• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.394-402
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• 2023

Backgrounds/Aims: Acute pancreatitis is an emergency presentation, which can range from mild to life threatening. Intravenous fluids are the cornerstone of management. Although the WATERFALL trial described the optimal fluid rate in mild/moderate pancreatitis, this trial excluded patients with moderate-severe/severe pancreatitis. The aim of this study was to establish clinical practice regarding intravenous fluid administration in acute pancreatitis and assess its effect on mortality. Methods: Prospective multi-centre audit of patients with acute pancreatitis was conducted. Data were collected regarding intravenous fluid administration within 72 hours of admission. The primary outcome was 30-day mortality. Multivariable logistic regression was used to identify predictors of 30-day mortality. Results: Those with severe pancreatitis received more fluid; median 5.7 L versus 4 L in 72 hours (p = 0.003). Participants with severe pancreatitis who died within 30 days received a median of 2,750 mL in the first 24 hours, compared to 4,000 mL in those who survived. The following factors were significant predictors of 30-day mortality: age, Glasgow score, C-reactive protein, ischaemic heart disease, and pancreatitis aetiology. Overall, volume of intravenous fluid was not associated with mortality. However, the effect of intravenous fluid volume on mortality differed significantly depending on pancreatitis severity. In severe pancreatitis, increased volume of intravenous fluid was associated with significant reductions in mortality (odds ratio = 0.655; 0.459-0.936; p = 0.020). Conclusions: In severe pancreatitis, more aggressive fluid prescription was associated with decreased mortality; however, this was not the case in milder disease. Further prospective trials guiding fluid resuscitation in severe pancreatitis are needed, as the impact of fluid on this population appears to differ from that in those with milder disease.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.55-78
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• 2005

The purpose of this study was to provide basic data for the improvement of the guidelines and training programs regarding the cardiopulmonary resuscitation performance of bystanders who can respond to the incidents in earlier times as the first responder of the cardiac arrest incident, by reviewing the performance of basic CPR and the influencing factors after providing 70 students of Department of Emergency Medical Technology with the CPR training. For the purpose of the study, the collected data were computerized and analyzed by SPSS-WIN program(ver. 10.1). The results for this study were as follows The duration of session between the groups in the BLS CPR were 3 minutes and 36 seconds, 2 minutes and 32 seconds respectively. The average compression number per minute were 24.3 times and 33,2 times respectively(p=.000), and the average compression rate per minute were 112 times and 122 times respectively(p=.000). The average ventilation number per minute were 3.54 times and 5.1 times respectively(p=.000). The errors in compression "Too shallow" were 20.73 times(34.6%) and 23,23 times(38,7%) out of 60 times in 4 cycles with the standard of 38 nun. In CPR performance results according to gender in the first episode, males showed better results in compression depth as 41.5 mm comparing to females average 38.2 mm(p=.015). When ventilation results were compared according to the use of FS, the average ventilation number per minute, total ventilation per minute and the average volume per episode were significantly higher when FS was not used(<.040), There was no significant difference in ventilation accuracy between two groups. According to the results, we need to improve and distribute portable barrier devices, and to be familiar with those devices. We need to enforce ventilations as well as to include compressions so that faster and more accurate CPR can be performed. Additionally, we need to exclude ventilation only cases, minimize the interference time of chest compression due to inaccurate ventilation, simplify or minimize the complicatedness of CPR performance and responding time related to breathing, provide first responders with various training programs such as initial assessment and ventilations only, or initial assessment and chest compression-only CPR and than provide advanced training with AHA BLS education including CPR for more than two people according to CPR skills and target characteristics.

• Journal of Hospice and Palliative Care
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• v.18 no.3
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• pp.179-187
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• 2015

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.317-325
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• 2017

Background: Extracorporeal membrane oxygenation (ECMO) has become an important treatment modality in pediatric patients with cardiopulmonary failure, but few studies have been conducted in Korea. Methods: We conducted a retrospective review of pediatric patients younger than 18 years who were placed on ECMO between January 2004 and December 2014 at Samsung Medical Center. Results: We identified 116 children on ECMO support. The overall rate of successful weaning was 51.7%, and the survival to discharge rate was 37.1%. There were 39, 61, and 16 patients on ECMO for respiratory, cardiac, and extracorporeal cardiopulmonary resuscitation, respectively. The weaning rate in each group was 48.7%, 55.7%, and 43.8%, respectively. The survival rate was 43.6%, 36.1%, and 25.0%, respectively. Sixteen patients on ECMO had functional single ventricle physiology; in this group, the weaning rate was 43.8% and the survival rate was 31.3%. Ten patients were on ECMO as a bridge to transplantation (8 for heart and 2 for lung). In patients with heart transplantation, the rate of survival to transplantation was 50.0%, and the overall rate of survival to discharge was 37.5%. Conclusion: An increasing trend in pediatric ECMO utilization was observed. The outcomes were favorable considering the early experiences that were included in this study and the limited supply of specialized equipment for pediatric patients.

