• 한국응급구조학회지
• /
• 제8권1호
• /
• pp.149-160
• /
• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

• 한국응급구조학회지
• /
• 제8권1호
• /
• pp.71-86
• /
• 2004

This study selected emergency medical technicians at 24 fire police boxes in Jeonnam in order to examine the relationship between job stress, fatigue and job satisfaction of 119 emergency medical technicians. Data were collected from Apr. 10 to May 9, 2004, questionnaires were mailed and returned by mail. Total 109 questionnaires were distributed and 89 questionnaires were collected and 80 except 9 omitting answers and showing inappropriate answers were used for final analysis. The results of this study are as follows. A. The total mean of areas composing job stress in the degree of job stress of 119 emergency medical technicians was over the average as 2.54 (SD .44) of 4 full marks. According to the degree of job stress by each area, the highest area of job stress was crisis situation (2.98), followed by role conflict as professional job (2.58), social factors (2.57), involvement in organization (2.55). To the contrary, the areas of the lowest job stress were professional knowledge and technique (2.35), psychological burden of medical limitation (2.38), conflicts in personal relationship and services (2.45) and improper treatment (2.53). B. The degree of fatigue of 119 emergency medical technicians by areas was over mean as 2.09(SD .49) of 4 full scores and physical fatigue was highest (2.18), followed by mental fatigue (2.11) and neurosensory fatigue (1.99). C. The degree of job satisfaction of 119 emergency medical technicians was 2.71 of 5 full scores and working condition area (3.70) showed the highest job satisfaction, followed by requirement of organization (2.85) and the lowest job satisfaction area was job itself (2.18), followed by desire for job (2.49). D. According to differences in demographical characteristics of 119 emergency medical technicians, there was no variable of statistical difference at job stress and job satisfaction in significance level .05, but fatigue showed statistical difference at final education (F=2.393, p=.046). E. According to differences related to job characteristics of 119 emergency medical technicians, job stress showed statistical differences at motif of current services (F=4.935, p=.003), fatigue showed those at health conditions (F=2.732, p=.008), job satisfaction at overtime (F=3.038, p.034) and the greatest reason of having job (F=3.217, p=.017), F. As a result of analyzing correlations between job stress. fatigue and job satisfaction of the subject, job stress showed positive correlations (r=.411, p=.000) with fatigue and negative correlation (r=-.267, p=.008) with job satisfaction. Fatigue showed negative correlation (r=-.287, p=.005) with job satisfaction. Therefore, the hypothesis of this study. "There will be relationship between degree of stress, fatigue and job satisfaction of subjects." was supported.

• 한국응급구조학회지
• /
• 제9권2호
• /
• pp.147-168
• /
• 2005

It examined the doubt point which AED motive relates until now, the AED should have bought a life how, present address of our country site pre-hospital care, comparison it tried to observe the advanced nation instance back. Gist of this research the AED important cold region once compared to informed to how many cardiac arrest patient, against him the what kind of preparation wanted informing the necessary cold region. It soaks simultaneously but the AED motive is widely supplied distant in future and it is generality and it is feeble but it wanted doing one morning. The habit difference of an American who does of course meat diet mainly and a Korean is many and it compares in the United States and the cardiac arrest patient comparison occurs holds a point few. To become Western anger but and be caused by with thin dietary life, stanching bleeding cung, with the fact that the heart attack is increasing rapidly with the hyperextension. It is a talk which anyone it knows all. The major league most Choi huy Sub in condition will catch the ball which floats and the multi co-player and to collide when falling down, the medical device which is committed with emergency aid is AED motive. From the United States subway station and the shopping which are a public place on the baseball field outside the jar which it will drive, the museum and the school, easily there is it will be able to discover the AED from the court of justice back. The Pittsburg university the students per the individual $30 the core phyey were receiving the smallness lifestyle alcoholic beverage and a AED motive actual training with mercy of degree. From the United States distant in future the AED motive is sold even from the retail store and. From our country like this plan government offices temporary disposal education from from 119 fire fighters emergency structure company in fire fighting government employee and nursing must magnify a former enterprise rainy spell in summer multi temporary disposal education with the head which it will burn with the head. This plan in early rising will be able to become fixed in Korea it forecasts with the fact that. The research which it sees it leads and like the United States to some day become fixed even from our country to believe and suspicion it is not and in the people in approach ease one AED supply plan fire fighting government employees stand in the first and feed with the fact that must be positive at this enterprise they become.

