• 한국산학기술학회논문지
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• 제13권11호
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• pp.5169-5178
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• 2012

본 연구는 2010년 심폐소생술 가이드라인에서 2인 구조자의 팀워크 중심에서 격려방법에 따른 가슴압박 질 차이를 알아보고자 한다. 대상자는 심폐소생술 교육과정을 이수한 응급구조과 재학생을 무작위 추출하였다. 집단은 1회 격려집단(33명)과 연속적 격려집단(33명)으로 구분하였다. 측정 기간은 2012년 4월 30일부터 5월 7일까지 진행되었다. 수집된 자료는 SPSS WIN program(version 12.0)으로 분석하였다. 연구결과 가슴압박 정확도(회, %)는 1회 격려집단(118.72회, 78.54%)이 연속적 격려집단(95.12회, 62.96%) 보다 정확도 질이 높았다(p<.05), 주관적 집중력 인식은 1회 격려집단(3.90점)이 연속적 격려집단(3.12점) 보다 집중력에 도움이 된다는 인식이 높았고(p<.05), 주관적 피로도 완화 인식도 1회 격려집단(3.96점)이 연속적 격려집단(3.30)보다 피로도 완화에 도움이 된다는 인식이 높았다(p<.05).

• 한국화재소방학회논문지
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• 제30권6호
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• pp.137-141
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• 2016

심폐소생술에서 인공호흡은 환자와 구조자간 또는 심폐소생술 교육생들 간의 교차 감염 가능성이 높으나, 감염방지 도구인 페이스 쉴드(face shield)의 병원성 세균 여과 성능에 대한 연구 자료는 매우 부족하다. 따라서 본 연구는 인공호흡용 페이스 쉴드의 병원성 세균 여과 성능을 비교하여 전염성 질환으로부터 심폐소생술 교육생과 병원 전 구조자의 안전을 확보하기 위해 시행되었다. 대상 쉴드는 국내 심폐소생술 교육기관에서 일반적으로 사용되고 있는 FA shield와 CM shield 2종을 임의로 선정하였다. 실험방법은 실제 교육생이 입으로 불어넣은 필터에서 채취한 세균을 대상 필터에 각각 도말한 후 백밸브마스크(Bag valve mask, BVM)로 환기하여 필터의 앞면과 뒷면의 세균 검출 유무를 확인하였다. 그 결과 FA Shield는 병원성 세균 여과 성능이 있는 것으로 확인되었으나, CM Shield는 병원성 세균 여과 성능이 없는 것으로 나타났다. 결론적으로 안전한 인공호흡을 위해서는 국내에서 판매되는 페이스 쉴드의 전반적 성능 평가와 페이스 쉴드의 여과 성능 기준이 제시되어야 할 것으로 판단된다.

• 한국응급구조학회지
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• 제19권3호
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• pp.19-32
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• 2015

Purpose: This study examined the effect of wearing personal protective equipment (PPE) on cardiopulmonary resuscitation (CPR), positive airway pressure, and the posture of emergency medical technicians (EMTs) when conducting CPR. Methods: Twenty 119 EMTs performed 30:2 CPR on a manikin for 4 min. Imaging data were digitized with Kwon3D XP (version 4.0). Data were collected by analyzing the motion when starting in one cycle, such as pressing to the maximum and in the final position (relaxed), and were analyzed with SPSS 18.0. Results: The angle of the elbow joints was significantly reduced (p < .05). The trunk angle was statistically significantly (p < .01, p < .001) increased. The angular velocities of the shoulder joint and left elbow joint were reduced (p > .05). The angular velocity of the trunk was significantly reduced in the starting and maximum compression postures. The hand-escape time was increased. The average compression depth was increased but not significantly (p > .05). The positive airway pressure was reduced (p > .05). Conclusion: The angle of the elbow joints and the angular velocity of the trunk were reduced, and the angle of the trunk was increased. The success of CPR and positive airway pressure was reduced.

