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

• Fire Science and Engineering
• /
• v.34 no.2
• /
• pp.103-109
• /
• 2020

This study aims to investigate the improvement in basic CPR quality on the basis of the hip joint angle of the rescuer among students in the Department of Emergency Medical Technology who completed a basic CPR curriculum. In this study, we carried out a comparative analysis using SimPad SkillReporter and Resusci Anne® QCPR® to measure the quality of CPR (depth of chest compressions, full relaxation, compression speed, and more) on the basis of the rescuer's hip joint angle in accordance with the 2015 AHA Guidelines and conducted chest compressions and CPR 5 times in a 30:2 ratio. It was found that maintenance of the rescuer's hip joint angle at 90 degrees while compressing and relaxing the chest made a statistically significant difference in both the experimental and control groups. Moreover, this indicated that the closer the hip joint angle was to 90 degrees, the better was the quality of basic CPR. However, there was no significant difference in the hip joint angle, degree of CPR, depth of chest compressions, chest compression speed, chest compression and relaxation percentages (%), accuracy of chest compressions, hands-off time during CPR, and percentage of chest compression time (p > 0.05). Maintaining the hip joint angle at 90 degrees for basic CPR was not significantly different from not maintaining this angle. Nonetheless, good results have been obtained at moderate depth and 100% recoil. Therefore, good outcome and high-quality CPR are expected.

• Journal of Korean Biological Nursing Science
• /
• v.6 no.2
• /
• pp.57-68
• /
• 2004

The contrast medium is very commonly used in more than 90% of computed tomography(CT) scans. It is difficult to predict the occurrence of adverse reactions and the degree of adverse reactions are diverse from mild urticaria, itching, nausea, vomiting to even cardiopulmonary arrest. The purpose of this study was to evaluate the symptoms, occurrence rate and risk factors of the adverse reactions in patients after contrast injection during CT examinations. Two hundreds sixty-five patients showed symptoms of adverse reactions out of 71,117 adult patients who received intravenous contrast administration during CT scans from January 2003 to December 2003 at a general hospital. Data was collected by reviewing adverse reaction records and electronic medical record. The results of this study were as follows; 1. Adverse reactions occurred in 265 out of a total of 71,117 patients(0.37%). Clinical symptoms of adverse reactions were most commonly dermatologic problems such as urticaria(69.81%) and itching(63.02%), followed by dyspnea(14.34%), dizziness(11.70%), nausea(6.79%), and vomiting(7.17%). 2. Anaphylactoid reactions occurred in 47 out of a total of 265 patients, and their pattern of symptoms were most commonly related to cardiovascular system(90.91%), followed by respiratory system(82.22%), gastrointestinal system(51.72%), and dermatologic system(16.51%). Eleven patients were transferred to emergency room for further treatment and two patients needed cardiopulmonary resuscitation. 3. The adverse reactions were significantly more common in women than in men(0.46% vs.0.32%, p=.003) and in type D contrast medium than the others(p<.001). The occurrence rate of adverse reactions was not significantly different according to the age and infusion speed of the contrast medium.

• The Journal of Internal Korean Medicine
• /
• v.31 no.4
• /
• pp.892-900
• /
• 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 Korean Journal of Emergency Medical Services
• /
• v.26 no.2
• /
• pp.97-111
• /
• 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.

• Journal of Chest Surgery
• /
• v.13 no.3
• /
• pp.212-218
• /
• 1980

A severe crushing injury of the chest produce a very striking syndrome referred to as traumatic asphyxia. This syndrome is characterized by bluish-red discoloration of the skin which is limited to the distribution of the valveless veins of the head and neck. And also if it is characterized by bilateral subconjunctival hemorrhages and neurological manifestations. But these clinical entities faded away progressively in a few weeks. Apporximately 90% of the patients who live for more than a few hours will recover from traumatic asphyxia when it occurs as a single entity. And so, death results from either severe associated injuries of from subsequent infection, rather than from pulmonary or cardiac insufficiency in traumatic asphyxia. We have experienced 4 cases of traumatic asphyxia with severe crushing thoracic injuries at department of the chest surgery, Captial Armed forces General Hospital during about 3 years from April 1977 to Aug. 1980. The 1st 22 year-old male was struct 2$\frac{1}{2}$ ton truck on the road and was transferred to this hospital immediately. He had taken tracheostomy due to severe dyspnea with contusion pneumonia and for removal of a large amount of bronchial secretion. The 2nd case was 23 year-old male who was got buried in a chasm. In this case, the heavy metal post tumbled over him back while at work. The 3rd case was 39 year-old male who leapt out of a window in 5th story while fire broke out in living room by oil stove heating. He had multiple rib fracture with right hemothor x and right colle's fracture and pelvic bone fracture. The last 22 year-old male was run over by a gun carriage. The wheel of this gun carriage passed over his thorax and right chin. He was brought to this hospital by helicopter. when he was first examined at emergency room, he was in semicomatose state and has pneurmomediastinum with multiple rib fracture and severe subcutaneous emphysema. As soon as he arrived, bilateral closed thoracostomy was performed and cardiopulmonary resuscitation was done. In hospital 8th weeks, chest series showed fibrothorax in right side even if chest wall stabilized. All 4 cases had multiple petechiae over their facees and chest and bilateral subconjunctival hemorrhages referred to as traumatic asphyxia. 3 cases except one case who received splenectomy, had been suffered from contusion pneumonia and had been treated with respiratory care. In these 3 cases, they had warning of impending injury before accident, and took a deep breath hold it and braces himself. And also, even if he had not impending fear in remaining one case, he had taken a deep breath and had got valsalva maneuver for pulling off the heavy metal post. Intrathoracic pressure rose suddenly and resulted to traumatic asphyxia in this situation. All these cases were recovered completely without sequelae except one fibrothorax, right.

