• Title/Summary/Keyword: 심장 정지

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Analysis of characteristics of out-of-hospital cardiac arrest patients by region in Chungcheong buk-do (충청북도 내 지역별 병원 전 심장정지 환자의 특성에 대한 분석)

  • Seong Bin Im;Hyeon Mo Yang;Young Jae Kim
    • Smart Media Journal
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    • v.13 no.5
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    • pp.33-44
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    • 2024
  • Chungbuk has various regional characteristics in terms of population composition by region, industrial facilities, and distribution of emergency medical institutions. However, there are no studies yet that have analyzed regional characteristic factors related to the occurrence characteristics of cardiac arrest patients. Therefore, this study provided basic data to establish a response system for OHCA patients suitable for the characteristics of the Chungcheongbuk-do region by analyzing the characteristics of OHCA patients and the transfer status of 119 paramedics in Chungcheongbuk-do. This study is a retrospective study that analyzed 1,188 cardiac arrest patients transferred by ambulance based on raw data from the survey on acute cardiac arrest in Chungbuk (2020). There are a total of 11 emergency medical institutions in Chungbuk-do, which are concentrated in city-level areas, so the transfer time of patients to hospitals in county-level areas was delayed. In the county-level area, the frequency of dispatch of special paramedics was relatively small, and the frequency of administration of cardiac arrest drugs to help resuscitate cardiac arrest patients was also low. In conclusion, efforts should be made to improve accessibility of emergency medical services (deployment of emergency vehicles in marginal areas, proper placement of emergency medical institutions, etc.), to promote prevention of traumatic cardiac arrest patients, and to expand the scope of work to strengthen the first aid expertise of paramedics.

Mathematical Programming and Optimization of the Resource Allocation and Deployment for Disaster Response : AED case study (수리계획법을 활용한 방재자원 배치 최적화: AED 배치 사례)

  • Hwang, Seongeun;Lee, Nagyeong;Jang, Dongkuk;Shin, Dongil
    • Journal of the Korean Institute of Gas
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    • v.25 no.3
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    • pp.53-58
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    • 2021
  • The number of patients with cardiovascular diseases who experience an out-of-hospital cardiac arrest (OHCA) are increasing among young adults as well as the aged population. An automated external defibrillator (AED) is vital in improving survival rates of OHCA victims. Survival rates of OHCA were shown to decline exponentially in time to defibrillation, yet studies in Korea are uncommon that captures the properties of their survival rates in examining optimal locations of AEDs. In this study, we worked on the maximal gradual coverage location problem (MGCLP) with exponential decay coverage function to decide on their optimal locations. The exponential decay coverage function mitigates the drawback of over-estimating survival rates of OHCA patients. It is expected that a more sophisticated facility location problem will be developed to identify the "emergent" characteristics of pedestrians who responds to the OHCA occurrence by incorporating random pedestrian locations and movement through simulation.

Successful Resuscitation of Cardiac Arrest with Acute Massive Pulmonary Embolism during Operation Using Percutaneous Cardiopulmonary Support (PCPS) - A case report - (수술 중 발생한 다량의 급성 폐동맥 색전증에 의한 심장 정지의 경피적 심폐 보조를 사용한 성공적 소생 - 1예 보고 -)

  • Park, Kyung-Taek;Kim, Yeon-Soo;Jang, Woo-Ik;Kim, Chang-Young;Ryoo, Ji-Yoon;Kwon, Sung-Uk
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.273-276
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    • 2008
  • Since the introduction of extracorporeal cardiopulmonary support of cardiac arrest in 1983, emergent cardiopulmonary support has been used to treat cardiac arrest. Acute massive pulmonary embolism is associated with a high mortality rate and it poses a challenge for both the anesthesiologist and the surgeons especially during operations. This report describes the use of the emergent bypass system in the effective management of an intraoperative massive pulmonary embolism and cardiac arrest in a 56-year-old woman. The patient was discharged on warfarin and there was no recurrence of the pulmonary embolism at the follow-up visit.

