한국화재소방학회논문지 (Fire Science and Engineering)

  • 제28권4호
  • /
  • Pages.104-111
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  • 2014
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  • 2765-060X(pISSN)
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  • 2765-088X(eISSN)
한국화재소방학회 (Korean Institute of Fire Science and Engineering)
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구급차 내에서의 심폐소생술 방법에 관한 연구

A Study on the Cardiopulmonary Resuscitation Methods in Ambulance

  • 투고 : 2014.05.20
  • 심사 : 2014.08.14
  • 발행 : 2014.08.31
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초록

이 연구는 소방에 근무하는 응급구조사에 의해 시행되는 구급차 내 심폐소생술 방법에 관한 연구이다. 연구 대상은 경기도 관할 780명으로 2012년 보수교육 종료 후 설문을 통하여 수집하였다. 일반적 특성, 가슴압박 방법(한 손 가슴압박 VS 두 손 가슴압박), 심폐소생술 방법(표준심폐소생술 VS 가슴압박소생술) 등에 대하여 Chi-square test, t-test. ANOVA로 분석하였다. 한 손을 이용한 가슴압박 14.0%, 두 손을 이용한 가슴압박 86.0%를 보였고, 표준심폐소생술(가슴압박 VS 인공호흡)은 28.3%, 가슴압박소생술 71.7%를 보였다. 고품질의 심폐소생술을 위해서는 심정지 환자의 구급 출동만이라도 운전자 포함 3명 이상의 응급구조사가 출동할 수 있도록 탄력적인 인력 운영 방안이 필요하며, 역량 강화를 위한 심폐소생술의 정기적인 교육이 필요하다.

The purpose of this study is to investigate the CPR within ambulance. The Subjects were 890 emergency medical technicians in fire department in Gyeonggido. After continuing education program, the emergency medical technicians completed the questionnaires from January to February, 2012. Questionnaire consisted of demographic characteristics, method of chest compression (one handed or two handed), chest compression - ventilation ratio, and hands only CPR. Data were analyzed by frequency analysis and Chi-square test, t-test. One-way analysis of variance (ANOVA) was followed by Scheffe post-hoc test to analyze changes in all parameters between all groups. One handed chest compression accounted for 14.0% and two handed chest compression accounted for 86.0%. Hands only CPR accounted for 71.7% and standard CPR (30:2) accounted for 28.3%. In order to perform the high quality CPR, as least three persons must be dispatched in the ambulance. The flexible management of manpower may improve the survival from the cardiac arrest. A systemic approach for educating and training EMT's in CPR is needed.

