심폐소생술 교육 방식 전환에 따른 비용효과

윤형완(Yun, Hyeong-Wan),어트겅후졸자야(Zolzaya),문진희(Moon, Jin-Hee) 전북대학교 교육문제연구소 2019 교육문제연구 Vol.25 No.1

현재 시행되고 있는 심폐소생술 교육 방식을 음악을 활용한 가슴압박 단독 심폐 소생술로 바꾸어 교육을 시행하였을 때 기존의 CPR 교육 방식에 비해 비용 편익 분석을 통해 경제적 타당성을 살펴보고 비용편익 분석을 통해서 가슴압박 단독 심폐소생술(hans only CPR) 교육의 경제적 효과를 알아보고자 한다. 연구 결과, 실제 심폐소생술 교육 대상자에게 발생되는 직접 편익의 경우 약 850억 원이지만 Hands only CPR 교육으로 전환할 경우 약 567억 원의 추가적인 직접 편익이 발생하게 된다. 심폐소생술 교육으로 인해 발생하게 되는 2차적 편익 인 간접편익은 기존 심폐소생술 간접 편익 약 91억에서 Hands only CPR 교육 전환 시 약 61억 원의 추가적 간접 편익이 발생하는 것으로 나타났다. 또한 교육이 가져오는 파생효과를 보여주는 교육 승수 효과는 기존 심폐소생술의 경우 경제적 편익의 승수효과를 Keynes의 단순 모형을 이용하였을 때 5배의 승수효과가 발생하여 사회적으로 약 4,705억 원의 파생효과가 발생한 반면, Hands only CPR 교육 전환 시 약 3,135억 원의 추가적 승수효과가 발생된다. 가슴압박 단독 심폐소생술에 대한 일반인의 접근성이 높아지면, 병원 전 심정지 환자의 생존율이 향상될 것이다. 이에 따라 본 연구 결과를 활용하여 가슴압박 단독소생술 교육 방식을 일반인에게 적용 보급 될 수 있기를 기대한다. On the basis of existing research, which took effect the current CPR educational methods which take advantage of the music to the chest-pressure CPR education into existing CPR when implemented educational cost benefits analysis, economic feasibility and cost benefits analysis Hans only CPR through education, to learn more of the economic effects. The actual study CPR Education subjects directly to the benefits of a 85 billion won, Hands only CPR Song education about Switching, a 56.7 billion won in additional direct benefits will occur. CPR education caused by a second, less indirect benefits achievable through the existing CPR about indirect benefits from a 91 billion Hands only CPR Song education for a change, about 61 billion additional indirect benefits have occurred. Education also bring education to show that the multiplier effect derived from the effects of the existing CPR if the multiplier effect on the economic benefits of the Keynes when using a simple model of the multiplier effect occurs five times, so socially about 4,705 billion won, on the other hand, derived effect occurred Hands only CPR Song education, transition, approximately 3,135 billion won by additional multiplier effect derived effect occurs. Cost benefits through an analysis of the low cost of education, but the effect can be enhanced through education CPR CPR nation could increase the utilization rate of the feed, and this CPR Public access is raised, the rate will increase, and in the end the hospital and patient s survival rate will improve. As a result, the results of the study music can take advantage using the chest pressure cardiopulmonary resuscitation educational methods will be introduced to the public.

119구급대의 어려운 기관내삽관 교육 전ㆍ후 비교

윤형완(Hyeong-Wan Yun),유은영(Eun-Yeong Yu),윤영현(Young-Hyun Yun) 한국콘텐츠학회 2011 한국콘텐츠학회논문지 Vol.11 No.1

