• 제목/요약/키워드: First Aid Experience

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승모판막 수술환자에서의 심방세동에 관한 치료관찰 (Control of Atrial Fibrillation in Mitral Valvular Heart Surgery [90 Cases])

  • 곽문섭
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.679-691
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    • 1985
  • Ninety patients underwent mitral valvular heart surgery associated with or without aortic valve surgery and subjected to a clinical study in relation to their control of postoperative atrial fibrillation. There were 26 males and 64 females ranged in age from 16 to 56 years with a mean of 35.2 years. Systemic arterial embolizations were observed in 11 patients [12.2%]. Four patients of them were in normal sinus rhythm and 7 in atrial fibrillation. Out of these, left atrial thrombi were found only in 2 at the operation. Intraoperatively confirmed left atrial thrombi were in 16 patients [17.7%] of all 90 patients: Eleven patients occurred at the age of more than 40 years, 14 were in atrial fibrillation and 2 only had previous episodes of systemic arterial embolization. Sixty three patients underwent isolated mitral valve surgery [OMC 28, MVR 35] and 27 patients associated with aortic valve surgery along with mitral valve [OMC+AVR 13, MVR+AVR 14]. Preoperatively, 44 patients [48.9%] were in normal sinus rhythm. Of them, 35 patients [79.5%] revealed normal sinus rhythm thoroughly after operation without any aid of digitalis or quinidine and 5 patients [11.4%] restored normal sinus rhythm with digitalization alone. Other 3 patients converted to normal sinus rhythm with the addition of quinidine, however, in 1 patient who was resistant to quinidine therapy, electrocardioversion was carried out on the postoperative third week showing normal sinus rhythm. Thus, the most atrial fibrillations that occurred for the first time in the postoperative period, were able to reverted to normal sinus rhythm responding well to antiarrhythmic therapy. Preoperatively, 46 patients [51.1%] were in atrial fibrillation. Of them, only 5 patients returned to sinus rhythm after operation without any aid of digitalis or quinidine and other 5 restored normal sinus rhythm with digitalization: namely 2 restored within early postoperative period and 3 after more than 3 months. Eight patients well responded to quinidine therapy showing normal Sinus rhythm. So far, 25 patients have remained in persistent atrial fibrillation on 6 to 36 months follow-up. In view of these, 17 patients [68%] were over 40 years of age, 22[80%] had long duration of symptom over 5 years and 10[40%] have had atrial thrombi before operation. Left atrial dimension were still more than 40mm in 21 patients on follow up M-mode echocardiogram. One month after operation, 87 hospital survivors were improved by at least one functional NYHA class. There were 3 operative deaths [3.3%, bleeding 1, LCOS 2] and 4 late deaths [LCOS 1, valve thrombosis 1, late bleeding 1, fulminant hepatitis 1] during follow-up period. According to our limited experience, we may conclude that better results will be expected with the addition of quinidine therapy judiciously in the cases of postoperative persistent atrial fibrillation who were aged or had longer history of symptom and left atrial thrombi.

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구명뗏목에서의 비상대응 심폐소생술의 효과 분석 및 개선에 관한 연구 (A Study on the Effect Analysis and Improvement of Cardiopulmonary Resuscitation on Life-rafts)

  • 이창우
    • 해양환경안전학회지
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    • 제25권4호
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    • pp.433-440
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    • 2019
  • 선박, 해양플랜트, 해상풍력 등과 같은 해양에서의 근무 환경은 고립되어 있고 거친 해상에 바로 노출되어 있어 안전사고의 높은 위험성을 안고 있다. 이에 해양에서 근무를 하는 모든 종사자에게는 비상상황에 대한 대처 능력이 요구되고 있고 비상대응업무를 수행하는 자에 대해서는 STCW협약, OPITO Safety Training Standard 등의 관련 규정에 근거하여 자격 증명이 이루어지고 있다. 특히, 고립된 상황에서 해양종사자들의 응급처치기술은 필수 요건 중의 하나이다. 그러나 선박을 포함한 해양구조물에서 비상탈출 시 사용하게 되는 구명뗏목에서의 심폐소생술은 구명뗏목의 바닥이 고무재질로써 충분한 가슴압박이 힘들어 응급처치자의 심폐소생술에 대한 피로도와 정확도에 영향을 미칠 것으로 추정된다. 본 논문은 조파장치가 설치되어 있는 안전훈련센터에서 15명의 응급처치강사를 표본으로 바다와 유사한 환경을 조성하여 구명뗏목에서의 심폐소생술 실험을 하였다. 실험 결과, 강의실에서의 심폐소생술의 정확도 평균은 99.6 %였으나 구명뗏목의 여러 환경에서의 심폐소생술의 정확도는 84 %였다. 두 장소의 심폐소생술 정확도에 대한 t 값의 절대값이 임계값의 절대갑보다 크기 때문에 구명뗏목의 심폐소생술의 정확도가 낮아짐을 검증하였다. 파도를 0.3미터 형성한 경우에는 구명뗏목의 심폐소생술의 정확도가 77 %로 낮아짐을 확인하였다. 이에 본 논문을 통해 구명뗏목에서의 심폐소생술은 2인 1조로 실시할 것을 제시하며 최근 활용되고 있는 흉부 압박 자동화 장비를 활용할 것을 추천한다.

