융합정보논문지 (Journal of Convergence for Information Technology)

중소기업융합학회 (Convergence Society for SMB)
권호 표지
DOI QR코드

DOI QR Code

병원 전 전문심장소생술을 위한 기계적 가슴압박기의 효과

The Effect of a Mechanical Chest Compressions for Out-of-hospital Advanced Cardiac Life Support

  • 이현지 (강원대학교 응급구조학과)
  • Lee, Hyeon-Ji (Department of Emegency Medical Services, Kangwon National University)
  • 투고 : 2019.10.18
  • 심사 : 2019.11.20
  • 발행 : 2019.11.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 병원 전 환경에서 기계식 가슴압박기(LUCAS)와 수기심폐소생술의 비교실험을 통해 가슴압박의 질을 평가하고 기계적 가슴압박기를 사용한 효과적인 전문심장소생술을 제안하는데 그 목적이 있다. 병원 전 심정지상황을 가정하고 구급대원이 3인 1조로 현장에서 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 적용하고, 구급차로 이송하며 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 시행하였다. 연구결과는 다음과 같다. 첫째, 현장과 이송중의 수기심폐소생술의 비교결과 현장에서 수기심폐소생술이 평균압박깊이와 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 둘째, 현장에서 수기심폐소생술과 LUCAS를 비교한 결과 LUCAS가 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 셋째, 구급차로 이송중 수기심폐소생술과 LUCAS를 비교한 결과 평균압박깊이, 압박률, 분당압박횟수에서 유의한 차이를 보였다(p<.001). 위와 같은 결과로 보아 LUCAS는 적절한 압력으로 가슴압박을 수행할 수 있고, 그 동안 구급대원의 전문기도기 삽입, 정맥로 확보 등의 전문심장소생술을 추가적으로 수행할 수 있으며 환자의 소생률을 높이는데 기여할 것이다.

The purpose of this study is to evaluate the quality of chest compression by conducting comparison research between mechanical chest compressor(LUCAS) and manuale cardiopulmonary resuscitation(CPR) in a out-of-hospital environment and suggest effective advanced cardiac life support using mechanical chest compressors. For this, a out-of-hospital cardiac arrest was simulated with a team of 3 ambulance workers, and manuale CPR and CPR using LUCAS were performed on site and during transport in an ambulance. The research results are as follows: the comparison of manuale CPR between on site and in an ambulance revealed that on-site manuale CPR showed significant differences in the average compression depth, compression rate, and relaxation rate. Second, the comparison between manuale CPR and LUCAS in an ambulance showed significant differences in the average compression depth, compression rate, the number of compression per minute.