본 연구는 J도 소방안전본부 산하 119구급대 60명을 대상으로 하였으며, 연구 기간은 2009년 12월 1일부터 2월 10일까지였다. 어려운 기관내삽관 교육 전ㆍ후 비교 및 일반적 특성에 따른 지식, 자신감, 학업적 자기효능감, 술기수행 능력을 SPSS 14.0을 이용하여 분석한 결과는 다음과 같다. 1. 지식, 자신감, 학업적 자기효능감, 술기수행 능력 모두 교육 전보다 교육 후 유의미하게 증가하였다. 2. 일반적 특성에 따른 교육 전ㆍ후 지식은 성별과 병원근무경력에서 모두 유의한 차이를 보였고, 자신감은 계급과 병원경력에서 모두 유의한 차이를 보였다. 학업적 자기효능감은 계급과 병원경력 및 학력에서 모두 유의한 차이를 보였다. 술기수행 능력은 유형 1에서 119구급대 근무경력, 유형 2에서는 대원의 연령과 최종학력이 유의한 차이를 보였으며, 유형 3은 119구급대 근무경력과, 병원에서 근무경력이 교육 후 유의한 차이를 보였다. 유형 4는 연령과 계급에서 교육 전ㆍ후 유의한 차이를 보였다. 결론적으로, 119구급대의 기도유지술에 관심을 갖고, 정확한 기관내삽관을 배울 수 있도록 자신감을 함양시킬 수 있는 교육 프로그램이 절실히 필요하다고 사료된다. The purpose of this study was to examine the effect of difficult endotracheal intubation education in the 119 rescue services. The subjects in this study were 60 members of the 119 rescue services that was under the umbrella of the Fire Service Headquarters of J province. A SPSS 14.0 program was utilized to find out the effect of tough tracheal intubation education on their relevant knowledge, self-confidence, academic self-efficacy and technical Performance in consideration of general characteristics. The findings of the study were as follows: 1. They showed a significant improvement in all the knowledge, self-confidence, academic self-efficacy and technical Performance after they received that education. 2. As for connections between general characteristics and knowledge before and after that education, there were significant differences in their knowledge according to gender and career of working in the hospital, and their rank and career of working in the hospital made a significant differences to their self-confidence. Their academic self-efficacy significantly differed with rank, career of working in the hospital and academic credential. There were significant gaps among them technical Performance Case 1 according to career of working in the 119 rescue services, and technical Performance Case 2 significantly varied with age and academic credential. There were significant gaps in technical Performance Case 3 according to career of working in the 119 rescue services and career of working in the hospital after that education was provided, and technical Performance Case 4 significantly varied with age and rank before and after the education was conducted. In conclusion, the kind of education programs that aim at stirring up the interest of the 119 rescue services in advanced airway and helping the members learn about tracheal intubation accurately with confidence is urgently required.

일반고-대학 연계 직업체험활동 '재난안전과 현장응급처치' 주말 강좌의 효과성 및 만족도에 관한 연구

윤형완(Hyeong-Wan Yun),정지연(Ji-Yeon Jung),정은경(Eun-kyung Jung) 한국컴퓨터정보학회 2019 韓國컴퓨터情報學會論文誌 Vol.24 No.12

이 연구는 ‘재난안전과 현장응급처치’란 주제로 대학과 고등학교의 주말 연계 프로그램을 활용하여 프로그램에 참여한 학생들의 만족도를 파악하고 대학의 전공연계 프로그램 개발과 교육방법을 만드는데 기초 자료를 제공하고자 시행되었다. 연구의 분석대상은 전라북도에서 실시한 D일반고와 B대학의 연계 주말 강좌에 참석한 고등학생 98명을 연구대상으로 하였다. 수집된 자료는 SPSS Statistics Version 21.0 프로그램을 이용하여 분석하였으며, 결론은 다음과 같다. 학년으로는 2학년이 52%(51명)로 가장 많았으며, 성별은 남자가 56.1%(55명), 여자가 43.9%(43명)를 차지했다. 주말 강좌 프로그램을 스스로 참여했다가 80.6%(79명)였으며, 분명한 동기와 목적을 가지고 있는 사람이 85.7%(84명), 참여이유로는 ‘응급구조학과에 관심이 많아서’ 42.9%(42명)를 차지했다. 프로그램 선택 시 가장 중요하다고 생각하는 기준은 ‘청소년들에게 도움이 되는 정도’가 4.68점으로 가장 높았으며, ‘지도자의 전문성’ 4.58점, ‘청소년들의 의견 반영 정도’ 4.53점 순으로 높게 나타났다. 프로그램 체험 후 ‘심폐소생술 응급처치 자격증 과정’이 중요도 4.78점, 만족도 4.83점으로 가장 중요하면서 가장 만족도가 높게 나왔다. 이처럼 다양한 직업체험을 활용한 대학의 진로 프로그램이 고등학생들의 진로정체감과 진로결정의 수준을 높일 수 있는 의미있는 경험이라고 할 수 있기 때문에 고등학교와 대학의 교육과정과의 연계를 강화하고 국가사회 시스템 환경이 충분히 갖추어야 하겠다. This study investigates the satisfaction of students who participated in ‘Disaster Safety and On-Site Emergency Management’ weekend course, the high school-university affiliated program, to provide the basic data on university’s major linked program developing and teaching methods. 98 high school students attended the courses at D General high school and B University in North Jeonlla Province. Among the participants, 52%(51 students) were sophomores, while 56.1%(55 students) were male and 43.9%(43 students) were female. The collected data was analyzed by using the SPSS statistics version 21.0 program. 80.6%(79 students) among the participants chose the weekend course program by themselves, 85.7%(84 students) were with clear motivation and goal, and 42.9%(42 students) answered “so interested studying Emergency at a college in the future” The most important reasons to choose this program are as follows: score 4.68 for ‘the degree to which the useful program for youth’, score 4.58 for ‘the leader’s expertise’, and score 4.53 for ‘reflecting the opinion of youth.’ After the program’s experience, the ‘certificate for cardiopulmonary resuscitation’ was the most important and the most satisfactory with score 4.78 and score 4.83 respectively. As the university career program using various job experience can be a meaningful experience that enhance the level of career status and career decisions of high school students, this program will strengthen the affiliation between high school and university curriculum and establish the sufficient national social system environment.

