• The Korean Journal of Emergency Medical Services
• /
• v.16 no.1
• /
• pp.81-90
• /
• 2012

Objectives: This study is to research delay time comparison for later defibrillation after hands off according to the changes in defibrillation electrodes. Study purpose: In defibrillation treatment that is the only way for cardiac arrest by arrhythmia, it is to find defibrillator device which can minimize late defibrillation delay time after important affect of hands off. Study object and method: After hands off according to the defibrillator device, we collected total 40 people for emergency medicine doctor, internal medicine doctor, general surgeon, nurse, emergency medical technician who are working at 2 CN, CS University hospitals in Gwangju Jeollanamdo district to find out hand off shock interval(HOSI). We then researched their general properties like occupation sector, experiences in clinic, gender, completion of AHA ACLS-P training and more. Then 40 participants continued ventricular fibrillation cardiac arrest simulation training (using human-model mannequin) designed by researcher and performed their roles as defibrillation operator. Each of participant used manual paddle and performed 4 times of defibrillation (150J) during 8 minutes of CPR and in 8day, the defibrillator devices were replaced from manual paddle to self-adhesive electrodes pads and 4 times of defibrillation (150J) under same simulation condition as manual paddle were performed. Study result: In comparison for delay time of later defibrillation after hands off of manual paddle and self adhesive electrodes pad, the self adhesive electrodes pad ($7.0{\pm}0.5sec$) seemed to reduce delay time of later defibrillation significantly (p<0.05) compared to manual paddle ($10.0{\pm}0.9sec$). The self adhesive electrodes pad, according to the general properties of participants, had no particular change in delay time after later defibrillation for the statistics (p>0.05) but the manual paddle had statistically significant differences for the occupation sector, experiences in clinic and gender (p<0.05). Conclusion: In defibrillation, the self adhesive electrodes pad($7.0{\pm}0.5sec$) showed short HOSI compared to manual paddle ($10.0{\pm}0.9sec$) significantly (p<0.05) and it applied identically for both existence and non-existence of ACLS-P training completion, experiences in clinic, gender and occupation sector. The manual paddle had also significant difference in experiences in clinic and occupation sector (p<0.05). which means the effect on HOSI according to the job mastery. Therefore, if the clinic experience is short or in case for the occupations without frequent defibrillation treatment has a danger of lowering success rate for the defibrillation using manual paddle. Therefore, it is true that using self adhesive electrodes pad for defibrillation electrodes when performing manual defibrillation in pre-hospital as well as in-hospital steps can generally minimize delay time of later defibrillation after hands off.

• Journal of Korean Critical Care Nursing
• /
• v.13 no.3
• /
• pp.11-23
• /
• 2020

Purpose : This study examined factors influencing the attitudes towards nurse-led defibrillation in the emergency department (ED) and intensive care unit (ICU). Methods : This was a cross-sectional study. A total of 212 nurses in the ED and ICU from three general hospitals responded to the survey. Data were collected between September and October 2015 using structured questionnaires. Independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression were used to analyze factors affecting nurses' attitudes towards nurse-led defibrillation. Results : The mean score of nurses' attitudes towards nurse-led defibrillation was 61.37 of a possible 91. Hierarchical multiple regression showed that nurses' attitudes towards nurse-led defibrillation were significantly affected by their experiences regarding cardiopulmonary resuscitation (p=.003), knowledge regarding electrocardiogram interpretation and defibrillation (p=.007), and tenure in ED or ICU (p=.043). Conclusion : Results indicate that employers should set policies to support nurses in maintaining their careers in the ED or ICU and conduct systematic educational programs for them. This will increase nurses' confidence in performing defibrillation, which will lead to early defibrillation during in-hospital cardiac arrest. Consequently, it can be a strategy to increase the survival rate of cardiac arrest patients.

