• Journal of Digital Convergence
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• v.11 no.9
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• pp.229-238
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• 2013

Out-of-hospital cardiac arrest is a major public health problem in Korea. The survival rate to discharge remains at approximately 3.5% and only 1% have good neurological function. To increase the survival rate, prehospital care should restore spontaneous circulation. The purpose of this study was to analyze the factors associated with return of spontaneous circulation(ROSC) after out-of-hospital cardiac arrest. Data used for this study were collected from KCDC Out-of-Hospital Cardiac Arrest Surveillance 2009. As for the results of decision tree analysis, it is clear that prehospital CPR, cardiac arrest witness, activity, past history(cancer/heart disease/stroke), place, bystander CPR, response time, age, etc are significant contributing factors in ROSC. Among 16 cardiac arrest types from decision tree classification, the ROSC rate of type 1 is the highest(29.6%). Also notable is the fact that bystander CPR was strongly correlated with ROSC of patents with cardiac arrest occurring in non-public places. Community resources should be concentrated on increasing bystander CPR and early prehospital emergency care.

• The Journal of the Convergence on Culture Technology
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• v.4 no.1
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• pp.119-128
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• 2018

In this paper, The purpose of this qualitative research was to explore the experience of a nursing simulation practice focused on patients with cardiac arrest with 50 4th-year nursing students who participated the simulation practical education. The data collection period was from 12/4/2017 to 12/6. Subjects were asked to write a self-reflection journals with a narrative style in order to explore the cardiac arrest simulation practice experience. Data were analyzed using Thematic Analysis by Braun & Clarke. The results were "Expectation for types of simulation education", "A great deal of regret", "Pre-experience in cardiac arrest situation", "Cognition in the importance of team interaction", "Active reaction", "Extended role from a nursing student to a nurse." The results indiate that understanding the experience of a nursing simulation education for nursing students will be able to be used as baseline data which is needed to manage the method of the simulation education effectively.

• 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.

• Phonetics and Speech Sciences
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• v.15 no.4
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• pp.109-118
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• 2023

Cardiac arrest is a critical medical emergency where immediate response is essential for patient survival. This is especially true for Out-of-Hospital Cardiac Arrest (OHCA), for which the actions of emergency medical services in the early stages significantly impact outcomes. However, in Korea, a challenge arises due to a shortage of dispatcher who handle a large volume of emergency calls. In such situations, the implementation of a machine learning-based OHCA detection program can assist responders and improve patient survival rates. In this study, we address this challenge by developing a machine learning-based OHCA detection program. This program analyzes transcripts of conversations between responders and callers to identify instances of cardiac arrest. The proposed model includes an automatic transcription module for these conversations, a text-based cardiac arrest detection model, and the necessary server and client components for program deployment. Importantly, The experimental results demonstrate the model's effectiveness, achieving a performance score of 79.49% based on the F1 metric and reducing the time needed for cardiac arrest detection by 15 seconds compared to dispatcher. Despite working with a limited dataset, this research highlights the potential of a cardiac arrest detection program as a valuable tool for responders, ultimately enhancing cardiac arrest survival rates.

• 건강소식
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• v.31 no.10 s.347
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• pp.32-33
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• 2007

기본인명구조술은 의식이 없는 환자를 발견한 후 구조를 요청하고 기도유지, 구조호흡, 흉부압박을 시행하는 심폐 소생술의 초기단계이다. 이번 호에는 심정지가 의심되는 환자를 발견하였을 때의 행동요령과 심폐소생술에 대하여 알아보고자 한다. 심정지의 발생은 예측이 불가능하며 심정지가 발생한 후 4~6분이 경과하면 치명적인 뇌손상이 발생하므로 환자가 발생한 현장에서부터 목격자에 의한 심폐소생술을 시행함으로써 폐와 심장의 기능을 유지하고, 뇌의 생리학적 사망을 연장시켜 심정지 환자의 생명을 살릴 수 있다. 그러므로 환자발견 현장에서 빠른 시간 내에 심폐소생술을 시행하는 것이 중요하다. 응급의료 선진국에서는 현장에서의 빠른 응급처치로 인해 20%의 생명을 살릴 수 있는 반면, 우리나라는 4%에 불과하다.

