• 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.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.155-160
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• 2020

Torsades de pointes refers to polymorphic ventricular tachycardia (PMVT), which is caused by the suppression of potassium channels owing to genetic and electrolytic abnormalities, resulting in the extension of the QT interval. Symptoms range from spontaneous circulation recovery to fainting and sudden death. Defibrillation, magnesium correction, and the use of lidocaine as an antiarrhythmic agent are recommended as treatments for persistent torsades de pointes. Currently, only amiodarone is available in the ambulance; however, torsades de pointes does not respond efficiently to amiodarone because it suppresses potassium channels and increases the refractory period of the myocardium. Lidocaine, in contrast, reduces the relative refractory period of the myocardium caused by suppressing sodium channels; thus, it inhibits the occurrence of and treats arrhythmia. In cases where PMVT did not respond to defibrillation, the administration of lidocaine showed no difference in survival and discharge rates compared to amiodarone. Thus, ambulances must be equipped with provisions to administer lidocaine.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.81-90
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• 2012

Objectives: This study is to research delay time comparison for later defibrillation after hands off according to the changes in defibrillation electrodes. Study purpose: In defibrillation treatment that is the only way for cardiac arrest by arrhythmia, it is to find defibrillator device which can minimize late defibrillation delay time after important affect of hands off. Study object and method: After hands off according to the defibrillator device, we collected total 40 people for emergency medicine doctor, internal medicine doctor, general surgeon, nurse, emergency medical technician who are working at 2 CN, CS University hospitals in Gwangju Jeollanamdo district to find out hand off shock interval(HOSI). We then researched their general properties like occupation sector, experiences in clinic, gender, completion of AHA ACLS-P training and more. Then 40 participants continued ventricular fibrillation cardiac arrest simulation training (using human-model mannequin) designed by researcher and performed their roles as defibrillation operator. Each of participant used manual paddle and performed 4 times of defibrillation (150J) during 8 minutes of CPR and in 8day, the defibrillator devices were replaced from manual paddle to self-adhesive electrodes pads and 4 times of defibrillation (150J) under same simulation condition as manual paddle were performed. Study result: In comparison for delay time of later defibrillation after hands off of manual paddle and self adhesive electrodes pad, the self adhesive electrodes pad ($7.0{\pm}0.5sec$) seemed to reduce delay time of later defibrillation significantly (p<0.05) compared to manual paddle ($10.0{\pm}0.9sec$). The self adhesive electrodes pad, according to the general properties of participants, had no particular change in delay time after later defibrillation for the statistics (p>0.05) but the manual paddle had statistically significant differences for the occupation sector, experiences in clinic and gender (p<0.05). Conclusion: In defibrillation, the self adhesive electrodes pad($7.0{\pm}0.5sec$) showed short HOSI compared to manual paddle ($10.0{\pm}0.9sec$) significantly (p<0.05) and it applied identically for both existence and non-existence of ACLS-P training completion, experiences in clinic, gender and occupation sector. The manual paddle had also significant difference in experiences in clinic and occupation sector (p<0.05). which means the effect on HOSI according to the job mastery. Therefore, if the clinic experience is short or in case for the occupations without frequent defibrillation treatment has a danger of lowering success rate for the defibrillation using manual paddle. Therefore, it is true that using self adhesive electrodes pad for defibrillation electrodes when performing manual defibrillation in pre-hospital as well as in-hospital steps can generally minimize delay time of later defibrillation after hands off.

• The Journal of Internal Korean Medicine
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• v.31 no.4
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• pp.892-900
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• 2010

Objectives : To save the lives of patients with cardiac arrests, CPR must be performed rapidly and precisely. Regarding its critical necessity, there is a growing tendency to encourage whomever witnesses the cardiac arrest to perform basic CPR. However, the attitude toward basic CPR nor its current state of education in Korean Oriental Medical arena, which is one of the dual axes unique to Korean medical system, are not known. This is a kind of pilot study to research attitudes toward and the educative effect of basic CPR among oriental medical doctors in Korea. Methods : We carried out surveys and tests targeting nineteen apprentice doctors working in Dongguk University Ilsan Oriental Hospital, who were receiving training for 'AHA BLS course for healthcare providers', on the attitude toward and educative effect of basic CPR before and after the education. Results : The pre-educational survey showed that most of the participants felt the necessity to be trained in the BLS course, were not confident about performing CPR, and not well-acquainted with the whole process of performing CPR. After education, however, none of them responded with a lack of confidence to perform basic CPR, and the score of the confidence to perform basic CPR was significantly increased, too (from $2.05{\pm}0.71$ to $4.05{\pm}0.40$, n=19, p<0.001). Moreover, all of them answered they were satisfied with this BLS course, and it aroused their sense of responsibility as oriental medical doctors. All the participants passed the exam, and their average score for BLS scheme performance was $28.2{\pm}1.3$. Conclusions : It is necessary, in the future, to set up a management system for intensive, regular and continuous reeducation and expand the research on the perception and attitude targeting larger numbers and more multilevel groups of oriental medical doctors.