일개지역 구급활동 중 병원 전 심정지 및 약물중독 환자 분석 - 노인대 비노인의 차이를 중심으로 -

이재민,윤형완,Lee, Jae-Min,Yun, Hyeong-Wan 사단법인 한국응급구조학회 2010 한국응급구조학회지 Vol.14 No.3

Purpose: The purpose of this study is to determine potential differences in pre-hospital cases of cardiac arrest and drug Intoxication between elderly group and non-elderly group on local emergency activity sites of rescue 119 team for those cases, so that it can provide useful reference materials for a system of corresponding emergency medical services. Methods: Patients with cardiac arrest and drug intoxication in the elderly and the non-elderly group were analyzed by analyzing the Ambulance Run Report for 3 years from January 2007 to December 2009. Results: According to analysis on potential differences between elderly and the non-elderly group, it was found that there was no significant difference between elderly cases (evacuated to hospital due to cardiac arrest and drug poisoning) and non-elderly cases in year of onset (p = .247), quarter of onset (p = .813), sex (p = .235), consciousness state (p = .126), place of onset (p = .215) and number of first aid services (applied to emergency cases) respectively, but there were significant differences between elderly cases and non-elderly cases in guardian availability (p = .042), time zone of onset (p = .050), distance from the site of onset (p = .278), type of onset (p = .000), number of first aid services depending on distance of evacuation (p = .008) and effectiveness of emergency care (p = .003) on statistical basis. Conclusion: It is important to establish a system of early emergency case reports for rational emergency case management with lower mortality; shorten distance from the site of onset at each time zone of onset in emergency cases; employ more emergency team members; facilitate firsthand / secondhand medical instructions for emergency teams in specialized emergency care depending on distance of evacuation for each kind of onset (elderly group vs. non-elderly group); and improve rate of resuscitated emergency cases by extending the scope of works for emergency medical technicians into wider applications, so that it will be possible to take timely and appropriate measures for emergency settings of ever-increasing aged population in near future.

소방관의 난청에 영향을 미치는 요인에 관한 연구

장덕하(Deok-Ha Jang),윤형완(Hyeong-wan Yun),임석태(Seok Tae Lim) 한국화재소방학회 2023 한국화재소방학회논문지 Vol.37 No.2

응급구조학과와 간호학과 학생들의 자아탄력성과 재난에 대한 경험 및 재난대처핵심역량 비교

정지연(Ji-Yeon Jung),윤형완(Hyeong-Wan Yun) 한국컴퓨터정보학회 2019 韓國컴퓨터情報學會論文誌 Vol.24 No.9

This study was attempted to provide fundamental data in a disaster response education program by comparing the differences between students of the paramedic and nursing in ego-resilience, disaster-experience and core competencies of disaster response. The data is collected from March 2 to April 2, 2019, on a total of 358 students (196 paramedic students and 162 nursing students) based in Jeolla Province. The structured questionnaire were used as research tools and the collected data were analyzed by using the SPSS program as frequency, percentage, t-test, ANOVA and Pearson’s correlation coefficient. The average score of total ego-resilience among the subjects was 86.97 out of 125 points. The number of paramedic students who experienced or witnessed the disaster situation in person was 11.2%, and the number of nursing students was 11.7%. The core competence of disaster response was 3.21% in paramedic students and 3.16% in nursing students. The ego-resilience of the paramedic and nursing students according to their general characteristics is statistically significant differences (t=2.797, p<.005) and the paramedic students has an average score of 3.52 points, which is higher than the nursing students (3.42 points). General characteristics and experience in disasters are statistically significant differences (t=2.797, p<.005), paramedic students had more disaster experiences (3.11 points) than nursing students (2.67 points). It indicated the static correlation relationship between ego-resilience, disaster experience and core competences of disaster response (p<.000). Through this study, the paramedic students were found to be more ego-resilience, more disaster experience and more critical capacity for disaster treatment than nursing students.