• 한국응급구조학회지
• /
• 제9권2호
• /
• pp.55-78
• /
• 2005

The purpose of this study was to provide basic data for the improvement of the guidelines and training programs regarding the cardiopulmonary resuscitation performance of bystanders who can respond to the incidents in earlier times as the first responder of the cardiac arrest incident, by reviewing the performance of basic CPR and the influencing factors after providing 70 students of Department of Emergency Medical Technology with the CPR training. For the purpose of the study, the collected data were computerized and analyzed by SPSS-WIN program(ver. 10.1). The results for this study were as follows The duration of session between the groups in the BLS CPR were 3 minutes and 36 seconds, 2 minutes and 32 seconds respectively. The average compression number per minute were 24.3 times and 33,2 times respectively(p=.000), and the average compression rate per minute were 112 times and 122 times respectively(p=.000). The average ventilation number per minute were 3.54 times and 5.1 times respectively(p=.000). The errors in compression "Too shallow" were 20.73 times(34.6%) and 23,23 times(38,7%) out of 60 times in 4 cycles with the standard of 38 nun. In CPR performance results according to gender in the first episode, males showed better results in compression depth as 41.5 mm comparing to females average 38.2 mm(p=.015). When ventilation results were compared according to the use of FS, the average ventilation number per minute, total ventilation per minute and the average volume per episode were significantly higher when FS was not used(<.040), There was no significant difference in ventilation accuracy between two groups. According to the results, we need to improve and distribute portable barrier devices, and to be familiar with those devices. We need to enforce ventilations as well as to include compressions so that faster and more accurate CPR can be performed. Additionally, we need to exclude ventilation only cases, minimize the interference time of chest compression due to inaccurate ventilation, simplify or minimize the complicatedness of CPR performance and responding time related to breathing, provide first responders with various training programs such as initial assessment and ventilations only, or initial assessment and chest compression-only CPR and than provide advanced training with AHA BLS education including CPR for more than two people according to CPR skills and target characteristics.

• 한국응급구조학회지
• /
• 제16권1호
• /
• pp.7-18
• /
• 2012

Purpose: The purpose of this study is to help care workers to do their best as first respondents by analysing their recognition, knowledge, and self-efficacy on basic CPR (cardiopulmonary resuscitation) that is directly connected to the lives of patients and thus their education and methods can be improved for their positive basic lifesaving work. Method: For this purpose 360 structured questionnaires were used to the subjects in the eastern area of Jeonnam province from June 20 to July 4, 2011. Of these questionnaires 217 were used excluding 113 incomplete, 27 error, and 3 male ones. The collected data were analysed by the real number, the percentage, the average, the standard deviation, t-test, ANOVA, and Tukey with SPSS WIN 18.0. Results: 1. In the view of subjects, those aged over 51 accounted for 96(44.2%) as the majority, high school graduates, 95(43.8%), worked for 1 or more than 1 year-less than 2 years, 66(30.4%), experienced to see persons collapsed losing their consciousness, 46(21.2%), took the education, 184(85.7%), had 1 session of education, 80(43%), got the last education for 2 or more than 2 years 68(37%), and practiced through mannequin for the education aids, 86(46.7%). 2. There was significant difference in the view of recognition with the length of work (p=.010) and experienced to see persons collapsed losing their consciousness (p=.020), in the view of knowledge with academic background (p=.040) and the length of work, and in the view of self-efficacy with academic background (p=.002), the length of work (p=.010) and experienced to see persons collapsed losing their consciousness (p=.000). 3. There was significant difference in the session of education (p=.000), last education (p=.025) and education aids for basic CPR. Self-efficacy had significant difference according to the session of education for basic CPR (p=.001) and the time of education (p=.000). 4. There was correlation between recognition and self-efficacy (r=.41). The higher the recognition is, the better the self-efficacy improves. However the correlation between knowledge and self-efficacy was so low that the former did not have influence on self-efficacy. Conclusions: It needs to offer education to the lifesaving workers based on their experiences. If there is education more than 2 sessions in a year with mannequin and the simulation providing sufficient hours, care workers' recognition would be increased resulting in higher self-efficacy and thus they could keep the role of active lifesaving worker at the first practical site.