키워드

참고문헌

  1. K. Y. Lee & S. W. Yun. (2011). Prehospital Care of 119 EMT for Non-traumatic Cardiac Arrest and Improvement to Increase Advanced Care Rate. Fire Science and engineering, 25(5), 21-31.
  2. J. Mosier, A. Itty, A. Sanders, J. Mohler, C. Wendel, J. Poulsen, J. Shellenberger, L. Clark & B. Bobrow. (2010). Cardiocerebral Resuscitation is Associated with Improved Survival and Neurologic Outcome from Out-of-hospital Cardiac Arrest in Elders. Academic Emergency Medicine, 17(3), 269-275. https://doi.org/10.1111/j.1553-2712.2010.00689.x
  3. C. Axelsson, J. Nestin, L. Svensson, A. B. Axelsson & J. Herlitz. (2006). Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest-A pilot study. Resuscitation, 71(1), 47-55. https://doi.org/10.1016/j.resuscitation.2006.02.011
  4. Q. He, Z. Wan & L. Wang. (2003). Random control trial of the efficacy of cardiopump on pre-hospital cardiac arrest. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, 15(5), 292-294.
  5. R. A. Gyory, S. E. Buchle, D. Rodgers & J. S. Lubin. (2017). The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study. Western Journal of Emergency Medicine, 18(3), 437-445. DOI : 10.5811/westjem.2017.1.32575
  6. G. D. Perkins, R. Lall, T. Quinn & C. D. Deakin. (2015). Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. The Lancet, 385(9972), 947-955. DOI : 10.1016/S0140-6736(14)61886-9
  7. N. H. Krarup et al. (2011). Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions-a nationwide prospective feasibility study. Resuscitation, 82, 263-269. https://doi.org/10.1016/j.resuscitation.2010.11.003
  8. C. K. Lin, M. C. Huang, Y. T. Feng, W. H. Jeng, T. C. Chung, Y. W. Lau & K. I. Cheng. (2015). Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department. Journal of the Chinese Medical Association, 78(6), 360-363. DOI : 10.1016/j.jcma.2015.01.005. Epub 2015 Mar 5.
  9. J. S. Byun, I. S. Cho & C. M. Ha. (2019). Comparison of outcome of cardiopulmonary resuscitation with AutoPulse and LUCAS in out-of-hospital cardiac arrest patient. The Korean Society of Emergency Medicine, 30(1), 16-21.
  10. S. Steen, Q. Liao, L. Pierre, A. Paskevicius & T. Sjoberg. (2002). Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation. Resuscitation, 55(3), 285-299. https://doi.org/10.1016/S0300-9572(02)00271-X
  11. K. Couper, M. Smyth & G. D. Perkins. (2015). Mechanical devices for chest compression: to use or not to use?. Current Opinion in Critical Care, 2(1), 88-94.
  12. P. A. Meaney et al. (2013). Cardiopulmonary Resuscitation Quality:Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital A Consensus Statement From the American Heart Association. Circulation, 128, 417-435. https://doi.org/10.1161/CIR.0b013e31829d8654
  13. S. G. Hong & I. A. Son. (2009). A study on the factors influencing the accuracy of chest compression during cardiopulmonary resuscitation trying in a moving ambulance. The Korean Society of Emergency Medicine, 20(4), 343-354.
  14. J. G. Lee, J. S. Kim & S. G. Roh. (2018). Comparison of chest compression and ventilation volume using LUCAS and manual in virtual reality-based ambulance simulation -A manikin study-. The Korean Journal of Emergency Medical Services, 22(3), 67-76. https://doi.org/10.14408/KJEMS.2018.22.3.067
  15. G. Putzer, A. Fiala, P. Braun, S. Neururer, P. Paal. (2016). Manual versus Mechanical Chest Compressions on Surfaces of Varying Softness with or without Backboards: A Randomized, Crossover Manikin Study. The Journal of Emergency Medicine, 50(4), 594-600. https://doi.org/10.1016/j.jemermed.2015.10.002
  16. H. J. Lee, H. J. Kim & E. K. Jun. (2017). The changes of symptom, EKG and hemodynamic in healty firefighters after delivering multiple cycles of cardiopulmonary resuscitation. Journal of the Korea Academia-Industrial cooperation Society, 18(6), 381-388. https://doi.org/10.5762/KAIS.2017.18.6.381
  17. D. Smekal, J. Johansson, T. Huzevka, S. Rubertsson. (2011). A pilot study of mechanical chest compressions with the $LUCAS^{TM}$ device in cardiopulmonary resuscitation. Resuscitation, 82(6), 702-706. https://doi.org/10.1016/j.resuscitation.2011.01.032
  18. C. Ji, R. Lall, T. Quinn, C. Kaye, On behalf of PARAMEDIC trial Collaborators. (2017). Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomised trial of mechanical or manual chest compressions. Resuscitation, 118, 82-88. DOI : 10.1016/j.resuscitation.2017.06.026. Epub 2017 Jul 5.
  19. D. Smekal, E. Lindgren, H. Sandler, J. Johansson & S. Rubertsson. (2014). CPR-related injuries after manual or mechanical chest compressions with the $LUCAS^{TM}$ device: A multicentre study of victims after unsuccessful resuscitation. Resuscitation, 85(12), 1708-1712. https://doi.org/10.1016/j.resuscitation.2014.09.017
  20. R. Baumeister, U. Held, M. J. Thali, P. M. Flach & S. Ross. (2015). Forensic imaging findings by post-mortem computed tomography after manual versus mechanical chest compression. Journal of Forensic Radiology and Imaging, 3(3), 167-173. https://doi.org/10.1016/j.jofri.2015.08.001
  21. T. H. Kim et al. (2016). Quality between mechanical compression on reducible stretcher versus manual compression on standard stretcher in small elevator. The American Journal of Emergency Medicine, 34(8), 1604-1609. https://doi.org/10.1016/j.ajem.2016.05.072
  22. F. J. Ochoa, E. Ramalle-Gomara, V. Lisa & I. Saralequi. (1998). The effect of rescuer fatigue on the quality of chest compressions. Resuscitation, 37(3), 149-152. https://doi.org/10.1016/S0300-9572(98)00057-4
  23. Y. S. Cho, S. C. Choi, C. A. Lee, Y. S. Jung & G. W. Kim. (2012). Comparison of Manual Versus Mechanical Chest Compression During Simulative out of Hospital Cardiac Arrest. The Korean Society of Emergency Medicine, 23(4), 486-492.
  24. M. Levy, D. Yost, R. G. Walker, E. Scheunemann & S. R. Mendive. (2015). A quality improvement initiative to optimize use of a mechanical chest compression device within a high-performance CPR approach to out-of-hospital cardiac arrest resuscitation. Resuscitation, 92, 32-37. https://doi.org/10.1016/j.resuscitation.2015.04.005
  25. G. Putzer, P. Braun, A. Zimmermann, F. Pedross, G. Strapazzon, H. Brugger & P. Paal. (2012). LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue-a prospective, randomized, cross-over manikin study. The American Journal of Emergency Medicine, 31(2), 384-389. https://doi.org/10.1016/j.ajem.2012.07.018
  26. C. K. Lin, M. C. Huang, Y. T. Feng, W. H. Jeng & K. I. Cheng. (2015). Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department. Journal of the Chinese Medical Association, 78(6), 360-363. https://doi.org/10.1016/j.jcma.2015.01.005