• Title/Summary/Keyword: advanced life support(ALS)

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Cardiopulmonary Resuscitation and Pediatric Advanced Life Support for Pediatric Dentist (소아치과의사를 위한 심폐소생술과 소아고급생명구조술)

  • Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.2
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    • pp.243-255
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    • 2017
  • Cardiopulmonary resuscitation (CPR) is an emergency treatment that stimulates blood circulation and breathing when the function of the heart stops or stops breathing. CPR can be divided by basic life support (BLS) and advanced life support (ALS). BLS involves the use of chest compression to force the blood flow to the main organs, rescue breathing to improve the breathing to the respiratory failure patient and the use automated external defibrillator (AED). The categories of advanced life support include advanced cardiovascular life support (ACLS) for adult and pediatric advanced life support (PALS) for children. In the treatment of dental care for children, which is extremely difficult to deal with, and for a variety of reasons, the use of sedation is considered to treat the children who are unlikely to cooperate with dentistry. This is why there is an increasing possibility of an emergency situation involving cardiac arrest. PALS includes the BLS, and it presents a systematic algorithm to treat respiratory failure, shock and cardiogenic cardiac arrest. In order to manage emergency situations in the pediatric dental clinic, respiratory support is most important. Therefore, mastering professional PALS, which includes respiratory care and core cases, particularly upper airway obstruction and respiratory depression caused by a respiratory control problem, would be highly desirable for a physician who treats pediatric dental patients. Regular training and renewal training every two years is necessary to be able to immediately implement professional skills in emergency situations.

Effect of advanced life support (ALS) on recovery of spontaneous circulation in out-of-hospital cardiac arrest patients (병원 밖 심정지 환자의 전문소생술이 자발순환 회복에 미치는 영향)

  • Soeun Park;ByoungGil Yoon
    • The Korean Journal of Emergency Medical Services
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    • v.28 no.2
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    • pp.47-62
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    • 2024
  • Purpose: This retrospective study analyzed the effects of advanced life support on the recovery of spontaneous circulation (SC) in patients with out-of-hospital cardiac arrest. Methods: The subjects of this study were out-of-hospital cardiac arrest patients transferred to the hospital by 119 paramedics in Gyeongsangbuk-do from January 1, 2021, to December 31, 2022, amounting to a total of 2,524 patients. Results: The younger the age, the higher the probability of recovery of spontaneous circulation, and it was higher when cardiac arrest occurred in a public place or was witnessed. If the patient's initial electrocardiogram rhythm is defibrillable, the probability of recovery from spontaneous circulation is high. The recovery of the spontaneous circulation rate decreased with time between the time of report and the time of contact with the patient. Recovery of the spontaneous circulation rate was high when mechanical chest compression devices and advanced airways were not used. Additionally, this study had positive effects on defibrillation, peripheral intravenous catheter insertion, and epinephrine infusion. Conclusion: Paramedics should actively perform peripheral intravenous catheter insertion and epinephrine infusion, and it should be possible to clearly determine whether defibrillation should be applied through electrocardiographic education.

Systems Studies and Modeling of Advanced Life Support Systems

  • Kang, S.;Ting, K.C.;Both, A.J.
    • Agricultural and Biosystems Engineering
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    • v.2 no.2
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    • pp.41-49
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    • 2001
  • Advanced Life Support Systems(ALSS) are being studied to support human life during long-duration space missions. ALSS can be categorized into four subsystems: Crew, Biomass Production, Food Processing and Nutrition, Waste Processing and Resource Recovery. The System Studies and Modeling (SSM) team of New Jersey-NASA Specialized Center of Research and Training (NJ-NSCORT) has facilitated and conducted analyses of ALSS to address systems level issues. The underlying concept of the SSM work is to enable the effective utilization of information to aid in planning, analysis, design, management, and operation of ALSS and their components. Analytical tools and computer models for ALSS analyses have been developed and implemented for value-added information processing. The results of analyses heave been delivered through the internet for effective communication within the advanced life support (ALS) community. Several modeling paradigms have been explored by developing tools for use in systems analysis. they include objected-oriented approach for top-level models, procedureal approach for process-level models, and application of commercially available modeling tools such as $MATLAB^{R}$/$Simulink^{R}$. Every paradigm has its particular applicability for the purpose of modeling work. an overview is presented of the systems studies and modeling work conducted by the NJ-NSCORT SSM team in its efforts to provide systems analysis capabilities to the ALS community. The experience gained and the analytical tools developed from this work can be extended to solving problems encountered in general agriculture.

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SYSTEMS STUDIES AND MODELING OF ADVANCED LIFE SUPORT SYSTEM

  • Kang, S.;Ting, K.C.;Both, A.J.
    • Proceedings of the Korean Society for Agricultural Machinery Conference
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    • 2000.11c
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    • pp.623-631
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    • 2000
  • Advanced Life Support Systems (ALSS) are being studied to support human life during long-duration space missions. ALSS can be categorized into four subsystems: Crew, Biomass Production, Food Processing and Nutrition, Waste Processing and Resource Recovery. The System Studies and Modeling (SSM) team of New Jersey-NASA Specialized Center of Research and Training (NJ-NSCORT) has facilitated and conducted analyses of ALSS to address systems level issues. The underlying concept of the SSM work is to enable the effective utilization of information to aid in planning, analysis, design, management, and operation of ALSS and their components. Analytical tools and computer models for ALSS analyses have been developed and implemented for value-added information processing. The results of analyses have been delivered through the Internet for effective communication within the advanced life support (ALS) community. Several modeling paradigms have been explored by developing tools for use in systems analysis. They include object-oriented approach for top-level models, procedural approach for process-level models, and application of commercially available modeling tools such as MATLAB$\^$(R)//Simulink$\^$(R)/. Every paradigm has its particular applicability for the purpose of modeling work. An overview is presented of the systems studies and modeling work conducted by the NJ-NSCORT SSM team in its efforts to provide systems analysis capabilities to the ALS community. The experience gained and the analytical tools developed from this work can be extended to solving problems encountered in general agriculture.

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Report for Development of Korean Portable Cardiopulmonary Bypass Machine (한국형 이동식 심폐소생기 개발 보고 I. 실험견을 이용한 개흉식과 폐쇄식 심폐소생술 비교)

  • Kim, Hyoung-Mook;Lee, In-Sung;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Kim, Yeon-Soo;Kim, Maeng-Ho;Lee, Hye-Won;Lee, Kyu-Back;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.827-836
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    • 1998
  • Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

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Report for Development of Korean Portable Cardiopulmonary Bypass II. Experimental Study of Portable Cardiopulmonary Bypass for Emergency Cardiopulmonary Resuscitation after Cardiac Arrest in Normal Dogs (한국형 이동식 심폐소생기 개발 보고 II. 응급소생술을 위한 이동식 심폐소생기의 동물 실험 연구)

  • Kim, Hyoung-Mook;Lee, In-Sung;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Lee, Hye-Won;Lee, Kyu-Back;Chang, Jun-Kuen;Kim, Chong-Won;Kim, Hark-Jei
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1147-1158
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    • 1998
  • Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

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