보건교사의 응급의료체계 인식과 활용 실태

최욱진,Choi, Uk-Jin 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.2

Purpose : This study aims to provide basic data to establish an effective emergency medical service system by analyzing health educator' understanding and use of emergency medical service system at schools. Method : 93 questionnaires from 200 elementary, middle and high school nurses in the city D were collected from May 26 to July 7, 2008 and ${\chi}^2$ analysis and frequency analysis were carried out with SPSS win PC 14.0. Results : 1. As for emergency contact points, 3(3.30%) answers 'they do not have any knowledge', 40(43.96%) said 'they have some idea' and 48(52.75%) said 'they do know about it'. Among 24 respondents who have less than five years of working experience, 2(8.33%), 16(66.67%) and 6(25.00%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. As for 9 who have 6-10 years of career, 1(12.50%), 4(50.00%) and 3(37.50%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. Among 32 respondents who have 11~20 years, there were no respondents with no knowledge on the given question, and 9(29.03%) said they have some understanding and 22(70.97%) answered they have clear understanding on the topic. From this result, it can be said that there is statistically meaningful differences among different working year groups with ${\chi}^2=16.583$ and p= .010. 2. As for 119 emergency contact in the given district, 24(29.63%), 30(37.04%) and 27 (33.33%) answered 'do not know', 'know' and 'know very well' respectively. As for the question to ask whether they know Emergency Medical Information Center 1339, 66(70.97%) answered 'Yes' and 27(29.03%) answered 'No'. When it comes to emergency contact numbers and list of hospitals, 59(63.44%) said 'they have some list', 20(21.51%) answered 'they have well established contact network' and 14(15.05%) said 'they have none'. 3. As for the use of 119 service at the time of emergency at schools, 59(63.44%), said 'Yes' and 12(12.90%) answered 'No'. Among those who said 'yes', 29(31.18%), 24(25.81%) and 5(5.38%) answered they have used the service 1-2, 3-5 and 6-10 times respectively. Conclusion : In order to ensure health educator to effectively deal with emergency situations at schools, there should be special activities to enhance health educator' understanding on 119 and Emergency Medical Information Center 1339 and at the same time, a system should be established to connect schools, 119 in a given district, hospitals and Emergency Medical Information Center 1339.

흉부압박의 횟수증가가 구조자에게 미치는 생리학적 변화와 심폐소생술 정확도에 미치는 영향

최욱진,Choi, Uk-Jin 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.3

Purpose : This study was designed to examine physiological changes in the body of rescuers conduct CPR according to the 2005 new guideline from American Heart Association. The ratio of artificial respiration has changed from 15 : 2 into 30 : 2 in 2005. The researcher tried to know the correlation between the physiological changes and the accuracy of CPR. Method : The examinees of this study were 26 students (Dept. of Emergency Medical Service). After the training, participants conducted 10 minute CPR and soon after the CPR, their vital signs were checked, and lactic acid and concentration of ammonia were analysed from their blood samples. Questionnaires to ask their subjective fatigue level were filled out after blood samples and 10 minute - CPR was performed. Results : 1) After the CPR, concentrations of ammonia were $149.71{\mu}{\ell}/d{\ell}$ and $162.17{\mu}{\ell}/d{\ell}$ in 15 : 2 and 30 : 2, respectively. The number was higher in 30 : 2 but it wan not statistically meaningful (p = .493). Log value of lactic acid was a little higher in 30 : 2 with 42 log($mmol/{\ell}$) and 54 log($mmol/{\ell}$) in 15 : 2 and 30 : 2, respectively but it was not statistically meaningful (p = .113). 2) Blood pressure in 15 : 2 and 30 : 2 were 118.50 mmHg and 125.08 mmHg while pulse in two different cases were 96.14 and 97.25, showing no statistically significant differences (blood pressure : p = .155, pulse : p = .841). 3) Subjective fatigue was a bit high in 30 : 2 with 5.93 and 6.92 points in 15 : 2 and 30 : 2 respectively but it was not statistically meaningful (p = .142). 4) In the 10 minute CPR, respiration accuracy was 96.21% in 15 : 2 and 94.79% in 30 : 2. There was no statistical significances between the two(p = .225). In the meanwhile, chest compression accuracy was 92.57% in 15 : 2 and 91.83% in 30 : 2. From the beginning to the end of chest compression, there showed no difference(p = .425). the type of CPR did not influence upon the accuracy of chest compression(p = .756). Conclusion : In the CPR conducted by skilled rescuers for 10 minutes, there were no statistically meaningful differences between 15 : 2 and 30 : 2 in the concentration of fatigue element in a blood, subjective fatigue, vital signs and accuracy of CPR. Therefore, 30 : 2 CPR recommended by American Heart Association need to be recommended and performed in scene size up.

