922 Abstracts

participate and exceptions were made for power outages, hospi-tal computer malfunctions, and specialty unavailability. Diver-sion statistics were compared before and after the pilot. EMSproviders, emergency nurses, and emergency physicians weresurveyed at pilot completion with 99 responses (51 nurses, 46paramedics, 2 physicians). Results: Monthly diversions aver-aged 61/month for the previous 2 calendar years. During the pi-lot, the average number of monthly diversions was < 12 permonth, an 82% reduction. Survey results: 58% overall did notperceive an increase in ED volume (61% of paramedics, 42%of nurses, and 100% of physicians). Fifty-one percent overallperceived less tension between Emergency Department (ED)staff and EMS (51% of nurses, 48% of paramedics, and 100%of physicians). Fifty-one percent overall perceived no compro-mise of patient safety (89% of paramedics, 49% of nurses,and 100% of physicians). Fifty-seven percent of those surveyeddid not recognize an impact on workload (59% of paramedics,37% of nurses, and 100% of physicians). Conclusions: The sus-pension of a city-wide diversion policy can significantly reduceEMS diversion without creating a global provider concern overworkload, patient safety, or EMS/ED staff relations. The studywould benefit from a longer trial and more respondents, partic-ularly with more physician input. Recognition of specific safetyconcerns among the nurse group would also be very beneficial infuture research. Finally, the survey allows for potential agenda-based responses among participants who have a preference forprotocol termination or continuity.

, THE DIFFERENCE BETWEEN EMERGENCY REC-OGNITION AND SAFETY CONSCIOUSNESS AC-CORDING TO A COMMUNITY EDUCATIONPROGRAM FOR A RURAL EMERGENCY MEDICALSERVICE SYSTEM IN A RURAL COUNTRY: IN-TERVENTION STUDY. S. M. Lee, J. W. Jeung, H. Y. Lee,B. K. Lee, K. W. Jeung, H. H. Ryu, B. J. Chun, T. Heo,Y. I. Min, Emergency Department, Chonnam National

University Hospital, Gwnagju, KOREA.Objective: Compared to urban areas, rural ones have access

to relatively restricted emergency medical services (EMS), bothin quality and quantity. They, however, are in bigger need forsuch services due to their safety accidents and underlying dis-eases based on the aged population model. We set out to inves-tigate whether education for EMS would be helpful for theutilization of poor resources of EMS in rural areas and how ef-ficient it might be. Methods: Goheung (n = 796) and Haenam(n = 819) were selected; they seemed to be similar in terms ofarea, population composition, and quality and quantity ofEMS. While one area received ‘‘Life Helper for the Village,’’one of the educational programs for EMS, the other did not. Aquestionnaire containing items about the recognition ofEMS and their roles as the primary responder wasadministered. Results: Significant differences were found inthe recognition of EMS and safety awareness in Goheung, towhich education for EMS was provided. However, we did notfind the relationship between injury or accident developmentand education for a rural EMS system in two areas. Conclusions:It is thus required to provide education for developing commonresidents into primary responders in alienated rural and fishing

villages, offer them ongoing and repeating education to increasetheir recognition of EMS and safety awareness, and expand sucheducation to the areas in a similar situation.

, DETECTING PREHOSPITAL HEMOPERITONEUMREMOTELY THROUGH FAST AND 3 G NETWORK: ASIMULATION STUDY. K. J. Hong, K. J. Song, S. W. Song,Department of Emergency Medicine, Seoul NationalUniversity Boramae Medical Center, Seoul, KOREA;S. D. Shin, Department of Emergency Medicine, SeoulNational University Hospital, Seoul, KOREA.

Objective: Prehospital focused assessment with sonographyfor trauma (FAST) is used to diagnose hemoperitoneum and de-termine whether transportation to a trauma center is necessary.The goal of this study was to simulate detecting prehospital he-moperitoneum remotely through FAST and a 3 G network. Me-thods: We developed a real-time image transmission system forprehospital ultrasound. In the system, ultrasound image is ini-tially acquired using portable sonography (Sonosite Inc., Bo-thel, WA) and transmitted to the Emergency Department (ED)through a 3 G network. One emergency medical technician(EMT) acquired a prehospital FAST image inside an ambulance.Image acquisition and transmission was conducted at 3, 5, 10,and 15 km from the ED and during migration between. Ateach point, the EMT performed FASTwith hepatorenal view us-ing two phantom models randomly: normal model and hemo-peritoneum model. Eight Emergency Physicians interpretedFAST images. We analyzed sensitivity, specificity, and area un-der the curve (AUC). We also conducted subgroup analysis bygrade of emergency physicians (board, senior resident, juniorresident), moving status of ambulance vehicle and distancefromED. Results: A total of 17 image acquisitions and transmis-sions were attempted with a success rate of 15/17 (88.2%). Twoemergency medicine (EM) boards, four senior residents, andtwo junior residents were recruited to detect presence of fluidcollection of the hepatorenal area. Sensitivity, specificity, andAUC value of overall Emergency Physicians was 67.9%,78.1%, and 0.73 (95% confidence interval 0.65–0.81), respec-tively. Subgroup analysis of the EM board was 85.7%, 95.8%,and 0.90, respectively. Higher-grade Emergency Physiciansshowed significantly higher value of AUC (board: 0.90, seniorresident: 0.69, junior resident: 0.63, p = 0.01). There was no sig-nificant difference of AUC regarding moving status of ambu-lance or distance from ED (p = 0.34, 0.98). Conclusions:Simulation of detecting hemoperitoneum using prehospitalFAST through 3 G network showed acceptable performance.Higher grade of Emergency Physicians showed betterperformance.

, IMPLEMENTATION OF SCREENING, BRIEF IN-TERVENTION AND REFERRAL TO TREATMENT(SBIRT) FOR MEDICALLY UNEXPLAINED PSYCHI-ATRIC SYMPTOM. K. J. Hong K. J. Song, Department ofEmergency Medicine, Seoul National University BoramaeMedical Center, Seoul, KOREA; S. D. Shin, Department ofEmergency Medicine, Seoul National University Hospital,Seoul, KOREA; I. K. Lyoo, Department of Psychiatry, SeoulNational University Hospital, Seoul, KOREA; J. S. Choi,