Radionuclide Cerebral Angiography: A Confirmatory Test for the Diagnosis of Brain Death (동위원소 뇌혈관 촬영술을 이용한 뇌사의 판정)

  • Choe, Jae-Gol;Lee, Min-Jae
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.230-234
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    • 1992
  • 뇌와 뇌간의 모든 기능이 정지되어 인공적으로 심폐 기능은 유지되고 있더라도 뇌의 혈액순환은 중지되고 전체 뇌에 경색이 있어 회복이 불가능한 상태를 뇌사라 한다. 이렇게 뇌와 뇌간의 모든 기능이 정지된 이후에는 곧 심장 정지가 뒤따른다. 심장과 폐의 기능 정지에 의해 죽음을 정의하는 것은 심폐소생 장치 및 생명유지 장치의 효과적인 발달로 이제는 뇌자체의 기능을 평가하는 것으로 대치되게 되었다. 최근 장기 이식술의 발달로 혈액순환을 비롯한 식물적인 기능은 인공적으로 유지되는 상태에서 가능한한 빠른시간내에 적용할 수 있는 뇌사판정 방법의 필요성이 대두되었다. 그래서 이러한 판정을 하는데 소요되는 시간을 줄이기 위한 뇌사를 확신할 수 있는 여러가지 진단 방법에 대한 관심이 고조되었다. 동위원소 뇌혈관촬영술도 이런 진단방법중 하나로 뇌혈액순환의 정지를 보여줌으로써 임상적으로 뇌사를 진단하는 데 보조적인 방법으로 사용될 수 있다.

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Out-of-Hospital Resuscitation of Cardiac Arrest by 119 Emergency Medical Service System (119구급대에 의해 소생한 병원 전 심장정지 환자 1례)

  • Yun, Hyeong-Wan;Lee, Jae-Min;Jung, Ji-Yeon
    • Fire Science and Engineering
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    • v.24 no.5
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    • pp.142-149
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    • 2010
  • The aim of this study was to report the out-of-hospital resuscitation of cardiac arrest along with literature consideration. CPR is technology of resuscitating patient by maintaining oxygen supply to organ, by preventing progression from clinical death to biological death, and by recovering heart beat and circulation, through circulatory support of mechanical ventilation. It is not what every patient with cardiac standstill is revived even if being implemented CPR. Patient's survival rate is decided by how quickly and correctly CPR was executed. A patient, who wasn't witnessed the cardiac arrest on the field, was performed 5-cycle CPR for 2 minutes on the field before being transferred to hospital, and was allowed to be used AED. A person, who was observed, is recommended to be used AED immediately, and then is said to be needed ACLS (advanced cardiac life support). In the Out-of-Hospital stage, it is rare in a case that 119 Emergency Medical Service System transfers by being ROSC and in a case of executing ACLS. Cardiac arrest was witnessed on the field, but CPR wasn't executed. First-aid staff executed CPR after arriving, and led to ROSC on the field with ACLS, there by having experienced 1 case of a patient's surviving to leave hospital by being ROSC on the field.

The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

The Assessment of the Breath Hold and the Free Breath Methods about the Blood Flow Evaluation by Using Phase Contrast MRI (위상대조도 자기공명영상을 이용한 심장 혈류평가에 있어서 호흡정지 기법과 비 호흡정지 기법의 비교평가)

  • Kim, Seong-Ho
    • Journal of radiological science and technology
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    • v.39 no.2
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    • pp.149-156
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    • 2016
  • Measurement of cardiac blood flow using the magnetic resonance imaging has been limited due to breathing and involuntary movements of the heart. The present study attempted to improve the accuracy of cardiac blood flow testing through phase contrast magnetic resonance imaging by presenting the adequate breathing method and imaging variables by comparing the measurement values of cardiac blood flow. Each was evaluated by comparing the breath hold retrospective 1NEX and non breath hold retrospective 1-3NEX in the ascending aorta and descending aorta. As a result, the average blood flow amount/velocity of the breath hold retrosepctive 1NEX method in the ascending aorta were $96.17{\pm}19.12ml/sec$, $17.04{\pm}4.12cm/sec$ respectively, which demonstrates a statistically significant difference(p<0.05) with the non-breath hold retrospective method 1NEX of $72.31{\pm}13.27ml$ and $12.32{\pm}3.85$. On the other hand, the average 2NEX blood flow and mean flow velocity is $101.90{\pm}24.09$, $16.84{\pm}4.32$, 3NEX $103.06{\pm}25.49$, $16.88{\pm}4.19$ did not show statistically significant differences(p>0.05).The average blood flow amount/ velocity of the breath hold retrospective 1NEX method in the descending aorta were $76.68{\pm}19.72ml/s$, and $22.23{\pm}4.8$, which did not demonstrate a significant difference in comparison to non-breath hold retrospective method 1-3 NEX. Therefore, the non breath hold retrospective method does not significantly differ in terms of cardiac blood flow in comparison with the breath hold retrospective method in accordance with the increase of NEX, so pediatric patients or patients who are not able to breathe well must have the diagnostic value of their cardiac blood flow tests improved.

