• 한국응급구조학회지
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• 제25권2호
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• pp.169-186
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• 2021

Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.

• 한국응급구조학회지
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• 제23권1호
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• pp.157-163
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• 2019

Purpose: Advanced airway maintenance improves the quality of cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients. In this study, we evaluate the factors associated with advanced airway management while performing CPR for out-of-hospital cardiac arrest patients by 119 emergency medical technicians (EMTs). Methods: The observational analysis method was used ro retrospectively collect data from 119 rescue run sheets. This study was conducted in a fire station in Seoul, Korea. The subjects of this study were defined as OHCA patients who received CPR from July 2016 to June 2018. We divided the subjects into two groups according to whether advanced airway maintenance was performed or not, and then compared and analyzed both groups. We performed logistic regression analyses for characteristics that differed significantly between groups. Results: Out of 188 OHCA patients, 146 (77.7%) had received advanced airway management. Statistically significant differences in the logistic analysis were found regarding the total number of EMT professionals (adjusted odds ration [aOR]: 1.955; 95% confidence interval [CI]: 1.227-3.115; p=0.005) and scene-time (aOR:1.119;95%CI:1.019-1.228;p=0.019). Conclusion: Advanced airway maintenance while performing CPR for OHCA patients by EMT associated primarily with ensuring an adequate numbers of EMT professionals and sufficient scene time.

• 한국응급구조학회지
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• 제19권2호
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• pp.29-38
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• 2015

Purpose: The purpose of this study was to improve airway management ability by comparing the speed, angle of the neck, and confidence and ease of supraglottic airway laryngopharyngeal tube (SALT) and endotracheal intubation via direct laryngoscopy. Methods: The subjects of this experimental research study with a randomized crossover design were 44 emergency medicine technician - paramedics working in the fire department of 'J' - do. SPSS version 19.0 was used in the statistical analysis. Results: Speed and angle of the neck (p<.001), as well as confidence and ease (p<.001), showed significant differences between endotracheal intubation with a SALT and endotracheal intubation via direct laryngoscopy. Conclusion: If endotracheal intubation via direct laryngoscopy is difficult to use or in trauma patients, using a SALT is safe and enables fast intubation. Moreover, in order to improve the efficiency of advanced airway management, the application of SALT should be introduced in the domestic scene.

• 한국산학기술학회논문지
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• 제14권4호
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• pp.1709-1717
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• 2013

본 연구는 119 구급대의 1급 응급구조사에 의한 심장 마비 환자에 대한 전문기도유지술 실시횟수의 관련 요인을 파악하였다. 광주소방 본부의 1급 응급구조사 95명을 대상으로 구조화된 설문지를 이용하여 일반적 특성, 직업관련 특성, 자기효능감, 전문기도유지술을 시행하는데 저해요인을 조사하였고, 2010년 1월 1일부터 2011년 6월 30일까지 전문기도유지술 실시한 자료는 광주 소방본부에서 제공받았다. 본 연구의 결과로, 전문기도유지술 관련 특성과 실시횟수와 상관관계를 분석한 결과, 필요를 느낀 횟수(r=0.397, p<0.01)와 자기효능감(r=0.419, p<0.01)이 상관관계를 보였고, 저해요인과 실시횟수와 상관관계를 분석한 결과 자신감(r=-0.036, p<0.01)과 경험문제(r=-0.405, p<0.01)가 상관관계가 있었다. 결론적으로, 전문기도유지술의 필요성을 제대로 인식하도록 하고, 자기효능감을 향상시킬 수 있도록 현장위주의 교육 프로그램과 인적자원관리에 대한 대책 마련이 필요할 것이다.

• 대한치과마취과학회지
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• 제12권4호
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• pp.235-241
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• 2012

Although sevoflurane sedation have the advantage of the reduction of anxiety and pain relief, difficult airway is attributed to increased agitation, tachycardia, desaturation, ventilation difficulty, sedation failure. In the sedation for dental treatment, we should pay more attention to the airway management because dental procedures take place in the mouth of airway unlike any other area. The layngeal mask airway (LMA) has become commonly used device for airway management during anesthesia for relatively short procedures, such as minor oral surgery and dental procedures. It can be inserted without use of a larygoscope and muscle relexants, and insertion is easy to achieve and generally takes less time than endotracheal intubation. The LMA is an excellent barrier against aspiration of saliva, blood within the surgical field but should not be used in patients at risk of aspiration In this study, we reported that after a failure of airway management in inhalation sedation, we performed the short-emergency dental treatment successfully, using a laryngeal mask.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권3호
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• pp.181-184
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• 2015

