Fire Science and Engineering (한국화재소방학회논문지)

Korean Institute of Fire Science and Engineering (한국화재소방학회)
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Analysis of Predicted Instructions about Shockable Cardiac Arrest Patients by Dispatcher at 119 Emergency Situation Management Center

제세동이 가능한 심정지 환자를 119구급상황관리센터 상황요원이 예측한 지령 분석

  • 정은경 (원광보건대학교 의무부사관과) ;
  • 정지연 (호원대학교 응급구조학과)
  • Received : 2013.08.09
  • Accepted : 2013.12.06
  • Published : 2013.12.31
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Abstract

This study analyzed the emergency activity daily reports and emergency instruction sheets of the research subjects and proceeded with the shockable cardiac arrest cases transported to 119 emergency units for two years before the hospital from January 1, 2010 through December 31, 2011. The most frequently predicted instruction by the dispatchers at the 119 Emergency Situation Control Center was 74 cases of fainting (33.3%). Among varied types of predicted instructions, 112 cases (50.5%) like fainting, chest pain, general prostration and others were not able to be predicted while predictable instructions involved with cardiac arrest such as consciousness disorders, difficult breathing, cardiac attacks and convulsion were 110 cases (49.5%). In such cases, success rates of cardiopulmonary resuscitation (CPR) trials by eyewitnesses at predictable instructions involved with cardiac arrests were significantly higher. As mentioned, situation agents must categorize types of cardiac arrests accurately by posing questions over assessments regarding patients' consciousness and respiration in detail. The patients categorized by such methods must guide eyewitnesses to be able to do CPR. Moreover, not only emergency medical technicians who receive predictable instructions involved with cardiac arrests given by dispatchers (49.5%) but also filed emergency medical technicians who are not able to reach a precise conclusion to non-cardiac arrests on unpredictable instructions on cardiac arrests (50.5%) must prepare for situations related to cardiac arrests before being dispatched to the field.

본 연구는 2010년 1월 1일부터 2011년 12월 31일까지 2년간 119구급대로 이송된 병원 전 제세동 가능한 심정지 환자를 대상으로 연구를 진행하였으며 연구대상자들의 구급활동일지와 구급지령서를 분석하였다. 119구급상황관리센터 상황요원(Dispatcher)이 가장 많이 예측한 지령은 실신으로 74건(33.3%)이었다. 다양하게 예측된 지령 중 실신, 흉통, 전신쇠약, 기타와 같은 지령은 심정지로 예측 불가능한 지령으로 112건(50.5%)을 차지하였으며, 심정지로 예측 가능한 의식장애, 호흡곤란, 무호흡, 심정지, 경련과 같은 지령은 110건(49.5%)을 차지하였다. 이 때 심정지로 예측 가능한 지령에서 목격자의 심폐소생술이 유의하게 높았다. 이와 같이 상황요원은 환자의 의식평가와 호흡평가를 구체적으로 질문하여 심정지를 정확하게 분류해야하며, 이렇게 분류된 심정지 환자는 목격자가 심폐소생술을 할 수 있도록 지도해야 한다. 또한 상황요원에 의해 심정지로 예측 가능한 지령(49.5%)을 받은 구급대원뿐만 아니라 심정지로 예측 불가능한 지령(50.5%)에서도 심정지가 아니라고 정확하게 판단되지 않았다면 현장 구급대원은 심정지 상황에 대비하여 현장출동 준비를 해야 한다.

Keywords

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