• 한국응급구조학회지
• /
• 제16권1호
• /
• pp.81-90
• /
• 2012

Objectives: This study is to research delay time comparison for later defibrillation after hands off according to the changes in defibrillation electrodes. Study purpose: In defibrillation treatment that is the only way for cardiac arrest by arrhythmia, it is to find defibrillator device which can minimize late defibrillation delay time after important affect of hands off. Study object and method: After hands off according to the defibrillator device, we collected total 40 people for emergency medicine doctor, internal medicine doctor, general surgeon, nurse, emergency medical technician who are working at 2 CN, CS University hospitals in Gwangju Jeollanamdo district to find out hand off shock interval(HOSI). We then researched their general properties like occupation sector, experiences in clinic, gender, completion of AHA ACLS-P training and more. Then 40 participants continued ventricular fibrillation cardiac arrest simulation training (using human-model mannequin) designed by researcher and performed their roles as defibrillation operator. Each of participant used manual paddle and performed 4 times of defibrillation (150J) during 8 minutes of CPR and in 8day, the defibrillator devices were replaced from manual paddle to self-adhesive electrodes pads and 4 times of defibrillation (150J) under same simulation condition as manual paddle were performed. Study result: In comparison for delay time of later defibrillation after hands off of manual paddle and self adhesive electrodes pad, the self adhesive electrodes pad ($7.0{\pm}0.5sec$) seemed to reduce delay time of later defibrillation significantly (p<0.05) compared to manual paddle ($10.0{\pm}0.9sec$). The self adhesive electrodes pad, according to the general properties of participants, had no particular change in delay time after later defibrillation for the statistics (p>0.05) but the manual paddle had statistically significant differences for the occupation sector, experiences in clinic and gender (p<0.05). Conclusion: In defibrillation, the self adhesive electrodes pad($7.0{\pm}0.5sec$) showed short HOSI compared to manual paddle ($10.0{\pm}0.9sec$) significantly (p<0.05) and it applied identically for both existence and non-existence of ACLS-P training completion, experiences in clinic, gender and occupation sector. The manual paddle had also significant difference in experiences in clinic and occupation sector (p<0.05). which means the effect on HOSI according to the job mastery. Therefore, if the clinic experience is short or in case for the occupations without frequent defibrillation treatment has a danger of lowering success rate for the defibrillation using manual paddle. Therefore, it is true that using self adhesive electrodes pad for defibrillation electrodes when performing manual defibrillation in pre-hospital as well as in-hospital steps can generally minimize delay time of later defibrillation after hands off.

