• Title/Summary/Keyword: OHCA

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Machine-learning-based out-of-hospital cardiac arrest (OHCA) detection in emergency calls using speech recognition (119 응급신고에서 수보요원과 신고자의 통화분석을 활용한 머신 러닝 기반의 심정지 탐지 모델)

  • Jong In Kim;Joo Young Lee;Jio Chung;Dae Jin Shin;Dong Hyun Choi;Ki Hong Kim;Ki Jeong Hong;Sunhee Kim;Minhwa Chung
    • Phonetics and Speech Sciences
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    • v.15 no.4
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    • pp.109-118
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    • 2023
  • Cardiac arrest is a critical medical emergency where immediate response is essential for patient survival. This is especially true for Out-of-Hospital Cardiac Arrest (OHCA), for which the actions of emergency medical services in the early stages significantly impact outcomes. However, in Korea, a challenge arises due to a shortage of dispatcher who handle a large volume of emergency calls. In such situations, the implementation of a machine learning-based OHCA detection program can assist responders and improve patient survival rates. In this study, we address this challenge by developing a machine learning-based OHCA detection program. This program analyzes transcripts of conversations between responders and callers to identify instances of cardiac arrest. The proposed model includes an automatic transcription module for these conversations, a text-based cardiac arrest detection model, and the necessary server and client components for program deployment. Importantly, The experimental results demonstrate the model's effectiveness, achieving a performance score of 79.49% based on the F1 metric and reducing the time needed for cardiac arrest detection by 15 seconds compared to dispatcher. Despite working with a limited dataset, this research highlights the potential of a cardiac arrest detection program as a valuable tool for responders, ultimately enhancing cardiac arrest survival rates.

Mathematical Programming and Optimization of the Resource Allocation and Deployment for Disaster Response : AED case study (수리계획법을 활용한 방재자원 배치 최적화: AED 배치 사례)

  • Hwang, Seongeun;Lee, Nagyeong;Jang, Dongkuk;Shin, Dongil
    • Journal of the Korean Institute of Gas
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    • v.25 no.3
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    • pp.53-58
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    • 2021
  • The number of patients with cardiovascular diseases who experience an out-of-hospital cardiac arrest (OHCA) are increasing among young adults as well as the aged population. An automated external defibrillator (AED) is vital in improving survival rates of OHCA victims. Survival rates of OHCA were shown to decline exponentially in time to defibrillation, yet studies in Korea are uncommon that captures the properties of their survival rates in examining optimal locations of AEDs. In this study, we worked on the maximal gradual coverage location problem (MGCLP) with exponential decay coverage function to decide on their optimal locations. The exponential decay coverage function mitigates the drawback of over-estimating survival rates of OHCA patients. It is expected that a more sophisticated facility location problem will be developed to identify the "emergent" characteristics of pedestrians who responds to the OHCA occurrence by incorporating random pedestrian locations and movement through simulation.

Cardiac Arrest Management in the Workplace: Improving but Not Enough?

  • Alexis Descatha;Francois Morin;Marc Fadel;Thomas Bizouard;Romain Mermillod-Blondin;Julien Turk;Alexandre Armaingaud;Helene Duhem;Dominique Savary
    • Safety and Health at Work
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    • v.14 no.1
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    • pp.131-134
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    • 2023
  • The aim was to describe out-of-hospital cardiac arrest (OHCA) occurring in the workplace of a large emergency network, and compare the evolution of their management in the last 15 years. A retrospective study based on data from the Northern Alps Emergency Network compared characteristics of OHCA between cases in and out the workplace, and between cases occurring from January 2004 to December 2010 and from January 2011 to December 2017. Among the 15,320 OHCA cases included, 320 occurred in the workplace (2.1%). They were more often in younger men, and happened more frequently in an area with access to public defibrillation, had more often a shockable rhythm, had a cardiopulmonary resuscitation started by a bystander more frequently, and had a better outcome. Cardiopulmonary resuscitation started by a bystander was the only chain of survival link that improved for cases occurring after December 2010. Workplace OHCA seems to be managed more effectively than others; however, only a slight survival improvement was observed, suggesting that progress is still needed.