• 치위생과학회지
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• 제8권4호
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• pp.381-386
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• 2008

본 연구는 AHA의 기본 심폐소생술 2005 Guide-line에 의거하여 치위생과 학생을 대상으로 Video self-instruction program 교육 후 기본 심폐소생술의 지식 및 태도, 자기효능감을 조사하고 술기의 수행능력을 파악하고, 지식 및 태도, 자기효능감이 흉부압박 및 인공호흡 정확도, 정확한 술기 수행에 영향을 미치는지를 SPSS 14.0을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 기본 심폐소생술 지식에서는 교육 전 지식은 5.93에서 교육 후 지식은 12.46점으로 증가 하였으며, 태도에서는 교육 전 태도는 2.52점에서 교육 후 태도는 3.71점으로 증가하였다. 구체적 자기효능감에서는 교육 전 4.34점에서 교육 후 6.94점으로 증가하였으며, 일반적 자기효능감에서는 교육 전 3.22점에서 교육 후 3.26점으로 증가하였으며, 일반적 자기효능감을 제외하고는 통계적으로 유의하였다. 2. 기본 심폐소생술 흉부압박의 정확도는 68.90%였으며, 인공호흡 정확도는 19.00%이었다. 3. 기본 심폐소생술 술기의 수행능력의 전체 평균 점수는 4.51점으로 나타났다. 4. 교육 후 자기효능감(B=30.386, p < .05)이 흉부압박 정확도에 영향을 미치는 것으로 나타났으며, 교육 후 태도(B=15.310, p < .05)가 인공호흡 정확도에 영향을 미치는 것으로 나타났다. 또한 교육 후 태도(B=3.737, p < .05)는 기본 심폐소생술 술기의 수행에도 영향을 미치는 것으로 나타났다.

• 한국화재소방학회논문지
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• 제28권4호
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• pp.104-111
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• 2014

이 연구는 소방에 근무하는 응급구조사에 의해 시행되는 구급차 내 심폐소생술 방법에 관한 연구이다. 연구 대상은 경기도 관할 780명으로 2012년 보수교육 종료 후 설문을 통하여 수집하였다. 일반적 특성, 가슴압박 방법(한 손 가슴압박 VS 두 손 가슴압박), 심폐소생술 방법(표준심폐소생술 VS 가슴압박소생술) 등에 대하여 Chi-square test, t-test. ANOVA로 분석하였다. 한 손을 이용한 가슴압박 14.0%, 두 손을 이용한 가슴압박 86.0%를 보였고, 표준심폐소생술(가슴압박 VS 인공호흡)은 28.3%, 가슴압박소생술 71.7%를 보였다. 고품질의 심폐소생술을 위해서는 심정지 환자의 구급 출동만이라도 운전자 포함 3명 이상의 응급구조사가 출동할 수 있도록 탄력적인 인력 운영 방안이 필요하며, 역량 강화를 위한 심폐소생술의 정기적인 교육이 필요하다.

• Journal of Chest Surgery
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• 제31권12호
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• pp.1147-1158
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• 1998

배경:이동식 인공심폐기는 심정지 기간 동안 안정한 혈역학 상태를 유지하여 생존율을 향상시킬 수 있기 때문에 강력하고 효과적인 심폐소생법의 하나로 그의 사용이 증가하고 있다. 본 연구진은 초기모델의 한국형 이동식 심폐소생기를 이용한 심폐소생술과 기존의 개흉식 심폐소생술을 비교하여 혈역학 유지와 소생 여부 및 신체장기들에 미치는 효과를 알아보고자 하였다. 대상 및 방법: 한국산 잡견 8마리(30∼51kg)를 대상으로 개흉식 심폐소생술군과 심폐소생기를 이용한 심폐소생술군으로 각각 4마리 씩 나누었다. 4분 간의 심실세동형 심정지 기간이 지난 후 15분 간의 기본 심폐소생술(basic life support; BLS)을 실시하고 30분 간의 고급 심폐소생술(advanced life support; ALS)을 실시하여 자발순환회복, 혈역학 상태, 혈구성분에 미치는 효과, 혈액 가스 검사, 생화학 검사 및 생존율 등을 알아보았다. 심장압박과 폐환기는 두 군 모두 동일한 조건으로 유지하였으며, 고급 심폐소생술 시작과 동시에 제세동을 하고 에피네프린 및 탄산수소나트륨을 투여하여 자발순환회복을 유도하였다. 측정한 관찰값은 심정지전 관찰값으로부터의 변화율(%)로 환산하여 평균±표준편차로 표시하였다. 결과: 고급 심폐소생술 초기에 평균 체동맥압은 심폐소생기군에서 개흉식 심폐소생술군 보다 높게 유지되었고 (90±19% vs. 71±32%, p<.05), 평균 폐동맥압은 심폐소생기군이 개흉식 심폐소생술군 보다 낮게 유지되었다 (105±24% vs. 146±6%, p<.05). 자발순환회복은 모든 실험견에서 나타났다. 자발순환회복 후 심폐소생기군에서 혈중 헤마토크리트치, 적혈구와 혈소판 수가 유의하게 감소하였고 혈중 유리헤모글로빈치는 유의하게 증가하였다(p<.05). 혈액가스검사와 lactate 및 CK-MB치는 두 군간에 차이가 없었다. 실험 후 조기사망은 심폐소생기군에서 2마리, 개흉식 심폐소생술군에서 3마리에서 있었다(생존기간 228±153 vs. 31±36 시간, p=ns). 나머지는 모두 장기 생존율을 보였다. 결론: 본 연구결과 이동식 심폐소생기를 이용한 심폐소생술은 심정지 기간 동안 안정한 혈역학 상태를 유지하여 자발순환회복 및 장단기 생존율을 향상시킬 수 있다. 추후 이동식 심폐소생기 개선과 임상적용을 위해 초기모델을 수정 보완하는 실험연구가 더 필요하리라 본다.

