한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제15권2호
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  • Pages.760-766
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  • 2014
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  • 1975-4701(pISSN)
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  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
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심정지 환자의 생존율에 미치는 영향요인

The Effect Factors of Survival rate in the Patients with Cardiac Arrest

  • 조병준 (강원대학교 응급구조학과) ;
  • 김선예 (충남대학교 약학대학)
  • Cho, Byung-Jun (Department of Emergency Medical Technology, Kangwon National University) ;
  • Kim, Seon-Rye (Department of Pharmacy, Chungnam National University)
  • 투고 : 2014.01.13
  • 심사 : 2014.02.05
  • 발행 : 2014.02.28
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초록

본 연구는 심정지 환자의 생존율을 비교분석하여, 심정지환자의 생존에 미치는 영향요인을 규명하고자 시도하였다. 조사대상은 2010년 일개 도에서 119 구급대가 이송한 18세 이상 심정지 환자 4,092명으로 하였고, 구급일지와 심폐정지환자 응급처치 세부상황표, 인명소생 추천서를 유스타인 형식 조사지에 기록하였다. 연구결과 생존에 영향을 미치는 요인은 산소공급, 기도유지, 정맥로 확보, 병원도착 소요시간, 현장처치시간, 발생장소, 일반인에 의한 심폐소생술, 동승 구급대원의 자격, 자발순환 회복장소 등이었다. 결론적으로 심정지 환자에 대한 119 구급대의 응급처치는 생존율을 유의하게 높였다. 조기 제세동, 산소공급, 기도유지, 정맥로 확보 등 병원전 응급처치가 생존에 큰 영향을 미치므로, 119 구급대 중 1급 응급구조사의 인원증가를 위한 정책을 제정하고, 119 구급대의 응급처치 시행률을 높일 수 있는 방안을 마련하여 심정지 환자의 생존율을 개선해야겠다.

This study was performed to determine the effect factors in the survival of cardiac arrest patients. This study involved 4,092 cardiac arrest patients of K province, who were transported by 119 during 2010. The data collection involved using 119 rescue daily reports, cardiopulmonary arrest patients emergency treatment detail reports and 119 paramedics survival data. In conclusion, 119 rescue's interventions in the patients with pre-hospital cardiac arrest have significantly increased survival rates. 119 rescue's interventions included early defibrillation, oxygen supply, airway open, and intravenous access affected significantly survival rate. Therefore there is need to increase 119 rescue's interventions performance to improve survival rate of cardiac arrest patients.

