• Journal of Korean Clinical Health Science
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• v.1 no.1
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• pp.47-61
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• 2013

Purpose. Effective health policy to raise education rate and to provide basic data to identify the college of Education degree and CPR. Purpose of this study was to inform the need for retraining of college students received CPR training. Methods. The sample consisted of 70 a series of health related university students and 70 the general college students ; total 120 in J city. The period of data collecting was from November 1st to Nov. 16th. The tools were 24 questionnaires named "CPR Survey". The collected data were analyzed to get frequency, percentage, average, and standard deviation, t-test and Person's correlation coefficients by using of SPSS for WINDOW 12.0 K program. Results. The number of CPR-trained persons was significantly higher in the health related university students than general college students. Conclusions. CPR training after the passage of time, the percentage of correct answer got lower as time goes by. The answer should be 'School formal education' was the highest. The percentage of students who recognized the necessity of CPR re-education was high.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.1
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• pp.104-111
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• 1994

Necrotizing fascitis is a severe soft tissue infection characterized by extensive necrosis of superficial fascia, suppurative fascitis, vascular thrombosis, widespread undermining of surrounding tissues. Associated systemic problems are widespread undermining of surrounding tissues, Associated systemic problems are common, with chronic alcoholism and diabetes being most prominent. Most commonly this disease presents in the extremities, trunk, and perineum. Necrotizing fascitis of dental origing is rare and its fulminating clinical course is not well documented in the dental literature. The present report is a case of necrotizing fascitis following vital extirpation of the pulp in a patient with uncontrolled diabetes mellitus and liver cirrhosis. Originally throught to be caused by hemolytic streptococcus organism or stphylococcus aureus, advances in anaerobic culturing have shown it to be a synergistic bacterial infection involving aerobic and ovligate anaerobes. it is relatively rare in relatively rare in haea and neck regions. If it was not diagnosed and treated in early stages, necrotizing fascitis can be potentially fetal, with a mortality rate approaching 40%. It's treatment requires early recognition, prompt and aggressive surgical debriment and proper supportive cares, such as, antibiotic therapy, fluid resuscitation and correction of metabolic and electrolyte disorder, resolving of the underlying systemic disease. Recently, we experienced two cases of necrotizing fascitis in cervicofacial region, One patient was 60 years old male with uncontrolled Diabetes Mellitus and other patient was 48 years old with steroid therapy during 30 years. Local surgical wound healing was successful but, patients were died after admission, because of lung abscess, gastrointestinal bleeding, septic shock and respiration hold.

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

• Clinical and Experimental Pediatrics
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• v.58 no.4
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• pp.154-157
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• 2015

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.169-180
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• 2005

The purpose of this research was to evaluate retention of cognitive knowledge, psychomotor skills and self-confidence on CPR 3 months after CPR training program. The sample consisted of 39 nursing students. We provided one rescuer CPR training program for nursing college students on the basis of AHA. The questionnaires for knowledge of CPR were developed 50 items based on AHA guidelines. Self-confidence were checked by 11 items questionnaires. The accuracy of CPR skills were checked by Skillreporter CPR training manikin and by researcher's evaluation based on CPR skill checklist. The results were as follows ; 1. The majority of participants didn't have any previously experiences of CPR training (76.9%). Only 15.1% previously took the CPR training with CPR practice. 2. In terms of self-confidence of CPR. The score were increased for 2 days (p>.001) but retention of self confidence was significantly statistical decreased in 3 months after training (p<.001). 3. There was a statistically significant decrement in mean of knowledge of CPR between 2 days and 3 months after CPR training (p<.001). 4. There was a statistically significant decrement in cognitive knowledge of CPR based on CPR skills checklist(p<.001). 5. Retention scores of psychomotor skills of CPR 3 months after training were 42.10% in numbers of adequate ventilation, 52.81% in numbers of adequate chest compression (p<.001) respectively. 6. Retention of passing rate on chest compressions of CPR 3 months after training was 27% (p<.001), on ventilation was 2.63% (p>.001). The error items with statistically significant differences 3 months after CPR training were too little ventilation (74.36%) and too little chest compressions (92.31%). The results of the study suggest that we need further evaluation of course components which could improve retention of CPR for all trainees.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.89-100
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• 2005

