• 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.

• Journal of Korean Academy of Nursing
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• v.42 no.3
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• pp.361-368
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• 2012

Purpose: The purpose of this study was to analyze the cardiopulmonary resuscitation skills and teamwork of nurses in simulated cardiac arrests in the hospital. Methods: A descriptive study was conducted with 35 teams of 3 to 4 registered nurses each in a university hospital located in Seoul. A mannequin simulator was used to enact simulated cardiac arrest. Assessment included critical actions, time elapsed to initiation of critical actions, quality of cardiac compression, and teamwork which comprised leadership behavior and communication among team members. Results: Among the 35 teams, 54% recognized apnea, 43% determined pulselessness. Eighty percent of the teams compressed at an average elapsed time of $108{\pm}75$ seconds with 35%, 36%, and 67% mean rates of correct compression depth, rate, and placement, respectively. Thirty-seven percent of the teams defibrillated at $224{\pm}67$ seconds. Leadership behavior and communication among team members were absent in 63% and 69% of the teams, respectively. Conclusion: The skills of the nurses in this study cannot be considered adequate in terms of appropriate and timely actions required for resuscitation. Future resuscitation education should focus on improving the quality of cardiopulmonary resuscitation including team performance targeting the first responders of cardiac arrest.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.41-56
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• 2010

Purpose: To compare and analyze current state of domestic and foreign educational program to develop a program and provide basic information for qualitative improvement of the program. Method: Referred to records and used various methods as searching on the Internet. Analyzing methods and standards are as follow : 1) As for the current status of domestic educational program, find out about organizations that conduct the program 2) As for the current status of foreign program, find out about United States, Canada and United Kingdom. 3) As for comparison and analysis, find out about curriculum, subject, the number of people, content, cost and time. Results: In comparison and analysis of subjects and program, United States, Canada and U. K. specified the subjects according to occupations to offer various programs appropriate for special occupational situations whereas domestic program only provide education of CPR and usage of AED. Foreign countries provide sufficient time from 5.5 to 40 hours according to occupations. In contrast, Korea only provide 2-4 hours of educations, which is insufficient to master techniques of first aid. In addition, foreign countries precisely regulate organizations that fulfill the qualification and specific guidelines for content of education. However, Korea doesn't have any standards of qualification or guidelines. Discussion: It is necessary to specify first aid education according to occupations to provide diverse programs. Furthermore, it is necessary to establish nationwide regulations for subjects and content of the programs of the first responder.

• Journal of Home Health Care Nursing
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• v.11 no.1
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• pp.44-56
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• 2004

This study was conducted to investigate the evaluation of students on a practical performance of the home health care and to provide data for practical education on the home care nurse institution. Research was performed from March to December. 2002. 40 Respondents participated in the evaluation four times. The data were analysed by using the SPSS/PC + version 10. 0. The results of this study were as followings: 1. The average age of the subjects was 32. Majority of the subjects were interested in home health care. Majority of the subjects were staff nurse(57.5%) and workers at general hospitals(50%). 2. According to the result of the comparison of practical performances. performance evaluations of 20 items were higher when they admitted special practice than when they admitted any other practice. There was an positive increase in the evaluation of health assessment. nursing documentation. explanation. coping with emergency status. coordination and self assertion. In addition to health assessment. CPR. oxygenation. education & consultation. developmental assessment of child. nursing documentation. mastering nursing practice and consideration of client were significantly different. 3. The subjects were useful for practical circumference where they are working at. From these research findings. the following suggestions have been drawn: it is needed to manage practical curriculum variously and to include not only clinical aspect but also organic or administrational aspect and to reflect on students' needs and to choose to be reasonable items and to develop instruments for evaluation capability of home care nurse.

• Korean Journal of Applied Biomechanics
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• v.31 no.3
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• pp.220-225
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• 2021

Objective: The purpose of this study was to investigate the effect of levels of education on ground reaction force and center of pressure parameters during chest compression resuscitation. Method: Twenty male university students were divided into two groups; certified group (CG, n=10) and non-certified group (NCG, n=10). Two force plates were used to measure ground reaction force and center of pressure parameters during 30 times (three trials) chest compression resuscitation. Independent t-tests were used to compare ground reaction force and center of pressure parameters between two groups. An alpha level of 0.05 was used in all tests. Results: All chest-compression time parameters (total time, 1 systolic time, and diastolic time) in CG were significantly shorter than those in NCG (p<.05). Fy of the diastolic and Fz of the systolic in CG revealed significantly the larger GRF values and Fy of the systolic in CG showed significantly the smaller GRF value (p<.05). The standard deviation of Fz of the systolic and diastolic within the subject during 30 times chest-compression resuscitation revealed significantly the smaller values in CG (p<.05). Conclusion: First, CG performed chest compressions efficiently at an appropriate rate compared to NCG. Second, CG showed lower Fx and Fy values in both the mediolateral and anteroposterior axes compared to NCG, which reduced unnecessary chest-compression force consumption and minimized the movement in patients with cardiac arrest. Third, CG showed high Fz value of the systolic and low Fz value of the diastolic. Based on this, chest compression resuscitation was performed to increase the survival rate of cardiac arrest patients.

