• 한국응급구조학회지
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• 제17권3호
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• pp.21-28
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• 2013

Purpose: The purpose of this study is to get basic user guidelines of safe and efficient bag-valve-mask application on patients having abnormal pathophysiological pulmonary conditions. Methods: This study was performed by pre-qualified 35 EMS junior and senior students. Participants were instructed to compress ambulatory bag randomly about half, one-third, one-fourth within different airway resistance and pulmonary compliance. Resultant tidal volume and pulmonary wedge pressures on RespiTranier monitor were analysed in relation to pulmonary physiologic index. Results: At least over half compression of bag guaranteed minimal tidal volume regardless of pulmonary conditions. There was no increase of pulmonary wedge pressure above the level of barotrauma on half compression at any pulmonary conditions. Conclusion: Assisted ventilation with ambulatory bag on patients with pathological pulmonary conditions should be over half compressed regardless of respiratory disease entity.

• 한국컴퓨터정보학회논문지
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• 제27권11호
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• pp.219-229
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• 2022

본 연구는 백-밸브마스크 술기교육에 호흡량측정기를 활용한 중재 효과를 평가하기 위한 연구이다. 본 연구의 목적은 호흡량측정기를 적용한 중재군과 적용하지 않은 대조군의 백-밸브마스크 술기의 정확도를 비교하여 호흡량측정기를 활용한 백-밸브마스크 술기교육에 의한 일회 환기량 제공 개선 효과를 파악하여 술기교육 방안을 모색하기 위한 기초자료를 마련하고자 실시하였다. 중재군 30명, 대조군 30명으로 총 60명을 대상으로 한 본 연구에서 교육 전·후 일회환기량 정상범위 대상자 수를 비교하면 중재군의 정상범위 백분율은 교육 전 32.8%, 교육 후 86.7% 이었으며, 유의한 차이가 있었다(p<0.01). 대조군도 교육 전 20.0%, 교육 후 34.7% 이었으며, 유의한 차이가 있었다(p<0.05). 일회환기량 정상범위 포함 횟수의 영향요인을 알아보기 위해 로지스틱 회귀분석을 실시한 결과, 성별(10.305, 1.20-87.98), 소방실습경험(31.674, 1.25-805.16), 중재여부(92.750, 4.58-1879.69)가 유의한 영향 요인이었다. 이 연구를 통해 백-밸브마스크를 이용한 교육에 호흡량측정기를 활용한 중재가 효과적이었다는 것을 확인할 수 있었으며, 향후 응급구조(학)과 전공 학생 교육에 반영할 것을 검토할 필요가 있다.

• 한국응급구조학회지
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• 제22권1호
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• pp.49-59
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• 2018

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

• 한국응급구조학회지
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• 제22권1호
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• pp.73-82
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• 2018

Purpose: The purpose of this study was to compare the tidal volumes and airway pressures of 3 mask-sealing methods (one hand C-E, two hands C-E, and one hand O-E) for ventilation treatment. Methods: The study subjects were 45 paramedic students. Tidal volume was measured for the three sealing methods by setting a ventilator, connecting it to the masks for 2 minutes, and using Respi-trainer software. Results: Regarding general characteristics, the group of men, in upper grades, and with practical training experience and experience and experience in the implementation of bag-valve-mask ventilation provided higher tidal volumes. Regarding physical characteristics, larger hands and greater grip strength correlated with higher tidal volume. Two hands C-E generated the highest tidal volume of $483.78{\pm}34.14mL$, one hand O-E generated $449.59{\pm}51.09mL$ and one hand C-E generated $394.31{\pm}68.95mL$. Conclusion: Means of tidal volumes were statistically significantly different based on mask sealing methods (p<.001). Two hand C-E was performed by the two-persons task and was suggested as the most effective method. For the one-person task, one hand O-E was the more effective method compared to the previous one hand C-E.

• 한국응급구조학회지
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• 제16권2호
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• pp.67-74
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• 2012

Purpose : The purpose of this study is to get basal user guidelines of safer bag-valve-mask application on patient with normal pulmonary patho-physiologic condition. Methods : This study was accomplished by pre-qualified 25 EMS junior grade students. Participants were instructed randomly compress bag to one-third, half and total and also with differesnt compression speed. Resultant tidal volumes and mean airway pressures obtained in RespiTrainer were analysed in relation to the each compression depth and rate. Results : Demographic difference does not affect tidal volume with any compression depth and rate change. Increasing compression depth is correlated with tidal volume increasement at any compression rate and also with mean airway pressure. If the compression depth is same, compression rate change did not affect significantly the resultant tidal volume or mean airway pressure. Conclusion : Hand size, Experience, BMI dose not affect tidal volume. Compress the 1600 ml bag half to total amount is safe way to offer sufficient tidal volume without risky high airway pressure delivery to patient airway who with normal lung patho-physiologic condition.

• 한국응급구조학회지
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• 제20권1호
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• pp.7-15
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• 2016

Purpose: There are few studies on the quality of cardiopulmonary resuscitation (CPR) performed by a single rescuer using a bag-valve-mask device. The aim of this study is to compare CPR quality outcomes according to the rescuer's position or mask fixation grip method and to determine the optimal means of achieving therapeutic goals. Methods: The three CPR methods were defined as over-the-head, lateral-superior, and lateral-inferior, depending on the rescuer's position or mask fixation hand placement. CPR quality was estimated for 83 paramedic students who performed 5 minutes of CPR in a randomized sequence on a manikin using each of the three methods. Results: The over-the-head method showed no advantage for cardiac compression and ventilation quality, but minimized the rescuer's fatigue score. Conclusion: In contrast to previous studies or prevailing beliefs, the lateral-superior position is optimal for achieving therapeutic goals with moderate or minimal rescuer fatigue.

