• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.71-81
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• 2010

Purpose: To minimize an interruption in chest compression, reduce the hands-off time, the American Heart Association has recommended the ratio of chest compression to ventilation ratio to 30:2 from 2005 CPR guideline to 2010 CPR guideline. However, current studies have shown that the hands-off time was > 10 seconds with that method. For this reason, we devised new CPR method that a ventilation to chest compression ratio of 2:30 to reduce pt assessment time and skipped the assessment step of carotid artery pulse would be a more effective way to reduce the hands-off time & the time to set the CPR. According to the more detailed purpose are listed below. 1) We would like to confirm efficiency of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 to reduce the hands-off time & the time to set the CPR. 2) We would like to evaluate possibility of increasing for chest compression accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 3) We would like to evaluate possibility of increasing for ventilation accuracy of a ventilation to chest compression ratio of 2:30 than a chest compression to ventilation ratio of 30:2 Methods: According to 2005 American Heart Association Guidelines, 60 paramedic students(20 students X freshmen, sophomore, junior) performed 5 cycles of 3~ chest compressions : 2 ventilations after A, B, C evaluation with Laerdal Resusci R Anne SkillReporters. After 5 minutes rest, the 60 students performed 5 cycles of 2 ventilations : 30 chest compressions after A, B evaluation with the manikins between 13 and 17 September 2010. The short reports including speed & accuracy of chest compression, respiratory, CPR cycle were gained from the manikins. Hands-off times were measured by assistants. Results: Recently, the importance of high quality CPR was emphasized in order to perform the CPR faster and more accurate. To find out improving the conventional CPR method, we switch the procedure of the compression and the ventilation. By switching the procedure back and forth, we are able to compare the effectiveness of CPR between two type of CPR method which are 2:30 and 30:2 methods. 2:30 is that the breaths is delivered twice, first and perform 30 compressions while 30:2 perform 30 compressions first and give 2 breaths followed by the ABC method. Also, we verify the effectiveness of the hands off time, compression accuracy of the compression through the comparison of the two procedure as mentioned earlier. Consequently research verified that 2:30 is the efficient by providing faster set up delivering more accurate chest compression. Conclusion: 2:30 can minimize a time delay from cardiac standstill until starting the chest compression. In addition, hands-off time which is an interruption in chest compression can be shortened by 2:30 method, which result to effective oxygenation of coronary artery & maintenance of the bloodstream. Once again, performing the 2:30 method provide lessen hands off time and increase the accuracy of the chest compression.

• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.43-53
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• 2008

Purpose : This study was designed to examine physiological changes in the body of rescuers conduct CPR according to the 2005 new guideline from American Heart Association. The ratio of artificial respiration has changed from 15 : 2 into 30 : 2 in 2005. The researcher tried to know the correlation between the physiological changes and the accuracy of CPR. Method : The examinees of this study were 26 students (Dept. of Emergency Medical Service). After the training, participants conducted 10 minute CPR and soon after the CPR, their vital signs were checked, and lactic acid and concentration of ammonia were analysed from their blood samples. Questionnaires to ask their subjective fatigue level were filled out after blood samples and 10 minute - CPR was performed. Results : 1) After the CPR, concentrations of ammonia were $149.71{\mu}{\ell}/d{\ell}$ and $162.17{\mu}{\ell}/d{\ell}$ in 15 : 2 and 30 : 2, respectively. The number was higher in 30 : 2 but it wan not statistically meaningful (p = .493). Log value of lactic acid was a little higher in 30 : 2 with 42 log($mmol/{\ell}$) and 54 log($mmol/{\ell}$) in 15 : 2 and 30 : 2, respectively but it was not statistically meaningful (p = .113). 2) Blood pressure in 15 : 2 and 30 : 2 were 118.50 mmHg and 125.08 mmHg while pulse in two different cases were 96.14 and 97.25, showing no statistically significant differences (blood pressure : p = .155, pulse : p = .841). 3) Subjective fatigue was a bit high in 30 : 2 with 5.93 and 6.92 points in 15 : 2 and 30 : 2 respectively but it was not statistically meaningful (p = .142). 4) In the 10 minute CPR, respiration accuracy was 96.21% in 15 : 2 and 94.79% in 30 : 2. There was no statistical significances between the two(p = .225). In the meanwhile, chest compression accuracy was 92.57% in 15 : 2 and 91.83% in 30 : 2. From the beginning to the end of chest compression, there showed no difference(p = .425). the type of CPR did not influence upon the accuracy of chest compression(p = .756). Conclusion : In the CPR conducted by skilled rescuers for 10 minutes, there were no statistically meaningful differences between 15 : 2 and 30 : 2 in the concentration of fatigue element in a blood, subjective fatigue, vital signs and accuracy of CPR. Therefore, 30 : 2 CPR recommended by American Heart Association need to be recommended and performed in scene size up.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.139-148
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• 2015

