• 제목/요약/키워드: Resuscitation rate

검색결과 150건 처리시간 0.028초

4구급대원의 PPE(Personal Protective Equipment)착용 시 CPR 동작분석에 관한 연구 (A Study on the Motion Analysis of CPR on EMT Who Wearing PPE)

  • 신동민;정재한;김승용;홍은정;김경용;한용택
    • 한국안전학회지
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    • 제30권5호
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    • pp.74-79
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    • 2015
  • The purpose of this study is to find out its effect on changes in the joint angle and the success rate of cardiopulmonary resuscitation by conducting cardiopulmonary resuscitation (CPR) when wearing and not wearing PPE (personal protective equipment) targeting 20 paramedics with more than 5 years of experience. The subjects carried out CPR in 30:2 for 4 minutes and collected images were digitized by Kwon3D XP Software Package(Version 4.0) and then data were obtained. Data, which were collected by analyzing the motion when starting in one cycle, when pressing to the maximum, in the final position (relaxed), were analyzed by using SPSS 18.0. In conclusion, during CPR, the angle of the both shoulder joints was not significant (p>.05) and the angle of the right elbow joint was reduced in all positions and was statistically significant (p<.05) and the angle of the left was significantly reduced in the maximum pressure posture and the final position (p>.05). In the case of the trunk, the angle increased statistically significantly at all stages (p<.01, p<.001). Also, during CPR, the average compression rate was significantly reduced after wearing PPE (p<.05) and average hand escape time by cycle increased statistically significantly (p<.05) but chest compression execution rate at the correct depth did not show any significant difference between the two groups (p>05).

병원 전 전문심장소생술을 위한 기계적 가슴압박기의 효과 (The Effect of a Mechanical Chest Compressions for Out-of-hospital Advanced Cardiac Life Support)

  • 이현지
    • 융합정보논문지
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    • 제9권11호
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    • pp.227-233
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    • 2019
  • 본 연구는 병원 전 환경에서 기계식 가슴압박기(LUCAS)와 수기심폐소생술의 비교실험을 통해 가슴압박의 질을 평가하고 기계적 가슴압박기를 사용한 효과적인 전문심장소생술을 제안하는데 그 목적이 있다. 병원 전 심정지상황을 가정하고 구급대원이 3인 1조로 현장에서 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 적용하고, 구급차로 이송하며 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 시행하였다. 연구결과는 다음과 같다. 첫째, 현장과 이송중의 수기심폐소생술의 비교결과 현장에서 수기심폐소생술이 평균압박깊이와 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 둘째, 현장에서 수기심폐소생술과 LUCAS를 비교한 결과 LUCAS가 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 셋째, 구급차로 이송중 수기심폐소생술과 LUCAS를 비교한 결과 평균압박깊이, 압박률, 분당압박횟수에서 유의한 차이를 보였다(p<.001). 위와 같은 결과로 보아 LUCAS는 적절한 압력으로 가슴압박을 수행할 수 있고, 그 동안 구급대원의 전문기도기 삽입, 정맥로 확보 등의 전문심장소생술을 추가적으로 수행할 수 있으며 환자의 소생률을 높이는데 기여할 것이다.

COVID-19 대응 심정지에서 가슴압박 교대 인원에 따른 구조자의 피로도 -마네킹 연구- (Measuring rescuer's fatigue by evaluating varying sized groups of rescuers performing chest compressions on a manikin study for suspected COVID-19 patients)

  • 안희정;심규식;방성환;송효숙;한승은
    • 한국응급구조학회지
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    • 제25권3호
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    • pp.81-92
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    • 2021
  • Purpose: The aim of the study is to measure the quality of cardiopulmonary resuscitation (CPR) and the fatigue of rescuers wearing PPE (Level D) during a CPR session and to ultimately provide suggestions of safety standards for rescuers. Methods: 36 subjects were enrolled in the study. The subjects were divided randomly into three groups of two-members, three-members, and four-members. Each group performed CPR for 30 minutes. Blood lactate concentration, heart rate, rating of perceived exertion, chest compression depth and rate were measured before experiment and after each cycle. Results: There was a difference in the blood lactate concentration during CPR cycle by member of shifts (p=.014). The blood lactate concentration increased during CPR (p=.000). Subjective fatigue was a significant difference of chest compression in cycles 3, 4, and 5 for the member of shifts during CPR (p=.049, p=.009, p=.015). Depth and rate of chest compression were not different for the member of shifts during CPR. Conclusion: It is necessary to establish standards for the member of shifts during CPR, to reduce the fatigue of rescuers.

