• 제목/요약/키워드: cardiac arrest

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심정지(Cardiac Arrest)에 대한 개념분석: 개념적 속성 및 경험적 지표의 규명 (Concept Analysis of Cardiac Arrest: Identifying the Critical Attributes and Empirical Indicators)

  • 이강임;오현수
    • 성인간호학회지
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    • 제26권5호
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    • pp.573-583
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    • 2014
  • Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

응급구조사의 병원 전 심폐소생술에 대한 분석 - Chain of Survival 단계 별 - (A Analysis of CPR on prehospital cardiac arrest patients through Chain of Survival by EMT)

  • 박진욱;노상균;이경희
    • 한국응급구조학회지
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    • 제10권2호
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    • pp.35-42
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    • 2006
  • Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.

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심장정지 인지를 위한 360° 가상현실과 일반 동영상 개발 : 순차적 혼합 연구 (Development of 360° virtual reality videos and common videos for cardiac arrest recognition : A sequential mixed methods study)

  • 정은경;신준호
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.55-69
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    • 2021
  • Purpose: This study aimed to develop 360° virtual reality videos and common videos for cardiac arrest recognition. Methods: A sequential mixed methods study was conducted, using qualitative interviews (with a total of seven experts) and a quantitative survey. Results: First, the cardiac arrest situation should be developed within 2-3 minutes after witnessing the patient collapse, for each of the four cardiac arrest videos about apnea, gasping, seizure, gasping, and seizure. Second, the education program should be designed so that the education on cardiac arrest recognition can proceed before CPR practice begins. Conclusion: 360° virtual reality videos and common videos for cardiac arrest recognition can play an important role in the education of the general public about cardiac arrest experience.

119 응급신고에서 수보요원과 신고자의 통화분석을 활용한 머신 러닝 기반의 심정지 탐지 모델 (Machine-learning-based out-of-hospital cardiac arrest (OHCA) detection in emergency calls using speech recognition)

  • 김종인;이주영;정지오;신대진;최동현;김기홍;홍기정;김선희;정민화
    • 말소리와 음성과학
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    • 제15권4호
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    • pp.109-118
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    • 2023
  • 심정지는 초기 대응에 따라 생존율과 예후에 영향을 미치는 중요한 응급 상황이다. 특히 병원밖심정지(out-of-hospital cardiac arrest, OHCA)의 경우, 119 구조대의 초기 조치가 심정지 환자의 생존율을 높이는 데 결정적인 역할을 한다. 그러나 국내에서는 수보요원의 수가 제한적이지만 다량의 신고 전화에 응대해야 하는 현실이다. 이런 상황에서 머신러닝 기반의 OHCA 탐지 프로그램은 수보요원의 보조 역할로 심정지 환자의 생존률을 높일 수 있다. 본 연구에서는 이러한 문제를 해결하기 위해 머신러닝 기반의 심정지(OHCA) 탐지 프로그램을 개발하였다. 이 프로그램은 수보요원과 신고자의 통화 녹취록을 분석하여 심정지 여부를 판단한다. 제안한 모델은 수보요원 및 신고자와의 통화를 자동으로 전사하는 모델, 텍스트 기반의 심정지 탐지 모델, 그리고 프로그램 개발을 위한 서버와 클라이언트로 구성되어 있다. 실험 결과, 본 연구에서 제안한 모델은 F1 점수 기준으로 79.49%의 성능을 보였으며, 수보요원과 비교하여 심정지 감지 시간을 15초 단축하였다. 이 연구는 소규모 데이터셋을 사용하였음에도 불구하고, 심정지 기반의 탐지 프로그램이 수보요원의 보조 역할로 심정지 생존률에 기여할 수 있음을 입증하였다.

119구급서비스 품질관리가 병원 전 심정지 환자의 생존율에 미치는 영향 (The Effectiveness of Quality Control of 119 Emergency Medical Services on Survival Rate of Cardiac Arrest Patients)

  • 정은경;윤형완
    • 보건의료산업학회지
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    • 제7권1호
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    • pp.21-34
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    • 2013
  • Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

No frequency change of prehospital treatments by emergency medical services providers for traumatic cardiac arrest patients before and after the COVID-19 pandemic in Korea: an observational study

  • Ju Heon Lee;Hyung Il Kim
    • Journal of Trauma and Injury
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    • 제36권3호
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    • pp.172-179
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    • 2023
  • Purpose: Out-of-hospital traumatic cardiac arrest (TCA) often has a poor prognosis despite rescue efforts. Although the incidence and mortality of out-of-hospital cardiac arrest have increased, bystander cardiopulmonary resuscitation (CPR) has decreased in some countries during the COVID-19 pandemic. In the prehospital setting, immediate treatment of cardiac arrest is required without knowing the patient's COVID-19 status. Because COVID-19 is usually transmitted through the respiratory tract, airway management can put medical personnel at risk for infection. This study explored whether on-scene treatments involving CPR for TCA patients changed during the COVID-19 pandemic in Korea. Methods: This retrospective study used data from emergency medical services (EMS) run sheets in Gangwon Province from January 2019 to December 2021. Patients whose initial problem was cardiac arrest and who received CPR were included. Data in 2019 were classified as pre-COVID-19 and all subsequent data (from 2020 and 2021) as post-COVID-19. Age, sex, possible cause of cardiac arrest, and treatments including airway maneuvers, oropharyngeal airway (OPA) or i-gel insertion, endotracheal intubation (ETI), bag-valve mask (BVM) ventilation, intravenous (IV) line establishment, neck collar application, and wound dressing with hemostasis were investigated. Results: During the study period, 2,007 patients received CPR, of whom 596 patients had TCA and 367 had disease-origin cardiac arrest (DCA). Among the patients with TCA, 192 (32.2%) were pre-COVID-19 and 404 (67.8%) were post-COVID-19. In the TCA group, prehospital treatments did not decrease. The average frequencies were 59.7% for airway maneuvers, 47.5% for OPA, 57.4% for BVM, and 51.3% for neck collar application. The rates of ETI, i-gel insertion, and IV-line establishment increased. The treatment rate for TCA was significantly higher than that for DCA. Conclusions: Prehospital treatments by EMS workers for patients with TCA did not decrease during the COVID-19 pandemic. Instead, the rates of ETI, i-gel insertion, and IV-line establishment increased.