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

• Journal of Chest Surgery
• /
• v.11 no.3
• /
• pp.326-332
• /
• 1978

There appears some conduction defects frequently after total correction of Tetralogy of Fallot. Common defect is right bundle branch block due to surgical intervention. We experienced complete A-V block which occured 3 months later after total correction of Tetralogy of Fallot in a 8 year old boy. The patient was completely free of any A-V block after the operation for 3 months, and sudden onset of A-V block with coupled premature ventricular contractions resulted him in shock state during the attack of severe bronchopneumonia for 4 days prior to the second visit. Emergency implantation of Cordis demand type temporary pacemaker was necessary to control the complete heart block with bradyarrhythmia and frequent ventricular fibrillation. Permanent cardiac pacemaker was implanted two weeks later as indicated with Cordis Stanicor lambda demand pacemaker, and the patient was discharged uneventfully on the 8th post implantation day with the heart rate of 72/min. Another 3 months after the implantation, the patient was transported to this hospital as dead on arrival after an accidental fall from a 2 meter height, and all possible cardiopulmonary resuscitation was performed for 60 minutes at the emergency room in vain. Autopsy was done to find out the cause of sudden death and the etiology of complete heart block. Microscopic focal infarctions with scar formation were noted along the course of conduction system in the interventricular septum, which might be the main cause of complete heart block during the attack of severe bronchopneumonia complicated with acute bacterial endocarditis. The tip of the pacemaker wire was slipped from the granulation scar at the apex of the right ventricular cavity, and this might be the direct cause of pacing failure and death.

• Journal of Hospice and Palliative Care
• /
• v.16 no.4
• /
• pp.216-222
• /
• 2013

Purpose: The purpose of this study was to examine nurses' emotional responses and ethical attitudes towards elderly patients' Do-Not-Resuscitate (DNR) decision. Methods: Data were collected using a questionnaire which was filled out by 153 nurses who worked in nursing homes and general hospitals. Data were analyzed using real numbers, percentages, means, standard deviations and Pearson's correlation coefficients with SPSS 19.0 program. Results: The average score for ethical attitudes towards the DNR decision was 2.68 out of 4. Under the ethical attitudes category, the highest score was found with a statement that said 'Although they will not perform cardiopulmonary resuscitate (CPR), it is right to do their best with other treatments for DNR Patients'. Items regarding emotional responses to the DNR decision, the average score was 2.36 out of 4. Among them, the highest score was achieved on 'I understand and sympathize'. No significant correlation was found between ethical attitudes and emotional responses in relation to patients' DNR decision (r=-0.12, P=0.13). Conclusion: Regarding elderly patients' DNR decision, nurses showed somewhat highly ethical attitudes and slightly positive emotional response. A follow-up study is needed to investigate variables that affect our results.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.6
• /
• pp.481-485
• /
• 2012

Background: Tracheostomy is a common procedure for patients requiring prolonged mechanical ventilation. However, the timing of tracheostomy is quite variable. This study was performed to find out the factors determining the timing of tracheostomy in medical intensive care unit (ICU). Methods: Patients who were underwent tracheostomy between January 2008 and December 2009 in the medical ICU of Seoul National University Hospital were included in this retrospective study. Results: Among the 59 patients, 36 (61.0%) were male. Median Acute Physiology And Chronic Health Evaluation (APACHE) II scores and Sequential Organ Failure Assessment scores on the admission day were 28 and 7, respectively. The decision of tracheostomy was made on 13 days, and tracheostomy was performed on 15 days after endotracheal intubation. Of the 59 patients, 21 patients received tracheostomy before 2 weeks (group I) and 38 were underwent after 2 weeks (group II). In univariate analysis, days until the decision to perform tracheostomy (8 vs. 14.5, p<0.001), days before tracheostomy (10 vs. 18, p<0.001), time delay for tracheostomy (2.1 vs. 3.0, p<0.001), cardiopulmonary resuscitation (19.0% vs. 2.6%, p=0.049), existence of neurologic problem (38.1% vs. 7.9%, p=0.042), APACHE II scores (24 vs. 30, p=0.002), and $PaO_2/FiO_2$ <300 mm Hg (61.9% vs. 91.1%, p=0.011) were different between the two groups. In multivariate analysis, APACHE II scores${\geq}20$ (odds ratio [OR], 12.44; 95% confidence interval [CI], 1.14~136.19; p=0.039) and time delay for tracheostomy (OR, 1.97; 95% CI, 1.11~3.55; p=0.020) were significantly associated with tracheostomy after 2 weeks. Conclusion: APACHE II scores${\geq}20$ and time delay for tracheostomy were associated with tracheostomy after 2 weeks.