no experience at all.
The questionnaire was distributed to 1,781 EMS providers and 52 medical directors; of these, 1,314 (73.7%) EMS providers and 34 (65.3%) medical directors completed the survey. EMS providers rated themselves as above average (3 points) for most of the questions. However, the majority responded that they had no experience or low proficiency in endotracheal intubation and prehospital delivery (median 2; interquartile range [IQR], 0-3). Conversely, medical directors assessed the EMS provider’s proficiency as above average in use of I-gel, recognition of hypoglycemia, field management of trauma patients, use of oropharyngeal and nasopharyngeal airway, use of laryngeal mask airway, and optimal oxygen supply (median, 4; IQR, 3-4), but responded with low scores for most other questions. Based on the EMS provider certification, nurses scored themselves more proficient than level-1 emergency medical technicians (EMTs) for intravenous access (P<0.001), whereas level-1 EMTs recognized themselves more proficient than nurses for endotracheal intubation (P<0.001), use of Magill forceps (P=0.004), and pediatric cardiopulmonary resuscitation (P<0.001).
This study recognized the discrepancies in the perception of EMS provider’s field skill proficiency, as perceived by EMS providers and medical directors, and between level-1 EMTs and nurses. We propose that regional EMS authorities need to make persistent efforts to narrow these perception gaps through effective educational programs for EMS providers and medical directors.
Key words: Emergency medical technicians; Medical director; Proficiency; Emergency medical services
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