• Journal of Trauma and Injury
• /
• 제32권4호
• /
• pp.238-242
• /
• 2019

Extreme acidosis is a life-threatening physiological state that causes disturbances in the cardiovascular, pulmonary, immune, and hematological systems. Trauma patients commonly present to the operating room (OR) in hypovolemic shock, leading to tissue hypoperfusion and the development of acute metabolic acidosis with or without a respiratory component. It is often believed that trauma patients presenting to the OR in severe metabolic acidosis (pH <7.0) will have a nearly universal mortality rate despite aggressive resuscitation and damage control. The current literature does not include reports of successful resuscitations from a lower pH, which may lead providers to assume that a good outcome is not possible. However, here we describe a case of successful resuscitation from an initial pH of 6.5 with survival to discharge home 95 days after admission with almost full recovery. We describe the effects of acute acidosis on the respiratory and cardiovascular systems and hemostasis. Finally, we discuss the pillars of management in patients with extreme acute acidosis due to hemorrhage: transfusion, treatment of hyperkalemia, and consideration of buffering acidosis with bicarbonate and hyperventilation.

• 대한의용생체공학회:의공학회지
• /
• 제38권4호
• /
• pp.211-217
• /
• 2017

During the emergency situation such as cardiac arrest, cardiopulmonary resuscitation(CPR) is the most important treatment to maintain patient's blood circulation. Since the quality of CPR can not be easily measured or evaluated by the eye, an assistive device with an accelerometer can help to assess the pressure depth of CPR. In this study, we propose a single frequency analysis method to reduce the error of the accelerometer by extracting only one frequency component from the Fourier transform process. To verify the effectiveness of the single frequency analysis, acceleration data at CPR conditions were measured at a sampling rate of 50 / sec using a wristband equipped with an acceleration sensor. Then, We compared the existing distance estimation method and the single frequency analysis method using the measured data. The amplitude value proportional to the compression depth was obtained by applying the single frequency analysis method.

• 한국응급구조학회지
• /
• 제17권2호
• /
• pp.21-28
• /
• 2013

Purpose : The aim of the study is to compare the effect of cardiopulmonary resuscitation (CPR) with voice and CPR without voice by one rescuer. Methods : Subjects were 26 students in C University who had basic life support certificate for Healthcare Provider. They performed 30:2 CPR for 6 minutes by two groups of CPR with voice and CPR without voice by one rescuer from August 14 to 16, 2012. They performed CPR with Resusci Anne SkillReporter$^{TM}$ and Laerdal PC SkillReporting System Ver. 2.4.1(Laerdal Medical, Norway and recored voice using TES-1350A(TES Electrical Electronic Corp, Taiwan). Between each experiment, 1 day of rest was given, providing enough time to recover from the fatigue of CPR. Results : The depth, rate of chest compression, and ventilation volume were not affected by a voice (p >.05), and the ratio of chest compression to ventilation kept 30:2, when the subject made a sound (p <.05). Conclusion : Making voice during CPR was associated with an accurate ratio of 30:2 and the reduction in hands off time.

• 한국치위생학회지
• /
• 제13권6호
• /
• pp.1079-1086
• /
• 2013

Objectives : It is considered that the education of cardiopulmonary resuscitation and the preparation for quick response to cardiac arrest are very important to dental hygiene students who get employed in dental clinics and hospitals after graduation. The purpose of the study is to investigate the perception, attitude and knowledge of cardiopulmonary resuscitation(CPR) in dental hygiene students and to provide basic data to educate CPR education program for the dental hygiene students. Methods : The study subjects were 260 students in the department of dental hygiene in J city health college. A self-reported questionnaire was conducted from May 1st to 31st 2013. A frequency analysis and x2-test was carried out to confirm the general characteristics of the 260 respondents. Results : The perception rate of the CPR was 55.8%(145 persons). There were positive correlations between perception and attitude of CPR (r=.202) and attitude and knowledge(r=.249). Conclusions : CPR performance is the vital to the cardiac arrest victim. So it is necessary to educate the dental hygiene students in case of emergency situation. It is necessary to educate CPR and basic life support (BLS) in dental hygiene students.

• 중환자간호학회지
• /
• 제13권3호
• /
• pp.11-23
• /
• 2020

Purpose : This study examined factors influencing the attitudes towards nurse-led defibrillation in the emergency department (ED) and intensive care unit (ICU). Methods : This was a cross-sectional study. A total of 212 nurses in the ED and ICU from three general hospitals responded to the survey. Data were collected between September and October 2015 using structured questionnaires. Independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression were used to analyze factors affecting nurses' attitudes towards nurse-led defibrillation. Results : The mean score of nurses' attitudes towards nurse-led defibrillation was 61.37 of a possible 91. Hierarchical multiple regression showed that nurses' attitudes towards nurse-led defibrillation were significantly affected by their experiences regarding cardiopulmonary resuscitation (p=.003), knowledge regarding electrocardiogram interpretation and defibrillation (p=.007), and tenure in ED or ICU (p=.043). Conclusion : Results indicate that employers should set policies to support nurses in maintaining their careers in the ED or ICU and conduct systematic educational programs for them. This will increase nurses' confidence in performing defibrillation, which will lead to early defibrillation during in-hospital cardiac arrest. Consequently, it can be a strategy to increase the survival rate of cardiac arrest patients.

