한국응급구조학회지 (The Korean Journal of Emergency Medical Services)

  • 제16권3호
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  • Pages.9-18
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  • 2012
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  • 1738-1606(pISSN)
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  • 2384-2091(eISSN)
한국응급구조학회 (The Korea Society of Emergency Medical Services)
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제세동 패들에 가해지는 압력의 모니터링 효과

The effects of monitoring of the pressures applied on the defibrillator paddles - A manikin study -

  • 박시은 (조선대학교병원 응급의료센터) ;
  • 신동민 (한국교통대학교 응급구조학과)
  • Park, Si-Eun (Chosun University Hospital Emergency Medical Center) ;
  • Shin, Dong-Min (Department of Paramedic Science, Korea National University of Transportation)
  • 투고 : 2012.10.20
  • 심사 : 2012.12.10
  • 발행 : 2012.12.31
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초록

Purpose : The purpose of this study was to determine the changes that occur due to the real-time monitoring of paddle pressures which has an important influence on the defibrillation success rate in defibrillation treatment known as the only treatment for cardiac arrest patients with VF. Methods : 40 people participated in the cardiac arrest simulation training and played the role of the defibrillation operator. Investigators measured the pressure of paddle while defibrillating by using instrument which was developed by the investigator. Results : Through real-time monitoring of the paddle pressures of defibrillator by indicator, the front sternum paddle showed a 77.5% success rate and the apex paddle showed a 40% success rate. While the values without monitoring the paddle pressures, the front sternum paddle showed a 51% success rate and the apex paddle showed a 20% success rate. These experiment revealed statistically significant(p <.001) low success rate. Conclusion : The method of monitoring the paddle pressures during defibrillation showed that the paddle can be precisely gripped. The success rate of paddle pressures is significantly correlated with height, weight and grip strength.

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참고문헌

  1. Rea TD, Helbock M, Perry S, Garcia M, Cloyd D, Becker L, Eisenberg M. Increasing use of cardiopulmonary resuscitation during out-of-hospital ventricular fibrillation arrest: survival implications of guideline changes. Circulation 2006;114(25):2760- 2760-5. https://doi.org/10.1161/CIRCULATIONAHA.106.654715
  2. Hwang SO, Lim KS. Cardiopulmonary resuscitation and advanced cardiac life support. Seoul: Koonja, 2001. 203.
  3. Steinmetz J, Barnung S, Nielsen SL, Risom M, Rasmussen LS. Improved survival after an out-of-hospital cardiac arrest using new guidelines. Acta Anaesthesiol Scand 2008;52(7):908-13. https://doi.org/10.1111/j.1399-6576.2008.01657.x
  4. Hinchey PR, Myers JB, Lewis R, De Maio VJ, Reyer E, Licatese D, et al. Improved out-of-hospital cardiac arrest survival after the sequential implementation of 2005 AHA guidelines for compressions, ventilations, and induced hypothermia: the Wake County experience. Ann Emerg Med 2010;56(4):348-57. https://doi.org/10.1016/j.annemergmed.2010.01.036
  5. Kerber RE, Grayzel J, Hoyt R, Marcus M, Kennedy J. Transthoracic resistance in human defibrillation. Influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure. Circulation 1981; 63(3):676-82. https://doi.org/10.1161/01.CIR.63.3.676
  6. Sado DM, Deakin CD, Petley GW, Clewlow F. Comparison of the effects of removal of chest hair with not doing so before external defibrillation on transthoracic impedance. Am J Cardiol 2004;93(1):98-100. https://doi.org/10.1016/j.amjcard.2003.09.020
  7. Bissing JW, Kerber RE. Effect of shaving the chest of hirsute subjects on transthoracic impedance to self-adhesive defibrillation electrode pads. Am J Cardiol 2000;86(5):587-9. https://doi.org/10.1016/S0002-9149(00)01026-2
  8. Kerber RE, Kouba C, Martins J, Kelly K, Low R, Hoyt R, et al. Advance prediction of transthoracic impedance in human defibrillation and cardioversion: importance of impedance in determining the success of low-energy shocks. Circulation 1984;70(2): 303-8. https://doi.org/10.1161/01.CIR.70.2.303
  9. Dalzell GW , Cunningham SR, Anderson J, Adgey AA. Electrode pad size, transthoracic impedance of external ventricular defibrillation. Am J cardiol 1989;64(12): 741-4. https://doi.org/10.1016/0002-9149(89)90757-1
  10. Deakin CD, Sado DM, Petley GW, Clewlow F. Determining the optimal paddle force for external defibrillation. Am J Cardiol 2002; 90(7):812-3. https://doi.org/10.1016/S0002-9149(02)02623-1
  11. Anonymous. Part 6: advanced cardiovascular life support. Section 2: defibrillation. European Resuscitation Council. Resuscitation 2000;46(1-3):109-13. https://doi.org/10.1016/S0300-9572(00)00275-6
  12. Geddes LA, Tacker WA, Cabler P, Chapman R, Rivera R, Kidder H. The decrease in transthoracic impedance during successive ventricular defibrillation trials. Med Instrum 1975;9(4):179-80.
  13. Geddes LA, Tacker WA Jr, Schoenlein W, Minton M, Grubbs S, Wilcox P. The prediction of the impedance of the thorax to defibrillating current. Med Instrum 1976; 10(3):159-62.
  14. Sado DM, Deakin CD, Petley GW. Are European Resuscitation Council recommendations for paddle force achievable during defibrillation? Resuscitation 2001; 51(3):287-90. https://doi.org/10.1016/S0300-9572(01)00420-8
  15. Lee MH, Kim AJ, Park JS, Roh JY, Kim KH, Shin DW, et al. Paddle-skin Coupling Material Usage in Emergency Institutes in South Korea. J Korean Soc Emerg Med 2010;21(1)1:125-30.