심폐소생술 수행자의 엉덩관절 각도가 심폐소생술 결과에 미치는 영향

이재민(Jae-Min Lee),윤형완(Hyeong-Wan Yun) 한국화재소방학회 2020 한국화재소방학회논문지 Vol.34 No.2

이 연구는 기본심폐소생술 교과목을 이수한 응급구조과 학생을 대상으로 수행자 엉덩관절 각도에 따라 기본심폐소생술의 질이 향상되는지 알아보고자 하였다. 기본심폐소생술 중 엉덩관절 각도에 따른 기본심폐소생술 질(가슴압박 깊이, 완전한 이완, 압박속도 등)을 측정하기 위해 SimPad SkillReporter와 Resusci Anne?? QCPR?瑛? 이용하여 비교분석하였고, 2015 AHA Guideline 따랐으며, 가슴압박과 인공호흡의 비율은 30:2로 5주기 시행하였다. 실험군과 대조군의 일반적인 자세에서는 엉덩관절 각도, 인공호흡정도, 가슴압박 깊이, 가슴압박 속도, 가슴압박 이완, 가슴압박정확도, 가슴압박 중단시간(Hands off time), 가슴압박 적용시간 비율은 큰 차이를 보이지 않았다(p > 0.05). 엉덩관절각도를 90도로 유지하는 기본심폐소생술은 유지하지 않았을 때와 큰 차이는 없었으나, 적정깊이와 100% 이완에서는좋은 결과를 보여 주어 보다 더 나은 심폐소생술 질 향상을 기대할 수 있을 것이다. This study aims to investigate the improvement in basic CPR quality on the basis of the hip joint angle of the rescueramong students in the Department of Emergency Medical Technology who completed a basic CPR curriculum. In this study,we carried out a comparative analysis using SimPad SkillReporter and Resusci Anne?? QCPR?? to measure the quality ofCPR (depth of chest compressions, full relaxation, compression speed, and more) on the basis of the rescuer’s hip jointangle in accordance with the 2015 AHA Guidelines and conducted chest compressions and CPR 5 times in a 30:2 ratio. It was found that maintenance of the rescuer’s hip joint angle at 90 degrees while compressing and relaxing the chest madea statistically significant difference in both the experimental and control groups. Moreover, this indicated that the closer thehip joint angle was to 90 degrees, the better was the quality of basic CPR. However, there was no significant differencein the hip joint angle, degree of CPR, depth of chest compressions, chest compression speed, chest compression andrelaxation percentages (%), accuracy of chest compressions, hands-off time during CPR, and percentage of chestcompression time (p > 0.05). Maintaining the hip joint angle at 90 degrees for basic CPR was not significantly differentfrom not maintaining this angle. Nonetheless, good results have been obtained at moderate depth and 100% recoil. Therefore, good outcome and high-quality CPR are expected.

2급 응급구조사 양성과정 개선방안 연구 : 양성기관 현황 및 지정기준 검토

이남종,신동민,김병우,박시은,유은지,윤병길,윤성우,윤형완,이경열,최재웅,황성훈,Lee, Nam-Jong,Shin, Dong-Min,Kim, Byung-Woo,Park, Si-Eun,Yoo, Eun-Ji,Yoon, Byoung-Gil,Yun, Seong-Woo,Yun, Hyeong-Wan,Lee, Kyoung-Youl,Choi, Jae-Woong,Hwang, 한국응급구조학회 2019 한국응급구조학회지 Vol.23 No.2

Purpose: To discuss the records and legal standards of emergency medical technician training institutions in Korea and abroad, to identify the problems, and to provide the basic resources for improving the EMT-basic training institutions. Methods: We received advice through an advisory meeting of experts (professors of department of emergency medical technicians) and interested parties (Korean Association of Emergency Medical Technicians, officials of emergency medical technician training institutions) and referred to various reports published by governments, official institutions, and other trustworthy organizations. Also, we communicated with the related experts abroad (3 countries) on the phone or by email for surveys. Results: Compared to the abroad, it is necessary to categorize the standards and procedures of designating the emergency medical technician training institutions in Korea and improve the management of training institutions to train competent emergency medical technicians. Conclusion: It is necessary to designate and manage continuously the emergency medical technician-basic training programs for the systematic primary healthcare service.

