119구급대원의 아나필락시스 환자에 대한 병원 전 응급처치 현황 및 개선 방안
Prehospital care status and improvement plan of 119 emergency medical technician to anaphylaxis patients
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.
Abstract
Purpose: This study aims to analyze the current state of emergency care for patients with anaphylaxis and to identify problems and areas for improvement in prehospital care. Methods: This study was conducted using 119 emergency running sheets and medical records of 109 patients diagnosed with anaphylaxis. Questionnaires were also given to emergency medical technicians (EMTs) and emergency physicians. The data were analyzed using SPSS 21.0. Results: Prehospital emergency care included oxygen administration in 64.2%, an intravenous line in 15.6%, and medication injection in 11.0%. The most commonly administered medications were antihistamines in 66.7% and epinephrine in 8.3%. Of EMTs surveyed, 47.0% suggested an epinephrine injection and using direct medical control, while 53.8% of the emergency physicians suggested an epinephrine injection and using indirect medical control. Most emergency physicians 88.8% responded that epinephrine could be administered by EMTs. Conclusion: The data support epinephrine injection of patients with anaphylaxis by EMTs, but a larger sample size of EMTs is required. Education about the treatment of anaphylaxis should be improved for EMTs. The scope of paramedic responsibilities should also be redefined.
참고문헌 (24)
- "Anaphylaxis" (2016)[URL]
- E. Novembre, "Anaphylaxis in Children: Clinical and Allergologic Features", PEDIATRICS, 101(4), pp.e8~e8 (1998), American Academy of Pediatrics (AAP)[DOI]
- American Heart Association, "Part 10.6: Anaphylaxis", Circulation, 112(24), pp.143~145 (2005), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Simon G.A Brown, "Clinical features and severity grading of anaphylaxis", Journal of Allergy and Clinical Immunology, 114(2), pp.371~376 (2004), Elsevier BV[DOI]
- John M. Weiler, "Anaphylaxis in the general population: A frequent and occasionally fatal disorder that is underrecognized", Journal of Allergy and Clinical Immunology, 104(2), pp.271~273 (1999), Elsevier BV[DOI]
- Lieberman P, "Epidemiology of anaphylaxis: Finding of American College of allergy, asthma and immunology epidemiology of anaphylaxis working group", Ann Allergy Asthma Immunol, 97(5), pp.596~602 (2006)[DOI]
- Min-Suk Yang, "Epidemiologic and clinical features of anaphylaxis in Korea", Annals of Allergy, Asthma & Immunology, 100(1), pp.31~36 (2008), Elsevier BV[DOI]
- Anthony F.T. Brown, "Emergency department anaphylaxis: A review of 142 patients in a single year", Journal of Allergy and Clinical Immunology, 108(5), pp.861~866 (2001), Elsevier BV[DOI]
- 박상욱, "병원전 에피네프린 투여의 필요성 -벌자상으로 인한 아나필락시스의 조기 처치 관점에서-", 대한응급의학회지, 23(5), pp.578~583 (2012), 대한응급의학회
- "Be careful bee sting" (2015)[URL]
- "The death cause of firefighter is bee sting" (2015)[URL]
- Simons FE, "World allergy organization guidelines for the assessment and management of anaphylaxis", World Allergy Organ J, 4(2), pp.13~37 (2011)[DOI]
- 김지혜, "119 구급대원의 곤충교상환자에 대한 응급처치 현황 및 개선방안", 한국응급구조학회지, 17(1), pp.63~78 (2013), 사단법인 한국응급구조학회[DOI]
- Korean Council of Professors for Emergency Medical Service, "Emergency care(Bledsoe, Porter, Cherry)", pp.335~349 (2014), Hanmi Medical Publishing Co
- 김무정, "수원의 한 대학병원에서 10년간 경험한 아나필락시스 환자 분석", 천식 및 알레르기, 28(4), pp.298~304 (2008), 대한천식알레르기학회
- 조병준, "약물투여가 벌자상환자에게 미치는 효과", 한국콘텐츠학회 논문지, 15(1), pp.350~356 (2015), 한국콘텐츠학회
- 문일주, "단일 3차 의료 기관의 약물 유발 아나필락시스 발생 현황", 대한내과학회지, 88(3), pp.281~287 (2015), 대한내과학회[DOI]
- Rea TD, "Epinephrine use by emergency medical technicians for presumed anaphylaxis", Prehospital Emergency Care, 8(4), pp.405~410 (2004)
- Koenraad G. Monsieurs, "European Resuscitation Council Guidelines for Resuscitation 2015", Resuscitation, 95, pp.1~80 (2015), Elsevier BV[DOI]
- Fisher MM, "Clinical observations on the pathophysiology and treatment of anaphylactic cardiovascular collapse", Anaesth Intensive Care, 14(1), pp.17~21 (1986)
- A. Muraro, "The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology", Allergy, 62(8), pp.857~871 (2007), Wiley-Blackwell[DOI]
- American College of Surgeons Committee on Trauma, "Equipment for Ambulances", PEDIATRICS, 124(1), pp.e166~e171 (2009), American Academy of Pediatrics (AAP)[DOI]
- 전용규, "3차 의료기관에 내원한 병원전 심정지 환자에게 시행된 119 응급처치에 대한 평가", 대한응급의학회지, 22(5), pp.391~399 (2011), 대한응급의학회
- "Emergency Medical Service Act" (2016)[URL]
