• Title/Summary/Keyword: Emergency airway management

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Development and Effects a Simulation-based Emergency Airway Management Education Program for Nurses in a Neonatal Intensive Care Unit (신생아집중치료실 간호사를 위한 시뮬레이션 기반 응급기도 관리 교육 프로그램 개발 및 효과)

  • Kim, Minjung;Kim, Sunghee
    • Child Health Nursing Research
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    • v.25 no.4
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    • pp.518-527
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    • 2019
  • Purpose: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit. Methods: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0. Results: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem-solving ability, and confidence in clinical performance. Conclusion: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.

The Impact of a Simulation-based Education Program for Emergency Airway Management on Self-efficacy and Clinical Performance among Nurses (시뮬레이션 기반 응급기도관리 교육이 간호사의 자기효능감, 임상수행능력에 미치는 효과)

  • Lee, Mi-Ja;Jung, Dukyoo
    • Korean Journal of Adult Nursing
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    • v.26 no.1
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    • pp.1-10
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    • 2014
  • Purpose: This study was conducted to test the impact of simulation-based education program for emergency airway management on self-efficacy and clinical performance ability. Methods: A quasi-experimental non-equivalent control group pre-post test design was used. A total of 60 nurses, 30 nurses assigned to the simulation-based education group and 30 nurses to a traditional lecture group. The treatment group received a lecture, small group workshop and team simulation whereas the comparison group received lectures. Results: The participants in the simulation-based education group reported significantly higher self-efficacy of emergency airway management compared to participants in the lecture only group (t=5.985, p<.001). The simulation-based education group showed significantly higher clinical performance ability of emergency airway management compared with the lecture group (t=5.532, p<.001). Conclusion: Simulation-based education was verified to be an effective teaching method to improve the self-efficacy, clinical performance skills of nurses in the learning of emergency airway management.

Comparison of endotracheal intubation speed and ease by using the supraglottic airway laryngopharyngeal tube: A manikin study (성문위기도기 인후두튜브(SALT)를 이용한 기관내삽관 신속성과 용이성 비교: 마네킨을 이용한 연구)

  • Yun, Seong-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.2
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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.

The Effect of Complete Airway Obstruction Maneuver Training Program on the Learning Motivation, Knowledge and Skill of Choking Management (초등학교 고학년생의 이물질에 의한 완전기도폐쇄 응급처치 실기교육이 학습동기, 응급처치 지식과 기술에 미치는 영향)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.79-88
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    • 2005
  • The purpose of this study was to develope the Complete Airway Obstruction Maneuver Training Program and identify its effects on learning motivation, knowledge and skill of choking management in the primary school students. The subjects for the experimental group of 38 students and the control group of 39 students, all of whom are primary school students in Gwangju, the Republic of Korea. A non-equivalent control group pretest-posttest design was used and data were collected from November to December, 2003. During about 2 weeks, 2 times for a week with 80 minutes at a time, the complete airway obstruction maneuver training program was conducted in the experimental group. Experimental data were analyzed through SPSS/win 11.0 PC+, and the tests examining general characteristics between the experimental group and the control group were conducted through $x^2$-test. Fisher's exact probability test and t-test, and identifying the effect of the complete airway obstruction Maneuver training program was analysed through t-test and ANCOVA. The results of the study were as follows: 1. After intervention on the complete airway obstruction maneuver training program, Learning motivation in the experimental group was significantly higher than that of the control group. 2. After intervention on the complete airway obstruction maneuver training program, knowledge of choking management the experimental group was significantly higher than that of the control group(F=223.637, p=.000). 3. After intervention on the complete airway obstruction maneuver training program, skill of choking management the experimental group was significantly higher than that of the control group(t=46.800, p=.014). These findings suggest that the complete airway obstruction maneuver training program can facilitate learning motivation, knowledge and skill of choking management in the primary school students. Therefore it is considered that the complete airway obstruction maneuver training program can be utilized as a effective way to implement the 7th national curriculum for creative extra-activities.

