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The effects of out of hospital ACLS simulation training on the paramedic's duty ability

구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향

Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
박유나;조병준;김경용

  • Received : 2019.03.04
  • Accepted : 2019.04.20
  • Published : 2019.04.28

Abstract

The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.

Keywords

ACLS;simulation;paramedic;competency;training

References

  1. National fire agency 119. (2018). Statistical Yearbook http://www.nfa.go.kr/nfa/releaseinformation/statisticalinformation/main/?boardId=bbs_0000000000000019&mode=view&cntId=16&category=&pageIdx=&searchCondition=&searchKeyword=
  2. Korea centers for disease control. (2018). 2006-2016 Acute cardiac arrest survey statistics. 2018 http://www.cdc.go.kr/CDC/notice/CdcKrInfo0210.jsp?menuIds=HOME006-MNU2804-MNU2970&cid=142010
  3. P. S. Chan, B. McNally, F. Tang, A. Kellermann & C.S. Group. (2014). Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation, 130, 1876-82. doi: 10.1161/CIRCULATIONAHA.114.009711. https://doi.org/10.1161/CIRCULATIONAHA.114.009711
  4. T. Kitamura, T. Iwami, T. Kawamura, M. Nitta, K. Nagao & H. Nonogi, et al. (2012). Nationwide improvements in survival from out-of-hospital cardiac arrest in Japan. Circulation, 126, 2834-2843.doi: 10.1161/CIRCULATIONAHA.112.109496. https://doi.org/10.1161/CIRCULATIONAHA.112.109496
  5. S. O. Hwang. (2016). Cardiopulmonary Resuscitation and advanced Cardiopulmonary life support. Koonja publishing lnc.
  6. Hinchey P. R., Myers J. B., Lewis R., De Maio V. J., Reyer E., Licatese D., Zalkin J. & Snyder G. (2010). Improved out-of-hospital cardiac arrest survival after the sequential implementation of 2005 AHA guidelines for com-pressions, ventilations, and induced hypothermia: the Wake County Experience. Ann Emerg Med. 30. doi: 10.1016/j.annemergmed.2010.01.036 https://doi.org/10.1016/j.annemergmed.2010.01.036
  7. 2015 AHA guidelines for CPR and ECC.(2015). AHAhttp://www.eccguidelines.heart.org
  8. Maconochie I. K., de Caen A. R., Aickin R., Atkins D. L., Biarent D. & Guerguerian A. M. (2015). Part 6: Pediatric basic life support and pediatric advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 95, 147-168. doi: 10.1161/CIR.0000000000000445. https://doi.org/10.1161/CIR.0000000000000445
  9. D. H. Pack , H. J. Kim. (2019). Effects of a Simulation-based Training on Nursing Students' Knowledge, Confidence, Clinical Competence and Clinical Competence to Advanced Cardiovascular Life Support. Journal of Convergence for Information Technology, 9(1), 61-76. DOI : https://doi.org/10.22156/CS4SMB.2019.9.1.061 https://doi.org/10.22156/CS4SMB.2019.9.1.061
  10. G. Y. Cho. (2016). Effects of a Simulation-based education on Cardiopulmonary Emergency Care Knowledge, Critical Thinking and Problem solving ability in Nursing Students. JFMSE. 28(2), 439-449. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002101235 https://doi.org/10.13000/JFMSE.2016.28.2.439
  11. J. H. Kim (2007). An Exploration on the Use of Medical Simulation in Emergency Medical Technician Education. Fire Science. Engineering. 21(3), 104-112. https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001082755
  12. W. J. Kim. G. H. Kang & Y. S. Jang et al. (2015). Assessment of Advanced Cardiac Life Support Provider's Ability to Perform Cardioversion and Transcutaneous Pacing Using Standardized Patients. JKSEM, 2015 26(1), 118-127.
  13. Lo, B. M., Devine, A. S., Evans, D. P., Byars, D. V., Lamm, O. Y., Lee, R.J., Lowe, S. M., & Walker, L. L. (2011). Comparison of traditional versus high-fidelity simulation in the retention of ACLS knowledge. Resuscitation, 82(11), 1440-1443. doi: 10.1016/j.resuscitation.2011.06.017 https://doi.org/10.1016/j.resuscitation.2011.06.017
  14. S. A. Hong. (2004). Development of a nursing task protocol on CPR for non-traumatic adults in emergency setting. The Graduate School Yonsei University.
  15. KACPR(Korea association of Cardiopulmonary Resuscitation). (2016). http://www.Kacpr.org
  16. G. Y. Back. (2006). Effects of advanced cardiac life support simulation-basedtraining on nurses' competence in critical care settings. The Graduate School Yonsei University.
  17. Deshmukh H. G., Weil M. H., Gudipati C. V., Trevino R. P., Bisera J. & Rackow E. C. (1989). Mechanism of blood flow generated by precordial compression during CPR. I. Studies on closed chest precordial compression. Chest, 95, 1092-1099 .https://www.ncbi.nlm.nih.gov/pubmed/?term=Mechanism+of+blood+flow+generated+by+precordial+compression+during+CPR. https://doi.org/10.1378/chest.95.5.1092
  18. Baskett M, Nolan J & Parr M. (1996). Tidal volumes which are perceived to be adequate for resuscitation. Resuscitation. 31, 231-234. https://www.ncbi.nlm.nih.gov/ pubmed/8783408. https://doi.org/10.1016/0300-9572(96)00994-X
  19. Berg R. A., Kern K. B., Hilwig R. W., Berg M. D., Sanders A. B. & Otto C. W., et al. (1997). Assisted ventilation does not improve outcome in a porcine model of single-rescuer bystander cardiopulmonary resuscitation. Circulation, 95, 1635-1641. https://www.ncbi.nlm.nih.gov/pubmed /9118534. https://doi.org/10.1161/01.CIR.95.6.1635
  20. McInnes A. D.., Sutton R. M.., Orioles A., Nishisaki A., Niles D., Abella Miller D. M., Youkuhana I., Karunaratne W. U. &, Pearce A. (2001). Presence of protein deposits on 'cleaned' reusable anaesthetic equipment, Anaesthesia, 56(11), 1069-1072. https://doi.org/10.1111/j.1365-2044.2001.02277.x
  21. J. H/ Kim, G. S. Shim. (2017). Convergence study on the intravenous access of paramedics in ambulances. Journal of the Korea Convergence Society. 8(11), 177-182. https://doi.org/10.15207/JKCS.2017.8.11.177. https://doi.org/10.15207/JKCS.2017.8.11.177
  22. S. T. Kim, Y. H. Lee, D. M. Shin. (2017). Convergence awareness of basic emergency treatment by private ambulance drivers Journal of the Korea Convergence Society. 8(8), 127-136, https://doi.org/10.15207/JKCS.2017.8.8.127 https://doi.org/10.15207/JKCS.2017.8.8.127