Due to the improvement in life, we, human beings, are living in the more convenient world. However, as society gets complex, it comes to be faced a dangerous situation that needs to request a help due to an unexpected accident. The promptly emergency relief and emergency treatment from this accident, can be said to be extremely important in increasing a rate of resuscitation. This study analyzed on a case study and problems about the Emergency Medical System out of hospital in our country. The contents in the results of a study can be summarized as follows. 1. given the occurrence of medical disputes in a situation of emergency treatment, the regulation in the legal protection 'Will need to be reinforced. 2. in relation to the mobilization of ambulance, the preferentially passage right in ambulance needs to be guaranteed. In general, the preferentially passage right in ambulance is secured, but it will need to be supplemented by improving the education in civic consciousness and the social system. 3. in case of emergency duties in the emergency medical technician, the countermeasure will need to be strengthened in terms of abusive language and violence from a citizen. 4. in terms of emergency duties in the emergency medical technician, aiming to keep safety from a sudden situation, the possession of the protective equipments will need to be completely provided. 5. the limitation of activity will need to be eased by expanding the range of duties in the emergency medical technician within the ambulance, and the opening of duties will need not to be allowed to the similarly job category. 6. it needs to be reinforced the safety of the emergency medical technician from infectious diseases. Aiming at these emergency medical technicians whose service spirit is thoroughgoing, the nation and the local government will need to form all the conditions in which emergency medical technicians can be active passionately.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.273-276
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• 2008

Since the introduction of extracorporeal cardiopulmonary support of cardiac arrest in 1983, emergent cardiopulmonary support has been used to treat cardiac arrest. Acute massive pulmonary embolism is associated with a high mortality rate and it poses a challenge for both the anesthesiologist and the surgeons especially during operations. This report describes the use of the emergent bypass system in the effective management of an intraoperative massive pulmonary embolism and cardiac arrest in a 56-year-old woman. The patient was discharged on warfarin and there was no recurrence of the pulmonary embolism at the follow-up visit.

• The Korean Journal of Emergency Medical Services
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• v.22 no.1
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• pp.49-59
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• 2018

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

• Journal of Hospice and Palliative Care
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• v.26 no.2
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.101-109
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• 2011

Purpose: The Assessing Care Of Vulnerable Elders project has developed indicators for the quality of the end-of-life (EOL) care. However, family members of cancer patients may have a different view on the quality indicators (QIs) established by health care experts. We evaluated the QIs from the family members' perspective. Methods: The information used in this study was gathered by surveying family members of cancer patients who were admitted to the inpatient hospice ward in Korea. A cross-sectional anonymous questionnaire was distributed to 120 potential respondents from July to October 2009. We included 69 responses in this study (effective response rate, 57.5%). Statistical analysis was performed by using SPSS for Win ver. 14.0, with independent t-test and Pearson's chi-square test. Results: Among QIs for good hospice care, families agreed the most on "Medical examination by the palliative care team or specialist" (88.4%) and "Dying in the family's presence" (88.4%). They agreed the least on "Discussing cardiopulmonary resuscitation with patients" (15.9%). Among QIs for bad hospice care, "Occurrence of fall or pressure ulcer are undesirable" showed the highest agreement rate (94.2%). The lowest agreement rate was 11.6% on "Dying in the hospital is undesirable." In addition, women, patients who were aware of their prognoses, and people with a high socioeconomic status tended to agree more on the QIs. Conclusion: Patients' families did not agree on some of the QIs recommended by previous studies. Family members' characteristics were related to their opinions on QIs.