수련의 집단행동 이후 수련병원 응급의료센터에서 근무하는 1급 응급구조사의 업무 활동 변화 분석

Abstract

Purpose: This study aimed to examine changes in the clinical duties and working conditions of emergency medical technician-paramedics (EMT-Ps) in training hospitals following a 2024 resident and intern strike. The goal was to provide empirical evidence to redefine the roles of EMT-Ps and the need for institutional reform in the emergency medical system. Methods: A cross-sectional online survey was conducted among 161 EMT-Ps working at the emergency centers of designated training hospitals. Changes in duties and procedures performed before and after the strike were analyzed using descriptive statistics and chi-square tests. Results: The frequency of key procedures, including arterial blood sampling, gastric lavage, digital rectal examination, Foley catheterization, and wound suturing, increased significantly. Several new procedures, such as wound closure and drug administration during cardiac arrest, were performed by EMT-Ps after the strike, which had not been performed previously. This indicates that EMT-Ps played a compensatory clinical role during physician shortages (p < .05). Conclusion: The findings suggest that in crisis situations, EMT-Ps can expand their roles beyond prehospital care to include hospital-based clinical responsibilities. These results underscore the urgent need to revise legal definitions, institutional policies, and training curricula to support the expanded scope of EMT-P practices in hospitals. Establishing clear legal protections and standardized guidelines is essential to ensure patient safety and workforce sustainability in emergency medical services.