• The Korean Society of Law and Medicine
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• v.19 no.2
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• pp.209-233
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• 2018

The purpose of this study was to ascertain whether or not to recover the spontaneous circulation of patients with cardiac arrest before arrival in the emergency room for 5 years (2012 to 2016), and try to investigate the factors affecting this. In this research, we used the "raw material for acute cardiac arrest survey" conducted in "Disease management headquarters" from 2012 to 2016 for the whole country of our country as the main material. In this study, 136,212 cardiac arrest patients were analyzed in the study data of the cardiac arrest in the country during the 5 years from 2012 to 2016. We performed a Chi-square analysis to analyze the recovery of spontaneous circulation before arrival in the emergency room according to general characteristics, social·demographic characteristics, and developmental characteristics. and We performed a Binary logistic regression analysis to determine the factors affecting the recovery of spontaneous circulation. The analysis results of this study show that whether CPR sustained transport before endoplasmic reticulum arrival, whether to witness an acute cardiac arrest before arrival in the emergency room, the type of general cardiopulmonary resuscitation, the location of acute cardiac arrest, the acute heart Causes of stoppage cause factor of whether spontaneous circulation recovery recovers before arrival of the endoplasmic reticulum(P<0.001, P<0.01). Therefore, it is necessary to strengthen systematic government health policy implementation and dissemination and health education focusing on factors that affect recovery of spontaneous circulation of cardiac arrest patients.

• Proceedings of the Korea Institute of Fire Science and Engineering Conference
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• 2013.04a
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• pp.71-72
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• 2013

이 연구는 하트세이버를 배지를 수여 받은 구급대원과 심정지 환자 중 심폐소생술로 자발순환이 회복된 후 환자를 대상으로 심정지 생존의 요인을 파악하고 분석한 결과 심정지에서 소생한 환자의 75%가 가정에서 발생되었으며, 출동에서 현장까지 도착 소요시간이 6.1분, 현장심폐소생술 소요시간 6.2분, 출동에서 병원 응급실 도착까지 소요시간 23.0분이 소요되었다. 또한 목격자에 의해 시행된 심폐소생술은 50.0%, 발견 당시 심장리듬은 심실세동이 87.5%, 무수축 12.5%였고, 심폐소생술과 동시에 자동제세동기를 사용한 환자는 87.5%, 심폐소생술만 시행한 환자 12.5%, 기관내삽관 시행이 12.5%였다. 자발순환이 회복된 환자에게 시행된 심폐소생술 소요시간은 10.9분 이었으며, 책임구급대원은 1급응급구조사가 75.0%, 출동 구급인원은 3명 출동이 87.5%였다.

• Fire Science and Engineering
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• v.34 no.4
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• pp.135-140
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• 2020

The purpose of this study was to prevent electric shock to children. children are at high risk of electrocution by accidents. In the present case, a 2-year-old child was electrocuted after inserting metal chopsticks into a home outlet. In this case, professional advanced cardiac life support (ACLS) was properly performed by a 119 paramedic, resulting in the return of spontaneous circulation (ROSC) in the child. There are very few successful cases of resuscitation of patients involved in electric shock accidents in Korea, and we report a case of ROSC and discharge and proper resuscitation by a 119 paramedic.

• Journal of Chest Surgery
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• v.31 no.12
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• pp.1147-1158
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• 1998

Background: Portable cardiopulmonary bypass(CPB) technique has been used increasingly as a potent and effective option for emergency cardiopulmonary resuscitation(CPR) because it can maintain more stable hemodynamics and provide better survival than conventional CPR techniques. This study was designed to develop a prototype of Korean portable CPB system and, by applying it to CPR, to discriminate whether it would be superior to standard open-chest CPR. Material and Method: By using adult mongrel dogs, open-chest CPR(OCPR group, n=4) and portable-CPB CPR(CPB group, n=4) were compared with respects to restoration of spontaneous circulation(ROSC), hemodynamics, effects on blood cells, blood gas patterns, biochemical markers, and survivals. Ventricular fibrillation-cardiac arrest(VF-CA) of arrest(VF-CA) of 4 minutes followed by basic life support(BLS) of 15 minutes was applied in either group, which was standardized by the protocol of American Heart Association. Then, advanced life support(ALS) was applied to either group under the support of internal cardiac massage or CPB. ALS was maintained until ROSC was achieved but not longer than 30 minutes regardless of the presence of ROSC. All of the measured values were expressed as means±SD percent change from baseline. Result: During the early ALS, higher mean arterial pressure was maintained in CPB group than in OCPR group(90±19 vs. 71±32 %; p<.05) and lower mean pulmonary arterial pressure was also maintained in CPB group than in OCPR group(105±24 vs. 146±6%; p<.05). ROSC was achieved in all dogs. Post-ROSC levels of hematocrit, RBC, and platelet were decreased and plasma free hemoglobin was increased significantly in CPB group compared to OCPR group(p<.05). Changes in blood gas patterns, lactate, and CK-MB levels were not different between groups. Early mortality was seen in 3 dogs in OCPR group(survival time 31±36 hours) and 2 in CPB group(228±153 hours, p=ns). The remainders in both groups showed prolonged survival. Conclusion: These findings indicate that portable CPB can be effective to maintain stable hemodynamics during cardiac arrest, to achieve ROSC and to prolong survival. Further study is needed to refine the portable CPB system and to meet clinical challenges.