• The Journal of Korean Academic Society of Nursing Education
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• v.16 no.1
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• pp.121-128
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• 2010

Purpose: Bystander CPR has demonstrated improved survival of out-of-hospital cardiac arrest. The purpose of this study was to evaluate the effects of CPR education in the rural community. Method: One hundred eighty-nine rural laypersons (105 in the experimental group and 84 in the control group) participated in this study. In the experimental group, questionnaires were completed after participating in a small group BLS (Basic Life Support) course. In the control group questionnaires were collected from two rural health service centers. Data were analysed using $X^2$test, independent t-test and paired t-test. Result: There were significant differences in barriers to performing CPR, attitude and intention toward CPR and necessity recognition between the two groups. Conclusion: The proportion of positive attitudes toward CPR and willingness to perform CPR was higher in the experimental group than the control group. CPR education increased anxiety of being sued because of a bad outcome. For future CPR education for laypersons, the reluctance of bystanders to perform CPR should be reconsidered and CPR education should be extended to the rural community.

• The Korean Journal of Emergency Medical Services
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• v.14 no.1
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• pp.5-18
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• 2010

Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.557-567
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• 2018

Objective: The increasing number of people living in high-rise apartments may result in a delayed response from emergency medical technicians called out for an out-of-hospital cardiac arrest, making the role of apartment managers as the first responders extremely important. This study investigated whether automated external defibrillator (AED) placement influences the willingness of apartment managers to perform cardiopulmonary resuscitation (CPR) and use an AED. Methods: A cross-sectional target population-based survey was conducted in Daegu, July 2016. Questionnaires were sent to apartment managers working in apartments with more than 500 households. The general characteristics of the respondents, status of CPR education, and knowledge about and willingness to perform CPR and use an AED were investigated. Results: Of the 1,445 respondents, 758 (52.5%) worked in apartments with AEDs, of which 77.8% and 70.8% were willing to perform CPR and use an AED, respectively, compared with 68.1% and 60.0% of respondents who worked in apartments without AEDs. After adjusting for potential confounders, AED placement was associated with the willingness to perform CPR (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.04-1.71) and use an AED (OR, 1.39; 95% CI, 1.10-1.75). Prior CPR training and accurate knowledge of CPR skills were also associated with the willingness to perform CPR and use an AED. Conclusion: Placing AEDs in high-rise apartment buildings and providing refresher CPR education for maintaining CPR skills will be necessary to support apartment managers in their role as first responders.

• Journal of Biomedical Engineering Research
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• v.37 no.5
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• pp.153-160
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• 2016

This study proposes an algorithm for removal of CPR artifact in order that automated external defibrillator (AED) can effectively diagnose ECG rhythm during cardiopulmonary resuscitation (CPR). Current AED required to interrupt chest compression for reliable rhythm analysis to avoid the effect of artifacts produced by CPR. However even temporarily interruption of chest compression during CPR adversely affects the probability of restoration of spontaneous circulation (ROSC) and survival after the delivery of the shock. Therefore, we proposed a method for removal of CPR artifacts using least mean square (LMS) filter. The removal of the CPR artifacts would enable compressions to continue during AED rhythm analysis, thereby increasing the likelihood of resuscitation success. It was tested on 31 segments of shockable and 300 segments of non-shockable ECG signals recorded from three pigs during CPR. In the result, sensitivity (Se) and specificity (Sp) analysis on the test segments showed values of Se = 3.2%, Sp = 66.0% and Se = 96.8%, Sp = 98.7% in the case of unfiltered and filtered signals during CPR. In conclusion, it was shown that the proposed method can be a useful tool to exactly diagnose the ECG rhythm during the CPR.

• Korean Journal of Health Education and Promotion
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• v.25 no.4
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• pp.43-54
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• 2008

Objectives: To identify the willingness of laypersons to perform the cardiopulmonary resuscitation(CPR), we analyzed their characteristics of socio-economic status and health-medical conditions associated with their willingness. Methods: Based on a health survey of Incheon Metropolitan City adults(N=5,114), tests of the differences between a group with willingness to perform CPR(=1,531) and a group with non-willingness to perform CPR(=3,583), and a logistic regression analysis of two groups were executed on socio-economic status-gender, age, marital stats, education level, jobs, and monthly household income-and health-medical conditions-CPR-related self-confidence, CPR education, chronic diseases, accident experience, EMS(emergency medical service) experience, and health status. Results: The rate of the willingness group was 29.9%, which was relatively lower than other developed countries. There were statistically significant differences between the willingness group with the non-willingness group on gender, age, jobs, CPR-related self-confidence, CPR education, and so on. Furthermore, Gender, age, students or armed forces among jobs, CPR-related self-confidence, and CPR education were statistically significant influential factors on the willingness to perform CPR. Conclusion: This study indicated that there was considerable variation in socio-economic status and health-medical conditions associated with willingness to perform CPR in Incheon. The CPR education aimed at increasing CPR-related self-confidence and correcting inaccurate perceptions of CPR attitudes would promote its use in response to out-of-hospital cardiac arrest.

• Journal of the Korea Convergence Society
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• v.10 no.4
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• pp.99-106
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• 2019

The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.