LTS와 LMA를 이용한 병원 전 전문 기도 관리 연구

최욱진(Choi, Uk-Jin),심규식(Shim, Gyu-Sik) 한국산학기술학회 2012 한국산학기술학회논문지 Vol.13 No.12

심정지 또는 중증 외상 환자의 신속한 기도유지는 매우 중요하다. 본 연구의 목적은 후두튜브(LTS)와 후두 마스크(PLMA)의 삽관 속도, 성공률, 교육 전·후 자신감 변화를 비교하여 병원 전 단계의 주축을 담당하고 있는 119 구급대의 전문기도관리 능력을 향상 시키는데 있다. 연구 대상자는 119구급대원 중 1급 응급구조사 60명(LTS군 30명, PLMA군 30명)이며 마네킹을 대상으로 5분간 3회 실습 후 삽관 소요시간과 성공 여부, 자신감 변화를 측정하였다. 연구결과 LTS와 PLMA를 이용한 삽관 시간은 유의한 차이를 보였고(p=.000), 성공률은 유의한 차이가 없으며, 실험 후 자신감은 유의하게 상승하였다(p=.000). 결론적으로 경추가 고정되고 혀 부종이 있는 외상환자에게 신속한 삽관이 필요한 경우 LTS 사용이 효과적이며 교육을 통하여 전문기도관리 능력을 향상시킬 수 있을 것으로 사료된다. It is very critical to promptly maintain airway of cardiac arrest cases or serious traumatic cases. The purpose of this study is to compare intubation rate, successful rate and pre-/post-education self-confidence between laryngeal tube (LTS) and proseal laryngeal mask (PLMA), so that it may contribute to improving the ability of 119 emergency team - a pivotal role in pre-hospitalization process - to carry out advanced airway management. In order to achieve the purpose, total 60 paramedics (Class Ⅰ) who worked for incumbent 119 emergency team were asked to join a practical experiment and were also divided into two groups (LTS group: 30 people, PLMA group: 30 people). In details, they were all asked to take 3 sessions of practice (5 minutes per session) using dummy model to quantitatively measure the time and success/failure of intubation and the change of their self-confidence. As a result, it was found that there were statistically significant differences in the time of intubation between LTS and PLMA group (p=.000), but there was no significant difference in the rate of successful intubation between these two groups, and self-confidence of two groups tended to significantly increase after experiment (p=.000). Conclusively, if it is necessary to promptly apply intubation to traumatic cases with immobilized cervical vertebral and lingual edema, LTS can be useful as an effective means of intubation. And it is expected that continuing intubation training using LTS will improve the ability of emergency team to perform advanced airway management for traumatic cases.

