• Journal of Trauma and Injury
• /
• v.33 no.1
• /
• pp.23-30
• /
• 2020

Purpose: Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations. Methods: This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups. Results: We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%. Conclusions: Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.2
• /
• pp.744-750
• /
• 2013

This study is to collect a basic data of how Cardiopulmonary Resuscitation (CPR) procedure can influence to cardiac arrest patient with and without the Depth Device during the average transport time period. The data has achieved by comparing result sheet of CPR procedure by hands only versus with Depth Device by twenty 1st and 2nd class Emergency Medical Technician (EMT) from five different fire stations in city of Chong-Ju, and twenty Emergency Rescue major students who completed the BLS provide course. The experiment participators experienced loss of compression depth and rate increase over time. However, the CPR procedure with Depth Device shows that both EMT and students to allow maintaining both the compression depth and rate. The experiment leaves a positive result for CPR operators and considers being valuable domain for cardiac arrest patient.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.6
• /
• pp.381-388
• /
• 2017

The CPR guidelines emphasize the delivery of effective chest compressions but do not address the effects of chest compressions on CPR providers. This study determined the effects of chest compressions on healthy adult firefighters' symptoms, hemodynamics, and electrocardiography after performing multiple cycles of CPR. Healthy adult firefighters were trained in CPR and performed CPR on mannequins. The provider vital signs, electrocardiography, and fatigue scores were determined immediately before CPR, after 5cycles of CPR, and after 10 cycles of CPR. In addition, the presence of clinical symptoms among the providers was determined after CPR; 39 firefighters participated in the study. Their mean age was $35.54{\pm}10.26years$. Many providers developed fatigue, shortness of breath, and dizziness. Significant changes in heart rate (p=0.000), respiratory rate (p=0.010), end-tidal CO2(p=0.000), O2 saturation(p=0.000), and pulse pressure (p=0.000) were observed after both 5 and 10 cycles of CPR. One participant developed sinus dysrhythmia and premature ventricular contractions after 10 cycles of CPR. The delivery of chest compression results in fatigue and hemodynamic alterations in many young healthy adults after performing 5 or 10 cycles of CPR. The CPR guidelines and education should take into consideration the effects of chest compressions on CPR providers.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.5
• /
• pp.485-492
• /
• 2018

Objective: This paper reports the status of the advanced cardiac life support (ACLS) according to the guidelines by residents belonging to other departments other than the department of emergency medicine. The differences in status between the junior group and senior group was also investigated according to grades of residents. Methods: The ACLS performance for in-hospital cardiac arrest cases of one academic hospital, except for the cases occurring in intensive care unit between November 2015 and October 2017, were analyzed retrospectively. Data included the characteristics of residents, patients' outcomes, ACLS performance, and conventional treatment having discordance with the ACLS guidelines. Leaders during cardiopulmonary resuscitation (CPR) were divided into a junior group and senior group. Results: A total of 152 cases were enrolled in this study. Of these, 131 cases (86.2%) showed at least one treatment with inconsistency from the guidelines and the incidence of discordant treatment was similar in the two groups (55 [85.9%] vs. 76 [88.4%], P=0.657). Implicit use of sodium bicarbonate was more frequent in the senior residents group (odds ratio [OR], 3.04; 95% confidence interval [CI], 1.36-6.81). On the other hand, no use of a defibrillator was less frequent in the senior residents group (OR, 0.14; 95% CI, 0.03-0.81). Conclusion: In both groups, the rate of discordance with the ACLS guidelines during CPR were high. The rate of implicit use of sodium bicarbonate and no use of defibrillator were significantly different in the two groups. A customized education strategy for ACLS is needed for each group.

• The Korean Journal of Emergency Medical Services
• /
• v.26 no.3
• /
• pp.161-184
• /
• 2022

Purpose: This study aimed to develop a cardiopulmonary resuscitation training program for firefighters (FD-CPR) to help improve the survival rate after cardiac arrest on the fireground. Methods: The FD-CPR was developed following 3 steps of the FD-CPR instructional design based on the behaviorism theory. The content of the program was validated by a group of 7 experts using the contents validity index (CVI) and through a pilot-test. Results: A scenario consisting of 7 procedures, and a skill performance evaluation tool consisting of 16 questions were developed. The evaluation tool average score for the difficulty test was 41.16% (even) and that for the discrimination test was 0.32 (high). Subsequently, an 80 min training program was developed. As verified by the 7 experts through the CVI, it was as high as 1.0. Conclusion: The FD-CPR developed domestically for the first time in this study was effective in enhancing the CPR performance skills of the firefighters. If FD-CPR is added to the curriculum at the Fire Service Academy educational course for the new firefighters, the CPR performance skills could be maintained. Furthermore, the program can facilitate a better survival rate for colleagues having cardiac arrest on the field.

