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Seoul Policy Storytelling

  • Seoul’s Civic Medical Emergency System Saves 351 Lives

  • SMG 1452
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    Public Transfer of Emergency Patients in Critical Condition

    • Growing daily temperature range increases risks of cardiovascular disease and stroke.
    • Seoul establishes public system for the transportation of emergency patients across 25 boroughs with the participation of Seoul National University Hospital and 39 emergency centers.
    • Specially designed ambulances and highly skilled paramedics deployed immediately upon request of hospitals requiring transportation of emergency patients.
    • Korea’s first municipal emergency patient transfer system
      * Saved 351 lives this year alone
    • Seoul’s way of protecting each and every citizen

    As the seasons become colder and the daily temperature range increases, we are being exposed to a growing number of medical risks. Sudden cold spells serve to inhibit blood circulation in the frail and elderly, raising the risks of cardiovascular disease and stroke. As the temperature drops further, even relatively young and healthy people, especially those working at various types of industrial sites, need to watch for signs of health problems. The brain and heart are the most important organs in the human body, and cardiovascular and cerebrovascular diseases, which cause contractions and ruptures of blood vessels, are the second-most prevalent cause of death in Korea next to cancer and the leading cause of death worldwide.

    Ranking of causes of death in KoreaHow changes in blood pressure can lead to cardiovascular disease
    Ranking of causes of death in KoreaHow changes in blood pressure can lead to cardiovascular disease
    (Korea University Anam Hospital)

    Seoul Expands Public Emergency Patient Transfer System

    The chances of emergency patients dying in transit between hospitals are 2.9 times higher than those of patients who visit the appropriate emergency medical centers directly. The reason for this is that the private-sector carriers of emergency patients lack the sophisticated equipment and skilled personnel needed to ensure the survival and safety of the patients they transfer.

    Seoul City and hospitals sign agreement on inter-hospital transfer of emergency patientsSeoul’s public inter-hospital emergency patient transfer system (S-MICU): Overview
    Ranking of causes of death in KoreaHow changes in blood pressure can lead to cardiovascular disease
    (Korea University Anam Hospital)

    The Seoul Metropolitan Government (SMG) has thus expanded the reach of its public inter-hospital emergency patient transfer system, known as the “Seoul Mobile Intensive Care Unit (S-MICU).” Originally introduced in nine self-governing boroughs of the city in September 2015, the service was expanded to encompass 15 bureaus in September 2016.

    The S-MICU dispatches specially equipped ambulances and skilled paramedics to transport emergency patients suffering from cardiovascular disease or stroke, so as to ensure their quick and safe transfer between hospitals. This system, which Seoul was the first city in Korea to adopt, has been met with highly favorable responses, with 112 patients having used the service in the first three months of 2016.

    Specially equipped ambulanceTransferring an emergency patient
    Specially equipped ambulanceTransferring an emergency patient

    S-MICU: Ready to Carry Patients 24/7

    Seoul began the trial operation of this service by designating Seoul National University Hospital (SNUH) as its partner. Upon the request of a hospital located in any of the 15 boroughs requiring the transport of an emergency patient, the S-MICU Team at the SNUH dispatches an ambulance with a team of paramedics.

    The patient is required to pay only the transfer fee. Pursuant to the Emergency Medicine Act, the basic transfer fee is KRW 75,000 for the first 10 kilometers, with an additional fee of KRW 1,300 charged for every kilometer after that. (*These rates both increase by 20 percent from 00:00 to 04:00).

    The S-MICU ambulances are equipped with cutting-edge emergency medical equipment, including airway adjuncts, mobile respirators, vital sign meters, and the like. The medical team includes six specialists working at the SNUH and 11 paramedics and nurses.

    A number of recent studies have confirmed the correlation between the lack of proper medical care and staff for emergency patients in transit and the increased risk of mortality. Seoul thus expects this new system to improve emergency patients’ chances of survival, a goal that has been realized on a number of occasions so far. One day, a 30-day-old infant was rushed to an ER after it had stopped breathing. The medical staff at the ER managed to carry out a tracheal intubation, but there was no room for the baby in the hospital’s neonatal intensive care unit. The hospital thus contacted the SNUH to request the services of the S-MICU. The S-MICU quickly dispatched an ambulance with a team of paramedics, equipped with vital sign meters and breathing aids for infants, in order to transfer the baby to another hospital as safely as possible.

    Emergency management drill at SNUH (Newsis) Emergency patient transfer drill (Hyeondaegeongang News)
    Emergency management drill at SNUH (Newsis) Emergency patient transfer drill (Hyeondaegeongang News)

    On another occasion, the S-MICU was called upon to transfer a woman in her 50s from the ICU at a university hospital to another facility. Initially hospitalized for acute pneumonia, the patient’s condition had steadily declined while at the ICU, despite the respirator treatment. It was critical for her to be transferred to another university hospital so that she could receive extracorporeal membrane oxygenation (ECMO) therapy, or possibly a lung transplant, in case the ECMO therapy failed to restore her pulmonary functions. The woman was already connected to a number of complex life-sustaining devices, including an ECMO machine, so transferring her safely to another hospital was a very difficult task. Nevertheless, the emergency specialists, nurses, and paramedics on the S-MICU ambulance completed the task successfully and safety.

    In the Following Situations, Don’t Hesitate to Call on the S-MICU

    The main targets of the S-MICU service are patients in critical or severe condition who have already been admitted to a hospital in Seoul (ER, ICU, or ward) and require transfer to another hospital in Seoul for better care and treatment. Examples include:

    • * Patients who have been resuscitated following cardiac arrest and require comprehensive medical care afterward, including therapeutic hypothermia;
    • * Patients who have suffered acute myocardial infarctions, stroke, or other types of severe trauma;
    • * Patients who are on respirators or are likely to require ones;
    • * Infants and young children in need of emergency medical care;
    • * Other emergency patients in critical condition who require intensive care and observation in transit.

    Hospitals may request the services of the S-MICU only with the consensus of the medical staff and approval of other hospitals willing to receive the patients. The S-MICU is not mobilized upon the request of individual patients or their caretakers.

    S-MICU Saves 351 Lives in the First Half of 2016

    Introduced as the first-ever public emergency patient transfer system in Korea in 2015, the S-MICU managed to save 351 emergency patients in critical condition in the first seven months of 2016 alone, thus proving its value to the public. According to an international study, patients on respirators in transit, patients whose vital signs were weak before transit, and patients who remained in transit for protracted periods of time are much more likely than others to face life-threatening situations during transit. Another study analyzing occurrences of life-threatening situations during inter-hospital transfers found that 47 percent of such patients died in transit.

    Protecting Each and Every Citizen’s Life

    The SMG expects that expanding this service to all 25 boroughs of the city will significantly improve the treatment and chances of survival of emergency patients in critical condition. For more information, contact the S-MICU Center at the SNUH (Tel. 02-762-2525 or 02-870-1990).

    Seoul will continue extending the reach of the S-MICU to greater numbers of citizens by encouraging more boroughs and hospitals to participate in the program.