• Fire Science and Engineering
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• v.24 no.5
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• pp.142-149
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• 2010

The aim of this study was to report the out-of-hospital resuscitation of cardiac arrest along with literature consideration. CPR is technology of resuscitating patient by maintaining oxygen supply to organ, by preventing progression from clinical death to biological death, and by recovering heart beat and circulation, through circulatory support of mechanical ventilation. It is not what every patient with cardiac standstill is revived even if being implemented CPR. Patient's survival rate is decided by how quickly and correctly CPR was executed. A patient, who wasn't witnessed the cardiac arrest on the field, was performed 5-cycle CPR for 2 minutes on the field before being transferred to hospital, and was allowed to be used AED. A person, who was observed, is recommended to be used AED immediately, and then is said to be needed ACLS (advanced cardiac life support). In the Out-of-Hospital stage, it is rare in a case that 119 Emergency Medical Service System transfers by being ROSC and in a case of executing ACLS. Cardiac arrest was witnessed on the field, but CPR wasn't executed. First-aid staff executed CPR after arriving, and led to ROSC on the field with ACLS, there by having experienced 1 case of a patient's surviving to leave hospital by being ROSC on the field.

• Fire Science and Engineering
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• v.27 no.4
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• pp.61-67
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• 2013

This study was to investigate the cardiopulmonary resuscitation (CPR) outcomes and the clinical characteristics of outof- hospital cardiac arrest (OHCA) by analyzing date in one region. A total 8 patients, survived over 72 hours after ROSC. The cardiac arrest were caused by unknown (5 cases), cardiac disease (3 cases). The most common place of cardiac arrest was in the home (6 cases), witnessed cardiac arrest (8 cases), cardiopulmonary resuscitation by bystander was performed (4 cases), agonal respiration (3 cases). The initial electrocardiogram (ECG) showed ventricular fibrillation (VF) in 7 cases, pulseless electrical activity (PEA) other rhythms in 1 cases. Average time from call to scene arrival 6.1 minutes, call to hospital arrival 23.0 minutes, duration of total CPR was 8.7 minutes. The certificate of them were level 1 emergency medical technician (EMT) 6 cases, level 2 EMT 3 cases, total 3 members 7 cases. To improve the rate of survival for out-ofhospital cardiac arrest victims, development of continuous CPR educational program for lay rescue.

• Fire Science and Engineering
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• v.34 no.1
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• pp.127-134
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• 2020

When a pregnant woman experiences cardiac arrest, resuscitation is of the utmost importance. Cardiac arrest in pregnant women differs from cardiac arrest in the general population since both mother and fetus need to be taken into consideration. In the event of cardiac arrest, determining whether to deliver the baby is significant. Cardiopulmonary resuscitation is not always successful, and the survival rate depends on the speed and precision of the procedure. In this study, we focus on the case of a 30-year-old pregnant woman who experienced cardiac arrest and whose family was quick to perceive her condition and call the hospital. A witness performed initial cardiopulmonary resuscitation, while rescue workers performed the advanced procedure. In this case, the patient and baby received proper treatment and left the hospital after six days. It is extremely rare for a pregnant patient to achieve return of spontaneous circulation (ROSC) or receive advanced cardiac life support before reaching the hospital. However, the woman in question in this study achieved ROSC and received both cardiopulmonary resuscitation before reaching the hospital and advanced cardiac life support at the hospital. The specifics of the case are reported in the context of a literature review.