• The Korean Journal of Emergency Medical Services
• /
• v.7 no.1
• /
• pp.43-54
• /
• 2003

The purpose of this study was to evaluate the accuracy of CPR skills and the satisfaction of CPR Training targeted for college students. Also, this study made comparative study of nursing students and non-nursing students. The sample consisted of 248 students(132 nursing students, 116 non-nursing students). CPR Training was designed by two components which were a lecture and demonstration by one professor and individual practice by instructors. As tool of measurement estimation satisfaction of CPR Training questionnaires were developed based on educated contents. The accuracy of CPR skills were checked by SkillReporter CPR training manikin. Collected data were computerized and analyzed by SPSS-WIN program. The results were as follows : 1. The skills of CPR were cardiac compression 92.79 times/min, correct cardiac compression rate 90.85%, ventilation 9.93 times/min, correct ventilation rate 79.34%. 2. The mean of the accuracy of CPR skills were 2.94(SD .87). 3. When errors were analyzed, the highest item was stomach distension(51.2%) of ventilation skills and too little(70.6%) of cardiac compression skills. 4. The mean of the satisfaction of CPR training were 2.87(SD .17), the highest item of the satisfaction of CPR Training was practice. 5. We found significant statistical differences based on the accuracy and the error, non-nursing students were high in correct cardiac compression per minute(t=3.615, p=.000) and ventilation too much(t=4.292, p=.000), nursing students were high in correct ventilation rate(t=-3.885, p=.000) and cardiac compression too shallow) t=-2.842, p=.005).

• Journal of the Korea Society of Computer and Information
• /
• v.29 no.3
• /
• pp.165-171
• /
• 2024

This study aims to investigate the appropriate volume of artificial ventilation and success rate when Basic - emergency medical Technician administer bag valve mask(BVM) artificial ventilation to patients experiencing respiratory failure or respiratory arrest using a respiratory rate measurement device. The research was conducted from December 11th to 12th, 2023, targeting 20 Basic - emergency medical Technicians enrolled at D University. Ten participants were selected for the experimental group, receiving BVM ventilation training with the use of a respiratory rate measurement device, while the other ten were assigned to the control group, receiving BVM ventilation training without the use of a respiratory rate measurement device. The experiment involved providing artificial ventilation for 2 minutes. The results of the study indicated that the control group did not provide accurate tidal volume (p=.025). The experimental group demonstrated a higher success rate of ventilation over the 2-minute period, while the control group showed a significant difference (p=.001). Subjective perception of tidal volume and objectively measured tidal volume also exhibited a significant difference in the control group (p=.010). Therefore, training with a respiratory rate measurement device can align the subjective perception of tidal volume with objective measurements, increase the success rate of ventilation, and potentially contribute to improving survival rates in patients experiencing respiratory failure or respiratory arrest during cardiopulmonary resuscitation.

• Archives of Craniofacial Surgery
• /
• v.17 no.1
• /
• pp.28-30
• /
• 2016

Major maxillofacial bone injury itself can be life threatening from both cardiovascular point of view, as well as airway obstruction. Significant hemorrhage from facial fracture is an uncommon occurrence, and there is little in the literature to guide the management of these patients. We report a 73-year-old male driver who was transported to our hospital after a motor vehicle collision. The patient was hypotensive and tachycardic at presentation and required active fluid resuscitation and transfusion. The patient was intubated to protect the airway. All external attempts to control the bleeding, from packing to fracture reduction, were unsuccessful. Emergency angiogram revealed the bleeding to originate from terminal branches of the sphenopalatine artery, which were embolized. This was associated with cessation of bleeding and stabilization of vital signs. Despite the age and severity of injury, the patient recovered well and was discharged home at 3 months with full employment. In facial trauma patients with intractable bleeding, transcatheter arterial embolization should be considered early in the course of management to decrease mortality rate.

• The Korean Journal of Emergency Medical Services
• /
• v.21 no.3
• /
• pp.17-33
• /
• 2017

Purpose: The purpose of the study was to investigate knowledge and attitudes of students majoring in health-related fields toward automated external defibrillator (AED) and to identify the influencing factors of knowledge and attitudes in AED use among the students. Methods: Data were collected from 346 students and analyzed using descriptive statistics, t-tests, one-way ANOVA, post hoc $Scheff{\acute{e}}$ test, Pearson's correlation coefficient, and hierarchical multiple regression analysis, with SPSS Win 20.0 program. Results: Overall knowledge of AED in health-related major students, except paramedics and physical therapy was relatively low while attitudes were at moderate level. There were statistically significant differences in knowledge according to age, grade, major, cardiopulmonary resuscitation (CPR) awareness, exposure to AED and CPR education; and differences in attitude according to major, health status, health awareness, CPR awareness, exposure to AED, and CPR education. Significant factors explained 63% of knowledge on AED (F= 43.96, p<.001) and 37% of attitudes on AED (F= 15.84, p<.001). Conclusion: The study findings suggest that systemic education programs on AED should be implemented during undergraduate curriculum to improve survival rate of sudden cardiac arrest.

• The Korean Journal of Health Service Management
• /
• v.7 no.3
• /
• pp.29-44
• /
• 2013

The purpose of this study is to give the users, who wants to know the information about CPR and AED on the Internet, more accurate information which is analyzed and considered with the factors to improve the contents of them. The source of the instrument for this study is from the contents of twenty four websites which is able to join in and searched by the Web Search Engine with four keywords: 'Cardiopulmonary Resuscitation', 'CPR', 'Automated External Defibrillator', and 'AED'. According to the results of the study, frequency questions of more than 50% among 53 questions on whether to suggest were investigated as 22 questions from content analysis results of the websites, and it showed that the highest frequency, which were examined to that chest compressions and respiratory rate; 79.2%. The correctness of the contents of the all websites of the study is as low as 36.00 point full marks at 100 points.