• The Korean Journal of Emergency Medical Services
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• v.10 no.2
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• pp.35-42
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• 2006

Purpose: We studied that EMT took care in prehospital care of cardiac arrest patients by "the chain of survial", we need the data about treatment of EMT in prehospital care of cardiac arrest patients. and then we want to educate EMT for their emergency skill and knowledge of prehospital care of cardiac arrest patients. Method: We studied 162 cardiac arrest patients were transported by EMT in Jecheon province, Chingbuk. Results: 1. Stage of Early Access 96.9% of people who related the cardiac arrest patients used the Jecheon 119 Rescue at their emergency situation. 2 Stage of Early CPR The EMT supported keeping of airway to 148 of 162 cardiac arrest patients. Artificial respiration was 120 of 162 cardiac arrest patients and chest compression was 119 of 162 cardiac arrest patients. 3. Stage of Early AED There were shocked 6 cardiac arrest patients but weren't shocked 156 victims of 162 cardiac arrest patients by AED. 4. Stage of Early ACLS There were reported 3 of 162 cardiac arrest patients. to Doctor or Hospital Emergency Center for medical direction to EMT in prehospital area. There is no advanced airway, IV insertion and medication to the prehospital cardiac arrest patients.

• Journal of Trauma and Injury
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• v.36 no.3
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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.

• The Korean Journal of Emergency Medical Services
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• v.18 no.2
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• pp.125-136
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• 2014

Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinical characteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergency medical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours after return of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Data were analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystanders in 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventricular tachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR duration was 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standard prehospital care for these patients and educational programs regarding CPR for lay rescues should be developed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.4
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• pp.1540-1546
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• 2010

In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.

• Journal of The Korean Society of Emergency Medicine
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• v.29 no.6
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• pp.578-584
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• 2018

Objective: This study examined the initial partial pressure of carbon dioxide ($PCO_2$) as a possible indicator of prehospital ventilation and its association with prehospital i-gel in out-of-hospital cardiac arrest (OHCA) patients. Methods: The demographics and arrest parameters, including i-gel insertion and initial arterial blood gas analysis, of OHCA patients who visited the emergency department were analyzed retrospectively. Linear regression analysis was performed to examine the association between i-gel insertion and the initial $PCO_2$. Results: A total of 106 patients were investigated. Fifty-six patients had prehospital i-gel insertion and 50 patients did not have a prehospital advanced airway. The initial $PCO_2$ was higher in the i-gel group than the no advanced airway group (105.2 mmHg [77.5-134.9] vs. 87.5 mmHg [56.8-115.3], P=0.03). Prehospital i-gel insertion was associated with a higher initial $PCO_2$ level (${\beta}$ coefficient, 20.3; 95% confidence interval, 2.6-37.9; P=0.03). Conclusion: Prehospital insertion of i-gel was associated with higher initial $PCO_2$ values in OHCA patients compared to no advanced airway.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.1
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• pp.64-71
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• 2009

Purpose: This study shows the prehospital emergency nursing practices, and analyzes them associated with their individual characteristics and job conditions. Method: Based on a survey of the National Emergency Medical Center in Korea(2008), principal components were extracted from 7 prehospital emergency nursing practices by factor analysis, and some regression analyses of principal components(CPR-AED and V/S-I.V.) were executed on individual characteristics and job conditions. Results: The PENs gave themselves higher order ratings for vital sign check, airway management for loss of consciousness patients, CPR for suspicious cardiac arrest, keeping vein open for shock patients, AED for abnormal pulse rate, AED for suspicious cardiac arrest, and AED for loss of consciousness. Age and duty periods were statistically significant influential factors on the CPR-AED component. Conclusion: The results indicate that the PENs were competent in overall prehospital emergency activities and procedures even some weak self-evaluations, and that the standard curriculum and practice standard for prehospital nursing should be developed in order to increase nursing leadership in prehospital emergency settings.

• The Korean Journal of Emergency Medical Services
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• v.25 no.3
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• pp.189-200
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• 2021

Purpose: We aimed to provide effective emergency medical services (EMS) response strategies for coping with high acuity patients during the pandemic by analyzing the influence of the COVID-19 and social distancing on EMS. Methods: In this retrospective observational study, we analyzed the distribution of high acuity patients transported by Daejeon 1-1-9 EMS during the COVID-19 pandemic period, between February 1, 2020 and October 31, 2020 and the same period in 2019, as well as the level 3 social distancing enforced period, between July 27, 2020 and October 31, 2020. Results: The EMS dispatches decreased by 17% during the observed COVID-19 pandemic period compared to the same period in 2019. The number of cases with cardiac arrest and positive prehospital stroke scale rose by (p<.001). Patients with cardiac arrest, trauma, and positive prehospital stroke scale increased by during the level 3 social distancing period. Conclusion: Unlike the decreased EMS call volume and patient transports during the COVID-19 pandemic, cardiac arrest cases and the severity of high acuity patients tended to increase. We suggest that EMS systems should contrive a response strategy considering the collateral effect of major epidemics on the incidence rate of high acuity patients.

• Fire Science and Engineering
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• v.24 no.2
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• pp.185-193
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• 2010

This study aimed to develop a prehospital protocol on CPR to patients with nontraumatic cardiac arrest for emergency medical technicians. For the purpose, we prepared a protocol based on preliminary items and demonstrated its validity to confirm a final protocol from March 1, 2007- August 30. 2008. The practical CPR protocol on cardiac arrest victims can be used as means to support quick and exact decision-making on CPR, which will contribute to enhancement of emergency medical services.

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