한국응급의료서비스 민관파트너십 도입의 타당성에 관한 연구 (A Study on the Public-Private Partnership in the Emergency Medical System in Korea)

  • 김국래;김태윤
    • 한국화재소방학회논문지
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    • 제20권2호
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    • pp.31-43
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    • 2006
  • 현재 우리나라 응급의료서비스(Emergency Medical Service)의 대부분을 차지하는 119구급대는 구조적인 문제에 봉착해 있다. 119 EMS가 무료로 공급되면서 그에 대한 수요가 비정상적으로 증가하여 119구급대원들의 과부하가 문제시되는 한편 정작 중요한 성과지표인 소생률(resuscitation rate)은 외국에 비해 저조한 수준을 면치 못하고 있다. 이러한 문제를 해결하기 위해서는 예산 및 인력 증원이 필요한데 현 시스템 하에서는 막대한 예산 소요, 소방공무원 표준정원제와 소방력기준과의 불일치 등에 의한 제약 때문에 이마저도 쉽지 않다. 본 연구는 이러한 문제의식 하에서 현행 EMS 시스템이 의료기관이나 민간이송업체를 포괄하는 민관파트너십 시스템으로 이행하는 방식을 간략하게 설계하고, 그 타당성을 검토하고자 한다. 우선 미국 주요도시의 EMS 성과와 관련된 기초 통계를 바탕으로 분석해 본 결과, 소방이던 의료기관이던간에 단일기관이 EMS를 전담하는 경우보다는 복수의 기관이 협력하는 경우가 소생률이 높다는 것을 확인할 수 있었다. 또한 각국의 EMS 체계와 관련된 사례를 수집한 결과 한국과는 달리 대부분의 국가나 지자체들이 민관파트너십을 통해 보다 질 높은 EMS를 제공하고 있었다. 결국 한국의 EMS도 소방 중심에서 탈피하여 의료기관, 민간업체 등과 파트너십을 구축하는 방향으로 EMS 체계를 재설계하는 것이 타당할 것이라는 결론을 얻었다.

병원전 처치에서 자동제세동기의 사용 (Defibrillator(AED) in prehospital care)

  • 고봉연
    • 한국응급구조학회지
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    • 제9권1호
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    • pp.25-32
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    • 2005
  • Purpose: There has been an increase in the number of prehospital cardiac arrests due to increases in both cardiovascular diseases and the average age of the population, We performed this study to identify the proper resuscitation technique and AED to be used to increase the survival rate in prehospital cardiac arrest. Methods: We studied 57 victims with prehospilal cardiac arrest by EMT's Reports form January to December, 2004. Results: Fifty-seven of 92 victims were trasported with ECG in prehospital cardiac arrest. Ventricular fibrillation(VF)/ ventricular tachycardia was 56.2%, asystole was 33,3%, and pulseless electrical activity(PEA.) was 10.5% in initial rhythm analysis, There weren't attempt CPR in 14.0%. Twenty of the 32(62.5%) were shocked by AED for the adequacy method. There were no statistical differences the transportation time. Conclusion: With the increase in cardiovascular disease and old age, the number out-of-hospital cardiac arrests has risen accordingly. However, there were lack of CPR by bystander, defibrillation, advanced cardiac life support(ACLS) in prehospital stage. To improve the adequancy of basic life support and to increase the performance of ACLS, especially AED, we must create challenges to develop new protocols in prehospital care.

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심폐소생술교육의 대국민 인식에 따른 개선 홍보 방안 연구 - 경기도소방서 1권역을 중심으로 - (New research of CPR education Public Relations for general public - starting with first area from kyunggi fire stations -)

  • 기은영
    • 한국응급구조학회지
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    • 제10권3호
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    • pp.33-47
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    • 2006
  • This research is devoted to increase resuscitation rate of emergency patients, expanding CPR to a pan-national campaigning, revaluating popularity and suitability of the education about the existing CPR(Bystander cardiopulmonary resuscitation) education expansion of 119 EMS. Questionnaire was carried from seven hundred fifty eight residental and students in kyuggi fist area(Southern suwon, Middle suwon, Osan, Young-in) from July 20 to July 30, 2006. The institutional support for CPR education and special eduction institution are not prepared, 52.44% of those have CPR education, according to questionnaire. 39.9% of the educated is from 119 EMS and it is big outcome, 119 EMS efforts in the vortex of poor surroundings. But, 69.76% of the uneducated said they had not chance of CPR education and 19.63% said that the reason is no special eduction institution and information for CPR education. They say that CPR education was carried for only applicants in 119 EMS, without systematic and institutional support, special eduction institution. So, we have to expand the infrastructure, institute CPR education for systematic propagation of CPR education. And we need to make plan constructive public relations, intensify maintaining of CPR educated.

