한국응급구조학회지 (The Korean Journal of Emergency Medical Services)

  • 제25권3호
  • /
  • Pages.7-16
  • /
  • 2021
  • /
  • 1738-1606(pISSN)
  • /
  • 2384-2091(eISSN)
한국응급구조학회 (The Korea Society of Emergency Medical Services)
권호 표지
DOI QR코드

DOI QR Code

심폐소생술 시 아이젤의 고정 방법에 따른 환기량의 변화 비교: 시뮬레이션 마네킨을 이용한 연구

Comparison of changes in ventilation volume according to fixation method of I-gel during cardiopulmonary resuscitation: a study using a simulated manikin

  • 김선태 (원광대학교병원 응급의학과) ;
  • 신상열 (호원대학교 응급구조학과) ;
  • 최정우 (원광대학교 의과대학 응급의학교실)
  • Kim, Seon Tae (Department of Emergency Medicine, Wonkwang University Hospital) ;
  • Shin, Sang-Yol (Department of Emergency Medical Service, Howon University) ;
  • Choi, Jeong Woo (Department of Emergency Medicine, School of Medicine, Wonkwang University)
  • 투고 : 2021.10.27
  • 심사 : 2021.12.28
  • 발행 : 2021.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The I-gel device is Korea's most frequently used airway management method during pre-hospital cardiopulmonary resuscitation (CPR). This study aimed to compare changes in ventilation volume according to the fixation method with a simulated manikin. Methods: We placed I-gel into an advanced life support simulator and compared tape and band fixation conditions. CPR was performed according to the 2020 Korean CPR guidelines, using a mechanical chest compression device and an adult bag. The positional shift of I-gel and the ventilation volume of the simulated manikin were measured after performing CPR for 20 minutes. Five trials were carried out in each setting. Statistical analysis was carried out with SPSS 27.0. P < .05 was considered significant. Results: Positional shift after 20 minutes of CPR was as follows: tape fixation, 7.2 ± 0.2 mm; band fixation, no change, indicating a significant difference between the two groups (p=.003). The mean ventilation volume was tape fixation, 482.63 ± 30.84 mL; band fixation, 544.96 ± 22.98 mL, showing a significant difference (p=.002). Conclusion: When using the I-gel during pre-hospital CPR, using a band-type fixing device with elasticity rather than fixing the tape provides stable and appropriate ventilation by maintaining the fixed position.

키워드

과제정보

본 논문은 2021학년도 원광대학교 교비지원에 의해 수행되었음.

