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.
@ES The results were as following:
@EN 1. Among the total 5532 ED visiting patients during the study period, 1267 were adult trauma patient 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 sclae 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. Patients 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 patients (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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