• 한국응급구조학회지
• /
• 제13권2호
• /
• pp.73-86
• /
• 2009

Purpose : This study is a descriptive correlation study to offer the basic materials for developing the preventive program of continuously increasing AIDS in the young people by examining the knowledge and attitude of AIDS in college students. Methods : The period of data collection was from May 1 to 15, 2009, 300 freshman, sophomore and junior students who understood the purpose of the research and agreed to participate in the questionnaire were randomly sampled, structured questionnaire was distributed to them and their responses were collected. Instruments used for this study included those used by Kim and Lee and revised and complemented by this researcher to measure the knowledge of AIDS and those by Yun and Lee revised and complemented by the researcher to measure the attitude of AIDS. For data analysis, it measured technical statistics, t-test, ANOVA, and Pearson's correlation coefficient using SPSS/PC 12.0. Results : The results of this study are summarized as follows. 1. The whole knowledge of AIDS the subjects had scored 58.9 and their average attitude scored $3.78(1{\pm}25)$. 2. In the degree of knowledge of AIDS depending on general characteristics and health-related characteristics of the subjects, it was found that the students at the department of emergency medical showed higher knowledge(t=3.638, p=.001) and positive attitude of AIDS(t=3.330, p=.001) compared to students at other majors. 3. In the degree of knowledge of AIDS depending on AIDS-related education, subjects who had experienced AIDS education(t=1.973, p=.050), those with the experience of theory education(F=4.057, p=.008), those who felt the necessity of AIDS education(t=4.588, p=.000), and those who were willing to take part in AIDS education(t=2.898, p=.004) showed higher know1edge of AIDS. In the attitude of AIDS, subjects with theory-oriented AIDS education(F=3.012, p=.032), those who felt the necessity of AIDS education(t=2.445, p=.015), and those who were willing to take part in AIDS education(t=2.379, p=.018) showed positive attitude of AIDS education. 4. As the knowledge of AIDS the subjects was higher(r=.329, p=.000), they showed more positive attitude of AIDS and it meant that there was positive correlations. Conclusion : Consequently, systematic, concrete and continuous education of AIDS suitable to the requirements of college students is needed to induce changes of their knowledge and attitude of AIDS and for this, AIDS education program which can be used properly by the developmental stages of college students who belong to late adolescence should be developed in the field of school and if possible, curriculum of sex education including AIDS education should be established in all departments of college.

• 한국응급구조학회지
• /
• 제13권2호
• /
• pp.61-72
• /
• 2009

Purpose : This study aimed to analyze the posttraumatic stress research trends in Korean and foreign firefighters. Method : Total 63 published international articles were searched by Pub Med internet site and total 17 published Korean articles were searched by Korean Medical Database internet site using 'PTSD in firefighters'. These articles were analyzed by published time, domains of journal, research designs, key words and research subjects. Result : 1) By the published time, there were 29 disaster-related researches(46.0%) and 34 job-related researches(54.0%) among 63 international articles. However, there were 16 disaster-related researches(94.1%) and 1 job-related research (5.9%) of Korean 17 articles. 2) By the international research domain, 9 researches(14.3%) were published in The Journal of Nervous and Mental Disease. Among domestic research domain, there were 9 researches(52.9%) consisting of 6 master's degrees and 3 doctor degrees. In major analysis of Korean domain, the highest portion is 4 psychology researches. (23.5%) 3) In the term of the international research design, quantitative research methods were highly used in both 23 disaster-related researches (36.5%) and 30 job-related researches(47.5%). In domestic research, quantitative research methods were mostly used in 14 job-related researches(82.3%) and Q methodology was only used in 1 disaster-related research(5.9%). 4) Looking on the research content trends according to the key words, 9 researches (31.0%) done on posttraumatic stress and coping had the most research and was followed up by posttraumatic stress symptom. Among these researches, key words for PTSD(Posttraumatic Stress Disorder) and PTS(Posttraumatic Stress) were mostly used. Moreover, there was 1 domestic study done on verifying the trends of Posttraumatic Stress in disaster-related research with PTS as the key word. In job-related research, the relationship between the Posttraumatic Stress and other factors had the most with ten studies (62.5%). Among these researches, key words for 5 PTSD(31.3%) were mostly used. 5) According to the international research subjects, the Posttrau consist the most subjects with 16 cases each for disaster and job related stress ; however, domestic research had 16 studies(94.1%) only using firefighters and 1 (5.9%) with their families as subjects. Conclusion : Although the studies of Posttraumatic Stress on Korean firefighters had started later than those on Foreign firefighters, first used for crucial topics show research development in various fields of study and should be tested for studies like those done in abroad regarding multiple topics and methods.

