• Title/Summary/Keyword: cardiopulmonary resuscitation(CPR)

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Role and Prognosis of Extracorporeal Life Support in Patients Who Develop Cardiac Arrest during or after Office-Based Cosmetic Surgery

  • Kwon, Seong Soon;Park, Byoung-Won;Lee, Min-Ho;Bang, Duk Won;Hyon, Min-Su;Chang, Won-Ho;Oh, Hong Chul;Park, Young Woo
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.277-284
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    • 2020
  • Background: Cardiac arrest during or after office-based cosmetic surgery is rare, and little is known about its prognosis. We assessed the clinical outcomes of patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics. Methods: Between May 2009 and May 2016, 32 patients who developed cardiac arrest during or after treatment at cosmetic surgery clinics were consecutively enrolled. We compared clinical outcomes, including complications, between survivors (n=19) and non-survivors (n=13) and attempted to determine the prognostic factors of mortality. Results: All 32 of the patients were female, with a mean age of 30.40±11.87 years. Of the 32 patients, 13 (41%) died. Extracorporeal life support (ECLS) was applied in a greater percentage of non-survivors than survivors (92.3% vs. 47.4%, respectively; p=0.009). The mean duration of in-hospital cardiopulmonary resuscitation (CPR) was longer for the non-survivors than the survivors (31.55±33 minutes vs. 7.59±9.07 minutes, respectively; p=0.01). The mean Acute Physiology and Chronic Health Evaluation score was also higher among non-survivors than survivors (23.85±6.68 vs. 16.79±7.44, respectively; p=0.01). No predictor of death was identified in the patients for whom ECLS was applied. Of the 19 survivors, 10 (52.6%) had hypoxic brain damage, and 1 (5.3%) had permanent lower leg ischemia. Logistic regression analyses revealed that the estimated glomerular filtration rate was a predictor of mortality. Conclusion: Patients who developed cardiac arrest during or after cosmetic surgery at office-based clinics experienced poor prognoses, even though ECLS was applied in most cases. The survivors suffered serious complications. Careful monitoring of subjects and active CPR (when necessary) in cosmetic surgery clinics may be essential.

Analysis of Predicted Instructions about Shockable Cardiac Arrest Patients by Dispatcher at 119 Emergency Situation Management Center (제세동이 가능한 심정지 환자를 119구급상황관리센터 상황요원이 예측한 지령 분석)

  • Jeong, Eun-Kyung;Jeong, Ji-Yeon
    • Fire Science and Engineering
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    • v.27 no.6
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    • pp.122-128
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    • 2013
  • This study analyzed the emergency activity daily reports and emergency instruction sheets of the research subjects and proceeded with the shockable cardiac arrest cases transported to 119 emergency units for two years before the hospital from January 1, 2010 through December 31, 2011. The most frequently predicted instruction by the dispatchers at the 119 Emergency Situation Control Center was 74 cases of fainting (33.3%). Among varied types of predicted instructions, 112 cases (50.5%) like fainting, chest pain, general prostration and others were not able to be predicted while predictable instructions involved with cardiac arrest such as consciousness disorders, difficult breathing, cardiac attacks and convulsion were 110 cases (49.5%). In such cases, success rates of cardiopulmonary resuscitation (CPR) trials by eyewitnesses at predictable instructions involved with cardiac arrests were significantly higher. As mentioned, situation agents must categorize types of cardiac arrests accurately by posing questions over assessments regarding patients' consciousness and respiration in detail. The patients categorized by such methods must guide eyewitnesses to be able to do CPR. Moreover, not only emergency medical technicians who receive predictable instructions involved with cardiac arrests given by dispatchers (49.5%) but also filed emergency medical technicians who are not able to reach a precise conclusion to non-cardiac arrests on unpredictable instructions on cardiac arrests (50.5%) must prepare for situations related to cardiac arrests before being dispatched to the field.