Outcomes in patients with out-of-hospital cardiac arrest according to prehospital advanced airway management timing: a retrospective observational study

  • Sang-Hun Lee;Hyun Wook Ryoo
    • Journal of Yeungnam Medical Science
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    • v.41 no.4
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    • pp.288-295
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    • 2024
  • Background: In patients with out-of-hospital cardiac arrest (OHCA), guidelines recommend advanced airway (AA) management at the advanced cardiovascular life support stage; however, the ideal timing remains controversial. Therefore, we evaluated the prognosis according to the timing of AA in patients with OHCA. Methods: We conducted a retrospective observational study of patients with OHCA at six major hospitals in Daegu Metropolitan City, South Korea, from August 2019 to June 2022. We compared groups with early and late AA and evaluated prognosis, including recovery of spontaneous circulation (ROSC), survival to discharge, and neurological evaluation, according to AA timing. Results: Of 2,087 patients with OHCA, 945 underwent early AA management and 1,142 underwent late AA management. The timing of AA management did not influence ROSC in the emergency department (5-6 minutes: adjusted odds ratio [aOR], 0.97; p=0.914; 7-9 minutes: aOR, 1.37; p=0.223; ≥10 minutes: aOR, 1.32; p=0.345). The timing of AA management also did not influence survival to discharge (5-6 minutes: aOR, 0.79; p=0.680; 7-9 minutes: aOR, 1.04; p=0.944; ≥10 minutes: aOR, 1.86; p=0.320) or good neurological outcomes (5-6 minutes: aOR, 1.72; p=0.512; 7-9 minutes: aOR, 0.48; p=0.471; ≥10 minutes: aOR, 0.96; p=0.892). Conclusion: AA timing in patients with OHCA was not associated with ROSC, survival to hospital discharge, or neurological outcomes.

Factors influencing success and safety of AED retrieval in out of hospital cardiac arrests in Singapore

  • NG, Jonathan Shen You;HO, Reuben Jia Shun;YU, Jae Yong;NG, Yih Yng
    • The Korean Journal of Emergency Medical Services
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    • v.26 no.2
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    • pp.97-111
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    • 2022
  • Purpose: Automated External Defibrillator (AED) usage in out-of-hospital cardiac arrests (OHCAs) improves the survival of patients. In Singapore, public AEDs are protected by locked boxes with a 'break glass' mechanism to deter theft. Community responders have sustained injuries while breaking glass to retrieve AEDs. This unprecedented study aimed to elucidate the factors influencing successful retrieval of an AED and to document the prevalence of injuries. Methods: A survey was created and distributed. Participants were required to have responded to an OHCA in the past 12 months. Comparison tests were performed with the Fischer-Freeman-Halton Exact test or Pearson chi square test at 5% significance levels, and with multiple logistic regression with a logit link function. Results: Eighty-eight participants were eligible. The success of retrieving an AED was found not to be impacted by occupation, age, gender or time. Participants who responded to an OHCA because of activation by the myResponder App were more likely to retrieve an AED successfully. (AOR 11.111, 95% CI: 2.141-58.824) Conclusion: Use of the myResponder mobile application is associated with the greater success of retrieving an AED. Successful retrieval of an AED is not impacted by time, gender, age, or the occupation of the responder. Community responders in Singapore remain motivated to respond to Cardiac Arrests despite risk of injury.

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.