• 한국응급구조학회지
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• 제9권1호
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• pp.43-53
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• 2005

The purpose of this study was to survey a perception of frequency & importance level of job performance, from 249 paramedics who were working at fire station. The job related activities of 4 duties, 18 tasks and 145 task elements were checked by 4 rating scale. The data were analyzed using a SPSS program for descriptive statistics. The results of the study were as follows ; 1. Some of the most frequent tasks were medical tx, managing people & organization, trauma care, pt assessment, general coping skill 2. Some of the most frequent task elements were preparation of written reports, operation of pt lifting supplies, transportation of patients on stretchers, administration of cervical collar and utilization of scoop stretcher. 3. Some of the highest level of importance in task were resuscitation of circulation, surgical tx, safety & infection control, environmental emergency care, trauma care. 4. Some of the highest level of importance in task elements were administration of cervical collar, adult CPR, infant CPR, child CPR, and AED. 5. The highest level of task elements in perception of frequency & importance were administration of cervical collar, infection control after pt care, utilization of long back board, disinfection of ambulance after ride a long, care of chest pain pt, care of unconscious pt, tx of asthma. 6. A difference between frequent & importance score were due to lack of supplies(41%), structural problems(30%) and medical control system(16%), lack of skills(10%), Suggestion; 1. This paper would be more reliable and confirm through wilder range of survey. 2. It would be necessary of more depth survey through dacom study from paramedic. 3. Development of field oriented protocol & curriculum that based on task elements which have high score of both frequency & importance level is required.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.166-172
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• 2017

Purpose: Thoracic traumas represent 10-15% of all traumas and are responsible for 25% of all trauma mortalities. Traumatic cardiac injury (TCI) is one of the major causes of death in trauma patients, rarely present in living patients who are transferred to the hospital. TCI is a challenge for trauma surgeons as it provides a short therapeutic window and the management is often dictated by the underlying mechanism and hemodynamic status. This study is to describe our experiences about emergency cardiac surgery in TCI. Methods: This is a retrospective clinical analysis of patients who had undergone emergency cardiac surgery in our trauma center from January 2014 to December 2016. Demographics, physiologic data, mechanism of injuries, the timing of surgical interventions, surgical approaches and outcomes were reviewed. Results: The number of trauma patients who arrived at our hospital during the study period was 9,501. Among them, 884 had chest injuries, 434 patients were evaluated to have over 3 abbreviated injury scale (AIS) about the chest. Cardiac surgeries were performed in 18 patients, and 13 (72.2%) of them were male. The median age was 47.0 years (quartiles 35.0, 55.3). Eleven patients (61.1%) had penetrating traumas. Prehospital cardiopulmonary resuscitations (CPR) were performed in 4 patients (22.2%). All of them had undergone emergency department thoracotomy (EDT), and they were transferred to the operating room for definitive repair of the cardiac injury, but all of them expired in the intensive care unit. Most commonly performed surgical incision was median sternotomy (n=13, 72.2%). The majority site of injury was right ventricle (n=11, 61.1%). The mortality rate was 22.2% (n=4). Conclusions: This study suggests that penetrating cardiac injuries are more often than blunt cardiac injury in TCI, and the majority site of injury is right ventricle. Also, it suggests prehospital CPR and EDT are significantly responsible for high mortality in TCI.