• Journal of Chest Surgery
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• v.34 no.3
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• pp.224-230
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• 2001

배경: 지속적인 온혈 심성지액을 이용한 심금 보호술이 소개된 이수, 이를 토대로 많은 임상결과가 발표되고 있다. 그러나 지속적 심정지액 주입에 따른 적정한 수술시야 확보와 역행성 관류법에 따른 우심실 보호에 대한 문제들이 제기 되고 있다. 이에 Antonio 등은 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여 만족할 만한 임상결과를 보고 하였다. 본 임상연구는 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여, 개심술을 시행 받은 70례의 환잔의 임상결과를 분석하여 그 유용성을 알아보고자 하였다. 대상 및 방법: 1998년 5월부터 1999년 1월까지 포타슘만을 이용한 간헐적 온혈액 심정지술을 이용하여 관상동맥 우회술 및 판막수술을 시행한 70명의 환자와 같은 기간 간헐적 냉혈액 심성지술을 이용하여 동일 술자에 의해 수술을 시행한 70명의 임상결과를 비교 분석하였다. 결과: 총 심폐기 사동 시간(98.7$\pm$6.0분, 114.3$\pm$7.5분, p=0.018),수술중 심정지를 위해 필요한 심정지액의 양(1463.0$\pm$68.0cc, 3584.0$\pm$179.0cc, p<0.001), 의식이 회복될 때까지의 시간(3.5$\pm$0.4시간, 4.9$\pm$0.8시간, p=0.044), 기관 삽관의 제거까지의 시간(10.8$\pm$0.8시간, 13.2$\pm$0.6시간, p=0.017), 부정액으로 리도케인(Lidocaine)의 도움이 필요한 경우(75.2$\pm$6.8mg, 114.5$\pm$7.2mg, p=0.006)등에 있어서는 포타슘만을 이용한 간헐적 온혈액 심정지술이 유의성의 있었고, 술수 심근효소의 상승, 사망률과 이환율에 있어서는 두군간의 유의성은 없었다. 결론: 관상동맥 우회술 및 판막수술에 있어 포타슘만을 이용한 간헐적 온혈액 심정지술은 적어도 간헐적 냉혈액 심정지술과 같은 정도의 심근 보호를 할 수 있었으며, 기존의 warm heart surgery의 장점인 심폐기 가동시간이 짧고, 의식회복이 빠른 점과 함께 용적과부학(volume loading)를 줄일 수 있는 장점이 있어 유용한 심근 보호술의 하나로 사료된다.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.27-33
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• 1997

Retrograde myocardial protection is widely accepted in CABG operation because of the limitations of the antegrade method in the coronary arterial stenosis lesions. We analyzed 76 c ses of retrograde myocardial protection among 96 cases of CABG operation performed between April 1994 and August 1995, There were 48 males and 25 females, and the mean age was 58.2 $\pm$ 8.3 years. 53 patients (70%) were operated for unstable angina, 14 (18%) for stable angina, 6 (8%) for post-infarct angina, 1 (1%) for acute myocardial infarction, and 2()%) for failed PTCA. Preoperative coronary angiography revealed 3-vessel disease in 42 cases, 2-vessel disease in 11, 1-vessel disease in 10, and left main disease in 13 cases. We used SVG(63 cases), LIMA(69 cases), RIMA(11 cases), radial artery(6 cases), and gastroepiploic artery(1 case) for the grafts. Mean anastomosis was 3.2 $\pm$ 1.1. We protected the myocardium with antegrade induction and retrograde maintenance in all the cases except a case of retrograde induction and maintenance. During the aortic cross-clamping, blood cardioplegia was administered intermittently in 19 cases, and continuously in 57 In 39 cases, we used retrograde ardioplegia and antegrade perfusion of RCA graft simultaneously. We had no operative motality. Perioperative complications were arrhythmia in 15 cases, perioperatve myocardial infarction in 10, low cardiac output syndrome In 8, transient neurologic problem in 7, transient psychiatric problem in 6, ARF in 3, bleeding in 2, pneumonia in 2, wound infection in 1, and duodenal ulcer perforation in 1 . In this report, we experienced 76 cases of CABG operation with retrograde myocardial protection under the acceptable operative risk without operative mortality.