Association between prehospital i-gel insertion and PCO2 in patients with out-of-hospital cardiac arrest

  • Cho, Eunsom;Cho, Eun-Hye;Kim, Hyuk-Hoon;Choi, Sang-Cheon;Min, Young-Gi;Kang, So Young;Chae, Minjung Kathy
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.578-584
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    • 2018
  • Objective: This study examined the initial partial pressure of carbon dioxide ($PCO_2$) as a possible indicator of prehospital ventilation and its association with prehospital i-gel in out-of-hospital cardiac arrest (OHCA) patients. Methods: The demographics and arrest parameters, including i-gel insertion and initial arterial blood gas analysis, of OHCA patients who visited the emergency department were analyzed retrospectively. Linear regression analysis was performed to examine the association between i-gel insertion and the initial $PCO_2$. Results: A total of 106 patients were investigated. Fifty-six patients had prehospital i-gel insertion and 50 patients did not have a prehospital advanced airway. The initial $PCO_2$ was higher in the i-gel group than the no advanced airway group (105.2 mmHg [77.5-134.9] vs. 87.5 mmHg [56.8-115.3], P=0.03). Prehospital i-gel insertion was associated with a higher initial $PCO_2$ level (${\beta}$ coefficient, 20.3; 95% confidence interval, 2.6-37.9; P=0.03). Conclusion: Prehospital insertion of i-gel was associated with higher initial $PCO_2$ values in OHCA patients compared to no advanced airway.

Comparing the outcomes of out-of-hospital cardiac arrest between national health insurance and medical aid in Seoul before and during COVID-19 pandemic (코로나 전후 보험유형에 따른 서울 지역 병원밖 급성심정지 환자의 결과 비교)

  • Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.3
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    • pp.7-16
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    • 2023
  • Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

Analysis of factors for intention to perform cardiopulmonary resuscitation (심폐소생술 실시의사에 대한 요인분석)

  • Leem, Seung-Hwan
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.3
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    • pp.169-179
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    • 2013
  • Purpose: The performance rate to perform Cardiopulmonary Resuscitation (CPR) by witness in out-of-hospital Cardiac Arrest (OHCA) is very low in South Korea. To prevent the death caused by OHCA, it is important to encourage the witness to perform CPR actively. The purpose of the study is to investigate the influencing factors to affect bystander CPR rate. Methods: I conducted a questionnaire survey from 25 February to 4 March, 2013, receiving responses from 517 people in Korea. The questionnaire included social demographic factors, history of heart disease, knowledge of CPR, and the reliability of emergency medical service (EMS). A logistic regression analysis was conducted. Results: Among the 517 respondents, 294 (57.4%) had intention of performing CPR. Multiple logistic regression analysis found the following significant predictors of CPR intention: gender (odds ratio [OR] = 0.390), age (OR = 1.024), religion (OR = 0.843), and knowledge of CPR (OR = 4.734). Conclusion: This study indicated that the strongest predictor is knowledge of CPR. Therefore, it would be helpful to teach CPR nationwide to encourage performing CPR. In addition, effect of CPR education in religious facilities is necessary.

A Systematic Review of the Mechanical CPR and Manual CPR on Out-of-Hospital Cardiac Arrest Occurring in High-rise Building

  • ChanHo, Lee;ByounGgil, Yoon;HongBeom, Ahn;YongSeok, Kim
    • International Journal of Advanced Culture Technology
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    • v.10 no.4
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    • pp.434-443
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    • 2022
  • CPR in High-rise building is one of the challenging tasks to 119 paramedics, evacuating patient from the narrow and vertical area. This study was built to compare the method of mechanical CPR and manual CPR is to maximizing on-scene treatment time, and minimizing the hand-off time in cardiac arrest, transporting patient as fast as possible. The electronic data research (Science, Pubmed, Medline, Medline and 55 academic DB interworking) was conducted, and five articles were included by reviewing and excluding through the Covidence program and Review Manager version 5.4(Cochrane Collaboration). OHCA occurring on the higher floor indicates lower in survival. A total studies uniformly reported mechanical CPR is more effective during the high-rise building evacuation, than manual CPR in rate, depth, and hands-on time of chest compression. Use of mechanical CPR device is more suitable in case of High-rise building OHCA to improve the survival rate which is affected by high-quality CPR.