• Journal of Chest Surgery
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• v.56 no.3
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• pp.162-170
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• 2023

Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A single-center retrospective study was conducted, analyzing 51 consecutive patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and 2021. Results: The median age and body weight was 51 days (interquartile range [IQR], 17-111 days) and 3.4 kg (IQR, 2.9-5.1 kg), respectively. The cause of arrest was cardiogenic in 45 patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS was 77 minutes (IQR, 61-103 minutes) and duration of ECLS was 7 days (IQR, 3-12 days). There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation. In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05; p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes; p=0.021) were significant predictors of in-hospital mortality. In a receiver operating characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant. Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is crucial to improve C-CPR quality and shorten the time before ECLS initiation.

• Journal of the korean academy of Pediatric Dentistry
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• v.44 no.2
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• pp.243-255
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• 2017

Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

• Child Health Nursing Research
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• v.26 no.4
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• pp.454-462
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• 2020

Purpose: Sudden unexplained infant death (SUID) is a major contributor to infant mortality, and pediatric nurses have the responsibility to educate parents on SUID-reducing strategies. This study was conducted to measure pediatric nurses' knowledge of SUID-related safe sleep practices (K-SSSP) and infant cardiopulmonary resuscitation (K-ICPR). Methods: In total, 136 pediatric nurses were administered a survey including K-SSSP (13 items), K-ICPR (5 items), confidence in K-SSSP education (1 item; 5 points), and other factors relating to SUID experiences or education. Results: The correct answer rates of the K-SSSP and K-ICPR were 62.6% and 62.5%, retrospectively. The mean score for confidence in K-SSSP education was 2.6±0.9. Only 18 nurses (13.2%) responded that they educated parents on the content of the K-SSSP, while 76 nurses had received education on SUID. Positive relationships were observed between K-SSSP scores and higher education, between K-ICPR scores and having own child(ren) and clinical experience, and between confidence in K-SSSP education and higher education or having one's own child(ren). Nurses caring for newborns performed more SUID education than nurses working in other units. Conclusion: There is a profound need to implement a systemic educational program on SUID and strategies to reduce SUID for pediatric nurses.

• Journal of Trauma and Injury
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• v.33 no.3
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• pp.170-174
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• 2020

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

• Fire Science and Engineering
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• v.34 no.4
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• pp.135-140
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• 2020

The purpose of this study was to prevent electric shock to children. children are at high risk of electrocution by accidents. In the present case, a 2-year-old child was electrocuted after inserting metal chopsticks into a home outlet. In this case, professional advanced cardiac life support (ACLS) was properly performed by a 119 paramedic, resulting in the return of spontaneous circulation (ROSC) in the child. There are very few successful cases of resuscitation of patients involved in electric shock accidents in Korea, and we report a case of ROSC and discharge and proper resuscitation by a 119 paramedic.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.9-15
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• 2016

Programs provided by the Korea Association of Cardiopulmonary Resuscitation include Basic Life Support (BLS), Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Korean Advanced Life Support (KALS). However, programs pertinent to dental care are lacking. Since 2015, related organizations have been attempting to develop a Dental Advanced Life Support (DALS) program, which can meet the needs of the dental environment. Generally, for initial management of emergency situations, basic life support is most important. However, emergencies in young children mostly involve breathing. Therefore, physicians who treat pediatric dental patients should learn PALS. It is necessary for the physician to regularly renew training every two years to be able to immediately implement professional skills in emergency situations. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is absolutely necessary to be able to immediately implement professional skills in emergency situations.

• Clinical and Experimental Pediatrics
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• v.52 no.8
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• pp.856-861
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• 2009

Cardiopulmonary arrest has long been accepted as an unquestionable definition of death. An advent of cardiopulmonary resuscitation and artificial ventilation along with the development of organ transplantation has prompted the emergence of the concept of brain death. The criteria for brain death are based mainly on the clinical examination of coma, apnea and total loss of brain stem function. Although organ transplantation by donor brain death has increased in Korea over recent years, there is still a substantial shortage of donor organs compared to the demand. Improvement of government policies and changes of social culture for organ donation are needed for the activation of organ transplantation by donor brain death. Pediatricians have an important role for the search of potential donors in cases of brain death and optimal medical care for successful organ transplantation.

• Journal of The Korean Dental Society of Anesthesiology
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• v.12 no.4
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• pp.209-214
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• 2012

Background: This study evaluates the existing cardiopulmonary resuscitation (CPR) knowledge and skills of 1 st year dental students and also compares their CPR performance skill with those of 4 th year students. Methods: Incoming 1 st year and 4 th year dental students were surveyed about the level of their CPR knowledge before conventional CPR instruction. After we trained them for CPR performance, we tested CPR performance skill to randomly selected 10 1st year and 4 th year dental students and compared their CPR performance. Results: Overall CPR knowledge was low for both 1 st and 4 th year dental students. Especially, only 1 among 89 fourth year dental students answered the right sequence of CPR revised in 2010. Overall CPR performance was relatively low for both 1 st and 4 th year dental students. Irrespective of previous experiences of CPR education, their CPR performance was not statistically different. Conclusions: Retraining of CPR is a necessity. Information about the existing CPR knowledge for dental students will aid in establishing the goal of future CPR training and improve the current deficiency.

• The Korean Journal of Emergency Medical Services
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• v.17 no.3
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• pp.53-60
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• 2013

Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.103-110
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• 2013

Background: Recently the use of sedation by pediatric dentists in Korea is increased. This study describes training programs about sedation practices in Korean pediatric dentistry residency program. Methods: A questionnaire was filled in by participants of Korean Academy of Pediatric Dentistry on 17th-18th August, 2008. Also the data about sedation practices of the training institution is collected by phone call. Results: Seventy two percent of respondents used sedation. Most of them used sedation with agents under 25% of their patients. Distribution of ages in patients sedated with agents was 3 years, 4-5 years, under 2 years, 6-10 years, and more than 10 years. Determinative factors of using sedation were behavior management, number of visiting, amount of treatment and general condition, and oral route was the most favorable route. Sixty six percent of them have failed on sedation, and thity percent of them have rarely failed on sedation. Only fifty percent of dentists using sedation completed the cardiopulmonary resuscitation course. Conclusions: For safety, dentists using sedation need to be educated about emergency equipment and management. Especially medication dose, use frequency and the detail related to treatment procedure should be discussed carefully. Also putting a patient under general anesthesia and taking emergency measures should be discussed with Korean Dental Society of Anesthesiology.