Purpose: This study aimed to compare the chest compression quality between compression-only cardiopulmonary resuscitation (CPR) and conventional CPR. Methods: This study involved 123 participants randomly assigned to either the chest compression-only CPR training and conventional CPR training. After training for 120 min, the participants performed CPR for 4 min and the CPR quality was evaluated. The primary outcome was evaluated as the mean compression depth, and the secondary outcome was calculated as the proportion of chest compressions with an appropriate depth among the total chest compressions. Results: The mean compression depth was more deeper in conventional CPR than in compression-only CPR (57mm vs. 53mm, p <.001). The proportion of appropriate chest compression depth was also more higher in conventional CPR (98.8% vs. 68.6%, p <.001). As compared with every minute over time for a total of 4 min, the mean compression depth and the proportion of appropriate chest compression depth were deeper and higher after 1 min in conventional CPR than in compression-only CPR. Conclusion: The results suggested that conventional CPR is a better method than compression-only CPR in terms of chest compression quality.

• The Korean Journal of Emergency Medical Services
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• v.17 no.2
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• pp.21-28
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• 2013

Purpose : The aim of the study is to compare the effect of cardiopulmonary resuscitation (CPR) with voice and CPR without voice by one rescuer. Methods : Subjects were 26 students in C University who had basic life support certificate for Healthcare Provider. They performed 30:2 CPR for 6 minutes by two groups of CPR with voice and CPR without voice by one rescuer from August 14 to 16, 2012. They performed CPR with Resusci Anne SkillReporter$^{TM}$ and Laerdal PC SkillReporting System Ver. 2.4.1(Laerdal Medical, Norway and recored voice using TES-1350A(TES Electrical Electronic Corp, Taiwan). Between each experiment, 1 day of rest was given, providing enough time to recover from the fatigue of CPR. Results : The depth, rate of chest compression, and ventilation volume were not affected by a voice (p >.05), and the ratio of chest compression to ventilation kept 30:2, when the subject made a sound (p <.05). Conclusion : Making voice during CPR was associated with an accurate ratio of 30:2 and the reduction in hands off time.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.103-115
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• 2012

Purpose : Inadequate chest compression during cardiopulmonary resuscitation(CPR) may result in the insufficient blood flow to preserve critical organ function. The study evaluated changes of quality of cardiopulmonary resuscitation over time in 30:2 CPR by laypersons and analyzed rescuer factors affecting the quality of chest compressions over time. Methods : This study was designed to know quality of CPR changes during 5 minutes. 47 students completed CPR training courses. They were performed 30:2 CPR using a manikin with Skill-Reporter for 5 minutes continuously to get data of depth, rate of chest compression, volume and correct rate of ventilation. Results : Time dependent analysis showed significant ineffective compression depth in females and under weight rescuers. In case of female, we found effective compression depth has maintained up to 2 minutes, but it decreased significantly after 2 minutes. However, underweight rescuers maintained effective compression depth up to a minute but it decreased after 1 minute. Conclusion : Although compression rate maintained over time, chest compression quality declined significantly. It suggested switching compression at an interval of 2 minutes is reasonable for 30:2 CPR by layperson but underweight rescuers may provide effective chest compression by switching shift every one minute.

• The Korean Journal of Emergency Medical Services
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• v.23 no.2
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• pp.99-107
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• 2019