• The Korean Journal of Emergency Medical Services
• /
• v.16 no.3
• /
• pp.9-18
• /
• 2012

Purpose : The purpose of this study was to determine the changes that occur due to the real-time monitoring of paddle pressures which has an important influence on the defibrillation success rate in defibrillation treatment known as the only treatment for cardiac arrest patients with VF. Methods : 40 people participated in the cardiac arrest simulation training and played the role of the defibrillation operator. Investigators measured the pressure of paddle while defibrillating by using instrument which was developed by the investigator. Results : Through real-time monitoring of the paddle pressures of defibrillator by indicator, the front sternum paddle showed a 77.5% success rate and the apex paddle showed a 40% success rate. While the values without monitoring the paddle pressures, the front sternum paddle showed a 51% success rate and the apex paddle showed a 20% success rate. These experiment revealed statistically significant(p <.001) low success rate. Conclusion : The method of monitoring the paddle pressures during defibrillation showed that the paddle can be precisely gripped. The success rate of paddle pressures is significantly correlated with height, weight and grip strength.

• Journal of Biomedical Engineering Research
• /
• v.27 no.2
• /
• pp.47-52
• /
• 2006

The purpose of this study was to predict successful defibrillation in ventricular fibrillation using parameters extracted by wave analysis method and neuro-fuzzy. Total 15 dogs were tested for predicting successful defibrillation. Feature parameters were extracted for return of spontaneous circulation (ROSC) and non-ROSC by wave analysis method, and these parameters are an irregularity factor, spectral moments, mean power of level-crossing spectrum, and mean of alpha-significant value. Additionally, two parameters by analyzing method of frequency were extracted into a mean of power spectrum and a mean frequency. Then extracted parameters were analyzed in which parameters result to have high performance of discriminating ROSC and non-ROSC by a statistical method of t-test. The average of sensitivity and specificity were 62.5% and 75.0%, respectively. The average of positive predictive factor and negative predictive factor were 61.2% and 75.8%, respectively.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.4
• /
• pp.239-244
• /
• 2018

A 59-year-old man with no specific medical or family history complained of chest pain and became unconscious. A member of his family, who was a witness, called 119 and gave him dispatcher-assisted cardiopulmonary resuscitation, followed by defibrillation using an automated external defibrillator placed in his apartment. Afterward, he was given two sessions of defibrillation by the 119 emergency squad, then transferred to an emergency medical center with the return of spontaneous circulation. The patient was discharged with cerebral performance category (CPC) 1 15 days later. While dispatcher-assisted cardiopulmonary resuscitation and defibrillation is at its beginning stage in South Korea, this case seems to demonstrate its effectiveness. Moreover, this case suggests it can be particularly useful for helping untrained witnesses use an automated external defibrillator, which may have important implications in regions in which there are delayed responses of the 119 emergency squad to the site. It is also important to develop a plan for improving witness access to and quantitative supply of the South Korean public access defibrillation (PAD) program.

• The Transactions of the Korean Institute of Electrical Engineers D
• /
• v.55 no.4
• /
• pp.181-188
• /
• 2006

The purpose of this study is to predict the defibrillation success of a ventricular Fibrillation ECG signal using time-frequency analysis. During CPR, coronary perfusion pressure and electrocardiogram were measured. Parameters extracted from time-frequency domain were served as predictor of resuscitation success. Time frequency distribution(TFD) of ECG signals was estimated from the smoothed pseudo Wigner-Ville distribution(SPWVD). Median frequency, peak frequency, 1/f slope, frequency band ratios$(2{\sim}4Hz,\;4{\sim}6Hz,\;6{\sim}8Hz,\;8{\sim}10Hz,\;10{\sim}12Hz,\;12{\sim}15Hz)$ were extracted from each TFD as function of time. Paired t-test was used to determine the differences in ROSC and non-ROSC groups. In the statistical results, we selected four significant parameters - median frequency, 1/f slope, $2{\sim}4Hz$ band ratio, $8{\sim}10Hz$ band ratio. We made an attempt to predict defibrillation success by combining features extracted from time frequency distribution. Independent t-test was used to determine the differences ROSC and non-ROSC groups. Consequently, we selected four significant parameters-median frequency, 1/f slope, $2{\sim}4Hz$ band ratio, $8{\sim}10Hz$ band ratio. The relationship between coronary perfusion pressure and ECG parameters was analyzed with linear regression analysis. R-square value was 55%. 1/f slope and $8{\sim}10Hz$ band ratio had the significant relationship with coronary perfusion pressure.

