• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5819-5826
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• 2013

Purpose: The purpose of this study was to examine the effects of the simulation-based training for advanced cardiovascular life support on the knowledge and competence of nursing students. Method: The subjects were 22 nursing students, who ungraduated D university. Data were analyzed with SPSS/Win 18.0 program. Results: There was a significant improvement in knowledge and competence after receiving than before training. Conclusion: Simulation-based training for advanced cardiovascular life support is effective strategy for increasing the knowledge and competence of nursing students and will can provide basic data in development of standardized emergency nursing education programs. Further research is needed in the comparative analysis about various learning of advanced cardiac life support education and a longitudinal study of maintenance the knowledge and competence.

• 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.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.149-160
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• 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.

• Journal of Korean Clinical Health Science
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• v.2 no.1
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• pp.35-45
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• 2014

Purpose: This study analyzes occupational therapy interventions to improve activities of daily living (ADL) in dementia patients and the instruments used to verify their effects through a systematic review and attempts to use the results as preliminary data in selecting further interventions and instruments. Method: The databases searched included NDSL, DBpia, RISS, KISS and National Assembly Library with search words including 'Alzheimer's disease', 'Alzheimer', 'daily living' and 'ADL.' The subjects of analysis were a total of 7 studies, and a frequency analysis was used for the usage count of the interventions used in each study. In order to provide evidence, PICO Method was used for sorting. Result: As a result of this study, there were 7 occupational therapy interventions applied to improve ADL in dementia patients, which were used 7 times total. As for the instruments used to validate the effects of the interventions for the ADL, it turned out that '3 studies used AMPS (42.9%),' which was the most, followed by 'Allen Cognitive Level Screen' (ACLS) and Functional Independence Measure' (FIM), respectively used in 2 studies (28.6%); and 'Modified Barthel Index' (MBI) and 'Philadelphia Geriatric Center IADL' (PGC IADL), respectively used in 1 study. Regarding the qualitative level of evidence, it turned out that 4 studies were Level III (57.1%), followed by 2 studies at Level IV (28.6%) and 1 study at Level I (14.3%). Conclusion: This study suggested the kinds and frequencies of usage of the interventions and instruments of occupational therapy for the improvement of ADL in dementia patients, and the studies of evidence were presented by the PICO Method. It is judged that the results of this study can be used as preliminary data in selecting interventions and instruments to improve the ADL in dementia patients. In the future, studies should be carried out on the ADL in other areas related to dementia.

• The Korean Journal of Emergency Medical Services
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• v.14 no.2
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• pp.13-24
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• 2010

Objective : The purpose of this study is to understand the status of continuing education of the EMTs of the Korean fire department, to identify demand of them for content, method, and forms of the education, and to present basic data for developing more efficient, effective continuing education programs. Methods : The subjects of this study were 850 of the EMTs of the Korean fire department who work for fire stations located in Seoul and part of Gyeonggi-do and directly provide critical care in the field. The data was collected between February 8 and 28, 2010. Using SPSS 17.0 program, we obtained frequencies percentages, means, and standard deviations, and performed independent two sample t-test, one way ANOVA, and Cronbach's ${\alpha}$. Results : 1) As for status of the existing continuing education for of the EMTs of the Korean fire department, in general, the hour of each education was "less than four hours" (51.2%), the instructors of the education were "doctors" (65.2%), the method of the education was "lecture" (83.3%), the material for the education was "educational materials and slides" (97.2%), and the results from the education were "not helpful in job" (55.1%). 2) The effects of the EMTs of the Korean fire department were mean 2.44(${\pm}.51$), the ability was mean 2.40(${\pm}.50$), and the attitude was mean 2.49(${\pm}.57$) points. 3) As for the demands of the EMTs of the Korean fire department on the next continuing education, they preferred "the advanced cardiac life support(ACLS)" ($2.64{\pm}.62$) most in subject content, "investigating the demands of 119 emergency medical technicians annually" (44.1%) in methods to select subjects of the continuing education, "doctors and professors of Department of Emergency Medical Technology" in instructors of the education (190 persons, or 39.9%), "lectures with practices" in methods of the education (30.1%), and "One per year" (41.6%) and "less than four hours" (67.2%) in the period and hours of the text continuing education they hope. Conclusion : The continuing education for the EMTs of the Korean fire department conducts without accepting the demands of the technicians, In planning of the next continuing education, the results of this study suggest that it is needed to develop more various and professional educational program by active acquisition of the demands of the technicians.

