병원 전 영아 심정지 환자에서 150J 제세동과 심폐소생술 시행 후 생존한 1례

윤형완,홍수미,전윤철,이재민 한국응급구조학회 2013 한국응급구조학회지 Vol.17 No.3

응급의료 교육센터에서의 심폐소생술 교육이 교사들의 지식, 태도, 자기효능감에 미치는 효과

윤형완,신상열,원영덕 한국컴퓨터정보학회 2023 韓國컴퓨터情報學會論文誌 Vol.28 No.9

This study is to investigate the effect of CPR education on the knowledge, attitude, and self-efficacy of kindergarten, elementary, and secondary teachers. For the study, a total of 176 kindergartens, elementary schools, and secondary school teachers in J province who received CPR education at an Emergency Medical Education Center from March 21 to June 20, 2023 were surveyed. For the collected data, SPSS WIN 20.0 was used to analyze general characteristics, knowledge, attitude, self-efficacy, and educational program effects. As a result of the study, the knowledge score after education (t=-15.93, p<.001), attitude score (t=-5.11, p<.001), self-efficacy score (t=-12.52, p<.001) was significantly increased. After the education by experts, knowledge, attitude, and self-efficacy improved, and it is thought that the increase in knowledge increased attitude and self-efficacy. This is a result proving that the CPR education of the Emergency Medical Education Center was effective. Therefore, it is necessary to find ways for effective CPR education.

119구급대에 의해 소생한 병원 전 심장정지 환자 1례

윤형완,이재민,정지연 한국화재소방학회 2010 한국화재소방학회논문지 Vol.24 No.5

The aim of this study was to report the out-of-hospital resuscitation of cardiac arrest along with literature consideration. CPR is technology of resuscitating patient by maintaining oxygen supply to organ, by preventing progression from clinical death to biological death, and by recovering heart beat and circulation, through circulatory support of mechanical ventilation. It is not what every patient with cardiac standstill is revived even if being implemented CPR. Patient’s survival rate is decided by how quickly and correctly CPR was executed. A patient, who wasn’t witnessed the cardiac arrest on the field, was performed 5-cycle CPR for 2 minutes on the field before being transferred to hospital, and was allowed to be used AED. A person, who was observed, is recommended to be used AED immediately,and then is said to be needed ACLS (advanced cardiac life support). In the Out-of-Hospital stage, it is rare in a case that 119 Emergency Medical Service System transfers by being ROSC and in a case of executing ACLS. Cardiac arrest was witnessed on the field, but CPR wasn't executed. First-aid staff executed CPR after arriving, and led to ROSC on the field with ACLS, there by having experienced 1 case of a patient's surviving to leave hospital by being ROSC on the field. 심폐소생술이란 인공호흡과 순환보조를 통하여 조직으로의 산소 공급을 유지하여 임상적 사망에서 생물학적 사망으로 진행을 막고, 심장박동과 순환을 회복시켜 환자를 소생시켜주는 술기이다. 심폐소생술이 시행되더라도 모든 심장정지 환자가 소생되는 것은 아니며, 얼마나 신속하고 정확하게 심폐소생술이 시행되었느냐에 따라 환자의 생존률이 결정된다. 현장에서 심장정지가 목격되지 않은 환자는 병원이송 전 현장에서 2분간 5주기 심폐소생술을 수행하고 자동제세동기를 사용하도록 하였고, 목격된 환자에게는 즉시 자동제세동기를 사용할 것을 권장하고 있으며 이후 전문적인 심장구조술이 필요하다. 병원 전 단계에서 119구급대가 이송한 환자 중 자발순환회복(return of spontaneous circulation, ROSC)되어 이송하는 경우와전문심장구조술을 시행 하는 경우는 매우 드물다. 현장에서 심장정지가 목격되었으나 심폐소생술이 시행되지 않았고 구급대원이 도착한 후 심폐소생술 시행 및 전문심장구조술로 현장에서 자발순환회복되어 생존퇴원한 1례를 경험하여 문헌고찰과 함께 보고하는 바이다.

