• Title/Summary/Keyword: 심정지

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A Comparison of the Efficiency of Chest Compression Methods during Cardiopulmonary Resuscitation (소아 심폐소생술 중 가슴압박 방법의 효율성 비교)

  • Yun, Seong-Woo;Lee, Hyo-Ju
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.05a
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    • pp.388-390
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    • 2022
  • Cardiac arrest is a series of conditions that occur when the heart is stopped, regardless of the cause. Cardiac arrest due to heart disease is included in the cause of death in korea every year and is unpredictable. One of the only ways to save a patient's life when a cardiac arrest is cardiopulmonary resuscitation is to maintain circulation through this procedure. Therefore compared the quality of chest compressions with visual information using mirrors. There was a significant difference in the mean depth of chest compressions(48.93±6.76, 53.86±4.56, <0.001), and there was also a difference in compression to relaxation ratio(0.87±0.13, 0.96±0.10, <0.002). There was also a significant difference in attitude awareness(4.93±0.85, 8.14±1.38, <0.001).

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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.

A Case of Resuscitation of an Electrocuted Child by a 119 Paramedic (감전으로 심정지된 소아환자 소생 1례)

  • Lee, Jae-Min;Kim, Dae-Won;Yun, Hyeong-Wan
    • Fire Science and Engineering
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    • v.34 no.4
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    • pp.135-140
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    • 2020
  • The purpose of this study was to prevent electric shock to children. children are at high risk of electrocution by accidents. In the present case, a 2-year-old child was electrocuted after inserting metal chopsticks into a home outlet. In this case, professional advanced cardiac life support (ACLS) was properly performed by a 119 paramedic, resulting in the return of spontaneous circulation (ROSC) in the child. There are very few successful cases of resuscitation of patients involved in electric shock accidents in Korea, and we report a case of ROSC and discharge and proper resuscitation by a 119 paramedic.

Coronary Artery Bypass Surgery Using Retrograde Cardioplegics (역행성 심정지액을 이용한 관상동맥 우회술)

  • Mun, Hyeon-Jong;Kim, Gi-Bong;No, Jun-Ryang
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.27-33
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    • 1997
  • Retrograde myocardial protection is widely accepted in CABG operation because of the limitations of the antegrade method in the coronary arterial stenosis lesions. We analyzed 76 c ses of retrograde myocardial protection among 96 cases of CABG operation performed between April 1994 and August 1995, There were 48 males and 25 females, and the mean age was 58.2 $\pm$ 8.3 years. 53 patients (70%) were operated for unstable angina, 14 (18%) for stable angina, 6 (8%) for post-infarct angina, 1 (1%) for acute myocardial infarction, and 2()%) for failed PTCA. Preoperative coronary angiography revealed 3-vessel disease in 42 cases, 2-vessel disease in 11, 1-vessel disease in 10, and left main disease in 13 cases. We used SVG(63 cases), LIMA(69 cases), RIMA(11 cases), radial artery(6 cases), and gastroepiploic artery(1 case) for the grafts. Mean anastomosis was 3.2 $\pm$ 1.1. We protected the myocardium with antegrade induction and retrograde maintenance in all the cases except a case of retrograde induction and maintenance. During the aortic cross-clamping, blood cardioplegia was administered intermittently in 19 cases, and continuously in 57 In 39 cases, we used retrograde ardioplegia and antegrade perfusion of RCA graft simultaneously. We had no operative motality. Perioperative complications were arrhythmia in 15 cases, perioperatve myocardial infarction in 10, low cardiac output syndrome In 8, transient neurologic problem in 7, transient psychiatric problem in 6, ARF in 3, bleeding in 2, pneumonia in 2, wound infection in 1, and duodenal ulcer perforation in 1 . In this report, we experienced 76 cases of CABG operation with retrograde myocardial protection under the acceptable operative risk without operative mortality.

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Clinical Experiences of Continuous Tepid Blood Cardioplegia; Valvular Heart Surgery (미온혈 심정지액의 임상적 고찰)

  • 이종국;박승일;조재민;원준호;박묘식
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.130-137
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    • 1999
  • Background: In cardiac surgery, hypothermia is associated with a number of major disadvantage, including its detrimental effects on enzymatic function, energy generation and cellular integrity. Warm cardioplegia with normothermic cardiopulmonary bypass cause three times more incidence of permanent neurologic deficits than the cold crystalloid cardioplegia with hypothermic cardiopulmonary bypass. Interruptions or inadequate distribution of warm cardioplegia may induce anaerobic metabolism and warm ischemic injury. To avoid these problems, tepid blood cardioplegia was recently introduced. Material and Method: To evaluate whether continuous tepid blood cardioplegia is beneficial in clinical practice during valvular surgery, we studied two groups of patients matched by numbers and clinical characteristics. Warm group(37$^{\circ}C$) consisted of 18 patients who underwent valvular surgery with continuous warm blood cardioplegia. Tepid group(32$^{\circ}C$) consisted of 17 patients who underwent valvular surgery with continuous tepid blood cardioplegia. Result: Heartbeat in 100% of the patients receiving continuous warm blood cardioplegia and 88.2% of the patients receiving continuous tepid blood cardioplegia converted to normal sinus rhythm spontaneously after removal of the aortic cross clamp. There were no differences between these two groups in CPB time, ACC time, the amount of crystalloid cardioplegia used and peak level of potassium. During the operation, the total amount of urine output was more in the warm group than the tepid group(2372${\pm}$243 ml versus 1535${\pm}$130 ml, p<0.01). There were no differences between the two groups in troponin T level measured 1hr and 12hrs after the operation. Conclusion: Continuous tepid blood cardioplegia is as safe and effective as continuous warm blood cardioplegia undergoing cardiac valve surgery in myocardial protection.

