• Title/Summary/Keyword: 119 Emergency medical technicians

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Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, 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, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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Comparison of Three Supraglottic Airway Devices in Neutral and Cervical Neck Collar Position (융복합적 기술이 적용된 성문위기구들의 삽관용이성 비교)

  • Tak, Yang-Ju
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.369-375
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    • 2016
  • Purpose of this study was to compare the easiness of insertion of three Supraglottic airway devices(SADs) in a neutral and cervical neck collar position in a manikin setting. Three different SADs-Laryngeal Mask Classic (LMA), I-gel and Streamlined Liner of the Pharynx Airway(SLIPA) were applied. Thirty nine emergency medical technicians (EMTs) who are working in Korea 119 rescue services were taught briefly about the use of the LMA, I-gel and SLIPA in a manikin setting. The time to effective ventilation was shorter in I-gel ($10.5{\pm}2.2$, $11.4{\pm}5.7$) and SLIPA ($12.3 {\pm}5.1$, $12.0{\pm}6.8$) than LMA ($17.2{\pm}3.2$, $18.5{\pm}5.5$) in a neutral and cervical neck collar position, respectively(p<0.05). There was no difference between head positions in each of the airways. In conclusion, in the speed of insertion, I-gel and SLIPA were superior to LMA in the neutral and cervical collar setting of a manikin.

A Study on the Factors of Safety Enhancement in Mass Casualty Incidents (다수 환자 발생 시 안전 증진 요인에 관한 연구)

  • Lee, Jeong-Hyeok;Park, Joung-Je;Kim, Bo-Kyun
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.4
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    • pp.229-240
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    • 2019
  • Korea is experiencing various disasters both natural and artificial. This study is descriptive research designed to examine the perception of the disaster response ability of fire-paramedics during the response stage of disaster management. The subjects of this study were EMT-P's who had more than 2 years of experience in the field at a fire station in G Province. The questionnaire, including the items for the sub-factors of the field response ability, were prepared and 161 final questionnaires were collected and analyzed with the SPSS program. The mean scores of triage ability, patient treatment ability, patient transfer ability, disaster support ability, and disaster response speed were 3.53, 3.68, 3.66, 2.95, and 3.44, respectively. As a result of multiple regression analysis, variables affecting the speed of disaster response were in the order of patient treatment ability, patient transfer ability, and disaster support ability. In conclusion, fire-paramedics will have to consider the ability to treat patients, transfer patients, and disaster support to improve disaster response speed, and, ultimately, disaster response guidelines should be developed to improve disaster response capabilities.