Purpose: This study aimed to identify the position for the most accurate head-up cardiopulmonary resuscitation (CPR) by comparing saddle position CPR (SPCPR) and traditional CPR (TCPR). Methods: Sixty certified persons who completed a basic life support provider course between May 1 and June 21, 2019 were enrolled in the study. The participants were asked to perform 2 minutes of CPR, and the depth of chest compression, rate, position, full release, and hands off time were assessed. Accuracy was evaluated based on data collected from a smart phone application connected to the manikin via bluetooth and analyzed using frequency, percentage, t-test, analysis of variance and ${\chi}^2$. Results: The accuracy of chest compression was statistically significantly higher for SPCPR, 63.03%[${\pm}8.75$] for SPCPR and 55.50%[${\pm}10.17$] for TCPR [t=3.074, p=.003]. The depth of chest compression was statistically significantly greater for SPCPR, 4.51cm[${\pm}0.45$] for SPCPR and 4.16cm[${\pm}0.61$] for TCPR [t=2.503, p=.015]. The rate of chest compression was statistically significantly higher for TCPR, 105/min[${\pm}10.79$] for SPCPR and 111/min[${\pm}11.57$] for TCPR [t=-2.008, p=.049]. Accuracy of position of chest compression was statistically significantly higher for SPCPR, 96.10%[${\pm}13.73$] for SPCPR and 79.93%[${\pm}30.34$] for TCPR [t=2.659, p=.011]. Accuracy of full release was higher with SPCPR, with 86.30%[${\pm}30.53$] for SPCPR and 71.10%[${\pm}36.05$] for TCPR, but the difference was not statistically significant [t=1.762, p=.083]. Conclusion: Saddle position CPR was found to be more accurate than TCPR in the performance of manual head-up CPR.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.2
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• pp.339-346
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• 2010

Purpose: Bystander cardiopulmonary resuscitation (CPR) improves survival. However, there have been few studies on the performance of bystander CPR in Korea. This study was done to identify the reasons for being unwilling to perform CPR, and to investigate the factors associated with performing CPR on a stranger in an emergency situation. Method: The participants in this study were 444 local residents. Data were collected by using self-reported questionnaires from May 1 to June 30, 2010. For data analysis, descriptive statistics and multiple logistic regression were performed using SAS version 9.1. Result: Only 32.2% of respondents reported being willing to perform CPR on a stranger. The major reason for not being willing to perform CPR on a stranger was "have no confidence to perform CPR well". From multiple logistic regression analysis, statistically significant predictors of CPR performance on a stranger were found to be a higher educational level (OR=6.11, 95% CI 1.46-25.52), neighbors with angina pectoris or myocardial infarction (OR=6.65, 95% CI 3.93-11.24), and having confidence of performing CPR (OR=3.02, 95% CI1.78-5.14). Conclusion: CPR education (including automatic external defibrillator) should be offered to family members and neighbors. In addition, the Good Samaritan Law must be given wider publicity at the national level.

• Clinical and Experimental Emergency Medicine
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• v.3 no.3
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• pp.148-157
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• 2016

Objective Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). Methods This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. Results Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group ($31.2{\pm}30.3%$ vs. $55.1{\pm}37.5%$ vs. $54.0{\pm}36.9%$, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. Conclusion CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.

• Journal of muscle and joint health
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• v.26 no.2
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• pp.131-140
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• 2019

Purpose: The purpose of this study was to explore factors influencing for intention to perform cardiopulmonary resuscitation (CPR) in undergraduate nursing students. Methods: A total of 146 students at G University participated in this descriptive study. With a self-administered questionnaire, the data were collected from November 26 to November 30, 2018. Results: In this study, intention to perform CPR had significant positive correlations with attitude of CPR (r=60, p<.001), self-efficiency of CPR (r=.53, p<.001), and confidence in automated external defibrillator (AED) utilization (r=.47, p<.001). Stepwise multiple regression analysis showed that factors influencing for intention to perform CPR were attitude of CPR (${\beta}=.60$, p<.001) and confidence in AED utilization (${\beta}=.26$, p<.001). Overall, approximately 41% of the variability in intention to perform CPR was explained by these variables ($R^2=.41$, F=50.04, p<.001). Conclusion: In order to promote the intention to carry out CPR among nursing college students, it will be necessary to develop strategies to strengthen a positive attitude toward CPR in fundamental nursing and clinical nursing practices in addition to improve confidence in AED utilization.

• Journal of the Korean Society of School Health
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• v.30 no.3
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• pp.194-201
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• 2017

Purpose: The aim of the study was to identify factors influencing confidence in performing cardiopulmonary resuscitation (CPR) of university students. Methods: Data were collected from 261 students recruited from 2 cities using a questionnaire covering confidence, knowledge and attitude in regard to CPR. Results: There was a significant positive correlation between confidence and knowledge (r=.37, p<.001), between attitude and confidence (r=.61, p<.001), and between knowledge and attitude (r=.61, p<.001). Confidence in performance increased as knowledge, attitude, grade, CPR training frequency and educational satisfaction increased. Conclusion: There is a need for CPR training programs that can improve practical training and educational satisfaction of university students.