• Proceedings of the KIEE Conference
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• 2006.04b
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• pp.307-309
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• 2006

There are operated the six thousand train in the interior of a country. 95% of them are possible usage of resuscitation. Especially, Among them VVVF-Inverter vehicle has a merit of the highest recycle rate. but we don't use a apt recycled energy. Although the existing recycle energy used inverter method supply with electric power, it is decided in accordance with the state of sources. So efficiency of recycled electric power is of poor quality and catenary-voltage-fluctuation be generate because of recycled electric power. and it is able to affect system of safety train service. We'll research the method of supply according to wire condition after storing recycle energy made during train's stopping relation to Advanced EMU Research. Those methods are divided SMES, Fly-Wheel and Supercapacitor, and Considering the both economical efficiency and system application, we'll develop recycle energy storage system suitable our country condition.

• Proceedings of the KSR Conference
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• 2005.11a
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• pp.660-664
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• 2005

There are operated the six thousand train in the interior of a country, $95\%$ of them are possible usage of resuscitation, Especially, Among them VVVF-Inverter vehicle has a merit of the highest recycle rate, but we don't use a apt recycled energy. Although the existing recycle energy used inverter method supply with electric power, it is decided in accordance with the state of sources. So efficiency of recycled electric power is of poor quality and catenary-voltage-fluctuation be generate because of recycled electric power. and it is able to affect system of safety train service. We'll research the method of supply according to wire condition after storing recycle energy made during train's stopping relation to Advanced EMU Research. Those methods are divided SMES, Fly-Wheel and Supercapacitor. and Considering the both economical efficiency and system application, we'll develop recycle energy storage system suitable our country condition.

• Journal of Digital Convergence
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• v.12 no.2
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• pp.417-421
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• 2014

We conducted this study to verify effect of applying musical rhythm during the cardiopulmonary resuscitation(CPR) education. From June to October, 2013, we recruited participants of CPR education among mem's high school students. We divided total 57 participants to 2 groups. For experimental group we use musical rhythm during cardiac compression practice to assist adequate cardiac compression rate and for control group do not apply musical rhythm. The group with musical rhythm show more adequate compression rate(16.4sec) than non-rhythmic group(14.4sec). 90% of rhythmic group keep adequate compression rate, but only 44% of non-rhythmic group keep adequate rate. In conclusion, applying musical rhythm to CPR education is more effective to keep correct cardiac compression rate.

• Journal of Trauma and Injury
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• v.29 no.2
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• pp.47-50
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• 2016

Transcatheter arterial embolization (TAE) for blunt hepatic injury in children is not common and is especially rare after damage control surgery (DCS). We report a successful TAE after DCS on a child for massive bleeding from the left hepatic artery due to a motor vehicle accident. The car (a sport utility vehicle) ran over the chest and abdomen of a 4-year-old boy. On arrival, initial vital signs were as follows: blood pressure, 70/40 mmHg; heart rate, 149/min; temperature, $36.7^{\circ}C$; respiratory rate, 38/min. After resuscitation, computed tomography was done, and a suspicious contrast leakage from a branch of the left hepatic artery and a spleen injury (grade V) were found. TAE was performed successfully after DCS for a liver injury.

• Journal of the Korea Safety Management & Science
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• v.23 no.3
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• pp.89-96
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• 2021

This study analyzed the physical changes in 119 paramedics transporting equipment at the emergency site and performing post-cardiopulmonary resuscitation through experiments. First, the average heart rate increased by about 25 times comparing CPR was performed without physical load and with personal protective equipment after moving equipment. In the third quartile, it increased to about 27 times. Second, when CPR was performed without physical load, and CPR was performed after moving the equipment with personal protective equipment, both the body temperature was raised and the rising body temperature was measured within normal body temperature. Third, the change in respiration rate increased by 7 times on average comparing CPR was performed without physical load and CPR was performed after moving the equipment while wearing personal protective equipment. In the third quartile, it increased to about 11 times. Finally, the change in blood pressure increased by 26.6 mmHg on average comparing CPR was performed without physical load and with wearing personal protective equipment after moving the equipment, and increased by 31.2 mmHg on average in the third quartile.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.6647-6654
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• 2015

The purpose of this study was to analysis a Korean version of Satisfaction with Simulation Experience(SSE) Scale by paramedic students. Total number of 111 students majoring in the EMT-paramedic education area have taken part in the survey after completing the professional cardiac resuscitation simulative training, using the standardized simulation satisfaction evaluation method (SSE scale). Through the scale, one's preference, necessity, ACLS theory grade, and satisfaction rate per year regarding the training were measured. To analyze one's preference, necessity, ACLS theory grade, and satisfaction rate per year in regards to the training, one-way ANOVA was used. The result reveals that the overall satisfaction rate was generally quite high. When one's preference and necessity rate is high, the satisfaction rate also seems to increase. The result indicates that the simulation training will enhance the students' clinical skill, patient evaluation, and treatment capability as well as one's field adaptation skill at the time of an emergency occurrence. Eventually, training through the ACLS simulation will be used in the future for the benefit of encouraging students from emergency rescue to adapt to the site of an emergency. Therefore, such an education method should be maintained and further developed.