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Factors associated with advanced airway management while performing cardiopulmonary resuscitation for out-of-hospital cardiac arrest patients by 119 EMT (병원 외 심정지 환자에서 119 구급대원의 전문기도유지술 시행에 영향을 미치는 요인)

  • Seo, Ah Ram;Kim, Dae Hee
    • The Korean Journal of Emergency Medical Services
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    • v.23 no.1
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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.

Anesthetic management for emergency tracheostomy in patients with head and neck cancer: a case series

  • Ci Young, Kim;Seongji, Cho;Seung-Hwa, Ryoo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.6
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    • pp.457-464
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    • 2022
  • Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

A Development and Effects of Simulation-based Education Program on Emergency Airway Management (시뮬레이션 기반 응급기도관리 교육 프로그램 개발 및 효과)

  • Lee, Hyun Ah;Kim, Sung Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.282-293
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    • 2019
  • Purpose: After developing and imparting knowledge of a simulation-based emergency airway management education program for nursing students, this study identified the effects of the education by evaluating emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition. Method: The participants were 30 nursing students. Data were collected from October 14 to November 11, 2017, and analyzed using IBM SPSS Version 22.0. Results: The simulation-based nursing education program was developed and applied based on the ADDIE model involving five stages: analysis, design, development, implementation and evaluation. Comparing the pre-and post-education results, we observed statistically significant improvement when considering emergency airway management knowledge (t=-9.98, p<0.001), Clinical Performance Ability (t=-23.90, p<0.001), self-efficacy (t=-16.77, p<0.001), and critical thinking disposition (t=-5.04, p<0.001). Conclusions: Simulation-based emergency airway management training program is an effective educational program that enhances the emergency airway management knowledge, Clinical Performance Ability, self-efficacy, and critical thinking disposition of nursing students. We believe that the program developed in this study contributes towards improvement of patient nursing quality by enhancing the ability of nursing students to cope with emergencies in practice. Furthermore, it can be applied for educating new nursing students, and contribute to the development of nursing practices.

The current status and legal review of advanced airway management implemented by 119 EMTs (소방 119구급대원에 의해 시행된 전문기도관리 현황 및 법적 고찰)

  • Park, Si-Eun
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.2
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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.

Part 3. Clinical Practice Guideline for Airway Management and Emergency Thoracotomy for Trauma Patients from the Korean Society of Traumatology

  • Park, Chan Yong;Kim, O Hyun;Chang, Sung Wook;Choi, Kang Kook;Lee, Kyung Hak;Kim, Seong Yup;Kim, Maru;Lee, Gil Jae
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.195-203
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    • 2020
  • The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).

Comparison between laryngeal tube suction II and laryngeal mask airway in novice users - A manikin study - (초보자에서 후두튜브기도기와 후두마스크기도기의 삽관 비교 - 마네킨 연구 -)

  • Hwang, Ji-Young;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.3
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    • pp.19-28
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    • 2012
  • Purpose : The present study was designed to provide basic data for advanced pre-hospital airway management by comparing the insertion time and success rate between laryngeal tube suction II (LTS II) and laryngeal mask airway (LMA) in a manikin. Methods : A total of 32 participants were novice users to both of devices among paramedic students. After taking the introductory lecture and demonstrations, the participants made an attempt to insert the LTS II and LMA to compare the insertion time and success rate. They marked the easiness of insertion of the score ranged from 1 to 10 score scale and preference of the two devices. Results : The insertion time of the LTS II was significantly shorter than that of the LMA (p =.000). There was no significant difference between LTS II and LMA in the success rate. In the easiness of insertion, the score of LTS II $(8.47{\pm}1.41score)$ was significantly higher than that of LMA $(7.19{\pm}1.98score)$(p =.001). The preference of LTS II (75%) was much higher than that of LMA (25%). Conclusion : The manikin study data showed that the LTS II may be a good alternative airway device for providing and maintaining a patent airway.