• Title/Summary/Keyword: Cardiac Arrest patient

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Effectiveness of Student Learning with a Simulation Program focusing on Cardiac Arrest in Knowledge, Self-confidence, Critical Thinking, and Clinical Performance Ability (심정지 시뮬레이션 교육이 간호학생의 지식, 자신감, 비판적 사고성향 및 임상수행능력에 미치는 효과)

  • Chae, Min-Jeong;Choi, Soon-Hee
    • Korean Journal of Adult Nursing
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    • v.28 no.4
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    • pp.447-458
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    • 2016
  • Purpose: This study was designed to describe the effects of a nursing simulation focused on patients with cardiac arrest. The study was designed to measure knowledge, self-confidence, critical thinking, and clinical performance ability of nursing students. Methods: A non-equivalent control group quasi-experimental design was used. Thirty students in the experimental group received two hours of pre-learning and three hours of skill and simulation practice. Another thirty students in the experimental group received a two hour conventional lecture and three hours for skill practice. The post survey was completed by both groups. Results: Students in the experiemetal group scored significantly higher than students in control group. The critical thinking disposition was not significantly different between the two groups of students. Conclusion: The results indicate that a simulation education program is more effective in a number of areas including knowledge, self-confidence, and clinical performance. It is recommended that simulation education should be expanded to various clinical situations.

A Case of Cardiac Arrest Due to Severe Lithium Intoxication - Difficult Diagnosis - (중증 리튬 증독 후 발생한 심정지 1예 - 어려운 진단)

  • Ahn Jung Hwan;Choi Sang Cheon;Yoon Sang Kyu;Jung Yoon Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.130-134
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    • 2005
  • Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

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Emergency Surgery after Failed Percutaneous Transluminal Coronary Angioplasty (경피적 관상동맥 성형술후의 응급 관상동맥 우회술)

  • 박영환
    • Journal of Chest Surgery
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    • v.25 no.1
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    • pp.73-78
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    • 1992
  • From Octorber 1984 through September 1991, 480 patients underwent percutaneous tra-nsluminal coronary angioplasty and 7 of these[1.4%] required coronary artery bypass surgeries in the emergency base. The principal indications for surgery were coronary dis-sections[n=2], acute coronary occlusions[n=3], and ventricular arrhythmias[n=2]. There were two early deaths and one late death. No patient who developed cardiac arrest and had not been resuscitated before surgery survived the operation. The outcome of surgery was related to the preoperative clinical status of patients.

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Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality

  • Byeong A Yoo;Seungmo Yoo;Eun Seok Choi;Bo Sang Kwon;Chun Soo Park;Tae-Jin Yun;Dong-Hee Kim
    • Journal of Chest Surgery
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    • v.56 no.3
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    • pp.162-170
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    • 2023
  • Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021. Results: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant. Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.

A plan to Improve the Ratio of CPR done by the General Public using Smart-phone Location-Based Service APPs (스마트폰의 위치기반서비스 앱을 활용한 일반인 심폐소생술 시행률 향상방안)

  • Han, Seungtae
    • Journal of the Society of Disaster Information
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    • v.11 no.2
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    • pp.183-190
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    • 2015
  • When patients have acute cardiac arrest before they are hospitalized, the ratio of CPR done by the general public is directly related to patient survival ratio. However, compared with that of advanced nations, our nation has low patient survival ratio due to its low ratio of CPR done by the general public. To improve this situation, the current study conducted a pre-survey targeting 3,800 general public to find how to apply an emergent medical system using smart phone location-based service. According to its outcome, first, they have a high level of CPR experience while their recognition of CPR generality is low. Second, their self-confidence in doing CPR significantly differ according to their age, academic achievement and occupation yet with generally low self-confidence. Third, their participation in the emergent medical system using location-based service APPs is high, and has co-relation to their will for CPR, self-confidence in CPR and experience in CPR training.