Comparison of Video Lecture and Instructor-Led Lecture for the Recognition of Cardiac Arrest : Korean Youths (심정지 인지를 위한 동영상 교육과 강의식 교육의 비교 연구 : 청소년을 대상으로)

  • Jung, Eun-Kyung;Lee, Hyo-Cheol
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.139-145
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    • 2018
  • It is the first step to survive cardiac arrest for the general public to recognize cardiac arrest rapidly. The purpose of this study is to investigate the effective method of education by analyzing the degree of cardiac arrest recognition after performing the agonal breathing education in a video lecture or instructor-led lecture. The study subjects were assigned to either a video lecture or instructor-led lecture in a randomized way and were compared after the education according to the degree of recognition of cardiac arrest in the randomized controlled study. The study was conducted from October 30, 2015 to October 31, 2015. And the study subjects were 104 youths aged 15 years or older, of which 52 were selected as the experimental group and the remaining 52 as the control group. The results did not show a significant difference between these two groups when the subjects are given the video lecture where patients showed no reaction or sign of breathing(p=0.741). However, in the video lecture where there was no reaction of patients but still sign of agonal breathing, 43 people(82.7%) in the experimental group and 33 people(63.5%) in control group have successfully performed CPR and there has been a significant difference (p=0.006). Therefore, we could conclude that video lecture was more efficient than instructor-led lecture when teaching CPR.

Effects of Individual Tendencies and Psychological Variables of College Students on the Depth of Chest Compression During Cardiopulmonary Resuscitation (대학생의 개인성향 및 심리적 변인이 심폐소생술 시 가슴압박깊이에 미치는 영향)

  • Myung-Eun Kim;Hyun-Tae Kim;Hee-Kyoung Kim
    • Journal of Industrial Convergence
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    • v.22 no.5
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    • pp.57-67
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    • 2024
  • This study conducted to confirm the effect of college students' individual tendencies and psychological variables on the depth of chest pressure during CPR. For this, the depth of chest compression during CPR was measured after investigating individual tendencies, fatigue, performance confidence, and performance anxiety in 127 college students. Multiple linear regression analysis was performed using individual propensity and psychological variables as independent variables and chest compression depth as dependent variables to identify factors affecting chest compression depth. Pearson correlation analysis was performed to confirm the correlation between variables. As a result of the analysis, the higher the performance confidence, the deeper the chest compression depth, and the higher the performance anxiety, the lower the chest compression depth(p<0.05). The depth of chest pressure showed a positive correlation with individual tendencies, performance confidence, while it showed a negative correlation with fatigue and performance anxiety(p<0.01, p<0.05). Based on these results, it is necessary to increase performance confidence and lower performance anxiety in order to perform the correct chest compression depth. For this, various efforts such as program development, education and research are required.

Nurses' Understanding and Attitude on DNR (DNR에 대한 간호사의 인식 및 태도조사)

  • Han, Sung-Suk;Chung, Soon-Ah;Moon, Mi-Seon;Han, Mi-Hyun;Ko, Gyu-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.3
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    • pp.403-414
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    • 2001
  • The study was intended to identify the nurses' experiences, understanding, and attitudes on DNR. Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 347 nurses in eight general hospitals. The data were collected between August 1 and August 31, 2000. The data were analyzed using descriptive statistics and $x^2-test$. The results of the study were as follows : 1. Regarding DNR-related experience, 74.6 percent of the participants experienced DNR situations. Eleven percent of the participants received DNR education. DNR was most frequently (81.5%) requested by family members and relatives of patients. The decision-making on DNR was most frequently (76.8%) made by agreement between family members and medical staff. The DNR order was recorded at 81.9 percent on charts. Problems after DNR order were negligence in treatment and nursing care (30.6%) and guilty feelings due to doing the best (22.1%). CPR (cardiopulmonary resuscitation) was performed about 49.8 percent of DNR cases. 2. Regarding understanding and attitude on DNR, most of the participants (93.1%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery (44.4%) and death with dignity (41.1%). The decision-making on DNR was most frequently made by patient and family members (47.8%) and followed by agreement between family members and medical staff (25.6%), and patients themselves (16.4%). Most of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. Forty four percent of the participants thought that the most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals. Most of the participants (90.2%) thought a guide book for DNR is necessary to be made in hospitals. 3. There were significant differences in the participants' understanding and attitudes on DNR according to religion career education and experience of DNR. Of the participants those who have religions and education experience on DNR thought that there would be more DNR requests after DNR is explained to patients and family members (p<.05). In addition, there was higher understanding on the necessity of DNR in those who have more career and DNR experience(p<.01). The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects. Also, there needs to be more education on DNR in medical ethics to health care professional and to provide more information on DNR to the general public.

