• 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.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.143-147
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• 2018

Background: Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report: A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion: We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.

• International Journal of Advanced Culture Technology
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• 제10권4호
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• pp.23-244
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• 2022

The Pulpose of this systematic review is aimed to establish the procedure of the injection with saftey and efficiency in the pre-hospital cardiac arrest patient performing the cardiopulmonary resuscitation (CPR), compared with traditional medication administration using Ampoule and medication administration with Prefilled Syringe. Databases were searched for CPR, heart arrest, resuscitation, Pre-filled Syringe, and Ampoule by the electronic data research including Pubmed, EMBASE and Cochran Library of Konyang University Library: 4 articles were selected by three co-authors using EndNote X20 and Covidence (Covidence.org) and were systematically reviewed. The Result of this study, the medication administration using Pre-fillled Syringe improves the safety of patients and Emergency medical workers by reducing the error in administration dose and administering the drug in safe than the medication adminisrtaion using Ampoule, also, contributes to the increment of survival rate of cardiac arrest and severe patients by decreasing the administration time that prevents the delay of medication administration.

• Investigative Magnetic Resonance Imaging
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• 제22권1호
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• pp.56-60
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• 2018

Therapeutic hypothermia in cardiac arrest patients is associated with favorable outcomes mediated via neuroprotective mechanisms. We report a rare case of a 32-year-old male who demonstrated complete recovery of signal changes on perfusion-weighted imaging after therapeutic hypothermia due to cardiac arrest. Brain MRI with perfusion-weighted imaging, performed three days after ending the hypothermia therapy, showed a marked decrease in relative cerebral blood flow (rCBF) and delay in mean transit time (MTT) in the bilateral basal ganglia, thalami, brain stem, cerebellum, occipitoparietal cortex, and frontotemporal cortex. However, no cerebral ischemia was not noted on diffusion-weighted imaging (DWI) or fluid-attenuated inversion recovery (FLAIR) sequences. A follow-up brain MRI after one week showed complete resolution of the perfusion deficit and the patient was discharged without any neurologic sequelae. The mechanism and interpretation of the perfusion changes in cardiac arrest patients treated with therapeutic hypothermia are discussed.

• 한국응급구조학회지
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• 제28권2호
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• pp.47-62
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• 2024

Purpose: This retrospective study analyzed the effects of advanced life support on the recovery of spontaneous circulation (SC) in patients with out-of-hospital cardiac arrest. Methods: The subjects of this study were out-of-hospital cardiac arrest patients transferred to the hospital by 119 paramedics in Gyeongsangbuk-do from January 1, 2021, to December 31, 2022, amounting to a total of 2,524 patients. Results: The younger the age, the higher the probability of recovery of spontaneous circulation, and it was higher when cardiac arrest occurred in a public place or was witnessed. If the patient's initial electrocardiogram rhythm is defibrillable, the probability of recovery from spontaneous circulation is high. The recovery of the spontaneous circulation rate decreased with time between the time of report and the time of contact with the patient. Recovery of the spontaneous circulation rate was high when mechanical chest compression devices and advanced airways were not used. Additionally, this study had positive effects on defibrillation, peripheral intravenous catheter insertion, and epinephrine infusion. Conclusion: Paramedics should actively perform peripheral intravenous catheter insertion and epinephrine infusion, and it should be possible to clearly determine whether defibrillation should be applied through electrocardiographic education.

• 디지털융복합연구
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• 제15권1호
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• pp.227-238
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• 2017

급성 심정지는 갑작스러운 심장 기능의 상실로 인하여 수 분 안에 뇌를 비롯하여 온 몸에 혈액 공급이 되지 않아 사망으로 이어지는 대표적인 중증응급질환이다. 특히 병원 밖에서 발생하는 병원외 심정지 환자는 생존율이 매우 낮다. 그 이유는 갑작스런 발병으로 인해 주변사람들이 심정지 환자라는 것을 인식하지 못할 뿐만 아니라 인식한다 하더라도 전문 의료지식이 없어 정확한 응급조치를 취하는 것이 어렵기 때문이다. 기존의 심정지 관련 연구는 대부분 심정지 발생 후의 치료법 방안에 집중되어 있었으나, 이는 근본적인 문제해결이 어려워 생존율을 높이는데 한계가 있었다. 이러한 문제를 해결하기 위해 본 논문에서는 널리 보급된 스마트폰을 활용하여 급성 심정지 환자를 위한 알림, 사전예방, 응급조치 등의 기능을 갖춘 솔루션을 개발하였다. 이 솔루션을 활용하면 급성 심정지를 사전에 예방할 수 있고, 설사 발병한다고 하더라도 주변사람에게 신속하게 알려 최대한 골든타임(4분)을 지킬 수 있으며, 1차 발견자가 신속하고 정확한 심폐소생술을 실시할 수 있어 생존율을 한층 더 높일 것으로 기대한다.

• 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.

• 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.

• 대한임상독성학회지
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• 제16권2호
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• pp.176-180
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• 2018

Drug abuse and its related problems are increasing continuously in Korea. One of the most frequently abused drugs is methamphetamine, but there are few medical report in Korea. This is the first report of the identification of methamphetamine in the blood of a patient who had a return of spontaneous circulation after cardiac arrest and survived discharge. A 33-year-old male arrived at the emergency department presenting with chest pain and dyspnea. He had ingested methamphetamine and alcohol approximately 7 hours before arrival. One hour after arrival, he had seizure followed by cardiac arrest. Spontaneous circulation was recovered after 4 minutes of CPR. An analysis of the National Forensic Service identified plasma methamphetamine with an estimated average concentration of plasma methamphetamine at the time of arrival of 0.6 mg/L, a lethal dose. He had rhabdomyolysis and acute kidney injury but survived after continuous renal replacement therapy. Since then, he has suffered chronic kidney disease, and he is being followed up at the out-patient department. In Korea, although drug abuse is still uncommon, it is on the increase. Therefore, emergency physicians should be aware of the clinical characteristics of methamphetamine poisoning.

• The Korean Journal of Pain
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• 제10권1호
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• pp.138-141
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• 1997

Rib fracture due to intense pain, may restrict patients from inadequate coughing. These conditions may produce varying degrees of complications such as atelectasis, pneumonia and arterial hypoxemia. Thoracic epidural analgesia has been used to treat pain associated multiple rib fractures because of its marked improvement in vital capacity and dynamic lung compliance. However, there are complications related to thoracic epidural analgesia which may include damage to spinal cord, perforation of dura, respiratory depression, decrease heart rate and arterial blood pressure. We experienced such a case of cardiac arrest during thoracic epidural analgesia while treating a patient for multiple rib fractures.