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Concept Analysis of Cardiac Arrest: Identifying the Critical Attributes and Empirical Indicators (심정지(Cardiac Arrest)에 대한 개념분석: 개념적 속성 및 경험적 지표의 규명)

  • Lee, Kang Im;Oh, Hyun Soo
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.573-583
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    • 2014
  • Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

Incidence of Peripheral Cyanosis in Patients with Therapeutic Hypothermia after Cardiac Arrest in the Acute Care Unit of a Tertiary General Hospital (일개 상급종합병원 응급중환자실 내 심정지 후 저체온요법을 적용한 환자의 말초 청색증 발생 현황)

  • Bang, Soo Youn;Yi, Young Hee
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.128-140
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    • 2021
  • Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

The clinical Analysis of the Intermittent Warm Blood Cardioplegia by Admixing Potassium Only (포타슘만을 이용한 간헐적 온혈액 심정지술의 임상적 고찰)

  • Song, Hyun;Lim, Han-jung;Je, Hung-kon;Yu, Yang-gi;Sorkine, Vitality;Matsuda, Naruto;Choo, Suk-Jung;Lee, Jae-Won;Song, Myung-gun
    • Journal of Chest Surgery
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    • v.34 no.3
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    • pp.224-230
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    • 2001
  • 배경: 지속적인 온혈 심성지액을 이용한 심금 보호술이 소개된 이수, 이를 토대로 많은 임상결과가 발표되고 있다. 그러나 지속적 심정지액 주입에 따른 적정한 수술시야 확보와 역행성 관류법에 따른 우심실 보호에 대한 문제들이 제기 되고 있다. 이에 Antonio 등은 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여 만족할 만한 임상결과를 보고 하였다. 본 임상연구는 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여, 개심술을 시행 받은 70례의 환잔의 임상결과를 분석하여 그 유용성을 알아보고자 하였다. 대상 및 방법: 1998년 5월부터 1999년 1월까지 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여 관상동맥 우회술 및 판막수술을 시행한 70명의 환자와 같은 기간 간헐적 냉혈액 심성지술을 이용하여 동일 술자에 의해 수술을 시행한 70명의 임상결과를 비교 분석하였다. 결과: 총 심폐기 사동 시간(98.7$\pm$6.0분, 114.3$\pm$7.5분, p=0.018),수술중 심정지를 위해 필요한 심정지액의 양(1463.0$\pm$68.0cc, 3584.0$\pm$179.0cc, p<0.001), 의식이 회복될 때까지의 시간(3.5$\pm$0.4시간, 4.9$\pm$0.8시간, p=0.044), 기관 삽관의 제거까지의 시간(10.8$\pm$0.8시간, 13.2$\pm$0.6시간, p=0.017), 부정액으로 리도케인(Lidocaine)의 도움이 필요한 경우(75.2$\pm$6.8mg, 114.5$\pm$7.2mg, p=0.006)등에 있어서는 포타슘만을 이용한 간헐적 온혈액 심정지술이 유의성의 있었고, 술수 심근효소의 상승, 사망률과 이환율에 있어서는 두군간의 유의성은 없었다. 결론: 관상동맥 우회술 및 판막수술에 있어 포타슘만을 이용한 간헐적 온혈액 심정지술은 적어도 간헐적 냉혈액 심정지술과 같은 정도의 심근 보호를 할 수 있었으며, 기존의 warm heart surgery의 장점인 심폐기 가동시간이 짧고, 의식회복이 빠른 점과 함께 용적과부학(volume loading)를 줄일 수 있는 장점이 있어 유용한 심근 보호술의 하나로 사료된다.

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The effect of portal compression sensor on the quality of chest compressions during cardiopulmonary resuscitation (CPR): A mannequin based simulation study (심페소생술 시행 시에 휴대용 압박 센서 활용이 흉부압박의 질에 미치는 영향: 마네킹 기반 시뮬레이션 연구)

  • Yang, Hyun-Mo;Baeck, Kyung-Min;Kim, Kwang-Suk;Yoon, Byung-Gil;Kim, Jin-Woo;Kim, Hoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.2
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    • pp.744-750
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    • 2013
  • This study is to collect a basic data of how Cardiopulmonary Resuscitation (CPR) procedure can influence to cardiac arrest patient with and without the Depth Device during the average transport time period. The data has achieved by comparing result sheet of CPR procedure by hands only versus with Depth Device by twenty 1st and 2nd class Emergency Medical Technician (EMT) from five different fire stations in city of Chong-Ju, and twenty Emergency Rescue major students who completed the BLS provide course. The experiment participators experienced loss of compression depth and rate increase over time. However, the CPR procedure with Depth Device shows that both EMT and students to allow maintaining both the compression depth and rate. The experiment leaves a positive result for CPR operators and considers being valuable domain for cardiac arrest patient.