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Survey on the Educational Needs for Smartphone Based Emergency Situations - Targeting Parents with Elementary School Children (스마트폰 기반 응급상황 대처 교육에 대한 요구도 조사 - 초등학생 자녀를 둔 부모를 대상으로)

  • Min, Hae Young;Lee, Jung Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.2
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    • pp.259-267
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    • 2020
  • This study investigates the educational needs of parents of elementary school children, who use smartphones for emergencies. This is a descriptive cross-sectional study, and data of 200 parents of students under the 6th grade was collected from October 17 to 27, 2017. The study results indicate that 67.5% parents visited the emergency department due to a child's emergency accident. Of these, 74% respondents replied that they were unaware of how to deal with the emergency at that instance. Most parents had never received education, and were using smart-phones to acquire information on first aid. Ed. Notes: Do you mean education in general (i.e. Most parents were uneducated) or do you mean 'education for emergencies'? Please revise for more clarity. Parents' demand for education on child emergency response scored high, with an average of 3.40 (±0.42) out of 4 points. Among the educational categories, "the management of foreign body airway obstruction and cardiopulmonary resuscitation (CPR)" scored the highest average for educational needs (3.64±0.52). This research provides baseline information for understanding the educational needs of parents for first aid for the child. Our findings indicate that the smartphone is potentially an effective educational tool for parents.

Nurses' Emotional Responses and Ethical Attitudes towards Elderly Patients' DNR Decision (노인환자 심폐소생술금지 결정에 대한 간호사의 윤리적 태도와 정서상태)

  • Mun, Junghee;Kim, Sumi
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.216-222
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    • 2013
  • Purpose: The purpose of this study was to examine nurses' emotional responses and ethical attitudes towards elderly patients' Do-Not-Resuscitate (DNR) decision. Methods: Data were collected using a questionnaire which was filled out by 153 nurses who worked in nursing homes and general hospitals. Data were analyzed using real numbers, percentages, means, standard deviations and Pearson's correlation coefficients with SPSS 19.0 program. Results: The average score for ethical attitudes towards the DNR decision was 2.68 out of 4. Under the ethical attitudes category, the highest score was found with a statement that said 'Although they will not perform cardiopulmonary resuscitate (CPR), it is right to do their best with other treatments for DNR Patients'. Items regarding emotional responses to the DNR decision, the average score was 2.36 out of 4. Among them, the highest score was achieved on 'I understand and sympathize'. No significant correlation was found between ethical attitudes and emotional responses in relation to patients' DNR decision (r=-0.12, P=0.13). Conclusion: Regarding elderly patients' DNR decision, nurses showed somewhat highly ethical attitudes and slightly positive emotional response. A follow-up study is needed to investigate variables that affect our results.

