Abstract

OBJECTIVES
This study was designed to evaluate the problems of pre-hospital Emergency medical care system (EMS) in workplace. We analysed 25 fatal work-place injuries during the recent 4 years and the work-place EMS of 8 enterprises located in Masan-city, Changwon-city and Kuje-island.
METHODS
The safety managers and the members of Dept. of safety in the labor unions were interviewed about the work-place EMS. And we investigated on the injury reports, the work-place medical-room records and the medical records of emergency center for fatal 25 cases.
RESULTS
The enterprises had the at-risk machines and processes, volatile materials and high-altitude working processes. There were duty doctors in only 3 enterprises but a few duty nurses or health-care providers in the others. The time spent for the education to the workers on safety was 24hrs/yr in 3 enterprises in 1998 but less than Bhrs in the others. There were medical service center in all enterprises but the ambulances in three. The time for activation of the ambulance was ranging from 5 minutes to 10 minutes in 6 enterprises, and from 10 minutes to 30 minutes in two. The patient transportation to the emergency center was possible within 30 minutes in all enterprises but there were no equipments for airway maintenance and shock management in all enterprises. The 15 (60%) fatal injuries were occurred at one enterprise. The 64% of casualties had the duration of job-employment more than 10yrs and the 68% were suffered the typical type of work-place injury as descending injuries, collisions and falls. Most of all primary calls for rescue were concentrated on the fire-service agencies. But in 85% of fatal injtories, the tome for the activation of ambulance was more than 10 minutes and no emergency care was taken in the field in 48 percent of casualtles. The transportation time to the emergency center was more than 30 minutes in 50 percent. It toolk from injury to death was less than one hour in the 40 percent of all cases, and from one hour to four in the 50 percent. The causes of death in the 68 percent were the head-and-neck injuries or thoracic injuries.
CONCLUSIONS
We found that there was Insufficiency of the education associated with work-place injury for workers, manpower and facilities, equipments related to the work-place EMS, the problems of the delay in transportation system.