A study on Supply Extension Device of AED (AED의 보급 확대 방안에 관한 연구)

  • Koh, Jae-Moon;Kim, Young-Ho;Han, Sang-Hak
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.147-168
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    • 2005
  • It examined the doubt point which AED motive relates until now, the AED should have bought a life how, present address of our country site pre-hospital care, comparison it tried to observe the advanced nation instance back. Gist of this research the AED important cold region once compared to informed to how many cardiac arrest patient, against him the what kind of preparation wanted informing the necessary cold region. It soaks simultaneously but the AED motive is widely supplied distant in future and it is generality and it is feeble but it wanted doing one morning. The habit difference of an American who does of course meat diet mainly and a Korean is many and it compares in the United States and the cardiac arrest patient comparison occurs holds a point few. To become Western anger but and be caused by with thin dietary life, stanching bleeding cung, with the fact that the heart attack is increasing rapidly with the hyperextension. It is a talk which anyone it knows all. The major league most Choi huy Sub in condition will catch the ball which floats and the multi co-player and to collide when falling down, the medical device which is committed with emergency aid is AED motive. From the United States subway station and the shopping which are a public place on the baseball field outside the jar which it will drive, the museum and the school, easily there is it will be able to discover the AED from the court of justice back. The Pittsburg university the students per the individual $30 the core phyey were receiving the smallness lifestyle alcoholic beverage and a AED motive actual training with mercy of degree. From the United States distant in future the AED motive is sold even from the retail store and. From our country like this plan government offices temporary disposal education from from 119 fire fighters emergency structure company in fire fighting government employee and nursing must magnify a former enterprise rainy spell in summer multi temporary disposal education with the head which it will burn with the head. This plan in early rising will be able to become fixed in Korea it forecasts with the fact that. The research which it sees it leads and like the United States to some day become fixed even from our country to believe and suspicion it is not and in the people in approach ease one AED supply plan fire fighting government employees stand in the first and feed with the fact that must be positive at this enterprise they become.

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흉총창에 의한 심방파열 치험 2례

  • Lee, Doo-Yun;Kwack, Sang-Ryong
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.60-65
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    • 1980
  • We have experienced 2 cases of the hunshot wound sof the chest involving cardiac injuries at department of the thoracic surgery, Capital Armed Forces General Hospital during I year from April I 1979 to Jan. 1980. In one case of two patients , he was a 22 years old man who was transported to this emergency room 4 hour 10 minutes after having gunshot wound of the left chest by helicopter. Physical examination showed small inlet in left 3rd ICS and left parasternal border, large outlet in left 8th ICS and left scapular line, no breath sound on left side and distant heart sound. chest roentgenography demonstrated marked pleural effusion in left side and mediastinum shifted to right. As soon as chest X-ray was taken, the bleeding through penetrating wound became profuse and cardiac arrest ensued. Closed chest cardiac massage was started and vigorous transfusion continued, but no effective cardiac activity could not be obtained. The patient was pronounced dead due to exsanguinating hemorrhage from wuwpected cardiac wounds. In this critically injured patient with evidence of intrathoracic hemorrhage and suspected cardiac penetration, only emergency thoracic exploration and immediate surgical control of bleeding points might offer the maximum possibility of survival. The other case was a 23 years old man who was transferred to the emergency room 4 hours 50 minutes after having kmultiple communicated fractures of sternum and linear fracture of right mandible by a missile. Examination revealed about 30% skin loss of the anterior chest wall, weak pulse of 96 beats/min., distant heart sound and decreased breath sounds bilaterally. finding on the chest X-ray films showed multiple sternal fractures, marked pericardial effusion indicating hemopericardium. So, the patient was moved immediately to the operation room where, after endotracheal tube inserted, a median sternotomy was performced. A hemorrhagic congestion of the right upper lobe and marked bulging pericardium were disclosed. The pericardium was opened anterior to right phrenic nerve and exsanguinating hemorrhage ensued from the 0.5cm lacerated wound in the auricle of right atrium. The rupture site of right atrium was occluded with non-crushing vascular clamps and then was over sewn with interrupted sutures. It was thought to be highly possible that he was alive long enough to have cardiorrhaphy because of cardiac tamponade, which prevented exsanguinating hemorrhage. He was taken closed reduction for linear fracture of right mandible 2 weeks after repair of ruptured right auricle in dental clinic. This patient's post-operative course was not eventful.

