❖ It is a support plan to reduce the preventable mortality rate by establishing an organic system of regional hospitals and emergency transport so that severely-impaired patients can receive appropriate medical services.
□ Background and Necessity ○ Established a trauma system linking the customized system and related organizations considering the characteristics of the province ○ Creation and operation of regional autonomous administrative administrative organizations with expertise ○ There is no integrated system for smooth communication with the firefighting team and medical staff responsible for most of the transportation of emergency patients.
Limitations after the trauma business ➢ Poor patient transport system ➢ Poor environment and lack of link in base hospital ➢ Lack of integrated standard transfer guidelines ➢ Absence of integrative mechanisms connecting various institutions ➢ Lack of medical personnel (hospitals, paramedics) ➢ Qualitative growth of emergency personnel ➢ Hospital shortages and large areas
Advantages after establishing local trauma system ➢ Establish a transport system that takes local characteristics into account ➢ Prepare integrated standard guidelines ➢ Creation and operation of a traumatic organization that connects each department ➢ Create a system considering the lack of medical personnel ➢ Direct medical guidance and first aid training ➢ Establish an efficient transfer system between hospitals
□ Fire Fighting Instructions ✓ Key factors ➢ Criteria for selection of serious injury -Physical examination findings (Phase 1) ➠ Physiological findings (Phase 2) ➠ Injury mechanism and emergency personnel judgment (Phase 3) ➢ Transfer of Severe Trauma Patients to Gangwon Province-In principle, transfer to trauma center ➢ When it is difficult to transfer to the trauma center-In accordance with the standard guidelines considering the level of the transfer medical institution ➢ In case of long distance transport (more than 45 minutes on land)-In principle, air transport should be used. ➢ In principle, the area trauma center should be transported for air transportation. ➢ Role of the Comprehensive Situation Room-responsible for linked transfer relaying, patient information recording and delivery
□ Role of Fire Fighters ○ Selected and treated medical emergency centers for severe trauma patients ○ Establish a base for simultaneous emergency medical helicopter dispatch at the time of filing a report.
❖ To improve the professionalism of emergency education and the specialization, improvement and development of the curriculum. Of 2020 Paramedical Professor EMS Education Research Meeting I. Overview □ Related grounds ❍ Department of Education and Training, Central Fire Fighting School -428 (2019.2.26.) “ Employee Professor and Guidance Doctor EMS Education Research Group ” □ Background ❍ Specialization and standardization of firefighting schools’ first aid training and first-aid paramedic’s workplace training -Sharing and spreading excellent first aid courses and lecture techniques Ⅱ. Operation plan □ Outline ❍ Managed by: Central Fire Department Education and Training Division ❍ Target: First-aid professors and paramedics at national firefighting schools ❍ Operation: Regular meetings (local tours) and communication using social networks *
Social network: band, facebook, etc. ❍ Membership term: 1 year (2020. 3. ~ 2021. 2.) ❍ Operation details -Designing Standard Courses for New and Emergency Medical Rescue (Level 2) -Amendment and improvement plan of emergency guide on site emergency response -Sharing and co-development of excellent and advanced lecture techniques, teaching materials, teaching plans, etc. -Regular meetings of national paramedics and paramedics -Regular workshop for national emergency education and training staff III. Detailed operation plan □ Major Operation Plan ❍ Improve professionalism of emergency education and standardize, share and research curriculum -Discuss after selecting the designated key issues for each quarter ⇨ Suggestions for the direction of education -Share best practices and education and training techniques and listen to difficulties ❍ Meeting with national paramedics (instructors) and paramedics and workshops -Including emergency paramedics who want to participate voluntarily as a national paramedic professor (instructor) -Collect more opinions by expanding opinion collection window ❍ Promotion of awards for merit for emergency education and training (planned) -Identify and commend merit who contributed to the development of emergency education Inspire pride and create and spread atmosphere ❍ Enable mobile discussions using social networks * -Overcoming the time and space constraints of meetings and promoting a mobile discussion culture -Upload up-to-date educational materials from time to time to form a consensus on how to develop emergency education
Social network: band, facebook, etc. Ⅳ. Details of Major Research Activities □ Major Research Activities ❍ Research on the training of firefighters (emergency) and professional emergency education -Specialized first aid equipment, disaster response training, multiple damage accident response training -Multi-going education and training courses such as ambulances (general and professional), pump cars, helicopters ❍ Major emergency education research at home and abroad -Education and training courses for mental illnesses and intoxicants -Education and training courses, such as aviation emergency specialization courses ❍ Study on amendments to the standard guidelines for paramedics on-site first aid -Study mainly on guidelines related to controversial content -Identifying quality management measures and improvements compared to foreign guidelines Ⅴ. Future schedule, plan and budget □ Future schedule and plan ❍ Regular meeting of EMS Education Research Group (May) -Discuss after selecting key issues -Share best practices and education and training techniques and listen to difficulties ❍ Workshop for national emergency education and training officers and commendation for merit (November) -Discussion of curriculum design for improving the paramedic’s professionalism -Sharing up-to-date educational materials to create a consensus on the development of emergency education -Received a Merit Award for those who are involved in first-aid education for firefighting schools and education colleges ※ 1st place: Best Prize 1 (Ministerial Citation), 2nd place: Excellence Prize 1 (Cheongcheong citation), 3rd place: Encouragement Prize 3 (Chungcheong citation)
119 Notification 시 Receipt → Identify suspicious symptoms such as high fever, pneumonia and cough ① In case of suspected infectious disease report to 119 situation room, guide to the competent public health center or disease management headquarters (hotline 109). ② Even if the 119 reporter is not included in the definition of a suspected patient, even if he or she claims to be a suspected patient, the public health center will be able to respond and handle it. ③ If the reporter is a general patient with simple fever (37.5 ℃ or higher), pneumonia, cough, or a history of infectious disease confirmation, wear personal protective equipment (5 types) to guide the transfer.
