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Journal of The Korean Society of Emergency Medicine 1995;6(2): 388-393. |
| ASSESSMENT OF PERTINENT TREATMENT OF ADULT TRAUMA PATIENT BY THE EMT |
| Keun Jeong Song, Eun Kyoung Eo, Ji Young You, Han Kyoo Park, Sang Hyun Kim, Chang Sub Kim, Mun Soo Jang, Dong Seob Choi |
| Department of Emergency Medicine, Ewha University DongDaeMoon Hospital |
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Published online: December 31, 1995. |
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| ABSTRACT |
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In Korea, EMT have two classified subgroup of first and second degree : EMT-P, and EMT. For the beginning, authorization of the first EMT was made in this year through the EMT educational program There are 8 items which EMT can perform the treatment without the supervision by a physician. But there was no previous report of pertinent assessment of treatment performed by the EMT. There upon authors have conducted review of assessment done by the EMT in ED setting, and proposed the following treatment application can be used by EMT at the field of accident. The study materials include adult trauma patient older than 15 years, and sustained trauma within 48 hours before visiting Ewha University DongDaeMoon Hospital Emergency Department. The duration of study was from Apr. 1 1995 to Aug. 31 1995 . The study was conducted by 5 certified EMT by filling the performed survey including mechanism of injury(MOI), 3 different methods for evaluating mental status, means of treatment, calculating injury severity score and time of treatment spent by EMT. The EMT's performance was evaluated by the attending Emergency Medicine physician. The result were as followings ;
I. Among the total 5532 ED visiting patients during the study period, 1257 were adult trauma patients who received treatment within 48 hours of injury.
2. Among 1222 out of 1267 patients have completed performed survey.
3. Male to female ratio was 2.6 : 1, age distribution was from 15 to 87 years old and mean age was
34.6 years old.
4. The MOI showed : MVA (33.1 %), blunt trauma (29.9 %), slip down (16.8 %), penetrating injury
(15.4 %), and miscellaneous (5.7 %), burn (3.1 %), falling down injury(2.9 %), bite injury(1.1 %) in order.
5. There were 437 cases of survey completed by the EMT. For assessment of mental status of 3 different method : AVPU, 5 scale mental status and GCS, were correlated with EM physician with 99.1%, 98.6 %, 97.7 %, respectively.
6. For 320 out of 437 cases of survey completed, 319 patients received treatment by the EMT within 30 minute and 1 patient between 30 to 60 minute of an ED arrival.
7. For those 437 cases of survey completed, 266 patient (60.9 %) had adequate treatment and 54 patients (12.4 %) had inadequate treatment. 67 patient (15.3 %) did not received treatment but it was adequate inway, and 50 patients (11.9 %) did not received treatment even though patient required treatment.
In cases of adult trauma patients, EMT's mental status assessment was correlated with EM physician' s assessment. But treatment done by EMT without the supervision of EM physician was adequate only in 76.2 %. Therefore, continuous education and assessment of treatment performed by EMT in needed to improve field treatment by EMT in future.
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| Key words:
EMT |
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