참고문헌

  1. Song KJ, Lee SY, Cho GC, Kim G, Kim JY, Oh J et al. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 3. Adult basic life support. Clin Exp Emerg Med 2021 May;8(S):S15-S25. https://doi.org/10.15441/ceem.21.024
  2. National Fire Agency. Statistical analysis of emergency activities in 2021. Available at: https://nfa.go.kr/nfa/releaseinformation/statisticalinformation/main/
  3. Lim TH. Non invasive airway management. In The Korean Society of Emergency Medicine, Emergency Medicine. Seoul: Koonja Publishing Co. 2011. 305-11.
  4. Cho NS. Endotracheal intubation and Mechanical ventilation. In The Korean Society of Emer gency Medicine, Emergency Medicine. Seoul: Koonja Publishing Co., 2011. 323-35
  5. A comparison of supraglottic airway i-gelTM vs. classic laryngeal mask airway in small children. Korean J Anesthesiol 2014;66(2):127-30. https://doi.org/10.4097/kjae.2014.66.2.127
  6. Beringer RM, Kelly F, Cook TM, Nolan J, Hardy R, Simpson T et al. A cohort evaluation of the paediatrici-gelTM airway during anaesthesia in 120 children. Anaesthesia 2011;66:1121-6. https://doi.org/10.1111/j.1365-2044.2011.06884.x
  7. Beylacq L, Bordes M, Semjen F, Cros AM. The I-gel, a single-use supraglottic airway device with a non-infla table cuff and an esophageal vent: an observational study in children. Acta Anaesthesiol Scand 2009;53:376-9. https://doi.org/10.1111/j.1399-6576.2008.01869.x
  8. Lee JR, Kim MS, Kim JT, Byon HJ, Park YH, Kim HS et al. A randomised trial comparing the i-gel(TM) with the LMA Classic(TM) in children. Anaesthesia 2012;67:606-11. https://doi.org/10.1111/j.1365-2044.2012.07072.x
  9. Levitan RM, Kinkle WC. Initial anatomic investigations of the I-gel airway: a novel supraglottic airway without inflatable cuff. Anaesthesia 2005;60:1022-6. https://doi.org/10.1111/j.1365-2044.2005.04258.x
  10. Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. I-gel insertion by novices in manikins and patients. Anaesthesia 2008;63:991-5. https://doi.org/10.1111/j.1365-2044.2008.05542.x
  11. Klaver NS, Kuizenga K, Ballast A, Fidler V. A comparison of the clinical use of the laryngeal tube S and the ProSeal laryngeal mask airway by first-month anaesthesia residents in anaesthetised patients. Anaesthesia 2007;62:723-7. https://doi.org/10.1111/j.1365-2044.2007.05073.x
  12. Kitano M, Komasawa N, Fujiwara S, Minami T. Comparison of positional shift of supraglottic devices resulting from chest compressions: simulation using a manikin and automated chest compression system. Acute Med Surg 2014;2 (2):134-7. https://doi.org/10.1002/ams2.85
  13. National Fire Agency. 119 Standard Guidelines for on-site emergency response by paramedics in 2021. Available at: https://nfa.go.kr/nfa/publicrelations/legalinformation/archives/
  14. Kim JH, Cho JS, Lim YS et al. The current state of airway management and ventilation at the pre-hospital stage by emergency medical technicians. J Korean Soc Emerg Med 2011;22:129-41.
  15. Davies JD, Costa BK, Asciutto AJ. Approaches to manual ventilation. Respir Care 2014;59:810-22. https://doi.org/10.4187/respcare.03060
  16. Becker DE, Rosenberg MB, Phero JC. Essentials of airway management, oxygenation, and ventilation: part 1: basic equipment and devices. Anesth Prog 2014;61:78-83. https://doi.org/10.2344/0003-3006-61.2.78
  17. Ufberg JW, Bushra JS, Karras DJ, Satz WA, Kueppers F. Aspiration of gastric contents: association with prehospital intubation. Am J Emerg Med 2005;23:379-82. https://doi.org/10.1016/j.ajem.2005.02.005
  18. Koh JM, Kim Jo, Jo JM. Improvement device on scope of practice of paramedic in the emergency medical service's act. Korean J Emerg Med Ser 2007;11(3):17-30.
  19. Kim YL, Lee HY, Kim GW, Jo HS, Jung JH. Comparative study of prehospital airway devices tested using a manikin model: a comparison of the laryngeal airway classic(LMA Classic TM), Cobra perilaryngeal airway(Cobra PLATM) and the King laryngeal tube(King LTTM). Korean J Emerg Med Ser 2010;21(6):776-82.
  20. Kokkinis K. The use of the laryngeal mask airway in CPR. Resuscitation 1994;27(1):9-12. https://doi.org/10.1016/0300-9572(94)90015-9
  21. Rumball CJ, MacDonald D. The Ptl, combitube, laryngeal mask, and oral airway: a randomized prehospital comparative study of ventilatory device effectiveness and cost-effectiveness in 470 cases of cardiorespiratory arrest. Prehosp Emerg Care 1997;1(1):1-10. https://doi.org/10.1080/10903129708958776
  22. Kim SE, Jung MA. Emergency medical technology curriculum development for college. Korean J Emerg Med Ser 2008;12(2):5-26.
  23. Choi GJ, Kang H. Safety and clinical usefulness of supraglottic airway device. Korean Med Assoc 2015;58(10):905-14. https://doi.org/10.5124/jkma.2015.58.10.905
  24. Park SK, Choi GJ, Choi YS, Ahn EJ, Kang H. Comparison of the i-gel and the laryngeal mask airway proseal during general anesthesia: a systematic review and meta-analysis. PLOS ONE 2015;10:e0119469. https://doi.org/10.1371/journal.pone.0119469
  25. Tak YJ. Comparison of three supraglottic airway devices in neutral and cervical neck collar position. Journal of Digital Convergence 2016;14(12):369-75. https://doi.org/10.14400/JDC.2016.14.12.369
  26. Jung JY, Kim HJ, Choi HJ. Simulation of healthcare provider's safety on emergency transportation using advanced airway: extension tube usage or not. J Korean Soc Emerg Med 2019;30(2):140-6.
  27. Barr S, Smith G, Darroch S. Use of supraglottic airway devices by paramedics in the management of adult prehospital cardiac arrest patients: a literature review. Australas J Paramedicine 2017;14(1). https://doi.org/10.33151/ajp.14.1.500