응급구조과 학생의 성취동기와 임상실습 만족도와의 상관성 연구 (A Correlation Study on the Relationship between Motivation for Achievement and Satisfaction on Clinical Practice in EMT students)

  • 박대성;남건우
    • 한국응급구조학회지
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    • 제11권3호
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    • pp.47-64
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    • 2007
  • Purpose : This study examines satisfaction of students at the department of Emergency Medical Technology with clinical practice and relationship between motivation of achievement and satisfaction with clinical practice and aims to provide basic materials contributing to the improvement of clinical practice education. Method : It selected 237 students in the second and third grade at the dept. of Emergency Medical and having experience in clinical practice as the subjects, collected data from Sept. 1 to 30, 2007 and analyzed 237 questionnaires collected with SPSS 12.0 program. Result : 1. Degree of motivation of achievement scored 3.46 of full marks of five points and they showed motivation of achievement over average score. Students who entered the dept. of Emergency medical after beginning social career(3.78) showed higher motivation of achievement in the period of entrance and group having will to be volunteer(3.66) showed the highest motivation of achievement in selecting this major. The better personal relationship they have, the greater hospital grade and the higher their transcript, the higher motivation of achievement they have. In the desired area of employment after graduation, first-aid staffs at the field of industry group(3.85) showed the highest motivation of achievement. 2. Degree of their satisfaction with clinical practice scored 3.53 of full marks of five and they showed satisfaction with it over average score. They showed the highest satisfaction in the contents of practice(3.64). 3. There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice(r = .165, p < .05). Conclusion : There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice. Repeated research through sampling based on probability to generalize relevance of motivation of achievement and satisfaction with clinical practice is needed and further researches on developing program to inspire motivation of achievement in theoretical learning as well as in clinical practice are required.

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지방테마과학관의 실태분석 및 특성화방안 고찰 (Analysis of Actual Conditions and Consideration of Specification Plan of Local Theme Science Museum)

  • 정진주
    • 한국농촌건축학회논문집
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    • 제11권3호
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    • pp.1-9
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    • 2009
  • Through 'Local Theme Science Museum' aid program that is one of emphasis promotion strategic project by 2007 'Science.Technology.Cultural Project Plan', raises status of scientific technique by national core ability because all people expand base that understand and support scientific technique, and forms a social atmosphere which is scientific technique is important which scientific technique can be spread widely on national life and society whole, and proceeds target that expand local science museum facilities by a base of local science culture spreading and popularization. Accordingly, to plan balanced regional development and utilize to an advanced base of local science culture spreading because offer a science culture experience opportunity to local inhabitants, 'Local theme science museum' project is doing for that establish more 100 science museums for national.public.private institution in whole country until 2012 year. Support 39 projects to 2008 from 1999 thereby, in January, 2009, 13 'Local theme science museum' is opened and operated. This study examined arrangement preferentially about 'Science.Technology.Cultural Project Plan' that is background of 'Local theme science museum' project. Since surveying science museum which is on opening and operation at the present and analyzed actual conditions and facilities and investigated specification necessity and direction of 'Local theme science museum'. Hereafter, to seek plan for propriety of project by characteristic and difference of 'Local theme science museum' is purpose of this study. Now, need set and promotion of following specification direction for right activation of proceeding 'Local theme science museum' by each area. First, differentiation of theme and justifiability of building, Second, propriety of site position, Third, maximization of synergy effect by mixing concept of 'Specialized Economic Zone for Regional Developmental Policy' and Ecomuseum's 'Theme center'.