• 간호행정학회지
• /
• 제15권2호
• /
• pp.203-215
• /
• 2009

Purpose: In order to improve resuscitation rate of CPR through providing qualitative nursing while performing CPR in hospital ward and to enhance quality of emergency nursing in the ward, the author embarked on the research as a way of developing ventricular fibrillation protocol about CPR. Method: Collected data were analyzed by using the SPSS/PC14.0 program while the routes of final protocol developed in this research are as follows. Result: Based on analysis results of literature study and CPR electronic hospital records, a total of 22 items and 53 specific contents were confirmed through the gathering of opinions from panels, and the allotment of roles and tasks with a standard of 2 nurses was designated. As the result of specialists' verification on validity, the final protocol composed of a total of 23 items and 45 specific contents was confirmed. At the result of the pertinency evaluation of confirmed protocol, it was evaluated as relatively pertinent with its average score 2.89-3.32. Conclusion: The protocol developed in this research is seen as to contribute to nurses participating in CPR to avoid the overlapping of tasks and to develop CPR through effective teamwork of medical teams by presenting clear roles and tasks.

• 한국융합학회논문지
• /
• 제10권3호
• /
• pp.221-225
• /
• 2019

이 연구의 목적은 일반 대중이 심폐소생술을 쉽게 적용하기 위한 기본적인 데이터를 제공하는데 있다. 심폐소생술 마네킹과 CPR 큐브를 사용하는 두 그룹으로 나누었으며 실험에 앞서 참가자들에게는 3일 동안 실습을 동반한 심폐소생술 훈련을 실시하였고 2주 후 가슴압박에 대한 평가를 실시하였다. 참가자들은 가슴압박깊이, 가슴압박의 횟수, 가슴압박의 정확성, 불충분한 이완, 불완전한 압박위치를 기록하였다. 연구결과에서 불충분한 이완, 불완전한 압박위치는 통계적으로 유의한 차이가 있었다. 심폐소생술 교육의 확대를 위해서 CPR 큐브를 사용한다면 심폐소생술 시행 자신감과 질적인 측면에서도 유용할 것으로 생각된다.

• 한국컴퓨터정보학회논문지
• /
• 제24권4호
• /
• pp.153-159
• /
• 2019

In this paper, we propose a the effects of new chest compressions in the implementation of chest compressions during infant cardiopulmonary resuscitation, and to provide basic data for high-quality CPR. On March 12, 2019, the research target used the SPSS 22.0 Version as an experimental study using randomized cross-design of 30 emergency medical services students who completed BLS Health Care-provider. The study also showed significant differences in chest depth and average rate of pressure($34.61{\pm}1.29$, $39.40{\pm}1.08$, <0.001, $105.46{\pm}4.23$, $107{\pm}3.84$, <0.001) depending on chest compressions. There was also a significant difference in the convenience and degree of pain of chest compressions(<0.001). In addition, new chest compressions appeared close to vertical and showed statistically significant differences(p<.001). Based on the results of this study, we can see that the accuracy of the new chest compressions during infant cardiopulmonary resuscitation is increased, and the depth of chest compressions is improved, improving the quality index of chest compressions. However, it will be necessary to further study the use of the new chest compressions to identify the potential for clinical use.

• Journal of Chest Surgery
• /
• 제49권3호
• /
• pp.151-156
• /
• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• Journal of Medicine and Life Science
• /
• 제17권3호
• /
• pp.80-85
• /
• 2020

Urinary tract infections are among the most common infectious diseases and are the major causes of mortality and morbidity. These diseases result in many severe hospitalizations each year. Severe sepsis and septic shock are common and life-threatening medical conditions, and large cases are associated with urinary tract infection. The medical term "severe sepsis" is defined as sepsis complicated by hypotension, organ dysfunction, and tissue hypoperfusion, whereas "septic shock" is defined as sepsis complicated either by hypotension that is refractory to fluid resuscitation or by hyperlacteremia. A recent multicenter-study in Korea reported that the rate of in-hospital mortality associated with severe sepsis and septic shock was > 34%. Among the causative diseases, urogenital tract infection showed a high correlation. Moreover, it is very important that clinicians detect severe sepsis and septic shock early and treat them properly. The principles of initial treatment include provision of sufficient hemodynamic resuscitation and early administration of appropriate antibiotic therapy to mitigate uncontrolled infection. Initial resuscitation includes the use of vasopressors and intravenous fluids, and it is a key to achieve the target of initial resuscitation. Supportive care in the intensive care unit, such as glucose control, stress ulcer prophylaxis, blood transfusion, deep vein thrombosis prophylaxis, and renal replacement therapy, is also significant. We have summarized the key components in the treatment of severe sepsis and septic shock in patients with urinary tract infection. Urologists should be aware that appropriate early treatment is necessary to prevent fatal outcomes in these patients.