A son celebrates his fifth Children's Day. The day before Mother's Day, I left my parents' side. "Five years and five months with my child," he said, was like a gift. On the day of the interview, the child, who had endured an autopsy and makeup, was kept in a small box guarding the living room. The father, who wanted to feed him a hearty meal for the last time, put a lot of gobon rice and beef soup in the stainless steel bowl that his child used in his life. Boiled tofu, frank sausages and chocolate-soaked lollipops were also on hand. After eating his last breakfast at home, he was taken to Memorial Park that afternoon.
On the 5rd day of the Children's Day holiday, we summarized what happened to the family.
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The emergency room hit-and-run... Three Days of Progress
- I found a pension for Children's Day. The child, who was having fun, had a fever of 5 degrees at about 10 p.m. and coughed. After taking antipyretic drugs, the child fell asleep. I had a bad cold, but my mother considered it to be a 'common cold.'
- I'm back home. At about 5 o'clock in the afternoon, the mother went to the local councillor with the child. I was prescribed antipyretics and cough medicine.
- It didn't get better. After 6 p.m., I started with a fever of nearly 2 degrees, a severe cough, shortness of breath, and lethargy. The mother called 11 paramedics for help.
-40 paramedics called and asked the university hospital closest to their home, "Can you accept the child?" When the hospital complained, "We can wait a long time," the 119th paramedics, who had no other alternative, headed to the hospital.
- On behalf of the mother, who was soothing the frightened child, the paramedics got out of the car and took her to the hospital. The hospital said that even at the scene, "there are not enough beds" and that they could wait for nearly five hours. There was no guarantee that there would be a spot even if we waited.
-The 'emergency room hit-and-run' has begun. Unable to wait that long, paramedics called three other hospitals. The next hospital also expressed reluctance. The reason was 'not enough hospital beds'. He said the next hospital and the next hospital would be difficult. It was for the same reason. The fifth hospital I inquired about, I was able to receive medical treatment only with the condition that "only medical treatment is possible without hospitalization." Headed to the last hospital.
- The diagnosis is called 'acute obstructive laryngitis', aka Krupp. It is characterized by shortness of breath and a painful, strong cough, also known as barking cough. It is a common condition in children under 119 years of age. Although it depends on the case, children with narrow airways are at risk of blocking the airways and leading to suffocation if the larynx (throat) is swollen.
-The mother stayed with her child in the emergency room until 119 a.m. the next day.
- The next day after I returned home, I was given the medicine I had brought from the hospital.
-When her condition did not improve after 3 p.m., she called the fifth hospital she had been treated to again to ask if she could be admitted. The answer was the same. "You can get medical care, but you can't be hospitalized."
-In order to get medical attention, the family decides to take the child back to the hospital. Grandpa went out to prepare tea for a while, and my mother said, "Let's pee one last time and leave," and headed to the bathroom with the child.
- The child said, "Mom, I can't take a break. Mom, I can't hear your voice. Mom, why is my neck like this?"
- The astonished family called the 3th ambulance team for help again, and the child was taken to another hospital emergency room on a stretcher. Within 5 minutes of arriving, the child was dead. It was half-past nine at night.
After 7 days.
- Death determination, police statements, autopsy, and cremation. After a difficult journey, the child returned home for a short time in a small ash box.
-At 6 p.m. on the 119th, after the interview with the reporter, the child finishes his last breakfast at home.
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Can you be treated, can't you be hospitalized?" ... What's happening in the hospital
My father said, "How can this happen in the middle of Seoul?" We found out what happened at the five hospitals where the child knocked on the door that day, and based on the 119 emergency logbook obtained by the reporter.
One hospital with the nation's largest pediatric emergency bed said it had "a lot of waiting patients." The two hospitals, which did not have separate pediatric emergency departments, "had no beds for adult patients," he explained. Another hospital replied, "We don't see pediatric emergency patients at night."
The last hospital, which had the condition "medical treatment is possible, but hospitalization is not possible", explained that the professor on duty of pediatrics at the time treated it normally. He confirmed that there were no X-ray abnormalities, and he also performed a respiratory spray treatment called a nebulizer. He confirmed that the child was stable and prescribed medication to discharge him from the hospital.
He also acknowledged that some mistakes had been made. The difficulty of being admitted to the hospital was a mistake made by the information desk staff. However, he added that there was a situation of "burnout." The number of pediatricians has recently dropped from 12 to three, and they have been working 3 hours a day and have burned out and had to shut down the emergency room.
'Burned out' doctors..."Pediatric support? A brutal story"
The explanation "it was a mistake on the part of the information desk staff" is not reluctant, but the explanation of "burnout" is worth listening to.