• Journal of Chest Surgery
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• v.29 no.2
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• pp.199-207
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• 1996

Ischemic myocardial damage is inevitable to cardiac surgery. Myocardial damage after initiation of reperfusion through the coronary arteries is one of the most important determinants of a successful surgery. Adenosine is a potent vasodilator, and is also known to induce rapid cardioplegic arrest by its property of antagonizing cardiac calcium channels and activating the potassium channel. Thus, we initiated this study with adenosine to improve postischemic recovery in the isolated rat heart. We tested the hypothesis that adenosine could be more effective than potassium in inducing rapid cardiac arrest and enhancing postischemlc hemodynamic recovery. Isolated rat hearts, connected to the Langendorff appratus, were perfused with Krebs-Henseleit buffer and all hearts were subjected to arrest for 60 minutes. Three groups of hearts were studied according to the composition of cardioplegic solutions : Group A (n=10), adenosine 10mmo1/L+potassium free modified St. Thomas cardioplegia : Group B (n=10), adenosine 400mo1/L+S1. Thomas cardioplegia:Group C(control, n=10), St. Thomas cardioplegia. Adenosine-treated groups (group A & B) resulted in more rapid cardiac arrest than control group (C) (p< 0.01). There was greater improvement in recovery of coronary blood flow at 20 and 30 minutes of reperfusion in group A and at 20 minutes in group B when compared with control group(p<0.01). Recovery of systolic blood pressure at 10 minutes after reperfusion in group A and B was significantly superior to that in group C (p<0.01). Recovery of dp/dt at 10 minute after reperfusion in group A was also significantly superior to group C (p<0.05). Group A and B showed better recovery rates than control group in aortic blood flow, cardiac output, and heart rate, but there were no statistical differences. CPK levels of coronary flow in group A were significantly low (p< 0.01). We concluded that adenosine-enriched cardioplegic solutions have better effects on rapid cardiac arrest and postischemic recovery when compared with potassium cardioplegia.

• Journal of Chest Surgery
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• v.29 no.4
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• pp.365-372
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• 1996

In an attempt to evaluate the effect of St. Thomas' hospital cardioplegic solution (STH) I and II on the cultured rat myocardial cells, beating rate, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (Irtrazolium MTT) and lactate dehydrogenase activity were investigated, and also light and electron microscopic studies were carried out. After rat myocardial cells were cultured for 72 hours, cells were treated with STH I or with STH H solution for 30 and 120 min. and thereafter myocardial cells were cultured in control medium for 24 hours. The results obtained were as follows : 1. Beating rate was 154 times per min. in control group, 141 times per min. in STH I solution(for 2. 120 min.)-treated group and 145 times in STH ll solution (for 120 min.)-treated group. MTT absorbances by MTT assay were 102% in STH I solution (for 120 min.)-treated group and 93% in STH ll solution (for 120 min.)-treated group compared with control group. 3. The amount of lactate dehydrogenase released into the medium were 123% in STH I solution (for 120 min.)-treated group and 109% in STH H solution (for 120 min.)-treated group compared with control group. 4. In the light microscopy examination, myocardial cells showed no differences between experimental and control groups in their number and shape. 5. In the electron microscopy examination, myocardial cells treated with STH I solution showed fewer destroyed mitochondria compared to STH ll solution-treated group. These results suggest that both 51. Thomas'cardioplegic solution STH 1 and STH H have no cytotoxicity on cultured rat myocardial cells, but STH H solution has more protective effect on myocardial cells compared to STH I solution.

• 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.