• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.11
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• pp.5292-5298
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• 2012

The purpose of this study is to perform the effectively advanced airway management in an emergency patient with cardiac arrest and trauma by comparing the appearance of influence in a change of visual-field height upon endotracheal intubation according to a change in position with intubation of paramedics in a moving ambulance and by analyzing the appearance of the influence in a patient's change in position with intubation upon speed in endotracheal intubation. Research subjects were randomly extracted 60(30 people for control group, 30 people for experimental group) people as the paramedics who are working at 13 fire stations in C Province. Data analysis was carried out ${\chi}^2$-test, independent t-test, paired t-test by using SPSS WIN 14.0 Version. As a result of research, to improve speed of the advanced airway management, it is considered to be likely effective in a patient's sniffing position and in the endotracheal intubation in the upper space of the main stretcher. The self-confidence in intubation after experiment increased significantly. Thus, the continuous education(training) on the intubation position and method within ambulance is considered to be likely needed for improving efficiency of the advanced airway management.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.19-28
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• 2012

Purpose : The present study was designed to provide basic data for advanced pre-hospital airway management by comparing the insertion time and success rate between laryngeal tube suction II (LTS II) and laryngeal mask airway (LMA) in a manikin. Methods : A total of 32 participants were novice users to both of devices among paramedic students. After taking the introductory lecture and demonstrations, the participants made an attempt to insert the LTS II and LMA to compare the insertion time and success rate. They marked the easiness of insertion of the score ranged from 1 to 10 score scale and preference of the two devices. Results : The insertion time of the LTS II was significantly shorter than that of the LMA (p =.000). There was no significant difference between LTS II and LMA in the success rate. In the easiness of insertion, the score of LTS II $(8.47{\pm}1.41score)$ was significantly higher than that of LMA $(7.19{\pm}1.98score)$(p =.001). The preference of LTS II (75%) was much higher than that of LMA (25%). Conclusion : The manikin study data showed that the LTS II may be a good alternative airway device for providing and maintaining a patent airway.

• The Korean Journal of Emergency Medical Services
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• v.15 no.3
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• pp.71-80
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• 2011

Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the ease of intubation, the success rate and the time for intubation performed with Macintosh Laryngoscope, Gum Elastic Bougie and Pentax AirWay Scope on the floor and table. Methods : Intubation was performed 30 times in total, including 5 times for each of intubation using Macintosh Laryngoscope, Gum Elastic Bougie and Pentax Airway Scope on the table and floor, only on subjects who passed the practice test of the national exam for paramedics. Data were collected by measuring the ease of intubation, the success rate and the time for intubation, and then analyzed by descriptive analysis, paired t-test, ANOVA using SPSS 18.0. Results : 1. There was a significant difference in the ease of intubation according to intubation devices. 2. There was a significant difference in the ease of intubation according to table height for intubation. 3. There was a significant difference in the success rate according to intubation devices. 4. There was no significant difference in the success rate according to table height for intubation. 5. There was a significant difference in the intubation time according to intubation devices. 6. There was a partially significant difference in the intubation time according to table height for intubation. Conclusion : Sufficient training not only with Macintosh Laryngoscope but also with Gum Elastic Bougie and Pentax Airway Scope could improve the survival rate by intubation in patients with difficult airway.

• Journal of the Korea Society of Computer and Information
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• v.25 no.12
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• pp.227-233
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• 2020

The purpose of this study is to compare the speed, confidence, and ease of endotracheal intubation in a difficult posture by using the SALT(Supraglottic Airway Laryngopharyngeal Tube), and a direct laryngoscope to improve the ability to implement professional airway management. The subject of the study was an experimental study by a randomized crossover design, targeting 30 first-class emergency medical technicians working in J-do fire station, and the SPSS 20.0 version was used for data analysis. The endotracheal intubation by using SALT showed a significant difference in speed compared to endotracheal intubation by using a direct laryngoscope(p<.001), and also showed a significant difference in confidence and ease(p<.001). If it is difficult to endotracheal intubation by direct laryngoscope, or in the case of trauma patients, if SALT is used, safe and rapid intubation will be possible. In addition, to improve the efficiency of professional airway management, it is believed that the introduction of SALT in domestic sites is necessary.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.578-584
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• 2018