키워드

참고문헌

  1. RC Brownson, PL Remington. Chronic disease epidemiology and control. 2nd. ed. Washington, DC. 1998.
  2. Ministry of Health and Welfare. National Health and Nutrition Examination Survey. 2010
  3. Colin OK, Jon N, Janette T, Steve Gl. Role of ambulance response times in the survival of patients with out of hospital cardiac arrest. Emerg Med J 10, 1136-39, 2010
  4. Vukmir RB and the sodium Bicarbonate Study Group. Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improvers prehospital cardiac arrest survival. Emerg Med J 21, 370-373, 2004 DOI: http://dx.doi.org/10.1136/emj.2003.008383
  5. Pantridge JF, Geddes JS. A mobile intensive care unit in the management of myocardial infarction. Lancet 2, 271-173, 1967 DOI: http://dx.doi.org/10.1016/S0140-6736(67)90110-9
  6. Eisenberg MS, Horwood B, Cummins R. Cardiac arrest and resuscitation: a tale of 29cities. Ann Emerg Med 419, 179-86, 1990 DOI: http://dx.doi.org/10.1016/S0196-0644(05)81805-0
  7. Richard WS. Recommended guidelines for uniform reporting of data on out-of-hospital cardiac arrests: the"Utstein style". Can Med Assoc J 145, 15-25, 1991
  8. Emergency Medical Service Act, Korea Ministry of Government Legislation. 2010
  9. Eun SJ, Kim H, Jung JY, Cho KH, Kim Y. Prospective multicenter evaluation of prehospital care by 119 rescue services. J Korean Soc Emerg Med 18, 177-89, 2007
  10. BY Go, YS Park. Clinical Characteristics and Prehospital care in Prehospital Cardiac Arrest Patients by Paramedic's Reports. J Kor Acade Industr Copp Soc 11(4), 1540-1546, 2010 DOI: http://dx.doi.org/10.5762/KAIS.2010.11.4.1540
  11. SJ Kim, SJ Cho, SL Lee, SY Ryu, HY Kim, SJ Kim. The effects of prehospital cardiac arrest patients prognoses by emergency medical CPR group. J Korean Soc Emerg Med 16(1), 99-103, 2005
  12. Korea Health Industry Development Institute. 2009 year medical institution evaluation, 2010
  13. Mitchell RG, Guly UM, Cook R, Steedman DJ, Robertson CE. Can the full range of paramedic skills improve from out of hospital cardiac arrests? J Accid Emerg Med 14, 274-277, 1997 DOI: http://dx.doi.org/10.1136/emj.14.5.274
  14. Stiell IG, Wells GA, Field B, Spaite DW. Advanced cardiac life support in out-of-hospital cardiac arrest. N Eng J Med 351, 647-56, 2004 DOI: http://dx.doi.org/10.1056/NEJMoa040325
  15. Ng AY, Clinton JE, Peter G. Nontraumatic prehospital cardiac arrest ages 1-39 years. Am J Emerg Med 8, 87-91, 1990 DOI: http://dx.doi.org/10.1016/0735-6757(90)90190-B
  16. Brison R, Davidson J, dreyer J. Cardiac arrest in Ontario: circumstances, community response, role of prehospital defibrillation and predictors of survival. CMAJ 147, 1427-8, 1992
  17. Fredrinksson M, Herlitz J. Variation in outcome in studies of out of hospital cardiac arrest, a review of studies conforming to the Utstein guidelines. Am J Emerg Med 21, 276-81, 2003 DOI: http://dx.doi.org/10.1016/S0735-6757(03)00082-2
  18. Andgelic S. A prediction survival model for out-of-hospital cardiopulmonary resuscitation. J Critical Care 6, 235-243, 2010
  19. Weaver WD, Hill D, Fahrenbruch CE. Use of the automatic external defibrillator in the management of out of hospital cardiac arrest. N Emerg J Med 319, 661-666, 1998
  20. Weisfeldt ML, Kerber RE, McGoldrick RP, Moss AJ. Public access defibrillarion: a statement for healthcare professionals fron the American Heart Association Task Force on Automated External Defibrillation. Circulation 92, 2740-2747, 1995 DOI: http://dx.doi.org/10.1161/01.CIR.92.9.2740
  21. Cobb LA, Fahrenbruch CE, Olsufka M. Changing incidence of out of hospital ventricular fibrillation, 1980-2000. JAMA 288, 3008-13, 2002 DOI: http://dx.doi.org/10.1001/jama.288.23.3008
  22. Rosenberg M, Wang C, Hoffman-Wilde S. Results of cardiopulmonary resuscitation. Arch Intern Med 8: 87-91,1990
  23. Richard HK, Gerry E, Pasul G. Issues around conducting prehospital research on out of hospital cardiac arrest: lessons from the TOPCAT study. Emerg Med J 27, 637-638, 2010 DOI: http://dx.doi.org/10.1136/emj.2009.087395
  24. Bonnin MJ, Swor RA. Outcomes in unsuccessful field resuscitation attempts. Ann Emerg Med 18, 507-12, 1989 DOI: http://dx.doi.org/10.1016/S0196-0644(89)80834-0
  25. Michael P, Jonathan NV, James P, Andrew D. Hidden impact of paramedic interventions. J Accid Emerg Med 13, 383-385, 1996 DOI: http://dx.doi.org/10.1136/emj.13.6.383
  26. Eisenberg MS, Bergner L, Hallstrom A. Paramedic programs and out of hospital cardiac arrest: factors associated with successful resuscitation. Am J Public Health 69, 30-8, 1979 DOI: http://dx.doi.org/10.2105/AJPH.69.1.30
  27. SO Hwang, ME Ahn, YS Kim, KS Lim, JH Yun, KH Choe. The Result of CPR in the prehospital cardiac arrest patients. J Korean Soc Emerg Med 3(1), 27-36, 1992
  28. Anouk P, Rob HV, Jan GP. Use of automated external defibrillator by first responders in out of hospital cardiac arrest: prospective controlled trial. BMJ 327, 1-5, 2003