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치과위생사의 물질안전보건자료 인식도와 유해화학물질 취급 시 안전 실태에 관한 연구 (A study on the Recognition of Material Safety Data Sheets and Safety of Handling Harmful Chemicals in Dental Hygienists)

  • 김은경;정경이
    • 디지털융복합연구
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    • 제16권4호
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    • pp.185-194
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    • 2018
  • 본 연구는 치과위생사들의 치과재료에 대한 물질안전보건자료(Material Safety Data Sheet, MSDS)의 인식도와 유해화학물질 취급 시 안전 실태에 대해 파악하고자 실시하였다. 연구는 광주광역시에 근무 중인 치과위생사 250명을 대상으로 2015년 1월부터 2월까지 조사하였고, 235명의 자료를 최종분석 대상으로 하였다. 그 결과 치과재료에 대한 MSDS 인지 정도는 연령이 높을수록 인지도가 높게 나왔으며(p<0.05), 치과병원에 근무하는 치과위생사(p<0.001)에서 유의하게 높았다. 치과재료의 유해화학물질위해성에 대한 인식도에 영향을 미치는 요인은 MSDS인식도(p<0.001)이었고, 유해화학물질 노출 시 응급처치에 대한 인식도에 영향을 미치는 요인은 유해위험성 교육을 받은 경험(p<0.001)으로 나타났다. 따라서 치과위생사들의 치과재료에 대한 MSDS 인식도와 유해화학물질 취급 시 안전 실태에 대해 파악함으로써 유해화학물질 취급 시 안전에 대한 올바른 인식 확립과 이로 인한 사고를 예방하기 위한 교육 프로그램 개발에 기초자료를 제공하고자 한다.

초등학생의 안전의식과 안전사고 발생 실태에 관한 연구 (A Study on Safety Awareness and Safety Accident Occurrence of Elementary School Students)

  • 박대성;김광석
    • 한국응급구조학회지
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    • 제9권2호
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    • pp.5-20
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    • 2005
  • Purpose: This study is to examine the relationship between safety awareness and safety accident occurrence with elementary school students. Materials and methods: It selected 10 elementary schools under the supervision of Jeonnam Board of Education and sampled 700 students randomly from 2-3 classes in the 5th and the 6th grade. One preliminary survey was conducted to revise and complement the contents and forms of questionnaire with 70 students of a school from Apr. 1 to 6, 2004 and this study was conducted from Apr. 10 to 30, 2004. Total 700 questionnaires were distributed and 681 were collected (97%) and 602 were used for final analysis except 79 lacking responses. Data collected were analyzed with SPSS statistical program. Results: The average score of safety awareness of subjects by area was high as 2.72 points out of a possible 3. Area showing the highest safety awareness was safety from fire. Girl students had higher safety awareness than boy students. The fifth graders had higher safety awareness than the sixth graders. In safety awareness by the number of siblings, single son or single daughter showed the highest safety awareness. 53.2% of the subjects experienced accident for one year, the frequency of accident was mostly once and most of accidents were occurred at school. Accidents for the last year were higher in boy students, the sixth graders. According to relationship between safety awareness and safety accident, group with lower safety awareness in school safety(P < .022), traffic safety(P < .016), fire safety(P < .019), home safety(P < .007) and accident treatment and first aid(P < .003) had higher safety accidents than that with higher safety awareness. Conclusion: Development of safety education program by grade, that of parents safety education program, field experience and practice with students, teachers and parents and various safety education programs should be substantially and repeatedly accomplished for prevention education of safety accidents. In addition, to prevent and cope with safety accidents, safety education should be reflected on normal education, safety education textbook be developed, special safety education teachers be employed for safety education.