• 한국응급구조학회지
• /
• 제13권2호
• /
• pp.87-98
• /
• 2009

Purpose : This study set out to compare the educational effects of a video self-instruction program for child CPR education on childcare teachers by applying the 2006 KACPR Guideline. By adopting the nonequivalent control group posttest quasi-experimental design, the study examined the educational effects on a group that did not receive instructions from the instructor, another group that received his instructions, and the other group that received an extra three-minute practice training session in addition to instructions. Methods : Data were gathered from August 6 to 18, 2008. As for research tools, the Knowledge Instrument of CPR by Connolly (2006) was used along with the National Practice Test Protocol for C1ass 1 Emergency Medical Technicians (2007) and Common Protocol for CPR (2006) to examine the performance of child CPR. By shooting the guide screen of $Resusci^{(R)}$ Junior CPR Manikin of Leardal with a video camera and using the Skill Guide Checklist of the Common Protocol for CPR (2006), the subjects' technical accuracy of chi1d CPR was evaluated. There were three subject groups: 29 childcare teachers randomly assigned to received the video self-instruction program training for chi1d CPR and no instructions from the instructor made up the control group; 22 childcare teachers randomly assigned to received the program training and instructions from the instructor made up experiment group I; 23 childcare teachers randomly assigned to received an extra three-minute practice training session in addition to the program training and the instructions made up experiment group II. The gathered data were analyzed with SPSS/PC+ (Version 14.0) in frequency, percentage, $X^2$-test, ANOVA, Scheffe test. Results : 1) There were no statistically significant differences (F=1.030, p=.362) among the groups in terms of knowledge scores after the child CPR education. 2) There were statistically significant differences (F=13.625, p=.000) among the groups in terms of performance abilities after the child CPR education. 3) There were no statistically significant differences (F=1.610, p=.207) among the groups in terms of technical accuracy of mouth-to-mouth resuscitation after the child CPR education 4) There were no statistically significant differences (F=1.484, p=.234) among the groups in terms of technical accuracy of chest compression after the child CPR education. Conclusion : The results indicate that childcare teachers can improve their performance abilities in child CPR when the instructors are active with their instructions and extra practice hours are secured through a VSI program. It's also needed to provide education with increasing concentration ratio about the items of lower knowledge points in order to help the teachers learn the accurate theory of child CPR. And there should be VSI programs of diverse conditions to increase the effects of child CPR training among childcare teachers.

• 한국응급구조학회지
• /
• 제11권1호
• /
• pp.27-40
• /
• 2007

Even now, 119 rescue services have dissatisfactory aspects in operation, system and equipments as discussed above, It is the most urgent subject to systemize rescue services so that they can be suitable for our status, for we will make 21C welfare state come true before long. So, this author suggest that the followings have to be raised to activate 119 rescue service. 1) Bring up experts and offer high-quality rescue service 2) Prepare more up-to-date equipments 3) Operate transfer joint organizations 4) Promote the ability to meet with a press at the time of rescue service activities 5) Adjust regulations related to rescue services 6) Make up for a countermeasure to traffic accidents of ambulances 7) Adjust regulations making it mandatory to establish heliport at the target on hospitals more than a defined scale 8) Install more rescue service teams 9) Educate and train officials belonging to briefing rooms, where the officials with long experiences are arranged 10) Minimize the time for rescue team to reach fields 11) Establish legal protection system for rescue the team Nowadays, our country operates the department of fire fighting and rescue services without great difficulty, even though the circumstances are bad - insufficient members and the inferior circumstances. All of the fire fighting officials are given heavy duties in bad circumstances, and so are the team of rescue service. The rescue service team, taking charge of some emergency medical system, do a fire fighting inspection as a non-duty service, though they are scanty of sleep due to prevention and protection services of the fire fighting service team. But, they can not engage in rescue services completely and have to deal with miscellaneous duties. So they can not offer professional emergency medical services. But now, almost every fire fighting organization, belonging to National Emergency Management Agency, are separating rescue services, which shows a lot of good results. People recognize rescue services to get better and better gradually and the demands for this rescue services increase. So, this is the best time when rescue service teams should offer qualitative services rather than quantitative services. The people will recognize this rescue service team to be an organization sacrificing and serving for them. However well institutes and operation systems should be established, the rescue service team can not come true their aim without strong wills that they will serve and sacrifice themselves for people from their hearts. In addition, it is essential for the officials in charge of policies about emergency medical services to have a concernment on and practice the policy without failure.