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이동 중 주들것에서 심폐소생술 분석 (Analysis of cardiopulmonary resuscitation during main stretcher transport - A manikin study -)

  • 노상균
    • 한국응급구조학회지
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    • 제24권2호
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    • pp.39-50
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    • 2020
  • Purpose: This study aimed to compare the effect of chest compression and the resulting ventilation volume in walking cardiopulmonary resuscitation (CPR), straddling CPR, and mechanical CPR while moving manikins to main stretchers. Methods: We compared the chest compressions in terms of compression depth, number of incomplete releases, complete release depth, compression rate, duration between peak time of previous compression and peak time of current compression, and respiration. We analyzed the compression comparatively with the ventilation volume in three different types of CPR. Results: The chest compression depth was significantly improved during straddling CPR as compared to walking CPR, during which women were unable to achieve sufficient chest compression depth. A constant chest compression depth was maintained during mechanical CPR. Conclusion: High-quality chest compressions were difficult to achieve in moving spaces. Further, walking CPR may be helpful in men, but straddling or applying automatic chest compressions in women would result in more effective CPR. Our findings demonstrate the limitations and trends in administering CPR in men and women, which may be useful in devising better education and training methods in the future.

Study of military CPR quality and education by feedback device and debriefing

  • Moon, Soo-Jae;Kim, Seon-Rye;Cho, Byung-Jun
    • 한국컴퓨터정보학회논문지
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    • 제21권9호
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    • pp.107-112
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    • 2016
  • In this paper, we propose the effects of military cardiopulmonary resuscitation(CPR) on the quality of debriefing and feedback device training. The key idea of combination debriefing and feedback device training is to maximize effects of CPR. The participants of the research were non-medic soldiers in ROK army, and had not undergone any professional CPR training before. Each group of soldier was randomized to perform of military CPR by using training method in each group. After 5 minutes of performing CPR, each D, F, DF group showed significant improvement in CPR performance. When comparing each group, the rate of success in CPR performance in DF group was significantly higher than that of F group with the average difference of 11.160(p<.01) points. In summation, the training programs that DF received seemed to be more efficient and effective than that of D and F. The fatigue level was evaluated by comparing the lactate concentration in blood after performing CPR. Through this experiment, we show that the training programs that DF received is more efficient and effective than that of D and F.

119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 - (Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service)

  • 강병우
    • 한국응급구조학회지
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    • 제9권2호
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, 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, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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119구급대에 의해 소생한 병원 전 심장정지 환자 1례 (Out-of-Hospital Resuscitation of Cardiac Arrest by 119 Emergency Medical Service System)

  • 윤형완;이재민;정지연
    • 한국화재소방학회논문지
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    • 제24권5호
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    • pp.142-149
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    • 2010
  • 심폐소생술이란 인공호흡과 순환보조를 통하여 조직으로의 산소 공급을 유지하여 임상적 사망에서 생물학적 사망으로 진행을 막고, 심장박동과 순환을 회복시켜 환자를 소생시켜주는 술기이다. 심폐소생술이 시행되더라도 모든 심장정지 환자가 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존률이 결정된다. 현장에서 심장정지가 목격되지 않은 환자는 병원이송 전 현장에서 2분간 5주기 심폐소생술을 수행하고 자동제세동기를 사용하도록 하였고, 목격된 환자에게는 즉시 자동제세동기를 사용할 것을 권장하고 있으며 이후 전문적인 심장구조술이 필요하다. 병원 전 단계에서 119 구급대가 이송한 환자 중 자발순환회복(return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 현장에서 심장정지가 목격되었으나 심폐소생술이 시행되지 않았고 구급대원이 도착한 후 심폐소생술 시행 및 전문심장구조술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.