Kim Ji-hong, president of the Korean Academy of Pediatrics and Adolescent Sciences, cites the "lack of available beds" as the most important reason for the distortion of the pediatric emergency department structure. It's not that the total number of beds in the emergency department has decreased, it's that there are fewer beds available that can actually be operated.
The people who play a key role in the operation of the emergency department are the 'doctors'. General practitioners who have passed the medical examination and obtained a license go through one year of internship and four years of residency in their field of study, and the period of clinical training is called a specialty doctor.
It really is. Even if we expand the number of emergency rooms, buy the latest equipment, and bring in more beds, the hospital will be a shell if we don't have the manpower and doctors to assist the professors and share the on-call and patient surveillance responsibilities.
The reality is grim. In the hospitals involved in this case alone, there were no pediatric doctors at all, and there were as many as four. It is not possible to schedule an emergency room call 1 hours a day, 4 days a year.
Most of the hospitals that have doctors are "fourth-year" doctors, that is, doctors who will finish their specialties and leave in a short time. In this case, the hospital should have selected a large number of 4~24 year doctors, but the number of doctors applying for pediatrics is decreasing more and more. This year alone, there were 365 seats for pediatrics, while only 4 applicants applied. Thirty-eight out of 1 university hospitals had no applicants.
Some say. "There is a lack of sense of mission. Why would you want to go to a department that pays for you and not an essential department?" is not to blame for the sense of duty or irresponsibility of a few doctors. Not long ago, a pediatrician in my home said, "I knew I couldn't make money, but I didn't know it could be so scary."
The intensity of work is beyond imagination. The low pay is a personal and legal threat that is strangled. The burden of having to deal with the parents' complaints if the child's condition worsens despite their best efforts. The confusion when you look at the back of a colleague who can't stand it anymore and pulls out his resignation. In fact, even in the survey, these were the No. 2 reasons for avoiding pediatrics. One expert said, "We are holding out for a U-turn on the doctors, but even this hope is cruel on the ground."
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Induce understaffing, expand empty hospitals
High work intensity, low treatment, and personal legal threats. The brutal triple whammy resulted in a 'shortage of emergency medical personnel'.
The key is to elaborate the policy of inducing U-turns, as experts would like. If it's not feasible to reduce the intensity of work right away, then we need to ensure their treatment or the government should act as a shield to protect medical staff from threats.
The problem is that the government is focused on increasing the number of facilities. The Ministry of Health and Welfare announced in March that it would expand the number of pediatric specialized emergency medical centers from the current 3 to 4 in the '8th Basic Plan for Emergency Medical Care'. This included an extension of medical hours. He said he would increase the so-called Moonlight Children's Hospital, which provides outpatient care at night and on holidays for mild pediatric patients.
It's not that the government doesn't know the need to improve the price of money or that it hasn't tried, but it hasn't gotten to the ground. Kim Ji-hong, president of the Korean Academy of Pediatrics and Adolescent Sciences, emphasizes that "when salaries go up, medical staff will still come back, and for that to happen, the state must guarantee hospitals some profits." "Currently, there is no non-insurance system, and hospitals have to operate at the cost of admission and basic fees, so there is no reason or room for hospitals to hire additional personnel."
In the midst of the total chaos, while the majority left the pediatric emergency room, only a few remained to carry the heavy burden. Can we demand a sense of responsibility and mission from them in such a situation? It is a question that goes beyond the fact that the treatment of individual doctors went well. Unless we fundamentally overhaul the current emergency care system, which traps both patients and doctors in pain, the number of children who can't cross the threshold of the emergency room will never decrease.
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"I feel like I've woken up from a dream"
A son who was in good health without any serious illnesses. A son who was more patient than his peers. The son was curious and always asked, "What is in the clouds beyond the sky?" The father and mother said, "The five years and five months I spent with my child are like a dream, and now that my child is gone, I feel like I have dreamed and come back to reality."
From a child-rearing perspective, the shortage of pediatricians is not a story of yesterday or today, but the reality of being a party has been even more grim. One paramedic who must have looked bitter as if he had expected it when he was told that there was no doctor to see him, and another paramedic who would have rushed to swing the phone to find another hospital. I can't imagine the impatience of a mother who stood in the back of the ambulance, holding her child's hand, and watched with bated breath.
The Children's Day holiday started with excitement and ended in tragedy. It may not be the story of a poor "other person's child," but the story of a very ordinary "my child."
※The Ministry of Welfare issued an explanation on this issue to the effect that "it is not an emergency room hit-and-run." Originally, it was intended to be compiled into a single report, but there are many points to be pointed out in the explanation of the Ministry of Welfare. The rebuttal to the Welfare Department's data is a separate interview file < "It's not an emergency room hit-and-run" rebuttal from the Welfare Department... Continuing with the reporter's rebuttal >.