소방 119구급대원에 의해 시행된 전문기도관리 현황 및 법적 고찰
The current status and legal review of advanced airway management implemented by 119 EMTs
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Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.
Abstract
Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.
참고문헌 (28)
- John S Bradley, "Prehospital Oral Endotracheal Intubation by Rural Basic Emergency Medical Technicians", Annals of Emergency Medicine, 32(1), pp.26~32 (1998), Elsevier BV[DOI]
- 윤형완, "기관내삽관에서 속심일체형 삽관튜브 용이성에 관한 연구", 한국응급구조학회지, 23(3), pp.111~121 (2019), 사단법인 한국응급구조학회[DOI]
- Jeffrey L. Apfelbaum, "Practice Guidelines for Management of the Difficult Airway", Anesthesiology, 118(2), pp.251~270 (2013), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Lloyd E Kwanten, "Supraglottic airway devices: current and future uses", British Journal of Hospital Medicine, 79(1), pp.31~35 (2018), Mark Allen Group[DOI]
- Jia Wang, "Predictive risk factors of failed laryngeal mask airway insertion at first attempt", Journal of International Medical Research, 46(5), pp.1973~1981 (2018), SAGE Publications[DOI]
- Jonathan R. Benger, "Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome", JAMA, 320(8), pp.779~791 (2018), American Medical Association (AMA)[DOI]
- "Cheongnyeon doctor news" (2015)[URL]
- 최준원, "119구급대의 스마트의료지도 직무수행능력 영향요인", 한국응급구조학회지, 23(3), pp.7~16 (2019), 사단법인 한국응급구조학회[DOI]
- Ashish R. Panchal, "2019 American Heart Association Focused Update on Advanced Cardiovascular Life Support: Use of Advanced Airways, Vasopressors, and Extracorporeal Cardiopulmonary Resuscitation During Cardiac Arrest: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care", Circulation, 140(24), pp.e881~e894 (2019), Ovid Technologies (Wolters Kluwer Health)[DOI]
- 배현아, "병원 전 응급의료체계에서 간호사의 업무범위에 대한 소고(小考)", 의료법학, 20(2), pp.141~171 (2019), 대한의료법학회[DOI]
- Robert D. Friedberg, "Training Methods in Cognitive Behavioral Therapy: Tradition and Invention", Journal of Cognitive Psychotherapy, 27(1), pp.19~29 (2013), Springer Publishing Company[DOI]
- "National Fire Agency"[URL]
- Sean M. Caffrey, "Paramedic Specialization: A Strategy for Better Out-of-Hospital Care", Air Medical Journal, 33(6), pp.265~273 (2014), Elsevier BV[DOI]
- "Kentucky Board of Nursing"[URL]
- "Offering a holistic package of quality nursing care for nurses caring patients undergoing gastrointestinal endoscopy, to verify patient's safety" (2019)[URL]
- Borba MC, "Blended learning, e-learning and mobile learning in mathematics education", Science, Mathematics and Technology Education, 48(5), pp.589~610 (2016)
- Nagelkerk J, "Starting Your Practice: A Survival Guide for Nurse Practitioners", pp.325~ (2006), Mosby Elsevier
- 윤상민, "119구급대원의 응급구급활동과 관련한 형법적 책임, 20(4), (2006)", 한국화재소방학회 논문지, 20(4), pp.77~90 (2006), 한국화재소방학회
- Koshi Nakagawa, "Early endotracheal intubation improves neurological outcome following witnessed out‐of‐hospital cardiac arrest in Japan: a population‐based observational study", Acute Medicine & Surgery, 8(1), pp.e650~ (2021), Wiley[DOI]
- Jestin N. Carlson, "Paramedic Intubation: Does Practice Make Perfect?", Annals of Emergency Medicine, 70(3), pp.391~393 (2017), Elsevier BV[DOI]
- Kyung Kang, "Prehospital endotracheal intubation and survival after out-of-hospital cardiac arrest: results from the Korean nationwide registry", The American Journal of Emergency Medicine, 34(2), pp.128~132 (2016), Elsevier BV[DOI]
- Yutaka Takei, "Tracheal intubation by paramedics under limited indication criteria may improve the short-term outcome of out-of-hospital cardiac arrests with noncardiac origin", Journal of Anesthesia, 24(5), pp.716~725 (2010), Springer Science and Business Media LLC[DOI]
- Henry E. Wang, "How Many Attempts Are Required to Accomplish Out-of-hospital Endotracheal Intubation?", Academic Emergency Medicine, 13(4), pp.372~377 (2006), Wiley[DOI]
- John D. Hoyle, "Comparative Study of Airway Management Techniques with Restricted Access to Patient Airway", Prehospital Emergency Care, 11(3), pp.330~336 (2009), Informa UK Limited[DOI]
- Penelope C. Lema, "Avoid the Goose! Paramedic Identification of Esophageal Intubation by Ultrasound", Prehospital and Disaster Medicine, 33(4), pp.406~410 (2018), Cambridge University Press (CUP)[DOI]
- G Citerio, "Emergency system prospective performance evaluation for cardiac arrest in Lombardia, an Italian region", Resuscitation, 55(3), pp.247~254 (2002), Elsevier BV[DOI]
- 전경자, "산업간호사의 역할 경험", 한국직업건강간호학회지, 20(3), pp.250~260 (2011), 한국직업건강간호학회