119 구급서비스 유료화에 관한 응급의료전문가 델파이 조사 연구

윤형완,이정애,최정우 대한응급의학회 2017 대한응급의학회지 Vol.28 No.2

Purpose: This study was performed to suggest a realistic measure of charging for 119 emergency medical services (EMS) in Korea using Delphi study targeting emergency medical specialists. Methods: The Delphi study was conducted four times targeting 24 emergency medical specialists. The first Delphi survey contained five categories as follows: Subjects of charging for 119 EMS, method of charging, strategy of implementation, utilization of fund, measure of quality improvement. In the second and third Delphi surveys, respondents were asked to indicate the level of importance with the questionnaire statements on a Likert scale, ranging from 0 to 5. The final consultation survey collected opinions on the system of charging for 119 EMS. Results: The results from the first three Delphi surveys showed subjects of charging, method of charging, strategy of implementation, utilization of fund, and measure of quality improvement for 119 EMS. The fourth Delphi survey resulted in step 1 (classification of severity), step 2 (scene of accident), and step 3 (classification of severity at hospital). The classification of severity in steps 1 and 2 should be evaluated by first grade emergency medical technicians, and the classification of severity in step 3 should be evaluated by a person notified by the Ministry of Health and Welfare. Non-emergent patients should pay for the charge of 119 EMS to the hospital. Conclusion: Delphi study proposed charging for 119 EMS based on three levels of severity. This study suggests that charging for EMS can reduce unnecessary emergency calls and offer proper medical services to emergency patients.

119구급대원의 감염관리에 대한 인지도와 수행도 관계 연구

윤형완,정지연 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.3

응급구조사 직업윤리에 대한 인식조사

윤형완,이재민 한국화재소방학회 2014 한국화재소방학회논문지 Vol.28 No.1

Complex ethical issues of Emergency Medical Techinician (EMT) out-of hospital emergency medical scene and the ER(Emergency Room) behaviors were studied. The survey was conducted by 500 EMT group members working in the fieldof ambulance work and general hospital and it was about their work ethics, discussions and solutions about the transferredpatients, and ethics regarding Do Not Attempt Resuscitate (DNAR). The survey includes work ethics, awarenessabout the target job, a discussion on the transfer of patients, measures, and deathbed. Discussions about the patient’s conditionand diagnosis results were majorly absent during patient transportation at the emergency care scene. More than90% of emergency care transfer were inappropriate. Sometimes, EMT working in the field facing morally unethical problemsbeyond their responsibility. When EMT, who can not make death diagnosis, received deathbed related DNAR issues,they gone through severe ethical conflicts. The institutional support and therapy for EMT was weak. In Korea, especiallyin the accident site, ethical issues education is more needed than DNAR prevalence of education and guidance. If ethicstraining and guidance are given to EMT, a lot of moral errors in the field can be resolved. 응급구조사는 병원 밖 사고 현장과 응급실의 응급의료 행위에 대해서 복잡한 윤리적 문제가 야기된다. 소방현장 및 종합병원에서 근무하는 응급구조사 500명을 대상으로 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종에 관한 윤리의식을 설문하였다. 직업윤리의식과 태도, 이송한 환자에 대한 논의와 대책 그리고 임종관련에 대한 윤리의식을 설문해 보았는데 직업적 윤리의식이나 응급구조사가 가져야 할 태도가 높게 나타났다. 현장에서 응급처치나 이송한환자에 대해서 결과를 논의하거나 예후를 알아보는 군은 자격에 따라 유의하게 나타났다. 부적절한 응급처치나 이송에대해서는 90% 이상이 토론 후 대책을 세우는 것으로 보여 졌으나, 지난 업무에 대해서는 그냥 넘어가기를 원하는 것과책임문제로 상관에게 보고하는 경우도 있어 도덕적으로 비윤리적인 문제도 안고 있었다. 사망진단을 내릴 수 없는 응급구조사에게 임종관련 DNAR 문제로 윤리적 갈등을 심하게 겪고 있는데, 제도적 뒷받침이 미약하여 불필요한 치료를 하고 있다. 사고현장에서 윤리적인 문제들, 특히 DNAR 교육은 필요성에 비해 교육과 지침서의 지급률이 지역과 소속마다차이가 심하였다. 따라서 응급구조사의 직업윤리교육과 지침이 반드시 필요하며, 응급현장에서 이용 시 많은 도덕적 오류들이 줄어들 것이다.