• The Korean Journal of Emergency Medical Services
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• v.1 no.1
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• pp.28-41
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• 1997

The purpose of this study was to identify the change of perceptions related to E.M.T. profession of E.M.T. student and to provide the basic data for development of curriculum. The subjects of the survey were 216 students from 3 junior college by questionaire from November 25 to November 29, 1996 in Kwang-Ju, Cheong-Ju, and Kong-Ju. The results were analyzed using the SAS and can be summerized as follows : 1. The view on profession was a statistically significant difference inspecial knowledge & skill training (t=-1.686, P<.001), high income (t=-0.753, P<.05) 2. The view on competence as a E.M.T. was a statistically significant differncein sufficient professional knowledge on the E.M.T. (t=-1.144, P<.001), own's health (t=-0.808, P<.001), sincerity and responsibility (t=-1.429, P<.01), satisfaction and effort (t=-1.335, P<.01), boundary of affairs (t=-1.356, P<.01) 3. The view on E.M.T. profession was a statistically significant difference inprotect of pt. life & to relieve the pain (t=-2.388, P<.001) 4. The view on necessary knowledge of E.M.T. was a statistically significant difference in patient assessment (t=-2.168, P<.001), ACLS (t=1.678, P<.001), hemorrhage & shock (t=-3.252, P<.001), trauma (t=-4.284, P<.001), cardiopulmonary disturbance (t=-2.897, P<.001), acute abdomen (t=-4.284, P<.001), neonatal disease (t=-4.032, P<.001), OBGY disease(t=-4.151, P<.001), emergency delivery (t=-2.825, P<.001), infectious disease (t=-2.930, P<.001), environmental emergency (t=-3.123, P<.05), recording(t=2.22, P<.05) 5. The view on ideology of E.M.T. was a statistically significant difference in belief & faith (t=-2.344, P<.001), knowing of own (t=-2.142, P<.01), humanity (t=-2.581, P<.05), knowing of patient (t=-2.079, P<.05).

• Journal of Korean Biological Nursing Science
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• v.4 no.1
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• pp.25-39
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• 2002

The purpose of this study is to develop and evaluate a web-based instruction Program(WBI) to help nurses improving their knowledge and skill of cardiopulmonary resuscitation. Using the model of web-based instruction(WBI) program designed by Rhu(1999), this study was carried out during February-April 2002 in five different steps; analysis, design, data collection and reconstruction, programming and publishing, and evaluation. The results of the study were as follows; 1) The goal of this program was focused on improving accuracy of knowledge and skills of cardiopulmonary resuscitation. The program texts consists of the concepts and importances of cardiopulmonary resuscitation(CPR), basic life support(BLS), advanced cardiac life support(ACLS), treatment of CPR, nursing care after CPR treatment. And in the file making step, photographs, drawings and image files were collected and edited by web-editor(Namo), scanner and Adobe photoshop program. Then, the files were modified and posted on the web by file transfer protocol(FTP). Finally, the program was demonstrated and once again revised by the result, and then completed. 2) For the evaluation of the program, 36 nurses who in K university hospital located in D city, and related questionnaire were distributed to them as well. Higher scores were given by the nurses in its learning contents with $4.2{\pm}.67$, and in its structuring and interaction of the program with $4.0{\pm}.79$, and also in its satisfactory of the program with $4.2{\pm}.58$ respectively. In conclusion, if the contents of this WBI educational program upgrade further based upon analysis and applying of the results the program evaluation, it is considered as an effective tool to implement for continuing education as life-long educational system for nurse.

• Investigative Magnetic Resonance Imaging
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• v.11 no.1
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• pp.27-32
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• 2007

Purpose : To evaluate the mucoid degeneration (MD) of the anterior cruciate ligament (ACL) of the knee by correlation of MRI findings with pathology, in the patients with osteoarthritis (OA). Materials and Methods : This study included 17 patients (mean 68.8 years old) who underwent preoperative MRI. In proton density-weighted sagittal and coronal images ACLs were evaluated for the thickness and signal intensity (SI). Total knee replacement arthroplasty was performed and the pathologic findings of ACL were evaluated. MD was classified as 3 grades according to the degenerated amount in microscopy. Thickness and SI was evaluated as normal or increased on MRI. Results : All of the 4 patients who showed thickened ACL showed increased SI on MRI. All of the 8 patients with increased SI of the ACL on MRI had MD in the ACL. However, remained 9 patients also had MD, in spite of their normal thickness and SI on MRI. Calcification was seen in 5 patients. Conclusion : Eight cases who showed ACL thickening or increased SI on MRI were well correlated with MD, however, because the other nine cases who showed normal thickness and normal SI of ACL on MRI also showed MD in pathology, normal MRI finding should not exclude the possibility of MD of ACL.