Factors Affecting Recovery of Spontaneous Circulation in Patients Before Cardiac Arrest in Emergency Department: 2012~2016 Focused on Medical Records Data (응급실 도착 전 심정지 환자의 자발순환 회복 여부에 미치는 요인 -2012~2016 의무기록 자료를 중심으로-)

  • Kim, Seok-hwan
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.209-233
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    • 2018
  • The purpose of this study was to ascertain whether or not to recover the spontaneous circulation of patients with cardiac arrest before arrival in the emergency room for 5 years (2012 to 2016), and try to investigate the factors affecting this. In this research, we used the "raw material for acute cardiac arrest survey" conducted in "Disease management headquarters" from 2012 to 2016 for the whole country of our country as the main material. In this study, 136,212 cardiac arrest patients were analyzed in the study data of the cardiac arrest in the country during the 5 years from 2012 to 2016. We performed a Chi-square analysis to analyze the recovery of spontaneous circulation before arrival in the emergency room according to general characteristics, social·demographic characteristics, and developmental characteristics. and We performed a Binary logistic regression analysis to determine the factors affecting the recovery of spontaneous circulation. The analysis results of this study show that whether CPR sustained transport before endoplasmic reticulum arrival, whether to witness an acute cardiac arrest before arrival in the emergency room, the type of general cardiopulmonary resuscitation, the location of acute cardiac arrest, the acute heart Causes of stoppage cause factor of whether spontaneous circulation recovery recovers before arrival of the endoplasmic reticulum(P<0.001, P<0.01). Therefore, it is necessary to strengthen systematic government health policy implementation and dissemination and health education focusing on factors that affect recovery of spontaneous circulation of cardiac arrest patients.

Surgical Management of Giant Aneurysm of Intracranial Artery Under Circulatory Arrest -one case report- (총순환정지를 이용한 두개강내 거대동맥류 치험 1례)

  • 홍종면;김오곤;이석재;홍장수;민경수;김상태;임승운;송우익
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.80-83
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    • 1999
  • Complete circulatory arrest with profound hypothermia has been an indispensable adjunct to the safe management of selected giant intracranial aneurysms. For the conduct of cardiopulmonary bypass, there are usually two kinds of methods, open and closed chest methods. We could manage one case of huge intracranial aneurysm that was successfully operated under circulatory arrest using the closed chest method, especially with percutaneous insertion of arterial and venous cannulas for cardiopulmonary bypass.

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Surgical Correction of Total Anomalous Pulmonary Venous Connection without Total Circulatory Arrest (완전 순환 정지 없이 시행한 총 폐정맥 환류 이상의 수술 교정)

  • Han Won Kyung;Cho Joon Yong;Lee Jong Tae;Kim Kyu Tae;Chang Bong Hyun;Lee Eung Bae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.12-17
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    • 2006
  • Background: Circulatory arrest under deep hypothermia is an important auxiliary means for surgical correction of total anomalous pulmonary venous connection (TAPVC), However, cardiac operations under deep hypothermic circulatory arrest are associated with the risk of post-arrest neurologic abnormalities. The purpose of this study is to evaluate the results of the surgical correction of total anomalous pulmonary venous connection without the total circulatory arrest. Materiai and Method: Between April 2000 and October 2004, hospital records of 10 patients were reviewed retrospectively. Result: The locations for abnormal anatomical connections were supracardiac in 7 cases, cardiac in 1 case, and infracardiac in 2 cases. The mean cardiopulmonary bypass time and aorta cross clamp time were 116.8$\pm$40.7 and 69.5$\pm$24.1 minutes. There was no surgical mortality. Postoperative complications were post-repair pulmonary venous stenosis in 1 case, pneumonia in 1, pneumothorax in 1, wound infection in 1,and diaphragmatic paralysis in 1. All patients without pulmonary venous stenosis were in NYHA class I at mean follow-up of 16.6 months (3$\∼$49 months) Conclusion: We could obtain excellent results by repair without the total circulatory arrest for total anomalous pulmonary venous connection.