119구급대원의 김염관리에 대한 인지도와 수행도 관계 연구

윤형완,정지연 사단법인 한국응급구조학회 2008 한국응급구조학회지 Vol.12 No.3

In order to protect Rescue 119 workers exposed on the spot from potential infection, this study identified their awareness and practices of infection control so that it could help preventing them from infection and also provide basic materials necessary for pre-hospital infection control. This study applied questionnaire survey to total 215 Rescue 119 workers at fire stations in Jeonbuk province, Jeonnam province and Gwangju city from July 14 to Sept. 14, 2006 for the benefit of data collection. The questionnaire about possible associations between awareness and practices of infection control consisted of total 46 times across 6 categories such as washing hands during emergency activities ; fluid therapy and injection ; respirator maintenance; individual hygienics ; disinfectant supplies and equipments maintenance ; and control of infectious wastes. And collected data were processed using SPSS statistic program to analyze frequency and percentage, mean and standard deviation, Pearson's correlation coefficient, t-test and one-way ANOVA. As a result, this study came to the following conclusions : In terms of awareness about infection control, our respondents showed highest awareness about infectious waste control, and also showed highest level of practices in washing hands during emergency activities. Throughout all domains, awareness means were higher than practice means. In particular, infectious waste control was the domain of significant differences between awareness and practices. In terms of associations between awareness and individual characteristics, it was found that female rescue worker group and hospital/general hospital career group (before joining the Rescue 119) showed significantly higher awareness on statistic level. In regard to associations between individual characteristics and practices, it was found that female rescue worker group showed higher level of practices than male group on statistic level. This study also analyzed correlations between rescue workers' awareness and practice of infection control. As a result, it was found that the higher awareness was in correlations with the higher practices across all 6 domains including washing hands. In addition, the higher awareness of a questionnaire item was in significantly positive correlations with the higher practice of other items. However, our respondents showed high awareness about anti-infection, but low practices in reality. This indicates necessity of devising possible solutions to improve the practices as much as awareness. Especially, it was noted that major reasons for insufficient practices of infection control guideline come from unhabituated practices and lack of supports for infection-preventing supplies and protective device (mask, etc). Hence, it is necessary to provide more infection-preventing supplies for local rescue workers sufficiently, in parallel with steady habituation of infection control. Furthermore, it is required to manage and study infection control policies even at pre-hospital step in efforts for effective infection control,

2018년 소방공무원 응급구조사 총조사

윤형완,박주호,이현경,한승태,이재민 한국응급구조학회 2021 한국응급구조학회지 Vol.25 No.3

119 현장에서 전문심장구조술에 의해 소생한 심정지 환자의 치매진단 사례

윤형완,이여진 한국보건기초의학회 2011 보건기초의학회지 Vol.4 No.3

기관내삽관에서 속심일체형 삽관튜브 용이성에 관한 연구

윤형완,이재민,정지연 사단법인 한국응급구조학회 2019 한국응급구조학회지 Vol.23 No.3

Purpose: Difficult organs or locations or inadequate tube intubations can cause complications. There are some cases in which the tube location changes or the tube is removed due to processing inside the organ while installing the stylet or rapid stylet removal. Thus, this study aimed to evaluate and develop an integrated intubation tube with stylet (IITS) for easier intubation of organs in emergency cases and reduce complications caused by the stylet. Methods: This study used a "Laerdal Airway Management Trainer". For stylet intubation, procedure No. 14 of the national practical test protocol was followed, but the removal step was omitted. In this study, each emergency case was intubated with an IITS, in which the stylet was not inserted or removed separately even though it has the function of an organ intubation stylet. Results: The existing classic ET intubation method had a success rate of 100% and had an average intubation time of 21.75 seconds, The developed IITS method was also successful in all cases and had an average intubation time of 15.78 seconds. Conclusion: Application of an IITS is expected to reduce intubation time and decrease inappropriate depth and intubation failure due to stylet removal, therefore improving the efficiency of airway maintenance.