K-MOOC 수강 완료 대학생의 학습경험 사례 연구

문진희(Jin Hee Moon),어트겅후졸자야(Zolzaya Eoteugeonghu),윤형완(Hyeong Wan Yun) 전북대학교 교육문제연구소 2018 교육문제연구 Vol.24 No.2

본 연구의 목적은 K-MOOC를 수강하는 대학생의 학습 경험을 분석하여, 향후 K-MOOC의 교수 설계 및 활용에 있어 교육적 방안을 제시하는 데 있다. 이를 위해 W 대학 교수학습지원센터 K-MOOC 수강 지원 프로그램에 참여하여, K-MOOC 강좌 수강을 완료한 42명의 대학생을 대상으로 주별 보고서 및 최종 보고서를 수집 후, 분석하였다. 연구 결과, K-MOOC 수강 완료에 학생들의 내·외재적 동기가 작용한 것을 알 수 있었다. 내재적 동기로는 학습 분야에 대한 평소 관심과 흥미가 있었으며, 외재적 동기로는 이수증 취득과 자격시험 준비 등이 있었다. 다음으로 본 연구에서 학생들은 K-MOOC 수강 과정에서 다층적인 상호작용을 경험 하였으며, 이 과정을 긍정적으로 인식하였다. 학생들은 K-MOOC 학습공간 밖에서 교수학습지원센터 및 담당자와의 상호작용에 긍정적으로 반응하였으며, 동일 프로그램참여자들 간의 상호작용에도 긍정적이었다. 또한 학습자들은 K-MOOC 학습공간 내 게시판과 과제 설명, 댓글을 통해 이루어지는 강의 교수 및 조교와의 상호작용을 긍정적으로 인식하고, 동일 강좌 수강생들 간에 동질감을 느끼는 것으로 나타났다. 한편, 학생들은 K-MOOC 강의 교수의 경직된 언어 사용과 단일 교수법의 사용에 불만족을 느낀 것으로 나타났다. 이밖에 온라인 학습공간에서의 퀴즈 및 과제, 중간·기말 시험에 대해서 부정적 인식을 갖고 있었으며, 매주 교수학습지원센터로 제출해야하는 보고서 작성에도 부담을 느끼는 것으로 나타났다. The purpose of this study is to analyze the learning experiences of college students taking K-MOOC and to present educational plans for K-MOOC instructional design and utilization in the future. For this purpose, I collected and analyzed weekly and final reports on 42 college students who participated in the K-MOOC course support program of the Center for Teaching and Learning at W University and completed the course. As a result of the study, it was found that internal and external motivation was effective in completing the K-MOOC course. As an intrinsic motivation, there was the usual interest in the field of learning. As an external motivation, there was acquisition of a certificate of completion and preparation for qualification examination. Second, in this study, students experienced multilevel interactions through learning experiences, and students perceived the interaction positively. The students responded positively to the interaction with the university s teaching and learning support center and staff outside of the K-MOOC learning space. They were also positive about the interaction between students participating in the same program. Also, students positively perceived the interaction with K-MOOC bulletin board, lecture professor and assistant through homework explanations and comments, and felt the homogeneity among students of the same course. On the other hand, students were dissatisfied with K-MOOC lecture professors use of rigid language and single teaching method. In addition, they had a negative perception about quizzes, assignments, and midterm and final exams in the online learning space, and were also burdened in submitting offline and weekly reports.

119구급대에 의한 병원 전 임산부 심장정지 소생환자 1례

이재민(Jae-Min Lee),홍수미(Soo-Mi Hong),안국기(Guk-Ki An),윤형완(Hyeong-Wan Yun) 한국화재소방학회 2020 한국화재소방학회논문지 Vol.34 No.1

임신부에서 심정지가 발생하였을 때, 가장 중요한 것은 임신부를 소생시키는 것이다. 임신부에서의 심정지는 산모와 태아를 동시에 고려해야 한다는 점 때문에 일반적인 심정지와 다른 부분이 있다. 임신부 심정지 환자에서는 태아를 분만해야 하는지를 결정하는 것은 산모와 태아 모두를 위하여 매우 중요하다. 심폐소생술이 수행되더라도 임신부 심정지 환자가 모두 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존율이 결정된다. 임신부 심정지 환자는 30세 목격당시 보호자에 의한 빠른 인지와 신속한 신고 및 목격자 심폐소생술이 이루어져 졌으며 119구급대에 의한 전문소생술이 적용되었고, 환자와 태아 모두 적절한 치료 후 6일 만에 건강하게 퇴원한 사례이다. 병원 전 단계에서 임신부 환자가 자발순환회복(Return of spontaneous circulation, ROSC)되어 이송하는 경우와 전문심장구조술을 시행 하는 경우는 매우 드물다. 임신부 심정지가 발생하여 목격자에 의한 심폐소생술과 119구급대원에 의한 전문심장소생술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다. 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.