• 한국응급구조학회지
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• 제12권1호
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• pp.27-41
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• 2008

Purpose : With increasing number of school accidents, it is crucial to find out necessity of first aid training among school health educator. This study has been conducted to have an clear idea on the demands and necessity for first aid training and what kind of training is most required from school health educator. Method : In this study, questionnaires from 87 school health educator in elementary, middle and high school health educator in the city D were analyzed. The survey was carned out from May 26, 2008 to June 7, 2008 and from the collected data, frequency, independent two samples t-test, paired T-test, one way ANOVA and pearson's correlation were conducted with SPSS 14.0. Result: 1. 51.61 % of nurse-teachers experienced emergency situations and the relations between the necessity they felt from experiencing those situations and demands for first aid training were not statistically meaningful(t=1.87, p= .175). 2. Necessity and demands for the first-aid training were checked with three point scale and there were statistical significance between the two with $2.44{\pm}.47$ and $2.24{\pm}.47$ respectively(t=3.275, p= .000). 3. 86.20%(75 persons) of the respondents have had received first aid training and the training they received were CPR 82.75%(72 persons), primary survey 81.60%(7l persons), contact to 911 79.30%(69 persons) and wounds treatment(lacerated wounds, bum and chilblains) 75.86%( 66 persons) in order. 4. As for the questions that ask on confidence of first-aid treatment, 80% answered they are confident on some limited kinds of treatments, 16% said they are confident and 4% answered they lack confidence. As for the treatment that they can show the highest confidence, wounds treatment topped the list with 93.24%, nose bleeding and removing foreign substance, and stanching followed the list with 82.43% and 81.08% respectively. 5. 97.67% of respondents said they were willing to take training and 89.62% answered to take the training to deal with emergency situations that are taking place in their schools. As for the question that asks for the most wanted treatments, CPR topped the list with 32.18%(28 persons) and treatment for obstruction of airway and shock followed the list with 35.63%(31 persons) and 27.59%(24 persons). Conclusion : Currently, first aid treatment has been centered on CPR, primary survey, contact to 119 and wounds treatment. However, since most of school health educator are fairly confident with wounds treatment, stanching and other first aids, in future training it will be more desirable to focus on CPR and treatment for obstruction of airway and shock that were shown to be most wanted by school health educator.

• Clinical and Experimental Reproductive Medicine
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• 제43권1호
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• pp.38-43
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• 2016

Objective: The number of assisted reproductive technology (ART) clinics, ART cycles, clinical pregnancy rate (CPR), and number of newborns conceived using ART have steadily increased in South Korea. This aim of this study was to describe the status of ART in South Korea between January 1 and December 31, 2011. Methods: A localized online survey was created and sent to all available ART centers via email in 2015. Fresh embryo transfer (FET) cases were categorized depending on whether standard in vitro fertilization, intracytoplasmic sperm injection (ICSI), or half-ICSI procedures were used. Thawed embryo transfer (TET) and other related procedures were surveyed. Results: Data from 36,990 ART procedures were provided by 74 clinics. Of the 30,410 cycles in which oocytes were retrieved, a complete transfer was performed in 91.0% (n=27,683). In addition, 9,197 cycles were confirmed to be clinical pregnancies in the FET cycles, representing a pregnancy rate of 30.2% per oocyte pick-up and 33.2% per ET. The most common number of embryos transferred in the FET procedures was three (38.1%), followed by two (34.7%) and one (14.3%). Of the 8,826 TET cycles, 3,137 clinical pregnancies (31.1%) were confirmed by ultrasonography. Conclusion: While the overall clinical pregnancy rate for the TET cycles performed was lower than the rate reported in 2010 (31.1% vs. 35.4%), the overall CPR for the FET cycles was higher than in 2010 (33.2% in 2011 and 32.9% in 2010). The most common number of embryos transferred in FET cycles was three, as was the case in 2010.