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Bronchial Rupture by Blunt Chest Trauma -a case- (외상성 기관지 단절의 수술 치험 -1례-)

  • 정종화
    • Journal of Chest Surgery
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    • v.21 no.3
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    • pp.547-552
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    • 1988
  • Rupture of the main bronchus followed by blunt chest trauma is comparatively very rare. Early recognition of bronchial rupture and emergency thoracostomy and management is essential for reducing of morbidity and mortality and late complications. This case was 11 years old female who was a primary school student. The patient was sustained a crushing injury to her right hemithorax by traffic accident and had been taken emergency closed thoracostomy at her second intercostal space, midclavicular line at emergency room. In the course of the next 2 hours, the girl`s condition remained critical with tension pneumothorax and abnormal arterial blood gas analysis. Induction of anesthesia started 3 hours after the accident. During the general anesthesia, cardiac arrest was occurred and cardiac resuscitation was performed. Right upper lobectomy and end-to-end anastomosis of ruptured right main bronchus was performed. Postoperative course was satisfactory.

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Transposition of the Great Arteries (TGA) -Report of An Autopsy Case- (대혈관전위증 부검 1례 보고)

  • 김학제
    • Journal of Chest Surgery
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    • v.10 no.1
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    • pp.106-112
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    • 1977
  • Transposition of the great arteries is one of the commonest forms of severe congenital heart disease and produces severe cyanosis threatening survival from the day of birth. Anatomical anomalies which the aorta arises from the infundibulum of the right ventricle and the pulmonary artery arises from the outflow tract of the left ventricle make the deranged circulation. Survival is possible only if additional anomalies are present which allow mixing of the pulmonary and systemic circulations. Preoperative diagnosis as TGA was taken on the 15 day old female via the preoperative examination and the right cordioangiography. As palliative treatment for cyanosis, Blalock-Hanlon operation was performed in this patient. The results were good as 54 mmHg changed from 27 mmHg of $PO_2$ in aorta, but sudden cardiac arrest was developed in postoperative 12 hours. In order to confirm the cause of death and the cardiac anomalies, autopsy was performed on the date of death. The diagnosis of the autopsy showed; [1] Transposition of the Great Arteries. [2] Patent Ductus Arteriosus. [3] Patent Foramen Ovale. [4] Ventricular Septal Defect, 2 Muscular Type. [5] Double Ureter, Right. [6] Artificial Atrial Septal Defect. [7] Total Collapse of the left lung and Intraparenchymal hemorrhage of right lung.

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The Change of Derum and Urine Amylase Level Following Cardiopulmonary Bypass in the Patients with Congenital heart disease (선천성 심기형 환아에서 체외순환후 혈청 및 소변 Amylase치의 변화)

  • Baek, Hui-Jong;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.28 no.10
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    • pp.892-899
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    • 1995
  • Pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass. Although ischemia is believed to be a factor, the exact cause of pancreatitis after cardiopulmonary bypass remains unknown.We prospectively studied 67 consecutive patients undergoing cardiac surgery with cardiopulmonary bypass for evaluation of the pancreatic injury after cardiopulmonary bypas. Serial measurement of amylase level in serum and urine was done postoperatively. Hyperamylasemia was detected in 15 patients[22.4% , of whom no patient had pancreatitis. There was no significant difference between serum amylase level and parameters such as cardiopulmonay bypass time, aortic cross clamp time, mean blood pressure, rectal temperature, flow rate, and use of circulatory arrest during cardiopulmonary bypass. Hyperamylasuria was detected in 8 patients[11.9% , and urine amylase level was elevated significantly in the groups with prolonged cardiopulmonary bypass, mean blood pressure more than 40mmHg, and rectal temperature more than 20 $^{\circ}$C. We recommend that serum amylase level and/or amylase-creatinine clearance ratio is measured for ealy detection and management of pancreatitis after cardiopulmonary bypass.

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