• The Korean Journal of Emergency Medical Services
• /
• v.20 no.1
• /
• pp.83-94
• /
• 2016

Purpose: This study aimed to assess defibrillator pad positioning by the general public and healthcare providers during basic life support (BLS) renewal education (RE). Methods: A total 130 subjects performed defibrillation using an automated external defibrillator (AED) equipped with electrode pads developed by the researchers and male resuscitation manikins, in order to assess electrode pad placement (EPP) before BLS RE. Subjects included 54 Healthcare providers (HP) and 76 members of the general public (GP). Results: The apex EPP was positioned in the risk area (RA), more than 5 cm distant from the area recommended, by 63.2% of the GP (n = 48). The apex EPP was positioned in the RA by 44.4% of the HP (n = 23). The distance from the apex (GP $5.27{\pm}2.21cm$, HP $4.18{\pm}1.71cm$) was statistically significant, using Student's t-test. Conclusion: For both GP and HP, apex EPP was significantly in error. Thus, to prevent defibrillation failures, EPP education and practice for GP and HP in all BLS education programs should be improved, and incorrect Korean cardiopulmonary resuscitation guidelines and related literature should be revised and corrected.

• The Korean Journal of Emergency Medical Services
• /
• v.15 no.1
• /
• pp.79-88
• /
• 2011

Purpose : Prehospital emergency care for shockable rhythm is one of major concerns of emergency medical services. But, in Korea, prehospital medical service systems are not yet well established. We tried to offer one of the fundamental data to develop of these system. Method : After application of exclusion criteria, 200 patients who had shockable rhythm from January to December, 2008 were included in this study. Restrospective review of Prehospital care Reports of these patients was done. Result : Total 200 cases of shockable rhythm and prehospital arrest were analyzed. The rates of assessment of vital signs were 89.0%, the rate of level of consiousness was 99.5%. Just 6.0% were communicated with medical director providing the prehospital care. The frequency of defibrillation was performed 58.5%. Conclusion : Survival rate was higher in defibrillation group than that of nondefibrillation group(20.5% vs 2.4%, p=0.000).

• Journal of Distribution Science
• /
• v.17 no.12
• /
• pp.63-70
• /
• 2019

Purpose: This study was to propose effective deployment of automatic external defibrillators (AEDs) installed at general supermarkets. Research design, data, and methodology : We conducted interview and data surveys on 72 large distributors in Seoul and Gyeonggi province in South Korea. The content of this survey was consisted of general status on the general supermarkets, AED deployment and management regarding public access defibrillation (PAD). G^⁎Power (v 3.1.9.4; Universität Kiel, Kiel, Germany) was also used to analyze statistical power. Radius and actual distance, radius and retrieval time were compared by t-test at α=.05. respectively. Results : Difference between the radius (102.7 meters) and the actual distance (187.8 meters) was 85.1m, it had statistically significant difference (p<.001). The actual distance was longer compared to the radius distance. Difference between the radius (114.1 seconds) and the retrieval time (208.7 seconds) was 94.6s, it had statistically significant difference (p<.001). The retrieval time took longer compared to the radius time as well. Conclusions : The finding shows that only 45.9% of the general supermarkets are satisfied with the actual AED coverage within 3 minutes. This needs to enhance AED deployment to reduce defibrillation time and AED management to boost application in South Korea.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.7
• /
• pp.579-588
• /
• 2017

The purpose of this study was to examine the defibrillation efficiency according to the defibrillator type among paramedics by making a comparative analysis of the chest compression pause time and defibrillation efficiency after providing simulation education. The subjects in this study were 15 paramedics who were selected from a provincial 119 safety center. The experiment was conducted using a single-group pretest-post test design from March 2 to August 31, 2016. The collected data were analyzed by SPSS WIN 21.0, and a frequency analysis was conducted. The findings of this study were as follows: First, there was a significantly greater decrease in the chest compression pause time during CPR after providing simulation education when semi-automated defibrillators were used than when manual paddles and manual pads were employed. Second, there was a statistically significant decrease in the performance time of defibrillation when semi-automated defibrillators were used than when manual paddles and manual pads were used. The findings of this study are expected to provide paramedics with simulation education on how to promptly read ECGs using the manual mode of a semi-automated defibrillator to help more patients revive and on how to facilitate their job enlargement.