Perceptions of the Security Management at Critical Facilities in South Korea: College students' attitudes toward increasing demand for security personnel and the alternatives to police (공공부문 정규직 전환 및 의무경찰제도 폐지에 따른 보안산업 변화에 대한 인식)

  • Wang, Sug-Won;Choi, Yeon-Jun
    • Korean Security Journal
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    • no.61
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    • pp.87-107
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    • 2019
  • With the government policy on converting contract workers to full-time employees, there have been significant changes about the security personnel at the nation's critical facilities, including the National Assembly Building and airports. Moreover, the scheduled disbandment of the conscripted police force in 2023 has raised concerns about security management at different government agencies. To examine the college students' perceptions on the possible alternatives to fill the expected security gap, 234 undergraduate students of security management and protection in the Seoul metropolitan region were surveyed. Particularly, a comparative analysis was conducted on the legal bases and supervision, the employment types and salaries, and the scopes of responsibility and authority of suggested alternatives were compared. The results showed that utilization of private police forces was thought to be the most effective option. Based on the research findings, the university departments should develop and maintain a quality curriculum to educate their students to be prepared security professionals with a focus on emergency response capabilities and martial arts, including the courses on private police law and emergency rescue and cardiopulmonary resuscitation (CPR).

The Work and Job Satisfaction of Paramedics in the Emergency Room of University Hospitals (대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도)

  • Lee, Ok-Hee
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.47-63
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    • 2011
  • Purpose : This research is to examine the work and job satisfaction of paramedics in the emergency room of university hospitals. This research is done to provide basic data needed for establishing work realms of paramedics in hospitals and to enhance their degree of satisfaction. Methods : Research questionnaire survey was conducted on 141 paramedics working in the emergency room of 32 university hospitals from August 24, 2010 to September 30, 2010 through direct visits and telephone interviews or email to explain the purpose of this research and assurance of confidentiality of responses on the questionnaires. As the tool for the degree of job satisfaction, 'The Index of Work Satisfaction' developed by Slavitt, et al(1978) and revised and supplemented by Soon-shim Kim and Hye-ran Kwon(2002) was used. The collected data were analyzed by evaluating frequency, percentage, mean, standard deviation, t-test and ANOVA, Cronbach's $\alpha$ by using SPSS WIN 18.0 program. Results : 1. Investigating the work and role of paramedics in the emergency room of university hospitals, electrocardiogram(EKG) was found to be highest with $\alpha$ was widely used with the rate of patient evaluation and test area. In the medical treatment for patients area, cardiopulmonary resuscitation(CPR) with 95%(134 persons) and ventilation assistance through ambu bagging(BVM) with 95%(134 persons) were found to be high. $\alpha$ were performed. In the role within the hospital and other areas, a member of CPR team in the hospital accounted for 78%(110 persons). 2. In the measurements of the job satisfaction of paramedics working at university hospitals, the total mean score was 2.91. The mean score in each question area indicated: section on job 3.48, autonomy 3.05, interaction 3.01, organizational demand 2.85, working conditions 2.67, salaries 2.40. This result obviously demonstrates the work of paramedics itself was most satisfied but the salaries were most dissatisfied. 3. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the general characteristics showed significant difference in age (F=6.547, p=.002), gender (F=4.436, p=.000) marital status (F=-3.270, p= .001), religion (F=2.041, p= .043), motive for application (F=3.603, p= .015), and salary (F=6.658, p= .000). 대학병원 응급실 내 1급 응급구조사의 업무와 직무만족도 The Journal of the Korean Society of Emergency Medical Technology Vol. 15 (1) 63 4. In the measurements of the job satisfaction of paramedics working at university hospitals, job satisfaction based on the working environmental characteristics showed significant difference in total number of paramedics (F=3.779, p= .012), form of employment (F=5.601, p= .001), existence or non-existence of intention to change jobs (F=-4.037, p= .000). Conclusion : The work of paramedics in the emergency room of university hospitals consists of lots of treatment processes after specialized diagnosis and performance of professionally subdivided works. However, current legislation does not reflect such circumstances to which paramedics are exposed; thus, it should be considered for further revision and modification. The degree of job satisfaction of paramedics in the emergency room of university hospitals was high but low in salaries and working conditions were the weak points. The measures to enhance their degree of job satisfaction should be taken though improvement of labor conditions such as consideration of the rate of increase in salaries, compensation for overtime work, providing rest areas, improvement of current employment system, and conversion of temporary employees into regular employees.

Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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