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참고문헌

  1. B. S. Abella, N. Sandbo, P. Vassilatos, J. P. Alvarado, N. O'Hearn, H. N. Wigder, P. Hoffman, K. Tynus, T. L. Vanden Hoek and L. B. Becker, "Chest Compression Rates During Cardiopulmonary Resuscitation are Suboptimal: A Prospective Study During In-hospital Cardiac Arrest", Circulation, Vol. 111, No. 4, pp. 428-434 (2005). https://doi.org/10.1161/01.CIR.0000153811.84257.59
  2. R. A. Berg, R. Hemphill, B. S. Abella, T. P. Aufderheide, D. M. Cave, M. F. Hazinski, E. B. Lerner, T. D. Rea, M. R. Sayre and R. A. Swor, "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care", Circulation, Vol. 122, No. 15, pp. 685-705 (2010). https://doi.org/10.1161/CIRCULATIONAHA.110.970939
  3. International Liaison Committee on Resuscitation, "2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations: Adult Basic Life Support", Resuscitation, Vol. 67, No 23, pp. 187-201 (2005). https://doi.org/10.1016/j.resuscitation.2005.09.016
  4. S. Y. Feng, Y. Q. Song, Y. L. Zhang and Y. Li, "Evaluation of a Novel Device that Maintains the Balance of a Cardiopulmonary Resuscitation Performer in a Moving Ambulance to Improve Chest Compression Quality", Singapore Med. J., Vol. 54, No. 11, pp. 645-648 (2013).
  5. N. P. Foo, J. H. Chang, S. B. Su, H. J. Lin, K. T. Chen, C. F. Cheng, T. Y. Lin, P. C. Chen and H. R. Guo, "A Stabilization Device to Improve the Quality of Cardiopulmonary Resuscitation During Ambulance Transportation: A Randomized Crossover Trial", Resuscitation, Vol. 84, No 11, pp. 1579-1584 (2013). https://doi.org/10.1016/j.resuscitation.2013.06.015
  6. J. A. Kim, D. Vogel, G. Guimond, D. Hostler, H. E. Wang and J. J. Menegazzi, "A Randomized, Controlled Comparison of Cardiopulmonary Resuscitation Performed on the Floor and on a Moving Ambulance Stretcher", Prehosp Emerg Care, Vol. 10, No. 1, pp. 68-70 (2006). https://doi.org/10.1080/10903120500373108
  7. C. Havel, W. Schreiber, H. Trimmel, R. Malzer, M. Haugk, N. Richling, E. Riedmuller, F. Sterz and H. Herkner, "Quality of Closed Chest Compression on a Manikin in Ambulance Vehicles and Flying Helicopters with a Real Time Automated Feedback", Resuscitation, Vol. 81, No. 1, pp. 59-64 (2010). https://doi.org/10.1016/j.resuscitation.2009.10.007
  8. S. G. Hong and I. A. Son, "A Study on the Factors Influencing the Accuracy of Chest Compression during Cardiopulmonary Resuscitation Trying in a Moving Ambulance", Emergency Medical Journal, Vol. 20, No. 4, pp. 343-354 (2009).
  9. N. A. Paradis, G. B. Martin, E. P. Rivers, M. G. Goetting, T. J. Appleton, M. Feingold and R. M. Nowak, "Coronary Perfusion Pressure and the Return of Spontaneous Circulation in Human CPR", JAMA, Vol. 263, No. 8, pp. 1106-1113 (1990). https://doi.org/10.1001/jama.1990.03440080084029
  10. J. P. Nolan, "High-quality Cardiopulmonary Resuscitation", Curr. Opin. Care, Vol. 20, No. 3, pp. 227-233 (2014). https://doi.org/10.1097/MCC.0000000000000083
  11. R. W. Koster, "Limiting 'Hands-off' Periods During Resuscitation", Resuscitation, Vol. 58, No. 3, pp. 275-276 (2003). https://doi.org/10.1016/S0300-9572(03)00270-3
  12. B. S. Abella, J. P. Alvarado, H. Myklebust, D. P. Edelson, A. Barry, N. O'Hearn, T. L. Vanden Hoek and L. B. Becker, "Quality of Cardiopulmonary Resuscitation During In-hospital Cardiac Arrest", JAMA, Vol. 293, No. 3, pp. 305-310 (2005). https://doi.org/10.1001/jama.293.3.305
  13. C. K. Stone and S. H. Thomas, "Can Correct Closed-chest Compressions be Performed During Prehospital Transport?", Prehosp Disaster Med., Vol. 10, No. 2, pp. 121-123 (1995). https://doi.org/10.1017/S1049023X00041856
  14. C. Havel, W. Schreiber, E. Riedmuller, M. Haugk, N. Richling, H. Trimmel, R. Malzer, F. Sterz and H. Herkner, "Quality of Closed Chest Compression in Ambulance Vehicles Flying Helicopters and at the Scene", Resuscitation, Vol. 73, No. 2, pp. 264-270 (2007). https://doi.org/10.1016/j.resuscitation.2006.09.007
  15. R. A. Berg, K. B. Kern, R. W. Hilwig, M. D. Berg, A. B. Sanders, C. W. Otto and G. A. Ewy, "Assisted Ventilation Does Not Improve Out Come in a Porcine Model of Single-rescuer Bystander Cardiopulmonary Resuscitation", Circulation, Vol. 95, No. 6, pp. 1635-1641 (1997). https://doi.org/10.1161/01.CIR.95.6.1635
  16. W. Tang, M. H. Weil, S. Sun, D. Kette, R. J. Gazmuri, F. O'Connell and J. Bisera, "Cardiopulmonary Resuscitation by Precordial Compression but without Mechanical Ventilation", Am. J. Respir. Crit. Care Med., Vol. 150, No. 6, pp. 1703-1713 (1994).
  17. J. Berdowski, F. Beekhuis, A. H. Zwinderman, J. G. Tijssen and R. W. Koster, "Importance of the First Link: Description and Recognition of an Out-of-hospital Cardiac Arrest in an Emergency Call", Circulation, Vol. 119, No. 15, pp. 2096-2102 (2009). https://doi.org/10.1161/CIRCULATIONAHA.108.768325
  18. S. G. Roh, S. H. Bang, K. Y. Kim and J. H. Kim, "A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on One Area Heart Saver", J. Kor. Inst. Fire Sci. Eng., Vol. 24, No. 4, pp. 61-67 (2013). https://doi.org/10.7731/KIFSE.2013.27.4.61
  19. H. G. Lee, "Evaluation of Emergency Care to the Cardiac Arrest Patients Transferred to the Hospital by 119. Unpublished Master's Thesis", Kongju National University 2011, Gongju, Korea.
  20. Korea guidelines for CPR, KACPR (2011).
  21. AHA guidelines for CPR, AHA (2010).
  22. J. S. Hong, R. O. Ahn, S. H. Kim, W. Y. Kim, S. O. Kim and E. S. Hong, "Retention of CPR Skills by Nursing Students Received Training in AHA BLS Course for Healthcare Providers", Emergency Medical Journal, Vol. 20, No. 6, pp. 609-614 (2009).
  23. K. K. Smith, D. Gilcreast and K. Pierce, "Evaluation of Staff's Retention of ACLS and BLS Skills", Resuscitation, Vol. 78, No. 1, pp. 59-65 (2008). https://doi.org/10.1016/j.resuscitation.2008.02.007