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

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

A Comparative Study on Defibrillation Efficiency According to Defibrillation Type

제세동 유형에 따른 제세동 효율성 비교 연구

  • Lee, Hyeon-Ji (Department of Emergency Medical Technology, Kangwon Graduate University) ;
  • Hwang, Jeong-Hyeon (Department of Emergency Medical Technology, Kyungil University)
  • 이현지 (강원대학교 응급구조학과) ;
  • 황정현 (경일대학교 응급구조학과)
  • Received : 2017.06.05
  • Accepted : 2017.07.07
  • Published : 2017.07.31
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study was to examine the defibrillation efficiency according to the defibrillator type among paramedics by making a comparative analysis of the chest compression pause time and defibrillation efficiency after providing simulation education. The subjects in this study were 15 paramedics who were selected from a provincial 119 safety center. The experiment was conducted using a single-group pretest-post test design from March 2 to August 31, 2016. The collected data were analyzed by SPSS WIN 21.0, and a frequency analysis was conducted. The findings of this study were as follows: First, there was a significantly greater decrease in the chest compression pause time during CPR after providing simulation education when semi-automated defibrillators were used than when manual paddles and manual pads were employed. Second, there was a statistically significant decrease in the performance time of defibrillation when semi-automated defibrillators were used than when manual paddles and manual pads were used. The findings of this study are expected to provide paramedics with simulation education on how to promptly read ECGs using the manual mode of a semi-automated defibrillator to help more patients revive and on how to facilitate their job enlargement.

본 연구는 1급 응급구조사들을 대상으로 제세동 유형에 따른 제세동 효율성을 비교하기 위해 시뮬레이션 교육을 적용하여 가슴압박 중단시간, 제세동 효율성을 비교 분석하여 제세동 효율성을 알아보고자 함이다. 이를 위해 2016년 3월 2일부터 8월 31일까지 K도에 소재하고 있는 소방서 구급대원 중 1급 응급구조사 15명을 대상으로 단일군의 교육 전 후 설계 실험연구이다. 수집된 자료는 Windows용 SPSS Win 21.0을 사용하였다. 연구 결과는 다음과 같다. 첫째, 시뮬레이션 교육 후 심폐소생술 과정 중 가슴압박 중단시간은 반자동제세동기의 수동패들과 수동패드를 사용했을 때 유의미하게 시간이 감소하였다. 둘째, 제세동 수행시간은 반자동제세동기의 수동패들과 수동패드를 사용할 때 통계적으로 유의미하게 시간이 감소하였다. 이러한 결과로 보아 시뮬레이션 교육을 통해 1급 응급구조사의 반자동 제세동기의 수동모드를 이용한 신속한 심전도 판독 및 제세동을 통해 환자 소생률을 높이며 응급구조사 업무확대를 할 수 있는 기초자료로 제시하고자 한다.