Little Anne<SUP>Ⓡ</SUP>, BRAYDEN<SUP>Ⓡ</SUP>, HeartiSense<SUP>Ⓡ</SUP>를 이용한 심폐소생술 교육효과 비교

김진현(Jin-Hyeon Kim),최욱진(Uk-Jin Choi) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.11

연구목적: 본 연구는 Little Anne<SUP>Ⓡ</SUP>, BRAYDEN<SUP>Ⓡ</SUP>, HeartiSense<SUP>Ⓡ</SUP>를 이용하여 심폐소생술 교육에 사용되는 마네킹에 따른 교육효과를 비교하고자 시행하였다. 연구방법: 연구대상자는 응급구조사가 아닌 90명의 소방관이었다. A, B, C 세 그룹으로 나누어 50분 동안 심폐소생술 이론교육을 하였고, 이후 50분간 각 그룹별로 3인 1조 실습교육을 시행 하였는데, A그룹 30명은 Little Anne<SUP>Ⓡ</SUP>를 이용 하였고, B그룹 30명은 BRAYDEN<SUP>Ⓡ</SUP>를 이용 하였고, C그룹 30명은 HeartiSense<SUP>Ⓡ</SUP>를 이용하였으며, 이후 Resusci Anne SkillReporter<SUP>Ⓡ</SUP>를 사용해 수행한 심폐소생술 결과를 출력한 후 결과를 확인하고 설문지를 작성하도록 하였다. 연구결과: 마네킹에 따른 만족지수는 x²=81.050, p<.000로 유의한 차이를 보였고, 만족 이유는 x²=91.050, p<.000로 유의한 차이를 보였다. 정확한 흉부압박 비율은 F=5.087, p<.004, 정확한 인공호흡 비율은 F=10.54, p<.000으로 유의한 차이를 보였다. 결론: 정확하고 효율적인 CPR 교육이 필요한 대상에게는 교육효과가 높은 실시간 시각 교정이 가능한 정보를 제공하는 마네킹이 효과적일 것으로 사료된다. Purpose: The purpose of this study was to compare the effects of CPR training according to the mannequin used for CPR training using Little Anne<SUP>Ⓡ</SUP>, BRAYDEN<SUP>Ⓡ</SUP>, and HeartiSense<SUP>Ⓡ</SUP>. Method: Research subjects were 90 firefighters who were not paramedics. They were divided into three groups, A, B, and C. Theoretical education was conducted for 50 minutes, and practical education was conducted in groups of three for 50 minutes, using Little Anne <SUP>Ⓡ</SUP> for 30 people in Group A; BRAYDEN<SUP>Ⓡ</SUP> for 30 people in Group B; and HeartiSense<SUP>Ⓡ</SUP> for 30 people in Group C. The results of CPR were printed out using Resusci Anne SkillReporter<SUP>Ⓡ</SUP>, and the subjects were asked to fill in a questionnaire. Results: The following significant differences were noted: satisfaction index according to the mannequin, x²=81.050, p<.000; reason for satisfaction, x²=91.050, p<.000; ratio of accurate chest compression, F=5.087, p<.004; and ratio of accurate ventilation, F=10.54, p<.000. Conclusion: For the subjects who require accurate and efficient CPR training, it is judged that a mannequin that provides information to allow corrections in real-time would be effective, and have a high educational effect.

가정용 매트리스 위에서의 가슴압박 소생술 효율성

안희정(Hee-Jeong Ahn),최욱진(Uk-Jin Choi),심규식(Gyu-Sik Shim) 한국컴퓨터정보학회 2024 韓國컴퓨터情報學會論文誌 Vol.29 No.3

The purpose of this study was to determine the accuracy of chest compression according to the patient body weight and the rescuers weight when performing chest compression on a cardiac arrest patient that occurred on a home bed. From January 07 to January 19, 2023, 36 paramedic students from N and S universities who completed the KBLS provider curriculum of the Korea Cardiopulmonary Resuscitation Association were measured at the subjects knee position, the depth of the mattress being pressed by the weight of the manikin, and the depth of the mattress being pressed by the weight of the manikin were measured during continuous chest compression for 2 minutes. As a result of the study, if a childs cardiac arrest is found at home, the patient is moved to the floor to proceed with chest compression, and the first witness to find an adult cardiac arrest is recommended to proceed on the bed rather than force the patient under the bed to proceed with chest compression.