• 한국응급구조학회지
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• 제25권1호
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• pp.205-221
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• 2021

Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients' and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권1호
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• pp.57-64
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• 2018

Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.

• 한국응급구조학회지
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• 제23권1호
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• pp.113-123
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• 2019

Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.129-131
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• 2012

A 70-year-old male came to the emergency room of the authors' hospital because of sudden cardiac arrest due to inferior wall ST elevation myocardial infarction. His coronary angiography revealed multiple severe coronary spasms in his very long left anterior descending artery. After an injection of intracoronary nitroglycerine, his stenosis improved. The cardiac arrest relapsed, however, accompanied by ST elevation of the inferior leads, while the patient was on diltiazem and nitrate medication to prevent coronary spasm. Recovery was not achieved even with cardiac massage, intravenous injection of epinephrine and atropine, and intravenous infusion of nitroglycerine. The patient eventually recovered through high-dose nicorandil intravenous infusion without ST elevation of his inferior leads. Therefore, intravenous infusion of a high dose of nicorandil must be considered a treatment option for cardiac arrest caused by refractory coronary vasospasm.

• Journal of Chest Surgery
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• 제9권1호
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• pp.55-62
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• 1976

This is a report of 8 cases cardiac arrest developed in the operating room at Jeonbug university Hospital from January 1973 to October, 1975. Four patients of cardiac arrest developed during the elective operation, 3 during the emergency operation and the remaining one, bronchoscopy for foreign body removal under the general anesthesia. Immediate closed chest cardiac massage was performed in the 7 patients and the remaining one underwent open chest cardiac massage. Five of 7 patients with the closed chest cardiac massage regained consciousness and restored respiration, but 3 patients of these survived to be discharged. Two patients who underwent pneumonectomy for multiple lung abscess and open drainage for liver abscess, were resuscitated but did survived. The Latter died from bleeding due to rupture of the liver that developed during the closed chest cardiac massage. One patient who had open chest cardiac massage survived to be discharged without any sequele. Unsuccessful resuscitation was observed in two patients, one had a complication of malignant hyperthermia with muscle rigidity during gastrectomy for ulcer perforation and another had not firm support on the back during massage.

• 한국화재소방학회논문지
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• 제25권5호
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• pp.21-31
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• 2011

병원 밖에서 발생한 비외상성 심정지 환자에 대한 119 구급대원의 처치 현황과 개선방안을 연구하기 위해 대전충남에 근무하는 119 구급대원 322명에게 설문을 실시하였다. 119 구급대원들은 병원전 비외상성 심정지 환자에 대해 CPR은 96.9%(309명), AED는 53%(169명)에서 거의 매번 또는 매번 실시한다고 하였다. 1급 응급구조사와 간호사의 경우 IV는 94.7%(143명)에서 가끔 실시하거나 실시한 적이 없다고 하였고 약물처치의 경우도 90.7%(136명)에서 실시한 적이 없다고 응답하였다. AED, 기도확보 및 IV 를 실시하지 못했던 이유에 대해서는 구급인원이 부족하고, 시간이 부족하며, 흔들리는 구급차 때문이라는 의견이 많았다. 임상실습이나 병원실습의 경험이 있는 119 구급대원이 IV나 약물처치를 더 자주 실시하는 것으로 나타났다. 결론적으로, 심정지 환자의 소생률을 향상시키기 위해서는 구급차에 탑승하는 구급인원을 보강하고, 일반인들도 할 수 있는 기본심폐소생술 처치에서 더 나아가 전문심장소생술을 실시할 수 있도록 1급 응급구조사에게 에피네프린의 사용을 허가하며, 임상실기 교육을 강화하고 구급대원을 법적으로 보호할 수 있는 방안이 마련되어야 할 것이다.

• 한국화재소방학회논문지
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• 제34권1호
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• pp.127-134
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• 2020

임신부에서 심정지가 발생하였을 때, 가장 중요한 것은 임신부를 소생시키는 것이다. 임신부에서의 심정지는 산모와 태아를 동시에 고려해야 한다는 점 때문에 일반적인 심정지와 다른 부분이 있다. 임신부 심정지 환자에서는 태아를 분만해야 하는지를 결정하는 것은 산모와 태아 모두를 위하여 매우 중요하다. 심폐소생술이 수행되더라도 임신부 심정지 환자가 모두 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존율이 결정된다. 임신부 심정지 환자는 30세 목격당시 보호자에 의한 빠른 인지와 신속한 신고 및 목격자 심폐소생술이 이루어져 졌으며 119구급대에 의한 전문소생술이 적용되었고, 환자와 태아 모두 적절한 치료 후 6일 만에 건강하게 퇴원한 사례이다. 병원 전 단계에서 임신부 환자가 자발순환회복(Return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 임신부 심정지가 발생하여 목격자에 의한 심폐소생술과 119구급대원에 의한 전문심장소생술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.477-482
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• 2018

Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

• 한국화재소방학회논문지
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• 제24권5호
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• pp.142-149
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• 2010

심폐소생술이란 인공호흡과 순환보조를 통하여 조직으로의 산소 공급을 유지하여 임상적 사망에서 생물학적 사망으로 진행을 막고, 심장박동과 순환을 회복시켜 환자를 소생시켜주는 술기이다. 심폐소생술이 시행되더라도 모든 심장정지 환자가 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존률이 결정된다. 현장에서 심장정지가 목격되지 않은 환자는 병원이송 전 현장에서 2분간 5주기 심폐소생술을 수행하고 자동제세동기를 사용하도록 하였고, 목격된 환자에게는 즉시 자동제세동기를 사용할 것을 권장하고 있으며 이후 전문적인 심장구조술이 필요하다. 병원 전 단계에서 119 구급대가 이송한 환자 중 자발순환회복(return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 현장에서 심장정지가 목격되었으나 심폐소생술이 시행되지 않았고 구급대원이 도착한 후 심폐소생술 시행 및 전문심장구조술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

• Journal of Chest Surgery
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• 제57권1호
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• pp.79-86
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• 2024

Background: This study investigated the surgical outcomes associated with coronary artery fistulas (CAFs) in children. Methods: We retrospectively reviewed the medical records of 23 pediatric patients who underwent surgical closure of CAFs between 1995 and 2021. At presentation, 7 patients (30.4%) exhibited symptoms. Associated cardiac anomalies were present in 8 patients. Fourteen fistulas originated from the right coronary artery and 9 from the left. The most common drainage site was the right ventricle, followed by the right atrium and the left ventricle. The median follow-up duration was 9.3 years (range, 0.1-25.6 years) Results: The median age and body weight at repair were 3.1 years (range, 0-13.4 years) and 14.4 kg (range, 3.1-42.2 kg), respectively. Cardiopulmonary bypass was used in 17 cases (73.9%), while cardioplegic arrest was employed in 14 (60.9%). Epicardial CAF ligation was utilized in 10 patients (43.5%), the transcoronary approach in 9 (39.1%), the endocardial approach in 2 (8.7%), and other methods in 2 patients (8.7%). The application of cardioplegic arrest during repair did not significantly impact the duration of postoperative intensive care unit stay or overall hospital stay. One in-hospital death and 1 late death were recorded. The overall survival rate was 95.7% at 10 years and 83.7% at 15 years. A residual fistula was detected in 1 patient. During the follow-up period, no surviving patient experienced cardiovascular symptoms or coronary events. Conclusion: Surgical repair of CAF can be performed safely with or without cardioplegic arrest, and it is associated with a favorable prognosis in children.