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.37-52
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• 2013

The purpose of this study was to compare the differences of attitude to death and perception on HPC between nursing and medical students. The data was collected by questionnaires and the period of data collection was from September 17 to October 12, 2012. The results were as followings. Statistically significant differences were found course of knowing HPC(${\chi}^2$=24.29, p<.001), reason of unactive introduction(${\chi}^2$=15.92, p=.003), having to CPR in irresponsive terminal situation to you(${\chi}^2$=4.62, p=.032) and to your family(${\chi}^2$=5.64, p=.018), decision-making about DNR(${\chi}^2$=12.28, p=.002), awareness to medical authority legal representative(${\chi}^2$=14.75, p<.001), awareness (${\chi}^2$=11.01, p=.001) and subject(${\chi}^2$=24.73, p<.001) of AD, addiction(p<.001), tolerance(p<.001), taking a point(${\chi}^2$=23.28, p<.001) of narcotic analgesics and control of pain(p=.532). The findings of the study provides the basis for expanding practice and education to hospice-palliative care for nursing and medical students.

• Child Health Nursing Research
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• v.24 no.3
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• pp.310-318
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• 2018

Purpose: The purpose of this study was to develop a first aid coaching program (FACP) and to investigate its effects on the first aid knowledge, confidence, and performance of childcare teachers. Methods: A Delphi survey that included 16 experts was used to develop the FACP. A total of 60 participants were included to test the effectiveness of the program. The FACP developed using the survey results focused on improving first aid knowledge, confidence, and performance using a coaching-based method. First aid and cardiopulmonary resuscitation (CPR) performance was assessed using 39 items from the program content. Results: Using a 3-round Delphi survey, 6 areas and 42 detailed topics for group and individual coaching programs were developed. The knowledge scores were significantly higher in the experimental group than in the control group (t=4.24, p=.001). The confidence scores were significantly higher in the experimental group than in the control group (F=3.89, p<.001). The performance scores were significantly higher in the experimental group than in the control group (t=12.40, p<.001). Conclusion: Continuous application of the FACP among child care teachers is expected to minimize the harm caused by minor accidents at child care facilities. This program should be formally implemented on a consistent basis.

• The Journal of the Korean dental association
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• v.53 no.8
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• pp.530-537
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• 2015

Conceptually, the emergency is classified as an urgency and an emergency. The Urgency is not immediately life threatening, but could become so if not resolved promptly. So, it requires prompt patient care same as in the emergency situation. However, the emergency is immediately life threatening and requires immediate action, such as calling 119 and basic life support. Most medical emergencies in the dental clinic cases are urgencies. The incidence of true emergencies is approximately 1/1,000,000. Adequate managing medical urgencies are important because the chance of encountering medical emergencies in the dental clinic is high and higher these days especially because of rapidly aging Korean society. Many dentists indicate that many dentists feel difficulties to recognize and treat medical problems. This paper reviews the concept of medical emergencies and how to cope with commonly occurring urgencies in the dental clinic such as loss of consciousness, hypoglycemia, hyperventilation syndrome. The best treatment for medical urgencies and emergencies in the dental clinic is prevention. Also, it is required to make preparation for emergency situations such as CPR education for dentists and being well-acquainted with equipment and drugs for the emergency care as well as to systemic medical evaluation, patient monitoring, and sedations for controlling patient's anxiety and pain. In this paper, simple algorithms based on guidelines for common urgencies in the dental clinic are suggested. In conclusion, every dentist has competencies to do the urgency care adequately and basic life support. Also, advanced cardiac life support is strongly recommended when sedation is performed in the clinic.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.7-19
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• 2022

Purpose: The purpose of this study is to evaluate the interrupted chest compression time during the use of an automated external defibrillator (AED) depending on different AED practice training methods, and to report differences in self-efficacy before and after training. Methods: We enrolled university freshmen who have had cardiopulmonary resuscitation (CPR) training but have not or have had AED training but over 6 months. We examined differences between the group that practiced only shockable rhythms during training and the group that practiced both shockable and non-shockable rhythms. Results: A total of 72 individuals participated in this study, with 36 individuals each in the control and experimental groups. There was no statistically significant difference in the proficiency of AED usage between the two groups. In non-shockable cases, the experimental group showed shorter chest compression interruption time than the control group (2.30±1.21sec vs. 3.16±1.73 sec; p<0.01). In terms of self-efficacy before and after training, both groups showed higher self-efficacy after than before training. Conclusion: Individuals who underwent training that provided practice on both shockable and non-shockable rhythms had a shorter interrupted chest compression time when using the AED.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.12
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• pp.636-644
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• 2018

This study was conducted to examine the effects of an emergency treatment education program on nursing students' self-leadership, career decision-making self-efficacy, and nursing performance ability. The study was designed using a nonequivalent control group pretest-posttest design, and data were collected from June 1 to August 31, 2017. The participants consisted of 52 nursing students in D College of D City who were assigned to an experimental group (n=27) or control group (n=25). The pretest poll was performed on June 1, 2017 and posttest poll was performed 2 weeks later without any treatment in the control group. In the experimental group, the pretest poll was performed on July 25 before the emergency treatment education program and the posttest poll was performed on August 31 after the education program. The emergency treatment education program for the experimental group consisted of 2 hours of emergency treatment instruction, autonomously watching videos, and 4 hours of teaching elementary students about CPR for adults and first aid for airway obstruction, burns, bleeding, and fractures as a lecturer. The data were analyzed using descriptive analysis, independent t-test, $x^2$ test, and paired t-test with SPSS/WIN 20.0. After receiving the emergency treatment education program, a difference was observed in self-leadership (t=2.08, p<.05), career decision-making self-efficacy (t=4.22, p<.05) and nursing performance ability (t=5.02, p<.05) in the experimental group. The results of this study indicate that the emergency treatment education program was effective at increasing self-leadership, career decision-making self-efficacy, and nursing performance ability in nursing students.