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대동맥하단부-장골동맥의 급,만성 폐쇄성 동맥질환 2례 (Surgical Treatment of Aortoiliac Arterial Occlusion: Report of 2 Cases)

  • 마중성
    • Journal of Chest Surgery
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    • 제5권1호
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    • pp.19-24
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    • 1972
  • The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

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야외교육의 전문성 이해와 교육적 지향 (Understanding and expertise in outdoor education and education-oriented)

  • 이주욱;윤대현
    • 디지털융복합연구
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    • 제12권11호
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    • pp.607-615
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    • 2014
  • 야외교육은 학습자에게 기대하는 내적 성장부터 생태와 환경까지 다양한 체험을 강조한다. 더불어 야외교육의 공동체성, 생태적 관점 등의 중요성은 시대적 요구이기도 하다. 이러한 야외교육은 우리나라 국가수준의 교육과정에도 반영되어 문서로 제시하고 있다. 하지만 야외교육에 대한 교육목표가 뚜렷하지 않고, 철학적 고민이 부족한 실정이다. 이에 본 연구에서는 야외교육에 대한 교육목표를 명확히 하고, 전문성에 대한 담론을 분석해서 지향점을 제시하였다. 야외교육의 전문성에 대해 논의하기 위해 '교사' 전문성, '체육 교사'의 전문성을 분석했다. 야외교육의 지향점으로는 첫째, 총체적 체험과 문제해결능력, 둘째, 반성적 실천가로의 지향으로 구분했다. 이는 야외교육은 효율적 지도방법만을 추구하는 것이 아니라 지도자 자신의 삶과 행위를 통해 지속적으로 성찰하고 실천하는 전문인으로 거듭나야 한다는 것이다. 결론으로는 첫째, 야외교육 체험에서 안전에 대한 문제 해결을 위한 매뉴얼 개발이 필요하다. 둘째, 야외교육을 가르칠 수 있는 전문인 양성을 위한 교과정 개발이 필요하다. 셋째, 야외교육을 학교교육으로 한정하지 않고, 비제도권 교육에 포함시켜야 함을 제시했다.

원자력발전소 계획예방정비 기간중 피폭최적화 경험 (The Optimization Experience of Occupational Exposure during Unclear Power Plant Outage)

  • 송영일;김형진;박헌국;김희근
    • Journal of Radiation Protection and Research
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    • 제28권2호
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    • pp.145-154
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    • 2003
  • By optimizing the radiation protection the collective dose and individual dose could be reduced during YGN #4 $5^{th}$ outage in 2001. The collective doses for the two high radiation jobs decreased to 85% and 65% of expected doses. The proportion of workers with low dose (below 1mSv) exposure increased 4% while the proportion of workers with over 3mSv and 5mSv exposure are decreased to 2%, 1% respectively. But none is exposed over 8mSv for the annual dose. To aid decision of utilizing the robot, cost- benefit analysis was performed and reasonable point was proposed to use the robot. For the first time job, repeated ALARA meeting and mock up training were implemented to set up working procedure by identifying the trouble. To easily set up standard procedure, mockup process was videotaped and reviewed during ALARA meeting. Monitoring is a good approach to chase radiological working condition such as working time, dose rate. behavior of workers, especially for high radiation work. Those data were estimated and adjusted from the stage of work planning to mock up. At the stage of actual work the monitoring data were compared to the estimation and recorded to database. This database will not only be used as a powerful tool for dose optimization at the following outage but also as a guideline to dose constraint set up for optimization for each specific situation.

교원 대상 학교안전관리 역량 강화 프로그램 개발을 위한 교육 요구분석 (A Needs Assessment for Teachers' School Safety Management Competency Development Program)

  • 황영아;강형구
    • 한국학교보건학회지
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    • 제30권1호
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    • pp.70-80
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    • 2017
  • Purpose: Recently, various accidents and incidents occurred in our school environment, making it necessary to enhance teachers' competency in school safety management. To this end, this study was conducted to analyze the needs of teachers related to school safety management competency development. Methods: For this purpose, the existing teacher's task analysis related to school safety management was revised and surveys were conducted to measure teachers' present level, expectative level and importance of the items based on the task analysis. To analyze the data, Borich Needs Assessment and The Locus for Focus Model were used. Results: In the t-test between the teachers' present level and expectative level about school safety management, all 39 tasks were related (p<.001). The priorities in developing teachers' competency in school safety management were found to be the 6 tasks listed below: 'To deal with each type of accident,' 'To implement CPR and defibrillator,' 'To use fire extinguishers and fire hydrants,' 'To use descending life lines,' 'To give first aid,' and 'To cope with elevator accidents.' Conclusion: By utilizing the results of the teacher's competency and need assesment as components, teachers' training programs can be made more applicable to the school setting. In addition, more experience-based programs should be considered when designing teachers' training programs in order to apply the priority found from the teacher's need assessment.