병원 전 영아 심정지 환자에서 150J 제세동과 심폐소생술 시행 후 생존한 1례 (A survived case after 150J defibrillation and CPR were performed for out-of-hospital infant cardiac arrest)

  • 윤형완;홍수미;전윤철;이재민
    • 한국응급구조학회지
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    • 제17권3호
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    • pp.53-60
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    • 2013
  • Purpose: The purpose of the study is to emphasize the importance of out-of-hospital cardiac arrest resuscitation. This resuscitation by paramedic is very effectively performed under the medical direction of the doctors. Methods: The cardiac arrest victim was 4 month old infant. Informed consent from the parents of the infant was received. CPR combined with 150J defibrillation was performed to the 4 month old infant. Results: We reported that the 4 month old infant survived the cardiac arrest. Out-of-hospital cardiac arrest infant survived after 150J automated external defibrillator and CPR performance. Conclusion: Specific operative protocol is important because the paramedic can apply the proper manual defibrillator effectively. It is important to extend the work scpoe of the EMT.

병원 밖에서 발생한 급성 심장정지 환자의 생존결과에 영향을 미치는 요인 : 다수준 분석 (Determinants on survival outcomes of sudden out-of-hospital cardiac arrest: a multilevel analysis)

  • 김효실;전진호
    • 한국응급구조학회지
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    • 제24권2호
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    • pp.7-26
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    • 2020
  • Purpose: This study aimed to identify the factors affecting the survival outcomes of out-of-hospital cardiac arrest based on the Sudden Cardiac Arrest Survey by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Methods: Out of 84,776 cases, 57,104 cases of cardiac arrest were analyzed. To identify the factors that affect survival outcomes after a sudden cardiac arrest (SCA), we performed a logistic regression using SPSS. We also performed a multilevel analysis using SAS to determine whether the survival outcomes were affected by the socioeconomic level and health index of the communities. Results: When SCA was witnessed by someone, the possibility of discharge with survival outcomes increased by a factor of 4.54. If CPR was administered immediately in emergency situations, this possibility further increased. When defibrillation was performed before hospitalization, the possibility was increased by a factor of 10.31. The multilevel analysis reflected the personal and regional factors that had an impact on the survival outcomes. Conclusion: Because the initial response in SCA is crucial, a community response system is essential before hospitalization. It is necessary to actively publicize and educate the people because the their understanding, sympathy, and cooperation in emergency situations play a role in determining the survival outcomes of the patients.

전자담배용 니코틴 원액 음독 후 발생한 심정지 1례 (A Case Report of Cardiac Arrest Following Intentional Ingestion of Liquid Nicotine for Electronic Cigarette)

  • 김정호
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.172-175
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    • 2018
  • Acute nicotine poisoning by liquid nicotine for electronic cigarettes is becoming an increasing problem worldwide. On the other hand, there are no regulations regarding its concentration, container or labelling in Korea. This is the first case of a cardiac arrest after liquid nicotine ingestion that was confirmed by plasma nicotine detection in Korea. A 34-year-old male was found with a cardiac arrest at home by the emergency medical services crew, and had a return of spontaneous circulation after 27 minutes of cardio-pulmonary resuscitation. The cause of his cardiac arrest was suspected to be acute nicotine poisoning by the ingestion of liquid nicotine. Toxicology analysis of the National Forensic Service confirmed plasma nicotine, and the pharmacokinetic estimated average concentration of plasma nicotine at the time of the cardiac arrest was 29.7 mg/L, a lethal dose. He was hospitalized for further treatment, but was discharged after 20 days without any improvement. Considering the strong toxicity of nicotine, appropriate policy decisions are required for sales and distribution.

급성 심정지로 나타난 연수경색 (Medullary Infarction Presenting as Sudden Cardiac Arrest: Report of Two Cases and Review of the Literature)

  • 이응준;추일연;하수영;권형민
    • 대한신경과학회지
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    • 제36권4호
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    • pp.310-313
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    • 2018
  • The causes of sudden death after medullary infarction involve arrhythmia, central respiratory failure, and dysautonomia. Sudden cardiac arrest in a medullary infarction is uncommon. Most of these cases experienced sudden cardiopulmonary arrest within 2 weeks from stroke onset as the extent of lesion increased. Here, we report two cases of medullary infarction presenting as sudden cardiac arrest. These cases indicate that medullary infarction could be one of the causes of sudden cardiac arrest.