• 한국엔터테인먼트산업학회논문지
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• 제14권7호
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• pp.477-485
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• 2020

본 연구의 목적은 기도관리의 중요한 장비 중 하나인 bag-mask ventilation (BMV)의 환기 적절성이 상업화된 마스크의 종류에 따라 그리고 처치자의 손의 특성에 따른 영향요인을 분석해 가장 적확한 bag-mask의 종류를 제언해보기 위한 연구이다. 이를 위해 전남지역 D 대학의 기본인명 소생술 교육센터(대한심폐소생협회 등록기관)에 응급의료종사자를 위한 기본소생술 과정 및 한국형 전문심장구조술 과정을 수료한 학생을 39명을 모집하여, 손의 신체적 특성을 측정함은 물론, bag-mask를 이용한 분당 평균환기량을 측정 및 분석하였다. 결과적으로 손의 특성에 가장 영향을 받지 않고 적절한 환기량이 제공되는 마스크 유형은 Soft type(tube, silicon)의 마스크였다. 반면 Hard type(tube, silicon)의 마스크는 처치자의 손의 특성에 유의미한 영향을 받아 보편적으로 사용하기에 부적절함을 알 수 있었다. 현재 COVID-19로 인해 구급대원과 환자들에게 감염의 위험도는 증가하고 있다. 이러한 상황들을 고려했을 때 감염방지는 물론, 적절한 환기량에도 불리한 반영구 Hard type 마스크의 보편적 사용은 지양되어야 할 것으로 생각되며, 이에 환자 및 처치자의 감염 방지(1회 용) 용이성은 물론 적절한 환기량에서도 안정적인 환기량을 제공 가능한 Soft type 마스크의 '장점 인식'과 공급을 통해 현장에서 적극적으로 활용돼야 할 것이다.

• 한국화재소방학회논문지
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• 제28권6호
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• pp.76-81
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• 2014

이 연구는 RespiTrainer를 활용한 백밸브마스크 환기에서 1인 백밸브마스크, 2인 백밸브마스크, 전문기도삽관 별 호흡량과 기도압을 비교 분석하였다. 실험기간은 2014년 6월 2일부터 6월 10일까지이며, 수집된 자료는 SPSS 18.0을 이용하여 분석하였다. 그 결과 기관내삽관을 통한 환기 $497{\pm}78mL$, 2인 BVM 환기 $479{\pm}91mL$를 보였고, 1인 BVM 환기와 킹후두관기도기, 후두마스크 환기에서 각각 $386{\pm}59mL$, $365{\pm}05mL$, $351{\pm}35mL$를 보였다. 기도압에서도 기관내삽관을 통한 BVM 환기에서 가장 높은 기도압(11.67 cm $H_2O$)을 보였다. 결과적으로 기관내삽관을 통한 BVM 환기와 2인 BVM 환기에서 1/3 백 압착법은 적절하였다.

• 한국응급구조학회지
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• 제23권3호
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• pp.29-40
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• 2019

Purpose: This study was conducted to identify the effects of educational intervention on pre-test and post-test tidal volume, endotracheal peak pressure, and ventilation interval measurements during single-rescuer respiratory-assistant therapy by paramedic students. Methods: The present study, with a quasi-experimental design, included a pre-test and post-test nonequivalent control group. A total of 62 paramedic students (31, experimental group; 31, control group) participated in this study. The intervention lasted 80 minutes. Data were collected from each student before the intervention and two weeks after the intervention, between September 3 and 21, 2018. The collected data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Results: Tidal volume (p<.001) and endotracheal peak pressure (p=.002) measurements after the intervention were significantly different between the two groups. Analysis of covariance was used to control the variance (the pretest value of endotracheal peak pressure) in order to identify the effect of the intervention in the two groups. Endotracheal peak pressure was not significantly different between the two groups. Conclusion: Education and training of paramedic students in emergency medical services on single-rescuer respiratory-assistant therapy is necessary for the emergency care of patients with respiratory arrest.

• 한국응급구조학회지
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• 제21권1호
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• pp.99-109
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• 2017

Purpose: There is no recommended bag-squeezing technique for emergency medical providers to maintain correct tidal volume during mechanical ventilation. This study compared the tidal volume of two different bag-squeezing techniques during mechanical ventilation. Methods: The subjects were 38 paramedic students who were trained in airway management techniques. Two different bag-squeezing techniques were used with a bag valve mask on an intubated manikin: a conventional technique and a finger-marked, in which the bag is squeezed until the thumb and the middle finger come into contact. Hand size and grip strength were measured and analyzed statistically. Results: The mean tidal volumes for the finger-marked were significantly higher than those for the conventional technique ($542.6{\pm}35.92mL$ versus $338.0{\pm}111.15 mL$, p<.001). There was a correlation between the two techniques (Pearson $x^2=1.160$, p<.001). The subject's characteristics, including sex, hand size, and grip strength, showed no correlation with tidal volume. Conclusion: A finger-marked bag-squeezing technique provides adequate and correct tidal volumes during mechanical ventilation.