• Journal of the Korean Child Neurology Society
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• v.26 no.4
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• pp.240-245
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• 2018

Purpose: Early prediction of prognosis of children resuscitated from cardiac arrest is a major challenge. We investigated the utility of electroencephalography (EEG) and laboratory studies for predicting of neurologic outcome in children resuscitated from cardiac arrest. Methods: We retrospectively analyzed medical records of patients who were resuscitated from cardiac arrest from 2006 to 2015 at the Gil Medical Center. Patients aged one month to 18 years were included. EEG analysis included background scoring, reactivity and seizure burden. EEG background was classified score 0 (normal/organized), score 1 (slow and disorganized), score 2 (discontinuous or burst suppression), and score 3 (suppressed and featureless). Neurologic outcome was evaluated by Pediatric Cerebral Performance Category (PCPC) at least 6 months after cardiac arrest. Results: Total 26 patients were evaluated. Nine patients showed good neurologic outcome (PCPC 1, 2, 3) and 17 patients showed poor neurologic outcome (PCPC 4, 5, 6). Patients of poor neurologic outcome group showed EEG background score 3 in 88.2%, whereas 44.4% in patients of good neurologic outcome group (P=0.028). Electrographic ictal discharges except non-convulsive status epilepticus were presented in 44.4% of good neurologic outcome group and 5.9% of poor neurologic outcome group (P=0.034). Ammonia and lactate levels were higher and pH levels were lower in poor outcome group than good neurologic outcome group. Conclusion: Suppressed and featureless EEG background is associated with poor neurologic outcome and electrographic seizures are associated with good neurologic outcome.

• Journal of Chest Surgery
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• v.31 no.9
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• pp.827-836
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• 1998

Background: Effective cardiopulmonary resuscitation (CPR) should provide acceptable hemodynamics for the vital organs during cardiac arrest and early restoration of spontaneous circulation that guarantees long-term, neurologically intact survival. CPR using heart-lung bypass has been suggested as an option for that use. This study was designed to determine the effectiveness of standard CPR techniques, closed-vs. open-chest CPR, which could be used in the future study verifying the role of heart-lung bypass CPR. Material and Method: By using adult mongrel dogs, closed-chest CPR (CCCPR, n=4) and open-chest CPR (OCCPR, n=5) were compared with respects to hemodynamics, restoration of spontaneous circulation(ROSC), and survival. Ventricular fibrillation-cardiac arrest (VF-CA) was induced by electrical shock in all animals. After 4 minutes of cardiac arrest, basic life support (BLS) was applied for 15 minutes and followed by advanced life support (ALS). ALS was maintained until achi ving ROSC but not longer than 30 minutes regardless of the recovery. Resuscitation procedures in either group were standardized by adopting the protocol of American Heart Association. Result: Prearrest baseline hemodynamic data was not different between two groups. During resuscitation, substantially higher systolic pressure was maintained in OCCPR group than in CCCPR group (45$\pm$15 vs. 33$\pm$11 mmHg during BLS, 83$\pm$36 vs. 44$\pm$15 mmHg during ALS; p=NS). Mean pulmonary arterial pressure went up to the level of mean systemic arterial pressures in CCCPR group and to half of that in OCCPR group, and had kept higher in CCCPR group throughout CPR (32$\pm$10 vs. 22$\pm$4 mmHg during BLS and 32$\pm$15 vs. 24$\pm$10 mmHg during ALS; p=NS). ROSC was obtained in 4 of 5 dogs receiving open-chest CPR and 2 of 4 closed-chest CPR. Prolonged survival was noted in all dogs in OCCPR group (6 to 1440 hours) but not in CCPR group (p<.05). Conclusion: These findings indicate that open-chest CPR can be more effective t maintain hemodynamics during cardiac arrest and to obtain restoration of spontaneous circulation and survival. Further experiment will be designed to compare heart-lung bypass CPR with open-chest CPR.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.5
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• pp.3303-3307
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• 2015

The purpose of this study was attemped to investigate the clinical presentation and pathophysiology of 74-year-old female who developed pneumoperitoneum as complications of chest compression from sudden cardiac arrest. Such chest compression is the same one excercised to by-stander and paramedics. A healthy 74 year female had a sudden mental deterioration while working at a restaurant. She was transfered from 119 emergency medical system to the hospital. After the symptom developed, by-stander called 119 who carry out 6 minutes Cardiopulmonary resuscitation(CPR). Defibrillation and CPR was carried out by health provider after the arrival, and the patients spontaneous circulation returned. After Return of spontaneous circulation(ROSC), patients was transferred to the nearst hopspital, but suspicious of myocardial infarction, she was again transferred to a larger scale hospital. At the hospital she took X-rays and Abdominal CT, and the results of suspicious gastro-intestinal perforation near gastro-esophageal junction, surgical repair was recommended. But in operation room, while operation went on, cardiopulmonary arrest appeared again, and she expired. For this reason, prehospital CPR needs more accurate localization of cardiac massage and serious consideration of positive pressure ventilation. Moreover, treatment of pneumoperitoneum after CPR needs more cautious consideration of patients hemodynamic stability.