• The Korean Journal of Emergency Medical Services
• /
• v.18 no.1
• /
• pp.55-66
• /
• 2014

Purpose : The purpose of the study is to investigate the knowledge, attitude, confidence, and experiences of community health practitioner(CHP) regarding cardiopulmonary resuscitation(CPR). Methods : The subjects were 333 CHP in G Province, C Province, and I Metropolitan City. A structured self-reported questionnaire was filled out by 209 participants from July 29, 2013 to September 30, 2013. Results : Confidence level toward CPR was intermediate, and knowledge and attitude level was very low. Seventeen participants performed CPR to cardiac arrest victim. Eleven patients among 25 patients had spontaneous recovery of circulation (ROSC). So the rate was very high. Conclusion : It is necessary to perform the efficient CPR in CHP. In order to improve the positive attitude and confidence in CHP, the renewal system must maintain every two years.

• Journal of the Institute of Convergence Signal Processing
• /
• v.12 no.3
• /
• pp.157-162
• /
• 2011

This study is about implementing wireless transferring system in pre-hospital cardiopulmonary resuscitation(CPR). Also, this study includes monitoring based feedback between patient and hospital to increase the survival rate of emergency patient by developing the performance of cardiopulmonary resuscitation in pre-hospital. It minimizes the loss of flow rate or gastric inflation through the space between the airway and the esophagus, which enables the inspiration-expiration rate to be measured more precisely. Due to these reasons this study applied ET insertion based respiratory sensor to measure flow rate. The main indices of artificial ventilation are justified from minute respiration(V), end-tidal $CO_2(E_TCO_2)$, and tracheal pressure($P_{tr}$). The simulation is performed to verify the bandwidth and delay time of transport network for in-hospital monitoring even as transporting images and voice information simultaneously. The total bandwidth is 815 kbps, and WLAN (IEEE 802.11x) is used as communication protocol. The network load is under 1.5% and the transmit delay time is measured under 0.3 seconds.

• The Korean Journal of Emergency Medical Services
• /
• v.8 no.1
• /
• pp.149-160
• /
• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

• The Korean Journal of Emergency Medical Services
• /
• v.19 no.3
• /
• pp.7-18
• /
• 2015

Purpose: The purpose of this study was to describe and compare the return of spontaneous circulation (ROSC) cases of out-of-hospital cardiac arrest on the basis of Heart Saver laureate. Methods: This study aimed to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of patients with out-of-hospital cardiac arrest by analyzing the data of two regions. The data were prehospital emergency reports of 473 patients who survived for > 72 hours after ROSC in two region from January 2012 to December 2013. Results: Among the ROSC patients, 86.8% (G), 77.9% (S) were men and 72.9% (G), 67.9% (S) were of age 41~70 years, 87.6% (G), 82.9% (S) had a witnessed cardiac arrest; and 66.7% (G), 70.6% (S) received cardiopulmonary resuscitation from bystander. Of those who performed the resuscitation, paramedics in 89.1% (G), 89.8% (S). Furthermore, 119 emergency medical technicians were involved in 69.0% of two-rescue teams in G and in 90.4% of three-rescue team in S. Conclusion: Most heart savers were qualified paramedics, and three-rescuer-teams resulted in better survival rate than two-rescuer-teams.

• Journal of the Korean Society of School Health
• /
• v.27 no.3
• /
• pp.130-139
• /
• 2014

Purpose: The object of this study was to compare the educational effect about self-efficacy and the quality of chest compressions of Hands-only CPR and Basic CPR. Methods: It's a nonequivalent control group pre-post repeated quasi-experiment study conducted with entire fifth grade students belong to one school in H city. The study participants are 68 persons, and data were collected from December 2, 2013 to February 7, 2014. Self-efficacy was measured by 10 items, and the quality of chest compressions was measured by 5 variables which are average compression depth(mm), average rate (n/min), average count per minutes (n), abnormal placement (n), compression accuracy (%). Results: Self-efficacy of the experimental group and control group showed no significant difference but showed significant difference over time and was the highest at posttest 1 (immediately after education), the lowest at pretest (before education), middle at posttest 2 (8weeks after education) (p<.001). Experimental group was significantly higher than control group in average rate per minute. At posttest 1, experimental group was $130.0{\pm}9.38$ times, control group was $95.1{\pm}11.82$ times. At posttest2, experimental group was $124.0{\pm}14.89$ times, control group was $90.8{\pm}14.89$ times.(p<.001). Average rate (n/min) was significantly declined at control group in the quality of chest compressions over time (t=-2.400, p=.022). Average count per minute and compression accuracy were declined significantly so it were not maintained to posttest2. Conclusion: We need continuous CPR education because self-efficacy of CPR getting lower significantly over time. Hands-only CPR can't be seen as a way to increase the CPR ability of elementary school students having difficulty to perform artificial breathing. And, because the effect of education is not maintained 8wks after training, the technique centered repeated training is needed and a method which can increase compression accuracy is also needed.

• Clinical and Experimental Emergency Medicine
• /
• v.3 no.3
• /
• pp.148-157
• /
• 2016

Objective Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). Methods This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. Results Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group ($31.2{\pm}30.3%$ vs. $55.1{\pm}37.5%$ vs. $54.0{\pm}36.9%$, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. Conclusion CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.