Airway difficulties are a major concern for anesthesiologists. Even though fiberoptic intubation is the generally accepted method for management of difficult airways, it is not without disadvantages-requires patient cooperation, and cannot be performed on soiled airway or upper airways with pre-existing narrowing pathology. Additionally, fiberoptic bronchoscopy is not available at every medical institution. In this case, we encountered difficult airway management in a 71-year-old man with a high Mallampati grade and a thick neck who had undergone urologic surgery. Several attempts, including a bronchoscope-guided intubation, were unsuccessful. Finally, blind nasal intubation was successful while the patient's neck was flexed and the tracheal cartilage was gently pressed down. We suggest that blind nasal intubation is a helpful alternative in difficult airway management and it can be a lifesaving technique in emergencies. Additionally, its simplicity makes it a less expensive option when advanced airway technology (fiberoptic bronchoscopy) is unavailable.

• 한국응급구조학회지
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• 제16권2호
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• pp.75-89
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• 2012

Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the time to ventilation and success rate for tracheal intubation performed with Macintosh laryngoscope and intubating Laryngeal Mask Airway(ILMA) in a manikin. Methods : All participants were novice users among EMT-Paramedic students and were divided into two groups: (1) the group for Macintosh laryngoscope guided tracheal intubation(MLG-TI) (2) the group for ILMA guided tracheal intubation(ILMA-TI). After an introductory lecture and demonstration, each group made an attempt ten tracheal intubation to compare the ventilation time and success rate for tracheal intubation. Results : 1) There was significant difference in the time to ventilation through MLG-TI, the time to first and second ventilation through ILMA-TI of the 10 attempts. 2) The time to first ventilation through ILMA-TI was significantly shorter than that of ventilation through MLG-TI. 3) There was no significant difference between the time to ventilation through MLG-TI and the time to second ventilation through ILMA-TI. 4) The success rates of ILMA-TI were significantly higher than those of MLG-TI. Conclusion : ILMA-TI can be an alternative method for MLG-TI in advanced pre-hospital airway management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.119-123
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• 2018

In cases of intellectually disabled patients, there is sometimes difficult to obtain sufficient information due to the intellectual disorder, even though the patient has significant medical problems. Herein, we report a case of decreased oxygen saturation and inadequate air exchange during general anesthesia in an intellectually disabled patient. We also describe the subsequent management, including the diagnosis of tracheomalacia (TM) using bronchoscopy, and the management of airway compromise with manual and/or controlled respiration, which led to the prevention of complications.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.306-308
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• 2022

본 연구는 기관내삽관(Endotracheal intubation) 시 환자의 자세인 냄새맡는자세(Sniffing position)와 특별 제작된 기구를 사용하여 만든 수정된 경사면자세(Modified ramped position)을 비교·분석하여 전문기도술 수행을 향상시키는 데 목적이 있다. 연구대상은 전문심장소생술 및 전문기도관리학을 이수한 N대학교 응급구조학과 학생 30명을 대상으로 무작위 교차 방법(Randomized crossover study)으로 실험을 진행하였다. 연구결과 수정된 경사면자세에서 냄새맡는자세보다 더 나은 성문시야를 보였으며, 그에 따른 신속성에도 유의미한 차이를 보였다. 연구대상자의 주관적인 용이성, 자신감 그리고 선호도에서도 냄새맡는자세보다 수정된 경사면자세에서 더 향상된 결과를 나타냈다. 따라서 기관내삽관 시 환자를 수정된 경사면자세로 취할 경우 전문기도술 수행을 향상 시키는데 도움이 될 것 으로 사료된다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5893-5900
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• 2012

심정지 또는 중증 외상 환자의 신속한 기도유지는 매우 중요하다. 본 연구의 목적은 후두튜브(LTS)와 후두마스크(PLMA)의 삽관 속도, 성공률, 교육 전 후 자신감 변화를 비교하여 병원 전 단계의 주축을 담당하고 있는 119구급대의 전문기도관리 능력을 향상 시키는데 있다. 연구 대상자는 119구급대원 중 1급 응급구조사 60명(LTS군 30명, PLMA군 30명)이며 마네킹을 대상으로 5분간 3회 실습 후 삽관 소요시간과 성공 여부, 자신감 변화를 측정하였다. 연구결과 LTS와 PLMA를 이용한 삽관 시간은 유의한 차이를 보였고(p=.000), 성공률은 유의한 차이가 없으며, 실험 후 자신감은 유의하게 상승하였다(p=.000). 결론적으로 경추가 고정되고 혀 부종이 있는 외상환자에게 신속한 삽관이 필요한 경우 LTS 사용이 효과적이며 교육을 통하여 전문기도관리 능력을 향상시킬 수 있을 것으로 사료된다.