Objective: This study examined the initial partial pressure of carbon dioxide ($PCO_2$) as a possible indicator of prehospital ventilation and its association with prehospital i-gel in out-of-hospital cardiac arrest (OHCA) patients. Methods: The demographics and arrest parameters, including i-gel insertion and initial arterial blood gas analysis, of OHCA patients who visited the emergency department were analyzed retrospectively. Linear regression analysis was performed to examine the association between i-gel insertion and the initial $PCO_2$. Results: A total of 106 patients were investigated. Fifty-six patients had prehospital i-gel insertion and 50 patients did not have a prehospital advanced airway. The initial $PCO_2$ was higher in the i-gel group than the no advanced airway group (105.2 mmHg [77.5-134.9] vs. 87.5 mmHg [56.8-115.3], P=0.03). Prehospital i-gel insertion was associated with a higher initial $PCO_2$ level (${\beta}$ coefficient, 20.3; 95% confidence interval, 2.6-37.9; P=0.03). Conclusion: Prehospital insertion of i-gel was associated with higher initial $PCO_2$ values in OHCA patients compared to no advanced airway.

• The Korean Journal of Emergency Medical Services
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• v.24 no.1
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• pp.67-76
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• 2020

Purpose: Effective time management, as well as life-saving care, are important in maximizing the prognosis of patients who have sustained major traumas. This study evaluated the appropriateness of emergency medical system (EMS) provider's essential care and how this care impacted on-scene time in patients with major traumas. Methods: This retrospective observational study analyzed the EMS major trauma documents, classified according to the physiological criteria (Glasgow coma scale <14, systolic blood pressure <90mmHg, Respiration rate <10 or >29) in Daejeon, from January, 2015 to December, 2018. Results: Of the 707 major trauma cases, the mean on-scene time was 7.75±4.64 minutes. According to EMS guidelines, essential care accuracy was 67.5% for basic airway, 36.4% for advanced airway, 91.2% for cervical collar, 81.5% for supplemental oxygen, 47.0% for positive pressure ventilation, 19.9% for intravenous access and fluid administration, and 96.0% for external hemorrhage control. Factors affecting on-scene time were positive pressure ventilation (p<.004), and intravenous access and fluid administration (p<.002). Conclusion: Adherence to guidelines was low during advanced airway procedures, positive pressure ventilation, intravenous access, and fluid administration. In addition, the on-scene time was prolonged when the practitioner provided positive pressure ventilation, intravenous access, and fluid administration; however, these durations did not exceed the recommended 10 minutes.

• Tuberculosis and Respiratory Diseases
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• v.64 no.4
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• pp.272-277
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• 2008

Background: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. Methods: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately $-89^{\circ}C$, and the icing time was 5~20 seconds. Results: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications- one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. Conclusion: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.1
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• pp.33-37
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• 2012

Dental treatment under general anesthesia is considered a good way for behavioral control in disabled patients. General anesthesia for disabled patients sometimes requires difficult airway management. In this case, intra-oral camera is great helpful to intubation. Originally, the intra-oral camera is designed to facilitate diagnosis dental disease. The intra-oral camera is very efficient on intubation. Laryngeal photo taken by Intra-oral camera can be good guide for difficult intubation. In this report, an 11-year-old boy with chromosomal anomaly received dental care under general anesthesia. And he had a potentially difficult airway. We achieved nasotracheal intubation successfully with intra-oral camera.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2360-2367
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• 2013

The purpose of this study was to improve the paramedics skills to manage advanced airway by comparing speed and success rate between endotracheal intubation and laryngeal mask airway(LMA) insertion in a moving ambulance. Sixty subjects were randomly recruited and samely divided into control group and experimental group. And they were asked to join a practical experiment using dummy model. Data analysis was done by SPSS WIN 14.0 Version. As a result of this research, in terms of difference in speed according to patient's intubation posture, the speed of control group was indicated to be good in sniffing position(t=-4.038, p<.001). There was no difference in speed between two groups in neutral position. In the neutral posture given the endotracheal intubation, tooth fracture occurred in 16 people(53.3%). There was no difference in success rate between two groups. As for a change in self-confidence before and after experiment, the post self-confidence was indicated to have been enhanced in both groups. In conclusion, it is effective to use LMA in the traumatic patient who is unable to receive endotracheal intubation in sniffing position. It is very important for the paramedics to receive the continuous training of the airway management skills.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.9-15
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• 2016

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.