• Journal of Chest Surgery
• /
• v.57 no.3
• /
• pp.272-280
• /
• 2024

Background: The phenomenon known as the "weekend effect" impacts various medical disciplines. We compared outcomes between regular hours and off hours to investigate the presence of the weekend effect in extracorporeal cardiopulmonary resuscitation (ECPR). Methods: Between January 2018 and December 2020, 159 patients at our center were treated with veno-arterial extracorporeal membrane oxygenation (ECMO) for cardiac arrest. We assessed the time required for ECMO preparation, the rate of successful weaning, and the rate of in-hospital mortality. These factors were compared among regular hours ("daytime": weekdays from 7:00 AM-7:00 PM), off hours on weekdays ("nighttime": weekdays from 7:00 PM-7:00 AM), and off hours on weekends and holidays ("weekend": Fridays at 7:00 PM to Mondays at 7:00 AM). Results: The time from the recognition of cardiac arrest to the arrival of the ECMO team was shortest for the daytime group and longest for those treated over the weekend (daytime, 10.0 minutes; nighttime, 12.5 minutes; weekend, 15.0 minutes; p=0.064). The time from the ECMO team's arrival to ECMO initiation was shortest for the daytime and longest for the nighttime group (daytime, 13.0 minutes; nighttime, 18.5 minutes; weekend, 14.0 minutes; p=0.028). No significant difference was observed in the rate of successful ECMO weaning (daytime, 48.3%; nighttime, 39.5%; weekend, 36.1%; p=0.375). Conclusion: In situations involving CPR, the time to arrival of the ECMO team was longer during off hours. Furthermore, ECMO insertion required more time at night than during the other periods. These findings warrant specific training in decision-making and emergent ECMO insertion.

• The Korean Journal of Emergency Medical Services
• /
• v.15 no.1
• /
• pp.37-46
• /
• 2011

Purpose : This study is equivalence experiment performed to test practice effects between experimental group from both left and right direction of mannequin and control group having practice from only right direction in cardiopulmonary resuscitation education. Methods : Subject of the research were total 71 elementary and middle school teachers in J province who had not experience to have cardiopulmonary resuscitation. They were divided into experimental group of 35 participants who practiced cardiopulmonary resuscitation from both right and left direction of mannequin on Dec. 27, 2009 and control group of 36 participants who performed cardiopulmonary resuscitation from only right direction of mannequin on Dec. 28, 2009. Collected data were analyzed by SPSS/PC+(version 14.0). Results : 1. There was no statistically significant difference by sex among general characteristics of the subjects. 2. According to the quality of chest compression performed from the right direction of mannequin, experimental group showed better results in proper depth (time), insufficient depth (time), too lowered compression position (time) and inexact position (time) than control group(p<.05). In the quality of chest compression from the left side of mannequin, experimental group performed better results in proper depth (time), insufficient depth (time), inexact compression position (time) and mean chest compression depth(mm) than control group(p<.05) and also in more left-centered compression position (time) than control group(p<.001). 3. The quality of chest compression by experimental group, the right side of mannequin was superior in proper depth (time) to the left side of mannequin (p<.001) and showed better results in insufficient depth (time) and chest compression/recoil rate (p<.05). According to the quality of chest compression by control group, the right side of mannequin showed superior results in proper depth (time), insufficient depth (time), too left-centered compression position (time) and mean chest compression depth (mm) (p<.05) to the left side of mannequin. Conclusion : The group having practice from both right and left sides of mannequin was superior in the quality of chest compression to the group having practice from only right side of mannequin. How to practice cardiopulmonary resuscitation from both right and left sides of mannequin can be recommended and practice from left side of mannequin is also useful.

• The Korean Journal of Emergency Medical Services
• /
• v.17 no.1
• /
• pp.9-19
• /
• 2013

Purpose : The purpose of this study was to investigate the variation of elapsed time in the cardiopulmonary resuscitation (CPR) quality and the fatigue in continuous CPR by single rescuer. This study will provide basic data about the time for the alternation of the CPR providers. Methods : The volunteer students having healthcare provider certification were recruited from the department of emergency medical service. The students performed 30:2 CPR for 20 minutes, and the data were recorded and analyzed. Metrics were based on the 2010 American Heart Association (AHA) Guidelines, and the CPR continued without any feedback. Results : Among the indicators of CPR, the accuracy and the depth of chest compressions decreased after about 5.3 minutes, and the rate increased approximately after 6.8 minutes. Changes in clinical indicators appeared, and fatigue increased after about 3 minutes. According to the increase in fatigue level, the changes in the CPR indicators and clinical indicators showed up, and these results proved to be statistically significant. However, there were no associations among the time, fatigue, and gender. Conclusion : Even though the times of changes in the indicators appeared differently, the times of changes in fatigue and CPR quality were able to be confirmed.

• Journal of radiological science and technology
• /
• v.19 no.2
• /
• pp.51-57
• /
• 1996

Radiography should be used judiciously and should not delay patients resuscitation. In the patient with emergency multiple trauma, three radiography should be obtained-cervical spine, anteroposterior(AP) chest, and AP pelvis. These examinations can be done in the resuscitation area, usually with a portable X-ray unit, but should not interrupt the resuscitation process. A retrospective study was carried on 157 emergency multiple trauma patients who were admitted to Yong Dong Severance Hospital from January, to December in 1995. I analyzed the types of X-ray examinations in emergency multiple trauma patients, and classified the patients by disoriented group of mentality. The results were as follows: 1. The subjects were 7.1%(157patients) of 2,208 trauma patients(7.3%) in total 30,085 emergency patients. 2. Male to female ratio was 2.57 : 1. The age distribution was highest from 31 years to 40 years(28.0% ). 3. The peak time of patient's entrance in emergency center was between 8 : 00 pm and 2 : 00 am(36.9%), and second peak time was between 2 : 00 pm and 8 : 00 pm (29.3%). 4. According to the injury type, traffic accident, motorcycle accident and falling down were 71.3%, 8.3% and 20.4% respectively. 5. According to the exposure rate of Computed Tomography, chest CT, cervical CT pelvis CT and brain CT were 39.5%, 24.2%, 69.4% and 51.6% respectively.