On-site dispatch and transportation → Thorough wearing of personal protective equipment (5 types) ① When paramedics judge suspected patients * in the patient examination process ＊ Criterion for judgment: Reasonable decision based on the definition of suspected patient case (Ministry of Health) -(Principle) Transfer to hospital 24 hours by ambulance -(Exception) 119 ambulance support if the ambulance of the health center does not have a bulkhead facility and the arrival time of an ambulance with a bulkhead facility of a nearby health center takes more than 1 hour. ※ Application: 119 ambulance and driver (Health department officials) ② The transfer of suspect patients should be carried out by the emergency personnel (drivers) and health center personnel. -Public health center officials (Quarantine officers) are responsible for the transfer of patients. -Wear personal protective equipment for paramedics and wear masks to suspect patients ③ Paramedics do not judge suspected patients, but patients claim suspected -Inform the health center to the patient for secondary verification (check-up) at the local health center -Whether to transfer depends on the result * ＊ (suspect patient) use ambulance in public health center / (general patient) use 119 ambulance ④ Wear personal protective equipment (5 types) even for general patients with simple high fever (37.5 ℃ or higher), pneumonia, cough, etc.
On return ① Thoroughly disinfect and sterilize the vehicle’s interior and first-aid equipment after disinfection ※ Disinfection practitioners also wear personal protective equipment to disinfect ② Unprotected personal protective equipment is transferred to the transfer hospital and treated as medical waste at the hospital.
119 Ambulance transport support ① 119 ambulances are fully utilized in the national crisis stage when many infectious diseases occur simultaneously and it is difficult to cope with ambulance in public health center ② If suspected patients are in serious condition such as cardiac arrest or severe trauma, and need to transfer urgently, use 119 ambulance
Standard Precaution applies to all patients treated in the hospital, regardless of whether the patient is diagnosed or suspected to prevent infection from blood, secretions, wounded skin, or mucous membranes (see Infection Control Guidelines in the Ministry of Health and Welfare). ❍ (Hand Washing) Hand Washing (Hygiene) is the simplest and most important way to reduce the risk of microbial transmission between the patient and the patient. After washing and disinfecting equipment, make sure to wash your hands. ❍ (Gloves) Gloves should be worn during patient contact by providing contamination protection and protection when in contact with blood, body fluids, feces, mucous membranes and damaged skin. ❍ (mask) Must be worn to protect the mucous membranes of eyes, nose and mouth when performing procedures that may cause blood or body fluids to splash or spray. ❍ (protective clothing) Must be worn to protect clothing or body when performing procedures that may cause blood or body fluids to splash or spray. ❍ (Goods used for patients) Various goods used for the treatment of patients are considered contaminated, so consumable items must be discarded and reused items must be disinfected and sterilized before reuse. ❍ (Environmental management) The emergency equipment such as stretchers and splints, which have many contact with patients, should be washed and disinfected at the infection control room from time to time. ❍ (Preventing occupational exposure) Be careful not to be punctured when handling needles and other sharp instruments used on patients (be careful when cleaning instruments or discarding needles after treatment), and avoid direct contact with patients. Specific (medical) waste disposal measures ❍ (Required) Prevention of infection due to the generation of waste such as objects contaminated with blood or liquid, human tissue, cotton wool, needles, and personal protective equipment during the treatment, transportation, and cleaning of equipment (emergency). ❍ (Collection and Storage) Ambulance operators store wastes generated from ambulances in the waste storage area of the infection control room. ❍ (Disposal) Dispose of certain wastes from ambulances at designated hospitals * * Daesung Hospital, Wonju Severance Christian Hospital, etc. ❍ (Post-management) Thorough data management such as registration of system processing result such as ESMI when processing specific waste