Keywords

References

  1. Cause of death, Korea Statistical Office, kostat.go.kr, 2016.
  2. Hinchey PR, Myers JB, Lewis R, De Maio VJ, Reyer E, Licatese D, Zalkin J, Snyder G. 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. Annals of Emergency Medicine, vol. 56, no. 4, pp. 348-357, 2010. DOI: https://doi.org/10.1016/j.annemergmed.2010.01.036
  3. Woodall J, McCarthy M, Johnston T, Tippett V, Bonham R. Impact of advanced cardiac life support-skilled paramedics on survival from out-of-hospital cardiac arrest in a statewide emergency medical service. Emergency Medicine Journal, vol. 24, no. 2, pp. 134-138, 2007. DOI: https://doi.org/10.1136/emj.2005.033365
  4. S. O. Hwang, K, S, Lim. Cardiopulmonary resuscitation and advanced cardiovascular life support. koonja publisher, pp. 249-250, 2016.
  5. Pytte M, Pedersen TE, Ottem J, Rokvam AS, Sunde K. Comparison of hands-off time during CPR with manual and semi-automatic defibrillation in a manikin model. Resuscitation, vol. 73, no. 1, pp. 131-136, 2007. DOI: https://doi.org/10.1016/j.resuscitation.2006.08.025
  6. Berg RA, Hilwig RW, Kern KB, Sanders AB, Xavier LC, Ewy GA. Automated external defibrillation for prolonged ventricular fibrillation: lethal delays of chest compression before and after countershocks. Annals of Emergency Medicine, 42, pp. 458-467, 2003. DOI: https://doi.org/10.1067/S0196-0644(03)00525-0
  7. Christenson J, Andrusiek D, Everson-Stewart S, Kudenchuk P, Hostler D, Powell J. Chest compression fraction determines survival in patients with out-of-hospital ventricular fibrillation. Circulation, vol. 120, no. 13, pp. 1241-1247, 2009. DOI: https://doi.org/10.1161/CIRCULATIONAHA.109.852202
  8. W.G. Tomkins, A.H. Swain, M. Bailey, P. D. Larsen, Beyond the pre-shock pause: the effect of prehospital defibrillation mode on CPR interruptions and return of spontaneous circulation Resuscitation, 84, pp. 575-579, 2013. https://doi.org/10.1016/j.resuscitation.2012.12.018
  9. J. Y. Jang, C. B. Park, E. J. Lee, Y. J. Lee, S. D. Shin, K. J. Song. Diagnostic Test Performance Characteristics of ST-segment Elevation Myocardial Infarction by Level 1 Emergency Medical Technicians Before vs After an Electrocardiogram Education Program, vol. 21, no. 5, pp. 539-545, 2010. DOI: https://doi.org/10.1016/j.resuscitation.2012.12.018
  10. R. Partridge, Q. Tan, A. Silver, M. Riley, F. Geheb, R. Raymond. Rhythm analysis and charging during chest compressions reduces compression pause time, Resuscitation, 90, pp. 133-137, 2015. DOI: https://doi.org/10.1016/j.resuscitation.2015.02.025
  11. Sheldon Cheskes, Robert H. Schmicker, Jim Christenson, David D. Salcido, Tom Rea, Judy Powell, Dana P. Edelson, Rebecca Sell, Susanne May, James J. Menegazzi, Lois Van Ottingham, Michele Olsufka, Sarah Pennington, Jacob Simonini, Robert A. Berg, Ian Stiell, Ahamed Idris, Blair Bigham, Laurie Morrison. Perishock Pause:An Independent Predictor of Survival From Out-of-Hospital Shockable Cardiac Arrest. Circulation, 124, pp. 58-66, 2011. DOI: https://doi.org/10.1161/CIRCULATIONAHA.110.010736
  12. Sheldon Cheskes, Morgan Hillier, Adam Byers, P. Richard Verbeek, Ian R. Drennan, Cathy Zhan, Laurie J. Morrison. The association between manual mode defibrillation, pre-shock pause duration and appropriate shock delivery when employed by basic life support paramedics during out-of-hospital cardiac arrest. Resuscitation, 90, pp. 61-66, 2015. DOI: https://doi.org/10.1016/j.resuscitation.2015.02.022
  13. B. H. Jeon. Comparison of automated and manual modes in multimodal defibrillator with manikin model-in aspect of interrupting chest compression, and accuracy of ECG rhythm analysis, Chung Ang University, 2014.
  14. S. E. Park., D. M. Shin. The Changes of Defibrillation Time Depending on the Manual External Defibrillator Device. Journal of the Emergency Medical Technology, vol. 16, no. 1, pp. 81-90, 2012.
  15. Benedikte Mahl Halle, Henriette Ullerup-Aagaard, Lars Folkestad, and Mikkel Brabrand. Time and safety in defibrillation with paddles versus pads; a comparative study of two defibrillation regimes. Scand J Trauma Resusc Emerg, vol. 20, no. 2, pp. 50, 2010.
  16. Richard M Heames, Daniel Sado, Charles D Deakin. Do doctors position defibrillation paddles correctly Observational study, vol. 322, no. 7299, pp. 1393-1394, 2001. https://doi.org/10.1136/bmj.322.7299.1393
  17. K. Y. Lee, S. W. Yun. Prehospital Care of 119 EMT for Non-traumatic Cardiac Arrest and Improvement to Increase Advanced Care Rate. Journal of the Korean Institute of Fire Science & Engineering, vol. 25, no. 5, pp. 21-31, 2011.
  18. C. H. Kim, G. W. Kim, W. C. Cha, B. R. Kang, H. H. Do, J. S. Seo. For how long can two emergency medical technicians perform high-quality cardiopulmonary resuscitation?, Journal of International Medical Research, vol. 43, no. 6, pp. 841-850, 2015. DOI: https://doi.org/10.1177/0300060515595648
  19. S. H. Bang, J. H. Kim, G. Y. Kim, S. G. Roh, A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on one Area Heart Saver, Journal of the Korean Institute of Fire Science & Engineering, vol. 27, no. 4, pp. 61-67, 2013. DOI: https://doi.org/10.7731/KIFSE.2013.27.4.61
  20. H. R. Kim. Development and Effect of Team Based Simulation Learning Program on Undergraduate Nursing Students, Chosun University, 2012.
  21. I. H. Song. Developments and Effects of Simulation-based Education Program for Hyperglycemia Patient Emergency Nursing Care, Sahmyook University, 2015.
  22. D. A. Pearson, R. Darrell Nelson, Lisa Monk, Clark Tyson, James G. Jollis, Christopher B. Granger, Claire Corbett, Lee Garvey, Michael S. Runyon. Comparison of Team-Focused CPR vs Standard CPR in Resuscitation from Out-of-Hospital Cardiac Arrest: Results from a Statewide Quality Improvement Initiative. Resuscitation, 105, pp. 165-172, 2016. DOI: https://doi.org/10.1016/j.resuscitation.2016.04.008
  23. T. Y. Moon, The Effects of Trauma-patient Training Education Using Simulation on Knowledge, Satisfaction and Problem-solving in Emergency medical Students. Journal of the Korea Academia-Industrial cooperation Society, vol. 17, no. 4, pp. 710-717, 2016. DOI: http://dx.doi.org/10.5762/KAIS.2016.17.4.710